Secretion collector

Abstract

The present disclosure relates to a ventilator having an integrated cough-assist for use with a patient circuit in communication with a patient connector of a patient, the ventilator being operable in a breathing mode and a cough-assist mode. The ventilator includes a user input for switching operation from the breathing mode to the cough-assist mode without disconnecting the patient from the ventilator, a controller operable in response to the user input, and the controller controls operation of the ventilator in the cough-assist mode for providing at least one cough-assist to the patient, the cough-assist having an insufflation phase and a subsequent exhaust phase. A cough-assist valve, the cough-assist valve transmitting positive pressure to the ventilator connector when in a first state for the insufflation phase and transmitting negative pressure to the ventilator connector when in a second state for the exhaust phase. A secretion collector, the collector being a secretion collector for use between the patient connector and the patient circuit.

Description

[0001] This application is a divisional application of the Chinese invention application entitled “Ventilator with integrated cough-assist” filed on March 23, 2016, with application number 201680030445.1. Background of the Invention Technical Field

[0003] The present invention generally relates to an active exhalation valve for use with a ventilator having a pressure source that can be used to control the operation of the valve and thereby control the flow of exhaled gas from a patient.

[0004] Related technology introduction

[0005] Breathing can be characterized as comprising an inhalation phase, during which inspired air is drawn into the lungs, and an exhalation phase, during which expired air is expelled from the lungs.

[0006] Mechanical ventilators are used to assist with breathing. Conventional ventilators typically push inspired gases (including oxygen) into the patient's lungs. Many patients who use ventilators also require other types of assistive devices related to treating and maintaining their airways and lungs. For example, some patients may use a nebulizer to deliver medication to their lungs and / or airways. In addition, some patients may need help clearing secretions from their lungs and / or airways. This assistance is typically provided by a conventional suction device. Therefore, many patients require multiple devices in addition to the ventilator, and working with these devices can be particularly problematic.

[0007] Currently, in order to receive cough assistance, the patient must be disconnected from the mechanical ventilator and connected to a separate cough assistance device. After the cough assistance procedure, the patient must be disconnected from the cough assistance device and reconnected to the mechanical ventilator. Typically, after the patient has been disconnected from the cough assistance device and reconnected to the mechanical ventilator, suctioning of the patient's airway is also performed to remove secretions that were not adequately cleared from the patient's airway during the cough assistance procedure. In order to reduce the risk of hypoxemia in the patient during the period when the patient is not receiving a mechanical ventilator, it is common practice to deliver high levels of inspired oxygen before the mechanical ventilator is removed from the patient. Because this process can be lengthy, it is often not performed in the most advantageous manner for the patient.

[0008] Therefore, there is a need for a ventilator that is portable and / or provides additional functionality beyond delivering inspired gas to a patient's lungs. The present application provides such a product, and other advantages will be apparent from the following detailed description and accompanying drawings. Summary of the Invention

[0009] One embodiment includes a method of providing respiration to a human patient. The human patient has a patient connection connected to a ventilator apparatus via a patient circuit. Respiration has an inspiratory phase having a beginning and an end. The method includes delivering a bolus of oxygen to the patient circuit at or before the beginning of the inspiratory phase, terminating the delivery of the oxygen bolus before the end of the inspiratory phase, and delivering a breathing gas comprising air to the patient circuit before the end of the inspiratory phase. The patient circuit delivers the oxygen bolus and the breathing gas to the patient connection. Optionally, the method may further include waiting until the delivery of the oxygen bolus delivered for the respiration has terminated before delivering the breathing gas.

[0010] Optionally, the method may further comprise receiving a bolus volume value. In such an embodiment, the oxygen bolus delivered for the breath has a volume substantially equal to the bolus volume value.

[0011] Optionally, delivering breathing gas to the patient circuit includes providing breathing gas to the patient circuit at a first input location of the patient circuit, and delivering oxygen bolus to the patient circuit includes providing oxygen bolus to the patient circuit at a second input location of the patient circuit, the second input location being closer to the patient connection piece than the first input location.

[0012] The oxygen bolus delivered for breathing and the breathing gas together have a total inspiratory volume. Optionally, the volume of the oxygen bolus delivered for breathing is less than about 75% of the total inspiratory volume. Optionally, the oxygen bolus delivered for breathing has a volume between about 50% of the total inspiratory volume and about 75% of the total inspiratory volume.

[0013] Optionally, the method can further include receiving an oxygen flow equivalent value associated with an oxygen flow rate that, if applied continuously to the patient circuit from the beginning of the inspiratory phase of respiration to the end of the expiratory phase of respiration, would produce a first volume of oxygen. In such an embodiment, the oxygen bolus delivered for the respiration has a second volume of oxygen that is less than the first volume of oxygen.

[0014] Optionally, the method may further comprise detecting the onset of an inspiratory phase of breathing that has been initiated by the patient. In such an embodiment, the method may further comprise initiating delivery of a bolus of oxygen to the patient circuit in response to detecting the onset of an inspiratory phase of breathing that has been initiated by the patient.

[0015] The method can be used with an oxygen source connected to a valve. In such an embodiment, delivering a bolus of oxygen at or before the start of the inspiratory phase of breathing includes opening the valve to allow oxygen flow from the oxygen source to the patient circuit. Additionally, terminating delivery of the bolus of oxygen before the end of the inspiratory phase of breathing includes closing the valve to interrupt the flow of oxygen from the oxygen source to the patient circuit.

[0016] The method can be used with an oxygen generator connected to an oxygen source. In such an embodiment, the oxygen source is configured to store oxygen generated by the oxygen generator, and the method further includes detecting at least one of a concentration of the oxygen stored by the oxygen source and a pressure of the oxygen stored by the oxygen source, determining whether the detected value is below a threshold, operating the oxygen generator when the detected value is determined to be below the threshold, and delivering the oxygen generated by the oxygen generator to the oxygen source.

[0017] The method can be used with a user-specified total tidal volume. In such an embodiment, the breathing gas delivered for the breath has a first volume, the oxygen bolus delivered for the breath has a second volume, and the first volume and the second volume together substantially equal the user-specified total tidal volume.

[0018] The method can be used with a user-specified peak inspiratory pressure. In such an embodiment, the pressure of the breathing gas and oxygen bolus delivered for the breath does not exceed the user-specified peak inspiratory pressure.

[0019] The method can be used with a breathing gas delivery conduit and an oxygen delivery conduit. The breathing gas delivery conduit has a breathing gas output located at a first end of the patient circuit distal from the patient connector. The oxygen delivery conduit has an oxygen output located at a second end of the patient circuit adjacent to the patient connector. Delivering breathing gas to the patient circuit can include providing breathing gas to the breathing gas output through the breathing gas delivery conduit. Additionally, delivering an oxygen bolus to the patient circuit can include providing an oxygen bolus to the oxygen output through the oxygen delivery conduit, thereby isolating at least the oxygen bolus delivered for breathing from a portion of the patient circuit prior to the patient connector where the breathing gas delivered for breathing is present.

[0020] Optionally, the patient circuit includes a breathing gas delivery conduit and an oxygen delivery conduit. In such an embodiment, delivering the breathing gas to the patient circuit includes providing the breathing gas to the breathing gas delivery conduit, which delivers the breathing gas to the patient connector. Additionally, delivering the oxygen bolus to the patient circuit includes providing the oxygen bolus to the oxygen delivery conduit, which delivers the oxygen bolus to the patient connector, thereby isolating the oxygen bolus delivered for respiration from at least a portion of the patient circuit prior to the patient connector where the breathing gas delivered for respiration is separated. Optionally, the oxygen bolus exits the oxygen delivery conduit and enters the breathing gas delivery conduit at a location adjacent to the patient connector. Optionally, the oxygen bolus exits the oxygen delivery conduit and enters the breathing gas delivery conduit at a location within about 2 cm of the patient connector.

[0021] The method may be used with an operable compressor to compress the breathing gas. In such an embodiment, delivering the breathing gas to the patient circuit includes delivering at least a portion of the breathing gas that has been compressed by the compressor.

[0022] One embodiment includes a ventilator apparatus for use with an oxygen source and a patient circuit. The patient circuit is configured to receive breathing gas and oxygen for providing respiration to a human patient having a patient connector connectable to the patient circuit. Respiration has an inspiratory phase having a beginning and an end. The ventilator apparatus includes a compressor configured to deliver breathing gas to the patient circuit, and a control system configured to (a) allow oxygen to flow from the oxygen source to the patient circuit at or before the beginning of the inspiratory phase of respiration, (b) prevent oxygen from flowing from the oxygen source to the patient circuit before the end of the inspiratory phase of respiration, and (c) cause the compressor to deliver breathing gas to the patient circuit before the end of the inspiratory phase of respiration.

[0023] Optionally, the ventilator apparatus may include an input configured to receive a user-specified total tidal volume. In such an embodiment, the respiratory gas delivered to the patient circuit for breathing has a first volume, the oxygen allowed to flow to the patient circuit for breathing has a second volume, and the first volume and the second volume together substantially equal the user-specified total tidal volume.

[0024] Optionally, the ventilator apparatus may include an input configured to receive a user-specified peak inspiratory pressure. In such an embodiment, the combined pressure of the breathing gas delivered to the patient circuit for breathing and the oxygen allowed to flow to the patient circuit for breathing does not exceed the user-specified peak inspiratory pressure.

[0025] Another embodiment includes a ventilator apparatus for use with a patient circuit. The patient circuit is configured to receive breathing gas and oxygen for providing respiration to a human patient having a patient connector connectable to the patient circuit. Respiration has an inspiratory phase having a beginning and an end. The ventilator apparatus includes a compressor configured to deliver breathing gas to the patient circuit, a patient oxygen outlet connectable to the patient circuit, an oxygen source configured to deliver oxygen to the patient circuit, and a control system configured to (a) allow oxygen to flow from the oxygen source to the patient circuit at or before the beginning of the inspiratory phase of respiration, (b) prevent oxygen from flowing from the oxygen source to the patient circuit before the end of the inspiratory phase of respiration, and (c) cause the compressor to deliver breathing gas to the patient circuit before the end of the inspiratory phase of respiration. Optionally, the ventilator apparatus may include an input configured to receive a user-specified total tidal volume. In such an embodiment, the breathing gas delivered to the patient circuit for respiration has a first volume, the oxygen allowed to flow to the patient circuit for respiration has a second volume, and the first and second volumes, when combined, substantially equal the user-specified total tidal volume. Optionally, the ventilator apparatus may include an input configured to receive a user-specified peak inspiratory pressure. In such an embodiment, the combined pressure of the breathing gas delivered to the patient circuit for breathing and the oxygen allowed to flow to the patient circuit for breathing does not exceed the user-specified peak inspiratory pressure.

[0026] One embodiment includes a breathing system for use with a human patient having a patient connector connectable to a patient circuit. The system includes a control system configured to deliver oxygen to an oxygen source connectable to a patient oxygen outlet port of the patient circuit, and a compressor configured to deliver breathing gas to a ventilator connector connectable to the patient circuit. The ventilator connector is distinct from the patient oxygen outlet port. The control system is configured to identify an inspiratory phase of respiration and instruct the oxygen source to deliver oxygen to the patient oxygen outlet port before or during the inspiratory phase. In response to an instruction to deliver oxygen to the patient oxygen outlet port, the oxygen source is configured to deliver oxygen to the patient oxygen outlet port. The control system is further configured to, during the inspiratory phase, instruct the compressor to deliver breathing gas to the ventilator connector. In response to an instruction to deliver breathing gas to the ventilator connector, the compressor is configured to deliver breathing gas to the ventilator connector.

[0027] Alternatively, the compressor and ventilator connection may be integral components of the ventilator, and the oxygen source may be located external to the ventilator.

[0028] Alternatively, the oxygen source is an internal oxygen source of the ventilator. The internal oxygen source has an oxygen inlet port in fluid communication with the internal oxygen source. In such an embodiment, the ventilator system may include an external oxygen source in fluid communication with the oxygen inlet port for delivering oxygen from the external oxygen source to the internal oxygen source.

[0029] Optionally, the ventilator system also includes an oxygen generator in fluid communication with the oxygen source, which delivers oxygen to the oxygen source. The compressor, oxygen source, and oxygen generator can each be a component of the ventilator. Alternatively, the compressor and oxygen source can each be a component of the ventilator, with the oxygen generator being external to the ventilator.

[0030] Optionally, the ventilator system also includes a user interface having an input configured to receive a user-specified total tidal volume. The user interface is configured to provide the user-specified total tidal volume to the control system. The control system is configured to determine a first volume and a second volume. In such an embodiment, the breathing gas delivered for the breath has a first volume, the oxygen delivered for the breath has a second volume, and the first volume and the second volume, when combined, substantially equal the user-specified total tidal volume.

[0031] Optionally, the ventilator system also includes a user interface having an input configured to receive a user-specified peak inspiratory pressure. In such an embodiment, the user interface is configured to provide the user-specified peak inspiratory pressure to the control system, and the pressure of the breathing gas and oxygen delivered for the breath does not exceed the user-specified peak inspiratory pressure.

[0032] One embodiment includes a method of providing respiration to a human patient. The patient has a patient connector connected to a ventilator via a patient circuit, the ventilator having a first ventilator connector and a second ventilator connector different from the first ventilator connector. Each of the first ventilator connector and the second ventilator connector is in flow communication with the patient circuit. The method includes identifying, with the ventilator, the initiation of an inspiratory phase of a breath, delivering a bolus of oxygen to the first ventilator connector before or during the inspiratory phase, and delivering a respiratory gas comprising air to the second ventilator connector during the inspiratory phase. The ventilator isolates the oxygen bolus delivered to the first ventilator connector from the respiratory gas delivered to the second ventilator connector. Optionally, the ventilator can deliver the oxygen bolus at the initiation of the inspiratory phase of the breath. Optionally, the ventilator can determine a volume of the oxygen bolus delivered for the breath.

[0033] The method may further include identifying, with the ventilator, the end of the inspiratory phase of the breathing, and terminating the delivery of the oxygen bolus before the end of the inspiratory phase. The breathing gas may be delivered after the delivery of the oxygen bolus is terminated.

[0034] The method can be used with a user-specified total tidal volume. In such an embodiment, the breathing gas delivered for the breath has a first volume, the oxygen bolus delivered for the breath has a second volume, and the first volume and the second volume together substantially equal the user-specified total tidal volume.

[0035] The method can be used with a user-specified peak inspiratory pressure. In such an embodiment, the combined pressure of the breathing gas and oxygen bolus delivered for the breath does not exceed the user-specified peak inspiratory pressure.

[0036] One embodiment includes a ventilator apparatus for use with a human patient having a patient connector connectable to a patient circuit. The ventilator apparatus includes a ventilator connector connectable to the patient circuit, one or more first flow conduits in fluid communication with the ventilator connector, and a compressor configured to deliver breathing gas to the one or more first flow conduits. The one or more first flow conduits deliver breathing gas to the ventilator connector. The ventilator apparatus also includes a patient oxygen outlet port connectable to the patient circuit, one or more second flow conduits in fluid communication with the patient oxygen outlet port, and an oxygen source configured to deliver oxygen to the one or more second flow conduits. The patient oxygen outlet port and the one or more second flow conduits isolate oxygen from breathing gas delivered to the one or more first flow conduits and the ventilator connector.

[0037] Optionally, the one or more second flow conduits include a first conduit and a second conduit, and the ventilator device further includes a valve. The first conduit is in fluid communication with the valve for delivering oxygen from an oxygen source to the valve. The second conduit is in fluid communication with the valve for delivering oxygen from the valve to a patient oxygen outlet port. Opening the valve allows oxygen to flow from the oxygen source to the patient oxygen outlet port through the first conduit and the second conduit. On the other hand, closing the valve prevents oxygen from flowing from the oxygen source to the patient oxygen outlet port through the first conduit and the second conduit. Optionally, the ventilator device includes a control system configured to: (a) open the valve at or before the start of an inspiratory phase of breathing, thereby allowing oxygen to flow from the oxygen source to the patient oxygen outlet port; (b) close the valve before the end of the inspiratory phase of breathing, thereby preventing oxygen from flowing from the oxygen source to the patient oxygen outlet port; and (c) instruct the compressor to deliver breathing gas before the end of the inspiratory phase of breathing. Optionally, the control system can be configured to instruct the compressor to deliver breathing gas after the valve has closed.

[0038] Optionally, the ventilator apparatus includes an input configured to receive a user-specified total tidal volume. In such an embodiment, the breathing gas delivered for the breath has a first volume, the oxygen allowed to flow for the breath has a second volume, and the first volume and the second volume together substantially equal the user-specified total tidal volume.

[0039] Optionally, the ventilator device includes an input configured to receive a user-specified peak inspiratory pressure. In such an embodiment, the pressure of the delivered breathing gas plus the oxygen allowed to flow for the breath does not exceed the user-specified peak inspiratory pressure.

[0040] Optionally, the ventilator apparatus includes a user input configured to receive a user-selected parameter value. In such an embodiment, the control system is configured to maintain the valve open until a volume of oxygen has flowed through the valve, determined at least in part based on the user-selected parameter value.

[0041] The oxygen source can be configured to store oxygen. In such an embodiment, the ventilator device optionally includes an oxygen generator in fluid communication with the oxygen source, and a sensor configured to provide a signal to a control system. The signal encodes at least one of a concentration of oxygen stored by the oxygen source or a pressure of oxygen stored by the oxygen source. In such an embodiment, the control system is configured to use the signal to determine whether the amount of oxygen stored by the oxygen source is less than a threshold value, and to operate the oxygen generator to deliver oxygen to the oxygen source when the control system determines that the amount of oxygen stored by the oxygen source is less than the threshold value.

[0042] The patient circuit may have a sensor configured to detect a flow rate in the patient circuit and transmit a signal encoded with the flow rate. In such an embodiment, the control system may be configured to receive the signal from the sensor and use the signal to detect when the patient has initiated the start of the inspiratory phase.

[0043] Optionally, the ventilator device includes a sensor configured to detect a flow rate within the one or more first flow conduits and send a signal to a control system encoding the flow rate. In such an embodiment, the control system is configured to use the signal to detect when the patient has initiated the start of the inspiration phase.

[0044] Optionally, the ventilator device includes an accumulator configured to deliver at least a portion of the breathing gas to the compressor through at least one of the one or more first flow conduits, and a sensor configured to (a) detect a flow rate in at least one of the one or more first flow conduits, and (b) send a signal to a control system encoding the flow rate. In such an embodiment, the control system is configured to use the signal to detect when the patient has initiated the start of the inspiratory phase.

[0045] An embodiment of a pressure swing adsorption oxygen generator for isolating oxygen from air and for use with a pressure source capable of generating high and low pressures includes an adsorption bed having a bed of nitrogen adsorbent material; and a multi-position rotary valve for controlling the pressure swing adsorption of the adsorption bed, the multi-position rotary valve being connectable to and in fluid communication with the pressure source and in fluid communication with the adsorption bed. The rotary valve includes a cam having a first rotational position and a second rotational position. In the first rotational position of the cam, the rotary valve transmits the high pressure generated by the pressure source to the adsorption bed, and in the second rotational position of the cam, the rotary valve transmits the low pressure generated by the pressure source to the adsorption bed.

[0046] Optionally, the pressure swing adsorption oxygen generator may include an oxygen storage unit connected to the adsorption bed; a first regulator that allows oxygen generated in the adsorption bed to reach the oxygen storage unit based on a first condition sensed when the cam is in a first rotational position; and a second regulator that allows a portion of the oxygen in the oxygen storage unit to enter the adsorption bed based on a second condition sensed when the cam is in a second rotational position to assist in purging nitrogen from the adsorption bed.

[0047] Alternatively, the pressure swing adsorption oxygen generator may include an oxygen storage unit; a first pressure regulator connected to the adsorption bed and the oxygen storage unit, and in response to the pressure in the adsorption bed increasing to a preselected first pressure, the first pressure regulator adjusts the pressure in the adsorption bed to the preselected first pressure and allows oxygen generated in the adsorption bed to enter the oxygen storage unit through the first pressure regulator; and a second pressure regulator connected to the adsorption bed and the oxygen storage unit, and in response to the pressure in the adsorption bed decreasing to a preselected second pressure, the preselected second pressure being lower than the preselected first pressure, the pressure regulator adjusts the pressure in the adsorption bed to the preselected second pressure and allows oxygen stored in the oxygen storage unit to enter the adsorption bed through the second pressure regulator.

[0048] Alternatively, the pressure swing adsorption oxygen generator may be constructed such that when the pressure in the adsorption bed is below a preselected first pressure, the first pressure regulator prevents fluid communication between the adsorption bed and the oxygen storage unit through the first pressure regulator, and when the pressure in the adsorption bed is above a preselected second pressure, the second pressure regulator prevents fluid communication between the oxygen storage unit and the adsorption bed through the second pressure regulator.

[0049] Another embodiment of a pressure swing adsorption oxygen generator for isolating oxygen from air includes a pressure source that generates high and low pressures; an adsorption bed having a bed of nitrogen adsorbent material; and a multi-position rotary valve for controlling pressure swing adsorption of the adsorption bed and in fluid communication with the pressure source and the adsorption bed, the rotary valve including a cam having a first rotational position and a second rotational position. In the first rotational position of the cam, the rotary valve transmits the high pressure generated by the pressure source to the adsorption bed, and in the second rotational position of the cam, the rotary valve transmits the low pressure generated by the pressure source to the adsorption bed.

[0050] Optionally, the pressure source is a compressor, and the generated high pressure is positive pressure, and the generated low pressure is negative pressure.

[0051] Another embodiment of a pressure swing adsorption oxygen generator for isolating oxygen from air and used with a pressure source capable of generating high and low pressures includes an adsorption bed having a bed of nitrogen adsorbent material; and a multi-position rotary valve for controlling the pressure swing adsorption of the adsorption bed, connectable to and in fluid communication with the pressure source and in fluid communication with the adsorption bed. The rotary valve includes a cam having at least a first rotational position and a second rotational position; a rotary actuator configured to rotate the cam; and a plurality of valves that operate in response to the rotational position of the cam. In the first rotational position of the cam, at least one valve transmits the high pressure generated by the pressure source to the adsorption bed, and in the second rotational position of the cam, at least one valve transmits the low pressure generated by the pressure source to the adsorption bed.

[0052] Optionally, when the pressure swing adsorption oxygen generator is used with a pressure source, the pressure source being a compressor having a high pressure at its output port and a low pressure at its input port, the plurality of valves may include a first valve, a second valve, a third valve, and a fourth valve, each valve having a first port and a second port that are in fluid communication with each other in a first state and disconnected from each other in a second state, and the valves are selectively movable between the first and second states. The first port of the first valve is in fluid communication with the compressor output port, and the second port of the first valve is in fluid communication with the atmosphere. The first port of the second valve is in fluid communication with the adsorption bed, and the second port of the second valve is in fluid communication with the compressor output port. The first port of the third valve is in fluid communication with the adsorption bed, and the second port of the third valve is in fluid communication with the compressor input port. The first port of the fourth valve is in fluid communication with the compressor input port, and the second port of the fourth valve is in fluid communication with an air supply source from which oxygen is to be isolated. The first, second, third and fourth valves move between a first state and a second state in a repeating sequence in response to rotation of the cam, wherein when the cam is in a first rotational position, the second and fourth valves are in the first state and the first and third valves are in the second state, and when the cam is in a second rotational position, the first and third valves are in the first state and the second and fourth valves are in the second state.

[0053] Alternatively, the first valve and the third valve are moved in unison between a first state and a second state by a cam, and the second valve and the fourth valve are moved in unison between the first state and the second state by a cam.

[0054] Optionally, the cam has a first cam lobe and a second cam lobe, and further has a third rotational position and a fourth rotational position, wherein when the cam is moved to the first rotational position, the first cam lobe moves the fourth valve to the first state, and the second cam lobe moves the second valve to the first state, and the first valve and the third valve are in the second state, when the cam is moved to the second rotational position, the first cam lobe moves the first valve to the first state, the second cam lobe moves the third valve to the first state, and the second valve and the fourth valve are in the second state, when the cam is moved to the third rotational position, the first cam lobe moves the second valve to the first state, the second cam lobe moves the fourth valve to the first state, and the first valve and the third valve are in the second state, and when the cam is moved to the fourth rotational position, the first cam lobe moves the third valve to the first state, the second cam lobe moves the first valve to the first state, and the second valve and the fourth valve are in the second state.

[0055] Optionally, each valve may include a lifting member; a valve seat having a seat hole; and a push rod member having a cam follower adjacent to the cam and for push rod movement, in response to the cam rotation between the first rotational position and the second rotational position of the cam, the lifting member being coupled to the push rod member for moving with the push rod member to drive the lifting member into and out of the seating position of the valve seat to close and open the seat hole in response to the rotation of the cam.

[0056] Furthermore, each valve may also include a housing having an end opening facing the cam, the lifting member and the valve seat being positioned in the housing, the push rod extending through the end opening of the housing, and further comprising a flexible diaphragm positioned between the valve seat and the cam, the flexible diaphragm having an opening through which the push rod extends. The diaphragm closes the end opening of the housing and has a peripheral portion coupled to the housing and a central portion coupled to and moving with the push rod. The diaphragm may further have an active area, and the lifting valve may have a closed area that closes the seat opening. The active area of ​​the diaphragm and the closed area of ​​the lifting valve are sized to offset the force on the push rod generated by the pressure in the cavity between the valve seat and the diaphragm when the lifting valve is in the seated position of the valve seat, thereby reducing the force on the cam follower of the lifting member.

[0057] Another embodiment of a pressure swing adsorption oxygen generator for isolating oxygen from air includes a compressor having an input port and an output port; an adsorption bed having a bed of nitrogen adsorbent material; and a multi-position rotary valve for controlling the pressure swing adsorption of the adsorption bed and in fluid communication with the compressor and the adsorption bed. The rotary valve includes a cam; a rotary actuator configured to rotate the cam; and first, second, third, and fourth valves. Each valve has a first port and a second port that are in fluid communication with each other in a first state and disconnected from each other in a second state, and can selectively move between the first and second states in response to the rotational position of the cam. The first port of the first valve is in fluid communication with the compressor output port, and the second port of the first valve is in fluid communication with the atmosphere. The first port of the second valve is in fluid communication with the adsorption bed, and the second port of the second valve is in fluid communication with the compressor output port. The first port of the third valve is in fluid communication with the adsorption bed, and the second port of the third valve is in fluid communication with the compressor input port. The first port of the fourth valve is in fluid communication with the compressor input port, and the second port of the fourth valve is in fluid communication with an air supply source for isolating oxygen from the adsorption bed. The first, second, third, and fourth valves move between a first state and a second state in a repeating sequence in response to rotation of the cam, wherein during a first period, the second and fourth valves are in the first state and the first and third valves are in the second state to enable high-pressure air to be delivered to the adsorption bed to separate nitrogen from the air and produce oxygen, and during a second period occurring after the first period, the first and third valves are in the first state and the second and fourth valves are in the second state to enable nitrogen to be purged from the adsorption bed.

[0058] Optionally, the pressure swing adsorption oxygen generator includes an oxygen storage unit connected to the adsorption bed; a first regulator that allows oxygen generated in the adsorption bed to reach the oxygen storage unit based on a first condition sensed during a first time period; and a second regulator that allows a portion of the oxygen in the oxygen storage unit to enter the adsorption bed based on a second condition sensed during a second time period to assist in purging nitrogen from the adsorption bed.

[0059] Alternatively, the pressure swing adsorption oxygen generator may include an oxygen storage unit; a first pressure regulator connected to the adsorption bed and the oxygen storage unit, and in response to the pressure in the adsorption bed increasing to a preselected first pressure, the first pressure regulator adjusts the pressure in the adsorption bed to the preselected first pressure and allows oxygen generated in the adsorption bed to enter the oxygen storage unit through the first pressure regulator; and a second pressure regulator connected to the adsorption bed and the oxygen storage unit, and in response to the pressure in the adsorption bed decreasing to a preselected second pressure, the preselected second pressure being lower than the preselected first pressure, the pressure regulator adjusts the pressure in the adsorption bed to the preselected second pressure and allows oxygen stored in the oxygen storage unit to enter the adsorption bed through the second pressure regulator.

[0060] Optionally, the first pressure regulator prevents fluid communication between the adsorption bed and the oxygen storage unit through the first pressure regulator when the pressure in the adsorption bed is below a preselected first pressure, and the second pressure regulator prevents fluid communication between the oxygen storage unit and the adsorption bed through the second pressure regulator when the pressure in the adsorption bed is above a preselected second pressure.

[0061] The pressure swing adsorption oxygen generator is configured such that during a third period occurring after the second period, the second valve and the fourth valve are in the first state, and the first valve and the third valve are in the second state, so that high-pressure air is delivered to the adsorption bed to separate nitrogen from the air and produce oxygen, and during a fourth period occurring after the third period, the first valve and the third valve are in the first state, and the second valve and the fourth valve are in the second state, so that nitrogen is purged from the adsorption bed.

[0062] Optionally, the first valve and the third valve are positioned opposite each other on opposite sides of the cam, and the second valve and the fourth valve are positioned opposite each other on opposite sides of the cam.

[0063] Optionally, the cam has a first cam lobe and a second cam lobe, and during a first period, the first cam lobe moves the fourth valve to a first state, and the second cam lobe moves the second valve to the first state, and the first valve and the third valve are in the second state, during a second period, the first cam lobe moves the first valve to the first state, the second cam lobe moves the third valve to the first state, and the second valve and the fourth valve are in the second state, during a third period, the first cam lobe moves the second valve to the first state, the second cam lobe moves the fourth valve to the first state, and the first valve and the third valve are in the second state, and during a fourth period, the first cam lobe moves the third valve to the first state, the second cam lobe moves the first valve to the first state, and the second valve and the fourth valve are in the second state.

[0064] An embodiment of a ventilator with integrated cough-assist functionality is disclosed, the ventilator being in fluid communication with a patient connector of a patient via a patient circuit, the ventilator being operable in a breathing mode and a cough-assist mode. The ventilator includes a ventilator connector to which the patient circuit is fluidly connected, a portion of the ventilator that directs a flow of breathing air to the ventilator connector for delivery to the patient in the breathing mode, a user input for selectively switching the ventilator from the breathing mode to the cough-assist mode without disconnecting the patient from the ventilator, and a controller operable in response to the user input for switching the ventilator from the breathing mode to the cough-assist mode and controlling the operation of the ventilator in the cough-assist mode to provide at least one cough assistance to the patient, the cough assistance having an insufflation phase and a subsequent exhalation phase. The ventilator also includes a cough-assist valve that is in a first state for the insufflation phase of cough assistance and then moves to a second state for the exhalation phase of cough assistance. The cough-assist valve transmits positive pressure to the ventilator connection when the cough-assist valve is in a first state for the insufflation phase of cough assistance, and transmits negative pressure to the ventilator connection when the cough-assist valve is in a second state for the exsufflation phase of cough assistance.

[0065] Optionally, the positive pressure delivered by the cough-assist valve to the ventilator connection is sufficient to produce a patient airway pressure of 10 to 70 cmH2O, and when the cough-assist valve is in the second state for the exhalation phase of cough assistance, the negative pressure delivered by the cough-assist valve to the ventilator connection is sufficient to produce a patient airway pressure of -10 to -70 cmH2O.

[0066] Another embodiment of a ventilator with integrated cough-assist functionality includes a patient connector in fluid communication with a patient through a patient circuit, wherein the ventilator is operable in a breathing mode and a cough-assist mode, including a controller for controlling operation of the ventilator in the cough-assist mode to provide the patient with at least one cough-assistance having an insufflation phase followed by an exhaust phase, a ventilator connector to which the patient circuit is fluidly connected, a ventilator subsystem for directing a flow of breathing air to the ventilator connector for delivery to the patient in the breathing mode, a compressor having a compressor inlet and a compressor outlet, the compressor being operable to accelerate a gaseous fluid input to the compressor inlet and to deliver the accelerated gaseous fluid out of the compressor outlet, and the ventilator further including a cough-assist valve that is in a first state for the insufflation phase of cough assistance and then moves to a second state for the exhaust phase of cough assistance. When the cough-assist valve is in a first state for the insufflation phase of cough assistance, the cough-assist valve directs air flow to the compressor inlet and directs the accelerated air from the compressor outlet to the ventilator connection for delivery to the patient. When the cough-assist valve is in a second state for the expiration phase of cough assistance, the cough-assist valve directs the exhaust gas flow from the patient to the compressor inlet and exhausts the accelerated exhaust gas flow from the compressor outlet.

[0067] Optionally, when the ventilator is in the breathing mode, the cough-assist valve is maintained in the first state for operation.

[0068] Optionally, the ventilator portion directs a flow of breathing air to the ventilator connection, with the cough-assist valve maintained in a first state operative to direct breathing air to the compressor inlet for delivery to the patient in the breathing mode.

[0069] Another embodiment of a ventilator with integrated cough-assist functionality, the ventilator being in fluid communication with a patient connector of a patient through a patient circuit, the ventilator being operable in a breath mode and a cough-assist mode, comprising a controller for controlling operation of the ventilator in the cough-assist mode to provide the patient with at least one cough-assist having an insufflation phase followed by an exhalation phase, a ventilator connector to which the patient circuit is fluidly connectable, a portion of the ventilator for directing a flow of breathing air to the ventilator connector for delivery to the patient in the breath mode, a compressor having a compressor inlet and a compressor outlet, the compressor being operable to accelerate a gaseous fluid input into the compressor inlet and to deliver the accelerated gaseous fluid out of the compressor outlet, and a cough-assist valve that is in a first state for the insufflation phase of cough assistance and then moves to a second state for the exhalation phase of cough assistance. The cough-assist valve includes a first chamber, a second chamber, a third chamber, a valve inlet port communicating with an air supply source, a valve exhaust outlet port, a valve-compressor outlet port communicating with a compressor input, a compressor-valve inlet port communicating with a compressor output, a first port communicating between the first chamber and the second chamber, a second port communicating between the second chamber and the third chamber, a third port communicating with a ventilator connector, a first valve member movable between a first position closing the first port and a second position closing the valve inlet port, and a second valve member movable between a first position closing the valve exhaust outlet port and a second position closing the second port. When the cough-assist valve is in a first state for cough-assistance insufflation, the first valve member is in a first valve member first position and the second valve member is in a second valve member first position. When the cough-assist valve is in a second state for cough-assistance insufflation, the first valve member is in a first valve member second position and the second valve member is in a second valve member second position. The cough-assist valve further includes a valve actuator configured to move the first and second valve members to their first positions for an insufflation phase of cough assistance and to move the first and second valve members to their second positions for an exsufflation phase of cough assistance.

[0070] Optionally, when the ventilator is in the breathing mode, the cough-assist valve is maintained in the first state for operation.

[0071] Optionally, the ventilator portion directs a flow of breathing air to the ventilator connection, with the cough-assist valve maintained in a first state operative to direct breathing air to the compressor inlet for delivery to the patient in the breathing mode.

[0072] Optionally, the first and second valve members are attached to a connecting member, and the valve actuator is configured to move the connecting member to a first position to move the first and second valve members to their first positions for an insufflation phase of cough assistance, and to move the connecting member to a second position to move the first and second valve members to their second positions for an exsufflation phase of cough assistance.

[0073] Optionally, the valve actuator includes an electromagnetic coil and a permanent magnet, wherein one of the electromagnetic coil and the permanent magnet is attached to the connecting member and moves therewith as a unit, and the other electromagnetic coil and the permanent magnet are stationary, and when the electromagnetic coil is selectively energized to move the first valve member and the second valve member between their first position and the second position, the electromagnetic coil and the permanent magnet interact magnetically with each other.

[0074] Optionally, the ventilator further comprises a first permanent latching magnet and a second permanent latching magnet, and a first ferromagnetic member portion and a second ferromagnetic member portion, wherein one of the first permanent latching magnet and the first ferromagnetic member portion is attached to the connecting member and moves therewith as a unit and the other is stationary, and one of the second permanent latching magnet and the second ferromagnetic member portion is attached to the connecting member and moves therewith as a unit and the other is stationary, and when the first valve member and the second valve member are in their first position, the first permanent latching magnet is positioned sufficiently proximate to the first ferromagnetic member portion to retain the first valve member and the second valve member in their first position when the solenoid coil is de-energized, and when the first valve member and the second valve member are in their second position, the second permanent latching magnet is positioned sufficiently proximate to the second ferromagnetic member portion to retain the first valve member and the second valve member in their second position when the solenoid coil is de-energized.

[0075] Optionally, the ventilator further comprises a permanent latching magnet and a ferromagnetic component portion, wherein one of the permanent latching magnet and the ferromagnetic component portion is attached to the connecting member and moves therewith as a unit and the other is stationary, and when the first valve member and the second valve member are in one of their first and second positions, the permanent latching magnet is positioned sufficiently close to the ferromagnetic component portion to retain the first valve member and the second valve member in such one of their first and second positions when the electromagnetic coil is de-energized.

[0076] Optionally, the valve actuator includes a stationary electromagnetic coil and a movable permanent magnet, the electromagnetic coil being positioned in a stationary coil housing through which a connecting member extends, the permanent magnet being positioned in the coil housing, the electromagnetic coil extending around the permanent magnet, the permanent magnet being attached to the connecting member for movement as a unit therewith and positioned to magnetically interact with the electromagnetic coil, the electromagnetic coil and permanent magnet interacting magnetically when the electromagnetic coil is selectively energized to move the first valve member and the second valve member between their first and second positions.

[0077] Optionally, the ventilator further comprises a first permanent latching magnet and a second permanent latching magnet, and a first ferromagnetic member portion and a second ferromagnetic member portion, wherein one of the first permanent latching magnet and the first ferromagnetic member portion is attached to the connecting member and moves therewith as a unit and the other is stationary, and one of the second permanent latching magnet and the second ferromagnetic member portion is attached to the connecting member and moves therewith as a unit and the other is stationary, and when the first valve member and the second valve member are in their first position, the first permanent latching magnet is positioned sufficiently proximate to the first ferromagnetic member portion to retain the first valve member and the second valve member in their first position when the solenoid coil is de-energized, and when the first valve member and the second valve member are in their second position, the second permanent latching magnet is positioned sufficiently proximate to the second ferromagnetic member portion to retain the first valve member and the second valve member in their second position when the solenoid coil is de-energized.

[0078] Optionally, the ventilator further comprises a first permanent latching magnet and a second permanent latching magnet attached to the connecting member within the coil housing for movement with the connecting member as a unit, and a first ferromagnetic member portion and a second ferromagnetic member portion, wherein when the first valve member and the second valve member are in their first position, the first permanent latching magnet is positioned sufficiently adjacent to the first ferromagnetic member portion to retain the first valve member and the second valve member in their first position when the electromagnetic coil is de-energized, and when the first valve member and the second valve member are in their second position, the second permanent latching magnet is positioned sufficiently adjacent to the second ferromagnetic member portion to retain the first valve member and the second valve member in their second position when the electromagnetic coil is de-energized.

[0079] Optionally, the first ferromagnetic component portion is a first end portion of the coil housing, and the second ferromagnetic component portion is a second end portion of the coil housing.

[0080] Optionally, the ventilator further comprises a permanent latching magnet attached to the connecting member within the coil housing for movement with the connecting member as a unit, and a ferromagnetic member portion, wherein when the first valve member and the second valve member are in one of their first and second positions, the permanent latching magnet is positioned sufficiently proximate to the ferromagnetic member portion to retain the first valve member and the second valve member in such one of their first and second positions when the electromagnetic coil is de-energized.

[0081] Optionally, the connecting member is an elongated shaft extending completely through the second chamber and having a first end passing through the first hole into the first chamber and a second end passing through the second hole into the third chamber, the first valve member is attached to the first end of the shaft within the first chamber and between the valve air inlet hole and the first hole, and the second valve member is attached to the second end of the shaft within the third chamber and between the valve exhaust outlet hole and the second hole.

[0082] Optionally, the valve actuator includes an electromagnetic coil and a permanent magnet, wherein one of the electromagnetic coil and the permanent magnet is attached to the connecting member and arranged coaxially with the connecting member to move as a unit therewith, and the other electromagnetic coil and the permanent magnet are stationary, and when the electromagnetic coil is selectively energized to move the first valve member and the second valve member between their first position and the second position, the electromagnetic coil and the permanent magnet interact magnetically.

[0083] Alternatively, the other electromagnetic coils and the permanent magnets are arranged coaxially with the connecting member.

[0084] Optionally, the first chamber, the second chamber and the third chamber are all within the valve body.

[0085] Optionally, the first chamber, the second chamber and the third chamber are arranged linearly in the valve body, and the connecting member is an elongated shaft extending completely through the second chamber and having a first end extending into the first chamber and a second end extending into the third chamber.

[0086] Optionally, the valve inlet hole, the first hole, the second hole and the valve exhaust outlet hole are linearly aligned, and the connecting member is an extended shaft coaxially aligned with the valve inlet hole, the first hole, the second hole and the valve exhaust outlet hole, the shaft completely extending through the second chamber and having a first end extending through the first hole and entering the first chamber, the first end being attached to the first valve member in the first chamber and movable with the shaft between the first hole and the valve inlet hole, and having a second end extending through the second hole and entering the third chamber, the second end being attached to the second valve member in the third hole and movable with the shaft between the valve exhaust outlet hole and the second hole.

[0087] Optionally, the area of ​​the first hole closed by the first valve member when the first valve member is in the first position and the area of ​​the valve exhaust outlet hole closed by the second valve member when the second valve member is in the first position are sized to produce substantially equal and opposite directional forces on the first valve member and the second valve member, the directional forces being caused by air pressure delivered from the third hole and located in the second chamber, and the area of ​​the valve inlet hole closed by the first valve member when the first valve member is in the second position and the area of ​​the second hole closed by the second valve member when the second valve member is in the second position are sized to produce substantially equal and opposite directional forces on the first valve member and the second valve member, the directional forces being caused by air pressure delivered from the third hole and located in the second chamber.

[0088] Another embodiment of a ventilator with integrated cough-assist functionality, the ventilator being in fluid communication with a patient connector of a patient through a patient circuit, the ventilator being operable in a breath mode and a cough-assist mode, comprising a controller for controlling operation of the ventilator in the cough-assist mode to provide the patient with at least one cough-assist having an insufflation phase followed by an exhalation phase, a ventilator connector to which the patient circuit is fluidly connectable, a portion of the ventilator for directing a flow of breathing air to the ventilator connector for delivery to the patient in the breath mode, a compressor having a compressor inlet and a compressor outlet, the compressor being operable to accelerate a gaseous fluid input into the compressor inlet and to deliver the accelerated gaseous fluid out of the compressor outlet, and a cough-assist valve that is in a first state for the insufflation phase of cough assistance and then moves to a second state for the exhalation phase of cough assistance. The cough-assist valve further includes a valve inlet in communication with an air supply source, a valve exhaust outlet, a valve-compressor outlet in communication with a compressor input, a compressor-valve inlet in communication with a compressor output, a first valve member movable between a first valve member first position and a first valve member second position, a second valve member movable between a second valve member first position and a second valve member second position, and a third orifice in communication with a ventilator connector. When the cough-assist valve is in a first state for a cough-assist insufflation phase, the first valve member is in the first valve member first position, allowing air from the air supply source entering the valve inlet to flow through the valve-compressor outlet and into the compressor inlet while preventing air from entering the valve inlet from flowing directly to the third orifice, and the second valve member is in the second valve member first position, allowing accelerated air from the compressor outlet and entering the compressor-valve inlet to flow through the third orifice to the ventilator connector for delivery to a patient while preventing accelerated air from the compressor outlet and entering the compressor-valve inlet from passing through the valve exhaust outlet. When the cough-assist valve is in the second state for a cough-assisted exhalation phase, the first valve member is in the first valve member second position, allowing exhaust gas flow from the patient and entering the third orifice to pass through the valve-compressor outlet and into the compressor inlet, while preventing exhaust gas flow from the patient and entering the third orifice from passing through the valve inlet, and the second valve member is in the second valve member second position, allowing accelerated exhaust gas flow entering the compressor-valve inlet to pass through the valve exhaust outlet, while preventing accelerated exhaust gas flow entering the compressor-valve inlet from passing through the third orifice. The valve actuator is configured to move the first valve member and the second valve member to the first valve member first position and the second valve member first position for the cough-assisted insufflation phase, and to move the first valve member and the second valve member to the first valve member second position and the second valve member second position for the cough-assisted exhalation phase.

[0089] An embodiment employs a secretion collector between a patient connector and a patient circuit. The secretion collector comprises a first connection portion connectable to the patient connector for fluid communication therewith, a second connection portion connectable to the patient circuit for fluid communication therewith, and a central portion located between the first and second connection portions. The central portion has a first end portion in fluid communication with the first connection portion, a second end portion in fluid communication with the second connection portion, and a secretion collection well located between the first and second ends, the secretion collection well being sized to capture and retain secretions that enter the central portion.

[0090] Optionally, the first connecting portion has a first cross-section, the second connecting portion has a second cross-section, and the secretion collecting well is a chamber located between the first end and the second end, the chamber having a longitudinal portion having a third cross-section that is at least substantially larger than the first cross-section of the first connecting portion, so as to capture secretions entering the central portion and retain them in the secretion collecting chamber.

[0091] Optionally, the collector includes a drain in fluid communication with the secretion collecting well for removing secretions captured and retained by the secretion collecting well.

[0092] Optionally, the secretion collector, when used with a suction source, further comprises a drainage channel having a first end in communication with the secretion collection well and a second end connectable to the suction source for communication with the suction source to apply suction to the secretion collection well for removing secretions captured and retained by the secretion collection well.

[0093] Optionally, the first end of the drainage channel is in fluid communication with the secretion collection well at a position closer to the first end than to the second end of the secretion collection well.

[0094] Another embodiment of a secretion collector is for use between a patient connector including a connection portion having an internal passageway and a cough assist conduit including a connection portion having an internal passageway. The secretion collector includes a first connection portion connectable to a connection portion of the patient connector for fluid communication therewith, the first connection portion having an internal passageway, a second connection portion connectable to a connection portion of a cough assist conduit for fluid communication therewith, the second connection portion having an internal passageway, and a secretion collection chamber located between the first and second connection portions. The secretion collection chamber has a first chamber end positioned toward the first connection portion and a second chamber end positioned toward the second connection portion. One of the channels of the connection portion between the first connection portion and the patient connector forms a flow aperture for the secretion collection chamber at the first chamber end, and one of the channels of the connection portion between the second connection portion and the cough assist conduit forms a flow aperture for the secretion collection chamber at the second chamber end. The secretion chamber has a well sized to capture and retain secretions that enter the central portion.

[0095] Optionally, the secretion chamber has a longitudinal portion having a cross-sectional area sized such that a flow rate of a fluid entering the secretion chamber through the flow aperture at the first end of the chamber is sufficiently reduced within the secretion chamber so that the secretion collecting chamber can capture and retain secretions carried therein by the fluid.

[0096] Optionally, the secretion collector comprises a drainage channel in fluid communication with the secretion collecting chamber for removing secretions captured and retained by the secretion collecting chamber.

[0097] Optionally, when used with a suction source, the secretion collector further comprises a drainage channel having a first end in fluid communication with the secretion collection chamber and a second end connectable to the suction source for communicating with the suction source to apply suction to the secretion collection chamber for removing secretions captured and retained by the secretion collection chamber.

[0098] Optionally, the first end of the drainage channel is in fluid communication with the secretion collection chamber at a position closer to the first end of the chamber than to the second end of the chamber.

[0099] Another embodiment is a patient connector for use with a patient circuit, having an integrated secretion collector. The patient connector includes a patient breathing conduit portion and a secretion collection chamber having a first chamber end and a second chamber end. The first chamber end is in fluid communication with the patient breathing conduit portion, and the second chamber end is connectable to the patient circuit for fluid communication with the patient circuit. The patient breathing conduit portion and the first chamber end define a first end flow aperture for the secretion collection chamber at the first chamber end. The secretion chamber has a longitudinal portion having a cross-sectional area sized such that a flow rate of a fluid entering the secretion chamber through the first end flow aperture is sufficiently reduced within the secretion chamber to allow the secretion collection chamber to capture and retain secretions carried by the fluid therein.

[0100] Optionally, the patient connector further comprises a drainage channel in fluid communication with the secretion collection chamber for removing secretions captured and retained by the secretion collection chamber.

[0101] Optionally, when used with a suction source, the patient connection piece further comprises a drainage channel having a first end in fluid communication with the secretion collection chamber and a second end connectable to the suction source for communicating with the suction source to apply suction to the secretion collection chamber for removing secretions captured and retained by the secretion collection chamber.

[0102] Another embodiment is a patient circuit for use with a patient connector having an integrated secretion collector. The patient circuit includes a patient circuit tubing portion and a secretion collection chamber having a first chamber end and a second chamber end. The first chamber end is connectable to the patient connector for fluid communication therewith, and the second chamber end is in fluid communication with the patient circuit tubing portion. When the patient connector is connected to the first chamber end, a first end flow aperture for the secretion collection chamber is defined at the first chamber end. The secretion chamber has a longitudinal portion having a cross-sectional area sized such that a flow rate of a fluid entering the secretion chamber through the first end flow aperture is sufficiently reduced within the secretion chamber to allow the secretion collection chamber to capture and retain secretions carried by the fluid therein.

[0103] Optionally, the patient circuit further comprises a drainage channel in fluid communication with the secretion collection chamber for removing secretions captured and retained by the secretion collection chamber.

[0104] Optionally, when used with a suction source, the patient circuit further comprises a drainage conduit having a first end in fluid communication with the secretion collection chamber and a second end connectable to the suction source for fluid communication with the suction source to apply suction to the secretion collection chamber to remove secretions captured and retained by the secretion collection chamber.

[0105] Another embodiment of a patient connector having an integrated secretion collector and patient circuit. The secretion collector includes a patient airway portion, a patient circuit portion, and a secretion collection chamber having a first chamber end and a second chamber end. The first chamber end is in fluid communication with the patient airway portion, and the second chamber end is in fluid communication with the patient circuit portion. The patient airway portion and the first chamber end define a first end flow aperture for the secretion collection chamber at the first chamber end. The secretion chamber has a longitudinal portion having a cross-sectional area sized such that a flow rate of a fluid entering the secretion chamber through the first end flow aperture is sufficiently reduced within the secretion chamber to allow the secretion collection chamber to capture and retain secretions carried by the fluid therein.

[0106] Optionally, the patient connector further comprises a drainage channel in fluid communication with the secretion collection chamber for removing secretions captured and retained by the secretion collection chamber.

[0107] Optionally, when used with a suction source, the patient connection piece further comprises a drainage channel having a first end in fluid communication with the secretion collection chamber and a second end connectable to the suction source for communicating with the suction source to apply suction to the secretion collection chamber for removing secretions captured and retained by the secretion collection chamber.

[0108] Another embodiment is a ventilator having an integrated cough-assist and secretion collector for communicating with a patient connector. The ventilator is operable in a breathing mode and a cough-assist mode. The ventilator includes a ventilator connector and a first connection portion connectable to the patient connector for communicating with the patient connector, a second connection portion communicating with the ventilator connector, and a central portion located between the first and second connection portions. The central portion has a first end portion communicating with the first connection portion, a second end portion communicating with the second connection portion, and a secretion collection well located between the first and second ends, the secretion collection well being sized to capture and retain secretions that enter the central portion. The ventilator also includes a ventilator portion that directs a flow of breathing air to the ventilator connection for delivery to the patient in a breathing mode, a user input terminal for selectively switching operation of the ventilator from the breathing mode to the cough-assist mode without disconnecting the ventilator from the patient, and a controller operable, in response to the user input terminal, for switching operation of the ventilator from the breathing mode to the cough-assist mode and for controlling operation of the ventilator in the cough-assist mode to provide at least one cough assistance to the patient.

[0109] Optionally, when controlling operation of the ventilator in the cough-assist mode, the controller controls operation of the ventilator to provide at least one cough-assist mode having an insufflation phase followed by an exsufflation phase to the patient. The ventilator further comprises at least one cough-assist valve to deliver positive pressure to the ventilator connection during at least a portion of the insufflation phase of the cough-assist mode and to deliver negative pressure to the ventilator connection during at least a portion of the exsufflation phase of the cough-assist mode.

[0110] Optionally, the ventilator further comprises a drainage channel in fluid communication with the secretion collection well for removing secretions captured and retained by the secretion collection well.

[0111] Optionally, when used with a suction source, the ventilator further comprises a drainage channel having a first end in communication with the secretion collection well and a second end connectable to the suction source for communication with the suction source to apply suction to the secretion collection well to remove secretions captured and retained by the secretion collection well.

[0112] An embodiment employs a secretion collector between a patient connector and a patient circuit. The secretion collector includes a first connection portion connectable to the patient connector for fluid communication therewith, a second connection portion connectable to the patient circuit for fluid communication therewith, and a central portion positioned between the first and second connection portions, the central portion having a first end portion in fluid communication with the first connection portion and a second end portion in fluid communication with the second connection portion. The secretion collector further includes a secretion collection drain positioned in fluid communication with the central portion, the secretion collection drain being sized and positioned to remove secretions that enter the central portion.

[0113] The secretion collector can be used in conjunction with a suction source. In this case, the secretion collection drain can have a first end in fluid communication with the central portion and a second end connectable to the suction source for fluid communication with the suction source to apply suction to the central portion to remove secretions that have entered the central portion.

[0114] A passive valve is provided for use as a fixed leak valve for a ventilator by connecting to a patient connection piece. The passive valve includes a valve body having an internal chamber, a first valve body port in fluid communication with the internal chamber and configured to communicate with the patient connection piece, a second valve body port in fluid communication with the internal chamber and configured to communicate with the ventilator, a valve body passage in fluid communication with the internal chamber and with ambient air outside the valve body, and a check valve seal positioned to seal the valve body passage to allow air flow in the internal chamber to flow through the valve body passage to the exterior of the valve body and to prevent air flow from the external environment from flowing through the valve body passage into the internal chamber.

[0115] Optionally, the valve body passage is an elongate circumferentially extending passage extending at least partially around the valve body.

[0116] Optionally, the passive valve further comprises a plurality of first channels in fluid communication with the internal chamber and the channel.

[0117] Optionally, the check valve seal is an elongated, circumferentially extending flexible seal that is positioned within the passage and flexibly movable between a closed position and an open position, wherein the closed position is configured to close the first passage to prevent communication between the internal chamber and the passage through the first passage when the pressure in the internal chamber is below a threshold pressure, and the open position is configured to open the first passage to allow communication between the internal chamber and the passage through the first passage when the pressure in the internal chamber is above the threshold pressure, thereby providing a flow path between the internal chamber and ambient air outside the valve body.

[0118] Another embodiment of a passive valve used as a fixed leak valve for a ventilator by connecting to a patient connector. The passive valve includes a body having a first body portion, a second body portion, and a third body portion located between the first and second body portions. The first body portion has a first fluid channel extending therethrough, the first fluid channel having an outer end configured to communicate with the patient connector, the second body portion has a second fluid channel extending therethrough, the second fluid channel having an outer end configured to communicate with the ventilator, and the third body portion has a third fluid channel extending therethrough and communicating with the first and second fluid channels. The first, second, and third fluid channels together constitute the body fluid channel. The third body portion has a chamber extending at least partially therearound, the chamber having at least one internal opening communicating with the body fluid channel and at least one external opening communicating with the exterior of the body. A seal is included, at least a portion of which is located within the chamber and is movable between a closed position and an open position, wherein the closed position is used to close the at least one internal opening of the chamber when the pressure of the main fluid channel is below a threshold pressure, and the open position is used to open the at least one internal opening when the pressure of the main fluid channel is above the threshold pressure.

[0119] Optionally, the portion of the seal is a first peripheral portion of the seal.

[0120] Optionally, the first peripheral portion of the seal is flexible and moves from the closed position to the open position by flexing away from the at least one internal opening in response to a pressure in the bulk fluid passageway being above a threshold pressure.

[0121] Optionally, the seal further comprises a second peripheral portion of the seal which remains stationary relative to the body.

[0122] Optionally, the seal is flexible and moves from the closed position to the open position by flexing away from the at least one internal opening in response to a pressure in the bulk fluid passageway being above a threshold pressure.

[0123] Optionally, the at least one internal opening includes at least two internal openings, and a portion of the seal extends between the at least two internal openings of the chamber and is movable between a closed position and an open position, the closed position being used to cover and close the at least two internal openings to prevent the main fluid channel from communicating with the internal chamber through the at least two internal openings when the pressure of the main fluid channel is lower than a threshold pressure, and the open position being used to open the at least two internal openings to allow the main fluid channel to communicate with the internal chamber through the at least two internal openings when the pressure of the main fluid channel is higher than a threshold pressure, thereby providing a flow path between the main fluid channel and the at least one external opening of the chamber.

[0124] Optionally, the seal has a first peripheral portion and a second peripheral portion, one of the first peripheral portion and the second peripheral portion being positioned outboard of the other of the first peripheral portion and the second peripheral portion. The first peripheral portion of the seal extends between the at least two internal openings, is flexible, and moves from a closed position to an open position by flexing away from the at least two internal openings in response to a pressure in the fluid passage of the body exceeding a threshold pressure. The second peripheral portion of the seal remains stationary relative to the body.

[0125] Optionally, the chamber is an annular chamber extending completely around the third fluid passage, and the seal is an annular seal.

[0126] Another embodiment of a passive valve configured to function as a fixed leak valve for a ventilator by connecting to a patient connector. The passive valve includes a seal having a sealed central opening, a first body portion, a second body portion, and a chamber. The first body portion has a first fluid passage extending therethrough, the first fluid passage having an outer first end configured to communicate with the patient connector and an inner second end. The second body portion has a second fluid passage extending therethrough, the second fluid passage having an outer first end configured to communicate with the ventilator and an inner second end. The inner second ends of the first and second body portions are connected together with the seal positioned therebetween, the sealed central opening being aligned with the first and second fluid passages to form a body fluid passage extending between the outer first ends of the first and second body portions. The chamber extends around the body fluid passage and has at least one inner opening communicating with the body fluid passage and at least one outer opening communicating with the exterior of the body. The seal has a first peripheral portion located within the chamber, the first peripheral portion being movable between a closed position and an open position, the closed position being used to close the at least one internal opening when the pressure of the main fluid channel is lower than a threshold pressure, and the open position being used to open the at least one internal opening when the pressure of the main fluid channel is higher than the threshold pressure.

[0127] Optionally, the first peripheral portion of the annular seal is flexible and moves from the closed position to the open position by flexing away from the at least one interior opening in response to a pressure in the bulk fluid passageway being above a threshold pressure.

[0128] Optionally, the annular seal further comprises a second peripheral portion which remains stationary relative to the body.

[0129] Optionally, the at least one internal opening is formed by at least one gap between the inner second ends of the first and second body parts that are connected to each other.

[0130] Optionally, the at least one external opening is formed in a flange portion of at least one of the inner second end portions of the first and second body portions connected to each other.

[0131] Another embodiment of a ventilator with integrated cough assistance is provided for use with a patient. The ventilator includes a passive patient circuit for communication with a patient connection member, a ventilator connection member connectable to the patient circuit and in communication therewith, and the ventilator is operable in a breathing mode and a cough-assist mode. When the ventilator is in the breathing mode, the ventilator portion directs a flow of breathing air to the ventilator connection member for delivery from the patient circuit to the patient, the breathing air generating a pressure in the patient circuit above a threshold pressure. The ventilator also includes a user input for selecting to switch the ventilator operation from the breathing mode to the cough-assist mode without disconnecting the ventilator from the patient, and a controller operable, responsive to the user input, for switching the ventilator operation from the breathing mode to the cough-assist mode and controlling the operation of the ventilator in the cough-assist mode to provide the patient with at least one cough assistance having an insufflation phase followed by an exhalation phase. The ventilator also includes a cough-assist valve that is in a first state for the insufflation phase of cough assistance and then moves to a second state for the exhalation phase of cough assistance. When the cough-assist valve is in a first state for a cough-assisted insufflation phase, the cough-assist valve transmits positive pressure to the ventilator connector through the patient circuit when the patient circuit pressure is above a threshold pressure for delivery to the patient. When the cough-assist valve is in a second state for a cough-assisted expiration phase, the cough-assist valve transmits negative pressure to the ventilator connector through the patient circuit when the patient circuit pressure is below the threshold pressure for delivery to the patient. The patient circuit of the ventilator includes a passive valve that functions as a fixed leak valve. The passive valve includes a valve body having an internal chamber, a first valve body port in fluid communication with the internal chamber and configured to be in fluid communication with the patient connector, a second valve body port in fluid communication with the internal chamber and configured to be in fluid communication with the ventilator connector, a valve body passageway communicating with the internal chamber and ambient air outside the valve body, and a check valve seal positioned to seal the valve body passageway to allow airflow in the internal chamber to flow through the valve body passageway to the exterior of the valve body and to prevent airflow from the exterior of the valve body from entering the internal chamber through the valve body passageway.

[0132] Optionally, the valve body passage includes a passage chamber extending at least partially around an interior chamber of the valve body, the first valve body port includes at least two interior openings of the passage chamber, thereby providing a fluid connection between the passage chamber and the interior chamber of the valve body, and the second valve body port includes at least two exterior openings of the passage chamber, thereby providing a fluid connection between the passage chamber and an exterior of the valve body. The check valve seal is at least partially disposed in the passage chamber and extends between the at least two interior openings of the passage chamber. A portion of the seal is movable between a closed position and an open position, wherein the closed position is used to close the at least two interior openings of the passage chamber when the pressure of the interior chamber of the valve body is below a threshold pressure, and the open position is used to open the at least two interior openings of the passage chamber when the pressure of the interior chamber of the valve body is above the threshold pressure.

[0133] Optionally, the portion of the seal located within the access chamber is flexible and moves from the closed position to the open position by flexing away from the at least two internal openings of the access chamber in response to the pressure of the internal chamber of the valve body being above a threshold pressure.

[0134] Optionally, the sealing member further comprises a portion which remains stationary relative to the valve body.

[0135] Another embodiment of a patient connector for use with a ventilator and a patient having at least one lung. The patient connector includes a patient interface portion having a fluid passageway that is couplable to the patient for communication with the patient's at least one lung; and a passive valve portion that operates as a fixed-leak valve. The valve portion includes a valve body having an internal chamber, a first valve body port that is in communication with the internal chamber and configured to communicate with the fluid passageway of the patient interface portion, a second valve body port that is in communication with the internal chamber and configured to communicate with the ventilator, a valve body passageway that is in communication with the internal chamber and with ambient air external to the valve body, and a check valve seal positioned to seal the valve body passageway to allow airflow in the internal chamber to flow through the valve body passageway to the exterior of the valve body and to prevent airflow from the exterior of the valve body from entering the internal chamber through the valve body passageway.

[0136] Optionally, the valve body passage is an elongate circumferentially extending passage extending at least partially around the valve body.

[0137] Optionally, the patient connection component further comprises a plurality of first channels in fluid communication with the internal chamber and the passageway.

[0138] Optionally, the check valve seal is an elongated, circumferentially extending flexible seal placed in the channel and can be flexibly moved between a closed position and an open position, wherein the closed position is used to close the first channel when the pressure of the internal chamber is lower than a threshold pressure to prevent communication between the internal chamber and the channel through the first channel, and the open position opens the first channel when the pressure of the internal chamber is higher than the threshold pressure to allow communication between the internal chamber and the channel through the first channel, thereby providing a fluid connection path between the internal chamber and the external ambient air of the valve body.

[0139] An embodiment of an active exhalation valve for use with a ventilator to control the flow of patient exhaled gas. The active exhalation valve includes a patient circuit connector port, a patient connector port, an exhalation port, a pilot pressure port, a valve seat, and a movable poppet valve. The movable poppet valve includes an inner bellows member, an outer bellows member, and a bellows poppet valve face. The pilot pressure port is configured such that an activation pressure applied to the pilot pressure port causes the inner bellows member and the outer bellows member to extend so that the bellows poppet valve face engages with the valve seat and restricts the flow of patient exhaled gas to the exhalation port, and a reduction in the activation pressure to the pilot pressure port allows the inner bellows member and the outer bellows member to move the bellows poppet valve face away from the valve seat and disengage from the valve seat to allow patient exhaled gas to flow to the exhalation port, thereby controlling the flow of patient exhaled gas from the valve.

[0140] Optionally, an inner bellows chamber is formed between the inner bellows member and the outer bellows member, and the pilot pressure port is in fluid communication with the inner bellows chamber.

[0141] Optionally, the internal bellows member has an internal bellows fluid passage extending therethrough, the internal bellows fluid passage being in fluid communication with the patient circuit connector port and the patient connector port.

[0142] Optionally, the inner bellows fluid passage is in continuous flow communication with the patient circuit connector port and the patient connector port and is disconnected from the inner bellows chamber between the inner bellows member and the outer bellows member during operation of the exhalation valve.

[0143] Optionally, the internal bellows member has an internal bellows fluid passage extending therethrough, the internal bellows fluid passage being in continuous fluid flow with the patient circuit connector port and the patient connector port.

[0144] Another embodiment of an active exhalation valve for use with a patient connection and a ventilator having a pressure source that can be used to control the operation of the valve to control the flow of patient exhaled gas. The active exhalation valve includes a patient circuit connection port in fluid communication with the ventilator, a patient connection port in fluid communication with the patient connection, an exhalation port in fluid communication with air outside the valve for exhausting patient exhaled gas from the valve, a pilot pressure port in fluid communication with the pressure source, a valve seat, and a movable poppet valve. The movable poppet valve includes an inner bellows member, an outer bellows member, and a bellows poppet valve face. The pilot pressure port is configured such that, upon activation pressure applied to the pilot pressure port by a pressure source, the inner bellows member and the outer bellows member extend to seal the bellows poppet valve face with the valve seat and restrict the flow of patient exhaled gas to the exhalation port, and that a reduction in activation pressure applied to the pilot pressure port by the pressure source allows the inner bellows member and the outer bellows member to move the bellows poppet valve face away from the valve seat and out of sealing engagement with the valve seat to allow the flow of patient exhaled gas to the exhalation port, thereby controlling the flow of patient exhaled gas from the valve.

[0145] Optionally, an inner bellows chamber is formed between the inner bellows member and the outer bellows member, and the pilot pressure port is in fluid communication with the inner bellows chamber.

[0146] Optionally, the internal bellows member has an internal bellows fluid passage extending therethrough, the internal bellows fluid passage being in fluid communication with the patient circuit connector port and the patient connector port.

[0147] Optionally, the inner bellows fluid passage is in continuous flow communication with the patient circuit connector port and the patient connector port and is disconnected from the inner bellows chamber between the inner bellows member and the outer bellows member during operation of the exhalation valve.

[0148] Optionally, the inner bellows member and the outer bellows member define an inner bellows chamber therebetween, and the pilot pressure port is in continuous communication with the inner bellows chamber.

[0149] Another embodiment of using an active exhalation valve with a ventilator to control the operation of the valve to control the flow of patient exhaled gas. The active exhalation valve includes a patient circuit connector port, a patient connector port, an exhalation port, a pilot pressure port, a valve seat, and a movable poppet valve. The movable poppet valve includes an internal component, an external component, and a poppet valve face. The pilot pressure port is configured such that an activation pressure applied to the pilot pressure port causes the internal component and the external component to move toward the valve seat so that the poppet valve face engages with the valve seat and restricts the flow of patient exhaled gas to the exhalation port, and a reduction in the activation pressure flowing to the pilot pressure port allows the internal component and the external component to move away from the valve seat so that the poppet valve face disengages from the valve seat to allow patient exhaled gas to flow to the exhalation port, thereby controlling the flow of patient exhaled gas from the valve.

[0150] Optionally, an internal chamber is formed between the inner component and the outer component, and the pilot pressure port is in fluid communication with the internal chamber.

[0151] Optionally, the inner member has an inner member fluid passage extending therethrough, the inner member fluid passage being in fluid communication with the patient circuit connector port and the patient connector port.

[0152] Optionally, the inner member fluid passageway is in continuous fluid communication with the patient circuit connector port and the patient connector port and is disconnected from the interior chamber between the inner member and the outer member during operation of the exhalation valve.

[0153] Optionally, the inner member has an inner member fluid passage extending therethrough, the inner member fluid passage being in continuous fluid communication with the patient circuit connector port and the patient connector port.

[0154] Another embodiment of an active exhalation valve for use with a patient connection and a ventilator having a pressure source that can be used to control the operation of the valve. The active exhalation valve includes a valve body having an internal body chamber, wherein gas in the internal body chamber has a body chamber pressure, a first body port in fluid communication with the body chamber and configured to be in fluid communication with the patient connection, a second body port in fluid communication with the body chamber and configured to be in fluid communication with the ventilator, a passageway in fluid communication with ambient air external to the body chamber and the valve body, and a valve seal movable between a closed position for sealing the passageway and an open position for opening the passageway. The valve seal includes an outer member, an inner member disposed within the outer member, an inner sealing chamber located between the outer member and the inner member and in fluid communication with the pressure source, and a sealing member extending between and movable with the outer member and the inner member. The sealing member has a first surface portion located inside the sealing chamber, which is configured to move the valve seal toward a closed position in response to pressure applied thereto by a pressure source, and a second surface portion located outside the sealing chamber, which is configured to move the valve seal toward an open position in response to pressure applied thereto by the main chamber pressure, the movement amount and movement direction of the valve seal corresponding to the resultant force generated by the pressure source and the main chamber pressure on the first surface portion and the second surface portion.

[0155] Optionally, the internal component has an internal component fluid passage extending therethrough, the internal component fluid passage being in fluid communication with the body cavity and having a first end in fluid communication with the first body port and a second end in fluid communication with the second body port.

[0156] Optionally, the inner member fluid passageway is in continuous communication with the first body port and the second body port during operation of the exhalation valve and is disconnected from the sealed chamber between the inner member and the outer member.

[0157] Optionally, the internal component has an internal component fluid passage extending therethrough, the internal component fluid passage having a first opening in continuous fluid flow with the first body port and a second opening in continuous fluid flow with the second body port.

[0158] Optionally, the body has a wall portion located outside the valve seal, the wall portion forming a further chamber outside the valve seal, the passage being located in the wall portion.

[0159] Optionally, the body has a peripheral wall portion extending axially around the body cavity and external to the valve seal, the peripheral wall portion forming an elongated peripheral cavity extending at least partially around the body cavity, the passage being located in the peripheral wall portion.

[0160] Optionally, the passageway comprises a plurality of apertures in an outer wall of the body in fluid communication with the body chamber and ambient air external to the valve body.

[0161] Another embodiment of an active exhalation valve for use with a patient connection and a ventilator having a pressure source that can be used to control the operation of the valve includes a valve body having an internal body chamber, a body wall portion, and an aperture, wherein gas in the internal body chamber has an internal chamber pressure, a passage in the body wall portion in fluid communication with the pressure source, and the aperture in fluid communication with the passage; a first body port in fluid communication with the body chamber and configured to be in fluid communication with the patient connection; a second body port in fluid communication with the body chamber and configured to be in fluid communication with the ventilator; a passage in fluid communication with ambient air external to the body chamber and the valve body; and a valve seal movable between a closed position for sealing the passage and an open position for opening the passage. The valve seal comprises a longitudinally extending and longitudinally compressible outer wall, a longitudinally extending and longitudinally compressible inner wall located within the outer wall, each of the outer wall and the inner wall having a first end and a second end; a seal end wall capable of closing a space between the first end of the outer wall and the first end of the inner wall and capable of longitudinally moving relative to the first end of the outer wall and the first end of the inner wall; the main body wall portion capable of closing a space between the second end of the outer wall and the second end of the inner wall; and an internal seal chamber located between the outer wall and the inner wall and extending between the seal end wall and the main body wall portion. An aperture in the main body wall portion is in fluid communication with the seal chamber to provide fluid communication with a pressure source. The seal end wall is longitudinally movable within the valve body between a closed position and an open position, wherein the outer wall and the inner wall are in an extended configuration in the closed position and the outer wall and the inner wall are compressed in an at least partially compressible position in the open position. The seal end wall has a first surface portion located inside the seal chamber, which is configured to move the valve seal toward a closed position in response to pressure applied thereto by a pressure source, and a second surface portion located outside the seal chamber, which is configured to move the valve seal toward an open position in response to pressure applied thereto by the body chamber pressure, the movement amount and direction of the valve seal corresponding to the resultant force generated by the pressure source and the body chamber pressure on the first surface portion and the second surface portion of the seal end wall.

[0162] Optionally, the inner wall has an inner wall fluid passage extending therethrough, the inner wall fluid passage being in fluid communication with the body chamber and having a first end in fluid communication with the first body port and a second end in fluid communication with the second body port.

[0163] Optionally, the inner wall fluid passage is in continuous communication with the first body port and the second body port during operation of the exhalation valve and is disconnected from the sealed chamber between the inner wall and the outer wall.

[0164] Optionally, the inner wall has an inner wall fluid passage extending therethrough, the inner wall fluid passage having a first opening in continuous fluid communication with the first body port and a second opening in continuous fluid communication with the second body port.

[0165] Optionally, the longitudinally compressible outer and inner walls are corrugated, having a plurality of corrugations, and more than one corrugation is longitudinally compressed when in the at least partially longitudinally compressible position.

[0166] A final embodiment provides an active exhalation valve for use with a patient connection and a ventilator having a pressure source that can be used to control the operation of the valve. The active exhalation valve includes a valve body having an internal body chamber, a passage in fluid communication with the pressure source, and an aperture in fluid communication with the passage, wherein gas in the internal body chamber has body chamber pressure; a first body port in fluid communication with the body chamber and configured to communicate with the patient connection; a second body port in fluid communication with the body chamber and configured to communicate with the ventilator; a passage in fluid communication with ambient air external to the body chamber and the valve body; and a valve seal movable between a closed position for sealing the passage and an open position for opening the passage. The valve seal has a seal chamber defined by first and second longitudinally spaced ends, a longitudinally extendable outer wall, and a longitudinally extendable inner wall located within the outer wall. The aperture in the valve body communicates with the seal chamber to provide fluid communication with the pressure source. The first end of the seal chamber is longitudinally movable within the valve body and between a closed position of the valve body seal, wherein the outer wall and the inner wall are in a longitudinally extended configuration, and an open position of the valve body seal, wherein the outer wall and the inner wall are in a longitudinally retracted configuration. The valve seal is moved toward the closed position in response to pressure applied by a pressure source and toward the open position in response to pressure applied by the main body chamber pressure, with the amount and direction of movement of the valve seal corresponding to the combined force generated by the pressure source and the main body chamber pressure.

[0167] Optionally, the inner wall has an inner wall fluid passage extending therethrough, the inner wall fluid passage being in fluid communication with the body chamber and having a first end in fluid communication with the first body port and a second end in fluid communication with the second body port.

[0168] Optionally, the inner wall fluid passage is in continuous communication with the first body port and the second body port during operation of the exhalation valve and is disconnected from the sealed chamber between the inner wall and the outer wall.

[0169] Optionally, the inner wall has an inner wall fluid passage extending therethrough, the inner wall fluid passage having a first opening in continuous fluid communication with the first body port and a second opening in continuous fluid communication with the second body port. BRIEF DESCRIPTION OF THE DRAWINGS

[0170] Figure 1 is a block diagram illustrating an exemplary system including a ventilator for a human patient.

[0171] Figure 2A is with Figure 1 Illustration of a first embodiment of a passive patient circuit for use with a ventilator.

[0172] Figure 2B is with Figure 1 A cross-sectional view of a second embodiment of a passive patient circuit for use with a ventilator.

[0173] Figure 2C Shown in closed configuration Figure 2B An enlarged cross-sectional view of the valve assembly of the passive patient circuit.

[0174] Figure 2D Shown in open configuration Figure 2B An enlarged cross-sectional view of the valve assembly of the passive patient circuit.

[0175] Figure 2E yes Figure 2B Exploded view of the valve assembly of the passive patient circuit.

[0176] Figure 2F yes Figure 2A An illustration of an alternative embodiment to the first embodiment of a passive patient circuit is shown, in which the leak valve is incorporated into the patient connection.

[0177] Figure 3A is with Figure 1 A cross-sectional view of an embodiment of an active patient circuit for use with a ventilator.

[0178] Figure 3B yes Figure 3A Exploded view of the multi-lumen tubing assembly of the active patient circuit.

[0179] Figure 3C yes Figure 3A Exploded view of the active exhalation valve assembly of the active patient circuit.

[0180] Figure 3D yes Figure 3C An enlarged perspective view of the dual bellows component of the active exhalation valve assembly.

[0181] Figure 3E yes Figure 3A An enlarged cross-sectional view of the active patient circuit is shown showing the dual bellows member of the active exhalation valve assembly in the closed position.

[0182] Figure 3F yes Figure 3AA first enlarged cross-sectional view of the active patient circuit is shown showing the dual bellows member of the active exhalation valve assembly in the open position.

[0183] Figure 3G yes Figure 3A A second enlarged cross-sectional view of the active patient circuit is shown showing the dual bellows member of the active exhalation valve assembly in the open position.

[0184] Figure 4 It shows Figure 1 A block diagram of some exemplary components of a ventilator.

[0185] Figure 5A It shows Figure 1 Schematic diagram of some exemplary components of a ventilator assembly of a ventilator with a cough assistance valve of the ventilator assembly shown in a first configuration.

[0186] Figure 5B is a schematic diagram showing the cough assistance valve of the ventilator assembly in a second configuration.

[0187] Figure 5C is a diagram showing the cough assistance valve in a first configuration Figure 5A Enlarged portion of the schematic diagram.

[0188] Figure 5D is a diagram showing the cough assistance valve in a second configuration Figure 5B Enlarged portion of the schematic diagram.

[0189] Figure 5E is a block diagram illustrating example components of a control system for a ventilator, control signals sent by the control system to example components of the ventilator assembly, and data signals received by the control system from example components of the ventilator assembly.

[0190] Figure 6 It shows Figure 1 A block diagram of some exemplary components of a ventilator user interface.

[0191] Figure 7A It shows Figure 1 A schematic diagram of some exemplary components of an oxygen assembly of a ventilator.

[0192] Figure 7B is a block diagram illustrating example control signals sent by a control system to example components of an oxygen assembly, and data signals received by the control system from example components of an oxygen assembly.

[0193] Figure 8A is a block diagram illustrating the adsorption beds of an oxygen assembly during the first stage of a vacuum pressure swing adsorption ("VPSA") process.

[0194] Figure 8B is a block diagram illustrating the adsorption beds of the oxygen assembly during the second stage of the VPSA process.

[0195] Figure 8C is a block diagram illustrating the adsorption beds of the oxygen assembly during the third stage of the VPSA process.

[0196] Figure 8D is a block diagram illustrating the adsorption beds of the oxygen assembly during the fourth stage of the VPSA process.

[0197] Figure 9 is an illustration of the metering valve of the oxygen assembly.

[0198] Figure 10A is a perspective view of a first side of a first rotary valve assembly of an oxygen assembly.

[0199] Figure 10B is a perspective view of a second side of the first rotary valve assembly.

[0200] Figure 10C is a perspective view of a first side of the first rotary valve assembly including the shaft of the motor assembly and omitting other portions of the motor assembly.

[0201] Figure 10D is a perspective view of a second side of the first rotary valve assembly with the housing and printed circuit board removed.

[0202] Figure 10E is an exploded perspective view of one of the four poppet valves of the first rotary valve assembly shown with the end cap and fasteners.

[0203] Figure 10F is a cross-sectional view of the first rotary valve assembly with the second poppet valve and the fourth poppet valve opened.

[0204] Figure 10G is a cross-sectional view of the first rotary valve assembly with the first poppet valve and the third poppet valve opened.

[0205] Figure 11 is a graph showing the pressures and feed flows experienced by a bed of nitrogen adsorbent material of an oxygen generator during the four stages of a VPSA process.

[0206] Figure 12 is Figure 1 A flow chart of a method performed by a control system of a ventilator.

[0207] Figure 13A is an illustration of an alternative second rotary valve assembly of an oxygen assembly showing a first poppet valve of four poppet valves in the second rotary valve assembly in an open state.

[0208] Figure 13Bis an illustration of an optional second rotary valve assembly of an oxygen assembly showing a second poppet valve of four poppet valves in the second rotary valve assembly in an open state.

[0209] Figure 13C is an illustration of an alternative second rotary valve assembly of an oxygen assembly showing a third poppet valve of four poppet valves in the second rotary valve assembly in an open state.

[0210] Figure 13D is an illustration of an alternative second rotary valve assembly of an oxygen assembly showing a fourth of four poppet valves in the second rotary valve assembly in an open state.

[0211] 14A is a graph illustrating patient airway flow using a prior art ventilator during inspiration and exhaust phases.

[0212] 14B is a graph showing patient airway pressure during inspiration and exhaust phases using a prior art ventilator.

[0213] Figure 15A is shown for use during the inspiration and exhaust phases Figure 1 Diagram of airway flow in a patient on a ventilator.

[0214] Figure 15B is shown for use during the inspiration and exhaust phases Figure 1 A graph of airway pressure in a patient on a ventilator.

[0215] Figure 16 is shown with Figure 1 Block diagram of an exemplary suction assembly for use with a ventilator.

[0216] Figure 17A is a perspective view of a cough assistance valve of a ventilator assembly showing the inlet side of the cough assistance valve.

[0217] Figure 17B is a perspective view of the cough assistance valve showing the exhaust outlet side of the cough assistance valve.

[0218] Figure 18A is a cross-sectional view of the cough assistance valve in a first configuration used for normal breathing and during the inspiratory phase of a cough.

[0219] Figure 18B is a cross-sectional view of the cough assistance valve in a second configuration being used during the exhalation phase of a cough.

[0220] Figure 19A is an exploded perspective view of the end cap assembly of the cough assist valve.

[0221] Figure 19B yes Figure 19AAn enlarged perspective view of a second side of the seat member of the end cap assembly.

[0222] Figure 19C yes Figure 19A An enlarged perspective view of a first side of the seat member of the end cap assembly.

[0223] Figure 20 is a perspective view of a subassembly of a cough assist valve including a moving coil actuator, a shaft, and a pair of poppet valve assemblies.

[0224] Figure 21 is an exploded perspective view of a poppet valve assembly of a cough assist valve.

[0225] Figure 22 is an exploded perspective view of a subassembly of a cough assistance valve including a shaft, a guide member, and a retaining ring.

[0226] Figure 23A is a perspective view of the intake side of the cough assist valve with the end cap assembly and poppet assembly omitted.

[0227] Figure 23B It is a perspective view of the exhaust outlet side of the cough assistance valve with the end cover assembly omitted.

[0228] Figure 24A is a perspective view of a first side of an air intake body portion of a housing of a cough assistance valve.

[0229] Figure 24B is a perspective view of a second side of the air intake body portion of the housing of the cough assistance valve.

[0230] Figure 25 is a perspective view of the exhaust body portion of the housing of the cough assistance valve.

[0231] Figure 26 is a pair of graphs, the top graph showing airway pressure during the inspiration and expiration phases of a cough-assisted maneuver performed using a ventilator, and the bottom graph showing airway flow rate during the inspiration and expiration phases of a cough-assisted maneuver performed using a ventilator.

[0232] Figure 27 is a side view of the secretion collector.

[0233] Figure 28 is connected to the patient connection and patient circuit connection Figure 27 Side view of the secretion collector.

[0234] Figure 29 Including drainage channel Figure 28 Side view of an embodiment of a secretion collector.

[0235] Figure 30 is with Figure 2BExploded view of an alternative embodiment of a valve assembly for use with a passive patient circuit.

[0236] Figure 31A Shown in closed configuration Figure 30 An enlarged longitudinal cross-sectional view of a valve assembly.

[0237] Figure 31B Shown in open configuration Figure 30 An enlarged longitudinal cross-sectional view of a valve assembly.

[0238] Figure 31C yes Figure 31A The valve assembly from Figure 31A The position shown is an enlarged longitudinal cross-section rotated approximately 45° about its longitudinal axis.

[0239] Figure 32 yes Figure 30 A perspective view of a first valve housing of a valve assembly.

[0240] Figure 33 yes Figure 30 A perspective view of the second valve housing of the valve assembly.

[0241] Figure 34A is with Figure 5A A longitudinal cross-sectional view of an alternative embodiment of a cough assistance valve for use with a ventilator assembly, showing it in a first configuration being used for normal breathing and during the inspiratory phase of a cough.

[0242] Figure 34B yes Figure 34A A longitudinal cross-sectional view of a cough assistance valve showing it in a second configuration being used during the exhalation phase of a cough.

[0243] Figure 35 yes Figure 34A An exploded perspective view of the end cap assembly of the cough assist valve.

[0244] Figure 36 yes Figure 34A A perspective view of the cough-assist valve subassembly, which includes the actuator, shaft, and a pair of movable magnet subassemblies of the poppet valve assembly.

[0245] Figure 37 yes Figure 34A A perspective view of the air intake body portion of the cough assistance valve housing.

[0246] Figure 38 yes Figure 34A A perspective view of the exhaust body portion of the cough assistance valve housing.

[0247] The same reference numerals have been used in the drawings to identify the same components. DETAILED DESCRIPTION

[0248] Figure 1 1 is a block diagram illustrating an exemplary system 10, which includes a ventilator 100 with integrated cough assistance for use with a patient 102. The ventilator 100 can be configured to provide conventional volume-controlled and pressure-controlled ventilation. The ventilator 100 has an optional multi-lumen tubing connector 103, a primary ventilator connector 104, and a patient oxygen outlet 105. The patient 102 has a patient connector 106 (e.g., an endotracheal tube, a nasal mask, a mouthpiece, and the like) that is connectable to the primary ventilator connector 104 and / or the patient oxygen outlet 105 via a patient circuit 110.

[0249] As described below, the patient circuit 110 can be implemented as an active patient circuit or a passive patient circuit. Optionally, when the patient circuit 110 is implemented as an active patient circuit, the patient circuit 110 can include one or more ports 111 configured to be connectable to the optional multi-lumen tubing connector 103. The ports 111 allow one or more pressure signals 109 to flow between the optional multi-lumen tubing connector 103 and the patient circuit 110. It will be apparent to one of ordinary skill in the art that the pressure signal can be characterized as a gas obtained from a fluid (and / or gas) source for measuring pressure. The obtained gas has the same pressure as the fluid (and / or gas) source.

[0250] The primary ventilator connection 104 is configured to provide gas 112, including room air 114, optionally mixed with oxygen. Although referred to as "room air," one of ordinary skill in the art will recognize that room air 114 may include air obtained from any source external to the ventilator 100. Gas 112 may be used as inspiration gas (during the inspiration phase of breathing) or as insufflation gas during the insufflation phase of a cough. The primary ventilator connection 104 is configured to receive gas 113, which may include exhaust gas exhaled by the patient 102 during the exsufflation phase of a cough.

[0251] Air 114 is received by the ventilator 100 through a patient inlet 116. Oxygen, optionally mixed with the air 114, may be generated internally by the ventilator 100 and / or received from an optional low-pressure oxygen source 118 (e.g., an oxygen concentrator) and / or an optional high-pressure oxygen source 120. When the oxygen is generated internally, the ventilator 100 exhausts waste gases (e.g., nitrogen-enriched gas 122) through an outlet exhaust port 124. Optionally, the ventilator 100 may include a low-pressure oxygen inlet 126 configured to couple to the optional low-pressure oxygen source 118 and receive optional low-pressure oxygen 128 therefrom. The ventilator 100 may include an optional high-pressure oxygen inlet 130 configured to couple to the optional high-pressure oxygen source 120 and receive optional high-pressure oxygen 132 therefrom.

[0252] Patient oxygen outlet 105 is configured to provide a dose or pulse of oxygen 140 synchronized with the patient's breathing to patient connection 106 (via patient circuit 110). Unlike gas 112 provided by primary ventilator connection 104, the pulse of oxygen 140 does not include air 114.

[0253] The gas 112 and / or pulse of oxygen 140 delivered to the patient circuit 110, thereby being delivered as inspiration or insufflation gas 108, is delivered to the patient connector 106, which at least partially delivers these gases to the patient's lungs 142. Whenever the patient exhales during the expiratory phase of breathing or the exhalation phase of a cough, exhaled gas 107 enters the patient circuit 110 through the patient connector 106. Thus, the patient circuit 110 may contain one or more of the following gases: gas 112 provided by the ventilator 100, pulses of oxygen 140, and exhaled gas 107. For ease of description, the gas within the patient circuit 110 will be referred to as "patient gas" in the following sections.

[0254] Optionally, the ventilator 100 includes a suction connection 150 configured to couple to an optional suction assembly 152. The ventilator 100 can provide suction 154 to the optional suction assembly 152 via the optional suction connection 150. The suction assembly 152 can be configured to connect to the patient connection 106, the suction conduit 812 located within the patient connection 106 (see FIG. Figure 16 ), and / or drainage channel 1280 (see Figure 29 ).

[0255] refer to Figure 1 Optionally, the ventilator 100 includes a nebulizer connector 160 configured to couple to an optional nebulizer assembly 162. The ventilator 100 provides a gas 164 (e.g., air 114) to the optional nebulizer assembly 162 via the optional nebulizer connector 160. The optional nebulizer assembly 162 can be configured to connect to the patient circuit 110. However, this is not required.

[0256] Optionally, the ventilator 100 may include an outlet port 166 through which exhaust gas 167 may exit the ventilator 100 .

[0257] The ventilator 100 may be configured to be portable and powered by an internal battery (not shown) and / or an external power source (not shown), such as a conventional wall outlet.

[0258] Passive patient circuit

[0259] Figure 2Ais a diagram of a first embodiment of a passive patient circuit 170 that can be used to implement the patient circuit 110. Figure 2A , the passive patient circuit 170 has a first end 172 opposite a second end 174. The first end 172 is configured to connect or couple (e.g., directly or using a hose, flow line, tubing, or tube) to the main ventilator connector 104. The second end 174 is configured to connect or couple to the patient connector 106 (e.g., directly or using a hose, flow line, tubing, or tube). Optionally, a secretion collector 1250 (described below in conjunction with Figures 27-29 The passive patient circuit 170 transfers the gas 112 to the patient.

[0260] Air 114 (including air optionally mixed with oxygen) is directed from the primary ventilator connection 104 into the patient connection 106

[0261] (Optionally by Figures 27-29 Secretion collector 1250 shown).

[0262] In the illustrated embodiment, the passive patient circuit 170 includes an optional bacterial filter 176, a leak valve 177, and a flexible tubing segment 178. The optional bacterial filter 176 can be positioned between the first end 172 and the flexible tubing segment 178. The gas 112 can flow through the optional bacterial filter 176 and to the patient connector 106. When present, the bacterial filter 176 helps prevent bacteria (e.g., received from the patient connector 106) from entering the ventilator 100 (via the primary ventilator connector 104).

[0263] A leak valve 177 is coupled to the flexible tubing segment 178 near the second end 174. The leak valve 177 is configured to allow gas to flow out of the passive patient circuit 170 and into the environment outside of the passive patient circuit 170. The leak valve 177 can be implemented as a conventional fixed leak valve that is configured to allow up to a threshold pressure within the passive patient circuit 170 during inspiration and expiration phases.

[0264] The leak valve 177 can be implemented as a positive pressure valve that allows a portion of the patient gas to flow out of the passive patient circuit 170 and into the environment outside the passive patient circuit 170 whenever the pressure within the passive patient circuit 170 exceeds a threshold amount (e.g., ambient pressure). The leak valve 177 includes a flexible member or flap that covers and seals the outlet opening 180 when the pressure within the passive patient circuit 170 is below the threshold amount. Thus, when the pressure within the passive patient circuit 170 is below the threshold amount, the leak valve 177 is closed.

[0265] On the other hand, when the pressure within the passive patient circuit 170 exceeds a threshold amount (e.g., ambient pressure), the flapper 179 is configured to push outward and away from the outlet opening 180. Thus, when the pressure within the passive patient circuit 170 is above the threshold amount, the leak valve 177 opens. During normal breathing, the leak valve 177 is open during both the inspiration and expiration phases. This means that a portion of the patient gas within the passive patient circuit 170 flows out of the passive patient circuit 170 through the outlet opening 180 during both the inspiration and expiration phases and into the environment outside of the passive patient circuit 170. On the other hand, as described below, during the exhalation phase of a cough, the leak valve 177 closes. This prevents the patient gas within the passive patient circuit 170 from flowing out of the passive patient circuit 170 through the outlet opening 180. It also prevents air from entering the passive patient circuit 170 through the outlet opening 180.

[0266] Figure 2F yes Figure 2A 1 is an illustration of an alternative embodiment to the first embodiment of a passive patient circuit 170 in which the leak valve is incorporated into the patient connector 106 and connected or coupled thereto to the second end 174 of the flexible tubing segment 178. Alternatively, the leak valve 177 can be configured as a separate portion connected or coupled to the second end 174 of the flexible tubing segment 178 and the patient connector 106.

[0267] Figure 2B FIG2 is an illustration of a second embodiment of a passive patient circuit 440 that can be used to implement the patient circuit 110. The passive patient circuit 440 includes a connector 442, a flexible tubing segment 444, an open oxygen pulse delivery tube 446, and a valve assembly 448. The flexible tubing segment 444 can be implemented using conventional corrugated or inflatable respiratory hose or tubing (e.g., circuit tubing). The flexible tubing segment 444 has a first end 450 opposite a second end 451. The first end 450 is configured to connect or couple to the connector 442. The second end 451 is configured to connect or couple to the valve assembly 448.

[0268] The connector 442 has a generally tubular connector housing 452 having a first end 454 configured to connect to the primary ventilator connector 104 (e.g., directly or using a hose, flow line, pipe, or tube) and receive gas 112 (including air 114 optionally mixed with oxygen) from the primary ventilator connector 104. Optionally, a bacterial filter 176 (see Figure 2A ) may be placed between the connector 442 and the primary ventilator connector 104. In such an embodiment, the gas 112 flows to the connector 442 on its way through the bacterial filter 176. The bacterial filter 176 helps prevent bacteria (e.g., received from the patient connector 106) from entering the ventilator 100 (through the primary ventilator connector 104).

[0269] The connector housing 452 has a second end 456 configured to couple to the first end 450 of the flexible tubing segment 444 and provide the gas 112 received through the first end 454 to the flexible tubing segment 444. The flexible tubing segment 444 directs the gas 112 to the valve assembly 448.

[0270] The connector 442 includes a hollow tube segment 458 extending outwardly from the connector housing 452. In the illustrated embodiment, the tube segment 458 is substantially transverse to the connector housing 452. However, this is not required. The tube segment 458 has an open free end 459 that is configured to connect to the patient oxygen outlet 105 (e.g., directly or using a hose, flow line, pipe, or tube) and receive a pulse of oxygen 140 therefrom. Inside the connector housing 452, the tube segment 458 is connected to the oxygen pulse delivery tube 446 and provides the pulse of oxygen 140 thereto. In the illustrated embodiment, the tube segment 458 is connected to or includes a branch tube 460 that extends longitudinally within the connector housing 452. The branch tube 460 has an open free end 462 that is configured to couple to the oxygen pulse delivery tube 446 and provide the pulse of oxygen 140 thereto. Although the tube segment 458 extends into the connector housing 452, the tube segment 458 only partially obstructs the flow of the gas 112 through the connector housing 452. In other words, the gas 112 passes through or along the tube segment 458 or the branch tube 460, if present.

[0271] In the illustrated embodiment, oxygen pulse delivery tube 446 extends through flexible tubing segment 444 and at least partially into valve assembly 448. Thus, oxygen pulse delivery tube 446, along a substantial portion of passive patient circuit 440, isolates pulses of oxygen 140 from the gas in flexible tubing segment 444. Oxygen pulse delivery tube 446 has a first end 464 configured to couple to branch tube 460. Oxygen pulse delivery tube 446 has a second end 465 that terminates at or near patient connector 106. As a non-limiting example, second end 465 may terminate within approximately two centimeters of patient connector 106. Oxygen pulse delivery tube 446 directs pulses of oxygen 140 from branch tube 460 to patient connector 106. Simultaneously, passive patient circuit 440 directs gas 112 (including air 114, optionally mixed with oxygen) from primary ventilator connector 104 to patient connector 106.

[0272] In alternative embodiments, the oxygen pulse delivery tube 446 can be connected to the patient oxygen outlet 105 (e.g., directly or using a hose, flow line, pipe, or tube) to receive the pulse of oxygen 140 from the patient oxygen outlet 105. In such embodiments, the oxygen pulse delivery tube 446 can extend along the exterior of the flexible tubing segment 444. The second end 465 of the oxygen pulse delivery tube 446 can be connected to a portion of the passive patient circuit 440 at or near the patient connection 106 to provide the pulse of oxygen 140 from the branch tube 460 to the patient connection 106.

[0273] Figures 2C-2E Exemplary components of the valve assembly 448 are shown. In the illustrated embodiment, the valve assembly 448 includes a first valve housing 468, a second valve housing 469, and a flexible annular blade 470.

[0274] The first valve housing 468 is configured to couple to the patient connector 106 (see Figure 2A ). Optionally, secretion collector 1250 (see Figure 27 and 28 ) can be coupled between the first valve housing 468 and the patient connector 106. The second valve housing 469 is configured to be coupled to the second end 451 of the flexible tubing segment 444. The first valve housing 468 and the second valve housing 469 are configured to be coupled together with an annular blade 470 positioned therebetween. A peripheral portion 473 of the blade 470 is positioned within an annular chamber 474 defined by the first valve housing 468 and the second valve housing 469. One or more openings 476 are formed in the second valve housing 469 and connect the chamber 474 to the environment outside the passive patient circuit 440 (see Figure 2B ). In addition, one or more openings 478 are formed in the second valve housing 469 and connect the passive patient circuit 440 (see Figure 2B ) is connected to chamber 474.

[0275] Similar to baffle 179 (see Figure 2A ), the peripheral portion 473 of the blade 470 is configured to be a passive patient circuit 440 (see Figure 2B ) when the internal pressure exceeds a threshold amount (e.g., ambient pressure), the Figure 2C ) to the open position (see Figure 2D ). When the peripheral portion 473 of the blade 470 is in Figure 2C In the closed position shown, the vanes 470 block one or more openings 478 and isolate the chamber 474 from the environment within the passive patient circuit 440 (see FIG. Figure 2B ). On the other hand, when the peripheral portion 473 of the blade 470 is in Figure 2DIn the open position shown, the vanes 470 no longer block the one or more openings 478 and allow the chamber 474 to communicate with patient gases both inside and outside the passive patient circuit 440 (see FIG. Figure 2B Thus, gas may exit the passive patient circuit 440 through opening 478, chamber 474, and opening 476 (see FIG. Figure 2B ) inside.

[0276] During the inspiratory phase, the ventilator 100 regulates the pressure within the passive patient circuit 440 to achieve a preset inspiratory pressure that places or maintains the peripheral portion 473 of the blades 470 in the open position while the peripheral portion 473 of the blades places the opening 478 in the closed condition. Some patient gas flows to the patient 102 (see FIG. Figure 1 ), and some patient gas flows out through opening 476.

[0277] During the exhalation phase, the ventilator 100 regulates the pressure within the passive patient circuit 440 to achieve a baseline or positive end-expiratory pressure ("PEEP"), which places or maintains the peripheral portion 473 of the blades 470 in the open position. Figure 1 ) flows out through opening 476, and some of the exhaled gas 107 flows into the passive patient circuit 440 (e.g., into the flexible tubing segment 444).

[0278] Breathing may pause between the end of the expiratory phase and the beginning of the inspiratory phase. This pause can be characterized as dead time occurring between the two phases. During the pause, the ventilator 100 adjusts the pressure within the passive patient circuit 440 to PEEP, which can place or maintain the peripheral portion 473 of the blades 470 in the open position and allow gas 112 from the ventilator 100 to flow through the opening 476 and out of the passive patient circuit 440. In addition, during this period, at least a portion of the exhaled gas 107 that flowed into the passive patient circuit 440 during the expiratory phase is "scavenged" out of the opening 476 by the forward-moving gas 112 from the ventilator 100.

[0279] As described below, during the expulsion phase of a cough, the passive patient circuit 440 (see Figure 2B ) is less than a threshold amount (e.g., ambient pressure). This causes the peripheral portion 473 of the blade 470 to be in a closed position, which blocks the opening 478, thereby preventing patient gas within the passive patient circuit 440 from flowing out of the passive patient circuit 440 through the opening 476. It also prevents air from entering the passive patient circuit 440 through the opening 476.

[0280] The combined area of ​​openings 476 can be characterized as providing a fixed orifice. Thus, valve assembly 448 can be characterized as a one-way valve with a fixed orifice. If the combined area of ​​openings 476 is too large, most of the inspiratory airflow will leak out through openings 476, leaving little for patient 102. Conversely, if the combined area of ​​openings 476 is too small, exhaled gas 107 may not be completely cleared from passive patient circuit 440 during the expiratory phase and between the pauses, which are between the inspiratory and expiratory phases. As a non-limiting example, when the pressure within passive patient circuit 440 is approximately 10 centimeters of water ("cmH2O"), valve assembly 448 can be configured to leak approximately 20-50 liters per minute ("LPM").

[0281] Figure 30 is an exploded view of an alternative embodiment of a valve assembly 1448 that may be used with a passive patient circuit 440 (see FIG. Figure 2B ) instead of the valve assembly 448. In such an embodiment, the flexible pipe section 444 (see Figure 2B ) Gas 112 (see Figure 2B ) is directed to valve assembly 1448, oxygen pulse delivery tube 446 may extend through flexible tubing section 444 (see Figure 2B ) and extends at least partially into valve assembly 1448.

[0282] In the illustrated embodiment, the valve assembly 1448 includes a first valve housing 1468, a second valve housing 1469, and a flexible annular blade 1470. Figures 31A-31C As shown, the first valve housing 1468 and the second valve housing 1469 are configured to be coupled with an annular vane 1470 located therebetween.

[0283] refer to Figure 32 In the illustrated embodiment, the first valve housing 1468 has a first end 1480 opposite a second end 1482. An open end of a passage 1484 extends through the first valve housing 1468 between the first end 1480 and the second end 1482. The first end 1480 is configured to couple to the patient connector 106 (see FIG. Figure 2B ). Optionally, secretion collector 1250 (see Figures 27-29 ) can be coupled between the first end 1480 of the first valve housing 1468 and the patient connector 106 (see Figure 2B ).

[0284] The second end portion 1482 is configured to be coupled to the second valve housing 1469 (see Figure 30-31Cand 33). The second end portion 1482 includes an annular longitudinally extending inner wall 1486 disposed along and defining a portion of the passage 1484. The second end portion 1482 includes a first wall portion 1488 extending radially outward from the inner wall 1486 and terminating in an annular longitudinally extending outer wall 1489. The outer wall 1489 is coaxial with and spaced apart from the inner wall 1486 by the first wall portion 1488. The distal edge portion 1487 of the inner wall 1486 is configured to abut against the blade 1470 (see FIG. Figure 30-31C ) and presses the blade 1470 against the second valve housing 1469 (see Figure 30-31C and 33) for forming an annular seal between the first valve housing 1468 and the second valve housing 1469 and along a distal edge portion 1487 of the annular inner wall 1486. ​​Near where the outer wall 1489 terminates the first wall portion 1488, the outer wall 1489 has an annular groove 1490 formed along its inner surface that is open toward the inner wall 1486. ​​The outer wall 1489 has a longitudinally extending cutout or keyway 1491 formed therein.

[0285] refer to Figure 33 In the illustrated embodiment, the second valve housing 1469 has a first end 1420 opposite a second end 1422. An open end of the through passage 1424 extends through the second valve housing 1469 between the first end 1420 and the second end 1422. The second end 1422 of the second valve housing 1469 is configured to couple to the flexible tubing segment 444 (see FIG. Figure 2B ) of the second end portion 451 (see Figure 2B ).

[0286] The first end portion 1420 is configured to be coupled to a first valve housing 1468 (see Figure 30-32 ). The first end portion 1420 of the second valve housing 1469 includes a radially outwardly extending second wall portion 1428 having a distal portion 1429. A plurality of tabs 1430A-1430D are positioned along the distal portion 1429 of the second wall portion 1428. The tabs 1430A-1430D are configured to be received in a plurality of slots formed in the first valve housing 1468 (see FIG. Figure 30-32 ) of the outer wall 1489 (see Figure 32 ) in the annular groove 1490 (see Figure 32 ). The engagement between the tabs 1430A-1430D and the groove 1490 couples the first valve housing 1468 to the second valve housing 1469. The tab 1430D includes a portion configured to be received in a groove formed in the first valve housing 1468 (see FIG. Figure 30-32 ) of the outer wall 1489 (see Figure 32 ) Middle keyway 1491 (see Figure 32) in the key member 1432. When the first valve housing 1468 and the second valve housing 1469 are coupled together, the key member 1432 is received in the keyway 1491 to prevent the first valve housing 1468 from rotating relative to the second valve housing 1469.

[0287] The second valve housing 1469 includes a plurality of blade locating projections 1434A-1434D configured to be received within a plurality of blade locating projections 1434A-1434D formed on the blade 1470 (see FIG. Figure 30-31B ) in the center through hole 1436 (see Figure 30 ). Reference Figure 31C The blade positioning protrusions 1434A-1434D help position the blade 1470 relative to the first valve housing 1468 and the second valve housing 1469. When the first valve housing 1468 and the second valve housing 1469 are coupled together, the blade positioning protrusions 1434A-1434D are located along the inner wall 1486 (see FIG. Figure 32 ) extends to channel 1484 (see Figure 32 )middle.

[0288] refer to Figures 31A-31C , the peripheral portion 1473 of the blade 1470 is positioned within the annular chamber 1474 defined by the first valve housing 1468 and the second valve housing 1469. Figure 31A and 31B In the illustrated embodiment, the chamber 1474 is defined by an inner wall 1486 , a first wall portion 1488 , an outer wall 1489 , and a second wall portion 1428 .

[0289] One or more openings 1476 are defined between the first valve housing 1468 and the second valve housing 1469. In the illustrated embodiment, the second wall portion 1428 extends only partially toward the outer wall 1489 of the first valve housing 1468. However, as Figure 31C As shown, the distal end portion 1429 (see FIG. Figure 33 ) on tabs 1430A-1430D

[0290] (See Figure 33 ), contacting the outer wall 1489 of the first valve housing 1468. Therefore, referring to Figure 31A and 31B , the opening 1476 is defined in the distal portion 1429 of the second wall portion 1428 (see Figure 33 ) and the outer wall 1489 of the first valve housing 1468 and is positioned between the tabs 1430A-1430D (see Figure 33 ).

[0291] One or more openings 1476 connect the chamber 1474 to the environment outside the passive patient circuit 440 (see Figure 2B). Additionally, one or more openings 1478 are formed in the second valve housing 1469 and connect the passive patient circuit 440 (see Figure 2B ) is connected to the patient gas in chamber 1474. Figure 33 , one or more openings 1478 are positioned between the distal portion 1429 of the second wall portion 1428 and the blade locating protrusions 1434A- 1434D.

[0292] refer to Figures 31A-31C , flexible annular blade 1470 is substantially similar to flexible annular blade 470 (see Figures 2C-2E ). The peripheral portion 1473 of the blade 1470 is configured to be used as a passive patient circuit 440 (see Figure 2B ) when the internal pressure exceeds a threshold amount (e.g., ambient pressure), the Figure 31A and 31C ) to the open position (see Figure 31B ) turns or deflects. When the peripheral portion 1473 of the blade 1470 is in such a Figure 31A and 31C In the closed position shown, the vanes 1470 block one or more openings 1478 from entering the chamber 1474, thereby isolating the chamber 1474 from the environment within the passive patient circuit 440 (see FIG. Figure 2B ). On the other hand, when the peripheral portion 1473 of the blade 1470 is in the Figure 31B In the open position shown, the vane 1470 no longer blocks the one or more openings 1478 and allows the chamber 1474 to communicate with the patient gas within the passive patient circuit 440 (see FIG. Figure 2B ). Thus, gas may exit the passive patient circuit 440 through opening 1478, chamber 1474, and opening 1476 (see Figure 2B ) inside.

[0293] As described above, during the inspiratory phase, the ventilator 100 regulates the pressure within the passive patient circuit 440 to achieve a preset inspiratory pressure, which places or maintains the peripheral portion 1473 of the blades 1470 in the open position (see FIG. Figure 31B ). Some patient gas flows to patient 102 (see Figure 1 ), and some patient gas flows out through opening 1476.

[0294] During the expiratory phase, the ventilator 100 regulates the pressure within the passive patient circuit 440 to achieve a baseline or positive end-expiratory pressure ("PEEP"), which places or maintains the peripheral portion 1473 of the blades 1470 in the open position (see FIG. Figure 31B ). Some exhaled gas 107 from patient 102 (see Figure 1) flows out through opening 1476, and some of the exhaled gas 107 flows into the passive patient circuit 440 (e.g., into the flexible tubing segment 444).

[0295] During the pause between the end of the expiratory phase and the beginning of the inspiratory phase, the ventilator 100 adjusts the pressure within the passive patient circuit 440 to PEEP, which places or maintains the peripheral portion 1473 of the blades 1470 in the open position (see FIG. Figure 31B ), and causes gas 112 from the ventilator 100 to flow out of the passive patient circuit 440 through openings 1476. Additionally, during this time, at least a portion of the exhaled gas 107 that flows into the passive patient circuit 440 during the exhalation phase is "scavenged" through openings 1476 by the forward movement of gas 112 from the ventilator 100.

[0296] The combined area of ​​openings 1476 can be characterized as providing a fixed orifice. Thus, valve assembly 1448 can be characterized as a one-way valve with a fixed orifice. If the combined area of ​​openings 1476 is too large, most of the inspiratory airflow will leak out through openings 1476, leaving little for patient 102. Conversely, if the combined area of ​​openings 1476 is too small, exhaled gas 107 will not be completely cleared from passive patient circuit 440 during the expiratory phase and during the pause between the inspiratory and expiratory phases. As a non-limiting example, when the pressure within passive patient circuit 440 is approximately 10 centimeters of water ("cmH2O"), valve assembly 1448 can be configured to leak approximately 20-50 LPM.

[0297] As described below, during the expulsion of a cough, the pressure within the passive patient circuit 440 (see Figure 2B ) is less than a threshold amount (e.g., ambient pressure). When the passive patient circuit 440 (see Figure 2B ) includes valve assembly 1448 (rather than valve assembly 448), when passive patient circuit 440 (see Figure 2B ) is less than a threshold amount, the peripheral portion 1473 of the blade 1470 is placed in the closed position (see Figure 31A and 31C ), which prevents patient gas within the passive patient circuit 440 from flowing out of the passive patient circuit 440 through the opening 1476. It can also prevent air from entering the passive patient circuit 440 through the opening 1476.

[0298] It should be noted that the passive valve assembly described herein can be integrated into the patient connection 106, such as into a patient mask as a patient connection, rather than being part of the passive patient circuit 170 or the passive patient circuit 440. Figure 1As shown, patient 102 has a patient connection 106 , which may be a tube, nasal mask, mouthpiece, and the like, connectable to a primary ventilator connection 104 and / or a patient oxygen outlet 105 via a patient circuit 110 .

[0299] Active patient circuit

[0300] Figure 3A Depicted are methods that can be used to implement the patient circuit 110 (see Figure 1 ) active patient circuit 600. Figure 3A The active patient circuit 600 includes a connector 442 , a flexible tubing segment 444 , an oxygen pulse delivery tube 446 , a multi-lumen tubing assembly 602 and an active exhalation valve assembly 604 .

[0301] Similar to the passive patient circuit 440 (see Figure 2B ), a connector 442 is coupled to a first end 450 of a flexible tubing segment 444 and an oxygen pulse delivery tube 446. The connector 442 receives the gas 112 and provides it to the flexible tubing segment 444. In addition, the connector 442 receives pulses of oxygen 140 and provides them to the oxygen pulse delivery tube 446. The pulses of oxygen 140 exit the oxygen pulse delivery tube 446 at or near the patient connector 106. As a non-limiting example, the pulses of oxygen 140 may exit the oxygen pulse delivery tube 446 within approximately 10 centimeters of the patient connector 106. In the illustrated embodiment, the pulses of oxygen 140 exit the oxygen pulse delivery tube 446 at or near the active exhalation valve assembly 604.

[0302] Optionally, a bacterial filter 176 (see Figure 2A ) can be positioned between the connector 442 and the primary ventilator connector 104. In such an embodiment, the gas 112 flows through the bacterial filter 176 on its way to the connector 442. When present, the bacterial filter 176 helps prevent bacteria (e.g., received from the patient connector 106) from entering the ventilator 100 (through the primary ventilator connector 104).

[0303] The second end 451 of the flexible tube segment 444 is configured to be coupled to the active exhalation valve assembly 604. Figure 1 As described, the patient circuit 110 may include one or more ports 111 configured to allow one or more pressure signals 109 to flow between the optional multi-lumen tubing connector 103 and the patient circuit 110. Figure 3C In the embodiment shown, port 111 (see Figure 1 ) includes ports 111A-111C spaced longitudinally apart from each other. Ports 111A-111C are each formed in the active exhalation valve assembly 604. Port 111C is hereinafter referred to as pilot port 111C.

[0304] Figure 3B is an exploded perspective view of the multi-lumen tubing assembly 602. Figure 3B , the multi-lumen tubing assembly 602 includes a coupler 608, an elongated tubing segment 610, and a connector member 612. The coupler 608 is configured to couple a first end 620 of the tubing segment 610 to an optional multi-lumen tubing connector 103 (see FIG. Figure 3A ). Tube segment 610 has a second end 622 opposite first end 620. Second end 622 is connected to connector member 612. Three independent and continuous open passages 626A-626C extend longitudinally through tube segment 610.

[0305] The connector member 612 has a plurality of connectors connected to the ports 111A-111C (see FIG. Figure 3C ) are provided with three connectors 630A-630C. Connectors 630A and 630B receive pressure signals 109A and 109B from ports 111A and 111B, respectively (see FIG. Figure 5A Connector 630C transmits pressure signal 109C to pilot port 111C and also transmits pressure signal 109C from pilot port 111C (see Figure 5A ).

[0306] Continuous channels 632A-632C extend from connectors 630A-630C, respectively, to end 634 of connector member 612. When connector member 612 is connected to tubing segment 610, continuous channels 626A-626C of tubing segment 610 align with and communicate with continuous channels 632A-632C, respectively. Thus, multi-lumen tubing assembly 602 can be used to conduct pressure signals 109A and 109B, respectively, from ports 111A and 111B, to optional multi-lumen tubing connector 103. Additionally, multi-lumen tubing assembly 602 can be used to conduct pressure signal 109C from optional multi-lumen tubing connector 103 to pilot port 111C, and vice versa.

[0307] refer to Figure 3C The active exhalation valve assembly 604 includes a first valve housing member 640, a dual bellows member 644, and a second valve housing member 642. Ports 111A and 111B are formed in the first valve housing member 640 and extend laterally outward therefrom. A pilot port 111C is formed in the second valve housing member 642 and extends laterally outward therefrom.

[0308] Figure 3E and 3F are enlarged longitudinal cross-sectional views each showing a portion of active patient circuit 600 including active exhalation valve assembly 604. Oxygen pulse delivery tube 446 has been removed from Figure 3E and 3FIn the illustrated embodiment, the first valve housing member 640 includes an internal obstruction 646 located between ports 111A and 111B and configured to partially restrict flow through the first valve housing member 640. Figure 3E and 3F As shown, the interior of the first valve housing member 640 includes a first narrowed portion 647A adjacent to the obstruction 646 and the port 111A, and a second narrowed portion 647B adjacent to the obstruction 646 and the port 111B. Thus, the first narrowed portion 647A and the second narrowed portion 647B are longitudinally positioned opposite each other relative to the obstruction 646, wherein the first narrowed portion 647A is closer to the patient connector 106 (see FIG. 1 ) than the second narrowed portion 647B. Figure 3A Ports 111A and 111B lead to the first narrowed portion 647A and the second narrowed portion 647B, respectively.

[0309] refer to Figure 3G , together with obstruction 646, first and second narrowed portions 647A, 647B, and ports 111A and 111B, define an airway flow transducer 648 (e.g., a fixed orifice differential pressure flow meter) located within the interior of first valve housing member 640. During the inhalation phase, gas 112 can flow around obstruction 646 along a flow path identified by curved arrows 649A and 649B. During the exhalation phase, exhaled gas 107 can flow around obstruction 646 along a flow path opposite to that identified by curved arrows 649A and 649B.

[0310] refer to Figure 3C The first valve housing member 640 has a first end 650 configured to be coupled to the patient connector 106 (see Figure 3A ). Optionally, secretion collector 1250 (see Figure 27 and 28 ) can be coupled between the first end 650 and the patient connector 106. The first valve housing member 640 has a second end 652 configured to be coupled to the second valve housing member 642. The second valve housing member 642 has a first end 654 configured to be coupled to the second end 652 of the first valve housing member 640, and a second end 656 configured to be coupled to the second end 451 of the flexible tubing segment 444. The first end 654 of the second valve housing member 642 has a generally cylindrical bellows connector portion 657. An opening 658 of the pilot port 111C is formed in the bellows connector portion 657 of the second valve housing member 642.

[0311] See also Figure 3DThe double bellows member 644 has a generally annular shape with a centrally located through passage 660. The double bellows member 644 has a hollow interior 662 with an annular open end 664 opposite an annular closed end 666 (see FIG. Figure 3C ). In the illustrated embodiment, the double bellows member 644 has an inner sidewall 668 and an outer sidewall 669 that are similar to a concertina. The inner sidewall 668 extends along the centrally located through-passage 660 between an open end 664 and a closed end 666. The outer sidewall 669 extends between the open end 664 and the closed end 666 and is spaced radially outward from the inner sidewall 668. A hollow interior 662 is defined between the inner sidewall 668 and the outer sidewall 669. The inner sidewall 668 and the outer sidewall 669 have bellows portions 668A and 669A, respectively (see Figure 3C ), each bellows portion has an undulating longitudinal cross-sectional shape (also referred to as a corrugated or convoluted tubular shape). In alternative embodiments, the inner sidewall 668 and the outer sidewall 669 can include different numbers of convolutions, defining a single convolution or more than two convolutions.

[0312] The open end 664 is configured to fit like a sleeve over the bellows connector portion 657 of the second valve housing member 642. When the bellows connector portion 657 of the second valve housing member 642 is received in the open end 664 of the dual bellows member 644, the corresponding bellows portions 668A and 669A of the inner and outer sidewalls 668 and 669 (see FIG. Figure 3C ) is positioned adjacent to the bellows connector portion 657 of the second valve housing member 642. Thus, the opening 658 of the pilot port 111C communicates with a portion of the hollow interior 662 positioned between the bellows portions 668A and 669A of the inner and outer sidewalls 668 and 669.

[0313] refer to Figure 3C When the bellows connector portion 657 of the second valve housing member 642 is received in the open end 664 of the dual bellows member 644 , the opening 658 of the pilot port 111C can provide the pressure signal 109C to the interior of the dual bellows member 644 .

[0314] refer to Figure 3E and 3F As described above, the second end 652 of the first valve housing member 640 is configured to be coupled to the first end 654 of the second valve body member 642. When so coupled together, a circular chamber 670 is defined between the second end 652 of the first valve housing member 640 and the first end 654 of the second valve housing member 642. One or more openings 672 (see Figure 3C ) is formed in the first valve housing member 640 and connects the chamber 670 to the external environment of the active patient circuit 600 (see Figure 3A ). The bellows portions 668A and 669A of the outer side wall 669 (see Figure 3C ) and a peripheral portion 674 of the closed end 666 are placed in the chamber 670.

[0315] The double bellows member 644 is made of a flexible material (e.g., silicone rubber or a similar material). The corresponding bellows portions 668A and 669A of the inner and outer side walls 668 and 669 (see FIG. Figure 3C ) is configured to compress to move the closed end 666 from the closed position (see Figure 3E ) to the on position (see Figure 3F ). When the bellows parts 668A and 669A (see Figure 3C ) is not compressed, the closed end 666 is in Figure 3E In this configuration, the closed end 666 of the dual bellows member 644 abuts the annular seat 680 formed in the first valve housing member 640 and defines a portion of the chamber 670. This seals the chamber 670 from the interior of the active patient circuit 600. On the other hand, when the bellows portions 668A and 669A (see FIG. Figure 3C ) is compressed toward the second valve housing member 642, the closed end 666 is in Figure 3F 66 is spaced from the seat 680. This opens the chamber 670 by connecting it to the interior of the active patient circuit 600. Thus, when the closed end 666 of the dual bellows member 644 is in the open position, patient gas within the active patient circuit 600 can pass through the chamber 670 and the opening 672 (see FIG. Figure 3C ) to leave it.

[0316] The closed end 666 of the dual bellows member 644 is selectively moved between an open position and a closed position by controlling the pressure within the dual bellows member 644 using the pilot port 111C. For example, the closed end 666 of the dual bellows member 644 may be in the closed position during the inhalation phase (see FIG. Figure 3E ) and is in the open position during the expiratory phase. In such an embodiment, at the beginning of the inspiratory phase, the pilot port 111C provides a flow of gas (as pressure signal 109C) having the same pressure as the gas 112 (provided to the active patient circuit 600) to the hollow interior 662 of the dual bellows member 644. Figure 1) is less than the area of ​​the dual bellows member 644 exposed to the pressure provided by the pressure signal 109C, which causes the closed end 666 of the dual bellows member 644 to move to or remain in the closed position relative to the seat 680 even if the two pressures are equal. At the end of the inspiration phase, the pilot port 111C provides a flow of air at the pilot pressure (as the pressure signal 109C) to the hollow interior 662 of the dual bellows member 644. The pilot pressure is less than the pressure provided by the patient 102 (see FIG. 109 ) via the patient connector 106. Figure 1 ) and causes the closed end 666 of the dual bellows member 644 to move to or remain in an open position spaced apart from the seat 680. Thus, during normal breathing, the pressure within the hollow interior 662 of the dual bellows member 644 can alternate between a closing pressure, which is the same as the pressure of the gas 112 (provided to the active patient circuit 600), and an opening pressure, which is equal to the pilot pressure. If desired, the pressure within the hollow interior 662 of the dual bellows member 644 can be adjusted by allowing gas flow (in the pressure signal 109C) to flow from the hollow interior 662 to the pilot port 111C.

[0317] As described below, during the expulsion phase of a cough, the closed end 666 of the dual bellows member 644 may be placed in a closed position (see FIG. Figure 3E This prevents exhaust gases (exhaled by patient 102) entering active patient circuit 600 from exiting active patient circuit 600 through opening 672 (see Figure 3C It also prevents air from entering the active patient circuit 600 through opening 672 (see Figure 3C ). Note that during the beginning of the exhaust phase, when pressure is still positive, the dual bellows member 644 is in the open position and automatically closes when the pressure provided by the patient 102 drops below ambient.

[0318] Ventilator

[0319] Figure 4 is a block diagram illustrating some exemplary components of ventilator 100. Figure 4 , except about Figure 1 In addition to the components discussed, ventilator 100 includes breathing assembly 190, user interface 200, oxygen assembly 210, control system 220, and conventional monitoring and alarm system 221. Because conventional monitoring and alarm system 221 is familiar to those skilled in the art, it will not be described in detail herein.

[0320] The control system 220 receives input information 196 (e.g., placement, parameter values, and the like) from the user interface 200 and provides output information 198 (e.g., performance information, status information, and the like) to the user interface 200. The user interface 200 is configured to receive input information 196 from a user (e.g., a caregiver, a clinician, and a Figure 1 The user interface 200 receives input from a control system 220 (or a similar user associated with the illustrated patient 102) and provides the input to the control system 220 in input information 196. The user interface 200 is also configured to display output information 198 to the user.

[0321] As mentioned above, reference Figure 1 , the patient circuit 110 may include an optional port 111 configured to allow one or more pressure signals 109 to flow between the optional multi-lumen tubing connector 103 and the patient circuit 110. Figure 3A , optional multi-lumen connector 103 is configured to provide a pressure signal 109 to respiratory assembly 190 .

[0322] As will be explained below, respiratory component 190 may receive one or more control signals 192 from control system 220, and respiratory component 190 may provide one or more data signals 194 to control system 220. Similarly, oxygen component 210 may receive one or more control signals 260 from control system 220, and oxygen component 210 may provide one or more data signals 262 to control system 220. Control signals 192 and 260 and data signals 194 and 262 may be used by control system 220 to monitor and / or control the internal operations of ventilator 100.

[0323] Breathing components

[0324] Figure 5A and 5B is a schematic diagram illustrating some exemplary components of respiratory assembly 190 . Figure 5E is a block diagram illustrating example components of control system 220 , control signals sent by control system 220 to example components of respiratory assembly 190 , and data signals 194 received by control system 220 from example components of respiratory assembly 190 .

[0325] refer to Figure 5A and 5B The respiratory component 190 includes a cough assist valve 204, an accumulator 202, an internal flow transducer 212, a blower 222, an airway pressure transducer 224, an airway flow transducer module 225, an exhalation control component 226, an oxygen sensor 227, an ambient pressure transducer 228, an inlet muffler 229 and an internal bacterial filter 230.

[0326] The cough assist valve 204 is connected to the accumulator 202 by a pipe or flow line 214. For ease of illustration, a portion of the flow line 214 between the accumulator 202 and the internal flow transducer 212 has been removed. Figure 5A and 5B was omitted.

[0327] The cough assist valve 204 is connected to the outlet port 166 by a pipe or flow line 215. For ease of illustration, a portion of the flow line 215 between the cough assist valve 204 and the outlet port 166 has been removed. Figure 5A and Figure 5B was omitted.

[0328] The cough assist valve 204 is connected to the main ventilator connection 104 by a tube or flow line 273. For ease of illustration, a portion of the flow line 273 between the cough assist valve 204 and the internal bacterial filter 230 has been removed. Figure 5A and Figure 5B was omitted.

[0329] Figure 5A depicts the cough assistance valve 204 in a first configuration, Figure 5B The cough assistance valve 204 is depicted in a second configuration. Figure 5A , in the first configuration, the cough assist valve 204 receives gas 252 from the accumulator 202 (via flow line 214) and outputs gas 252 to the main ventilator connection 104 (via flow line 273). During normal breathing and ventilation, the cough assist valve 204 remains in the first configuration. When the cough assist function (described below) is used to perform a cough assist operation, the cough assist valve 204 is in the first configuration during the insufflation phase of a cough, and the cough assist valve 204 is in the second configuration during the exsufflation phase of a cough. Reference Figure 5B In the second configuration, the cough assistance valve 204 receives the exhaust gas 253 through flow line 273 and outputs the exhaust gas 253 (as exhaust gas 167 ) to the outlet port 166 through flow line 215 .

[0330] Figure 5C is an enlarged schematic diagram of the cough assistance valve 204 in a first configuration. Figure 5C Gas 252 is shown flowing through blower 222 and cough assist valve 204 (see FIG. 1 ) during the inspiratory phase of a breath or the insufflation phase of a cough assist maneuver performed by ventilator 100. Figure 1 and Figure 4 ).

[0331] Figure 5D is an enlarged schematic diagram of the cough assistance valve 204 in the second configuration. Figure 5DExhaust gas 253 is shown flowing through blower 222 and cough assist valve 204 during the exhaust phase of a cough assist maneuver performed by ventilator 100 (see FIG. Figure 1 and Figure 4 For ease of explanation, ports 275A-275C (see Figure 5A and 5B ) has been Figure 5C and 5D It is omitted.

[0332] refer to Figure 5C and 5D The cough assist valve 204 has a valve-blower outlet 1002, a blower-valve inlet 1004, an air inlet 1006, an exhaust outlet 1008 and an orifice 1010. The orifice 1010 is connected to the main ventilator connector 104 via a flow line 273. Figure 5C As shown, when the cough assistance valve 204 is in the first configuration, the air inlet 1006 is in fluid communication with the valve-blower outlet 1002, and the blower-valve inlet 1004 is in fluid communication with the orifice 1010. Additionally, the exhaust outlet 1008 is closed, and neither the valve-blower outlet 1002 nor the air inlet 1006 is in fluid communication with the orifice 1010, except through the blower 222. Thus, gas 252 can flow into the air inlet 1006, pass through a portion of the cough assistance valve 204, and out of the valve-blower outlet 1002, and into the blower 222. Gas 252 exiting the blower 222 flows into the blower-valve inlet 1004, passes through a portion of the cough assistance valve 204, and exits the cough assistance valve 204 through the orifice 1010. The orifice 1010 is connected to the flow line 273, which carries the gas 252 (see Figure 5A ) is conducted to the main ventilator connector 104.

[0333] like Figure 5D As shown, when the cough assistance valve 204 is in the second configuration, the air inlet 1006 is closed, and neither the blower-valve inlet 1004 nor the exhaust outlet 1008 is in fluid communication with the orifice 1010, except through the blower 222. In addition, the orifice 1010 is in fluid communication with the valve-blower outlet 1002, and the blower-valve inlet 1004 is in fluid communication with the exhaust outlet 1008. Thus, exhaust gas 253 flows into the orifice 1010, passes through a portion of the cough assistance valve 204, and flows out of the valve-blower outlet 1002 and into the blower 222. The exhaust gas 253 exiting the blower 222 flows into the blower-valve inlet 1004, passes through a portion of the cough assistance valve 204, and exits the cough assistance valve 204 through the exhaust outlet 1008. The exhaust outlet 1008 is connected to the flow line 215 (see FIG. Figure 5A and 5B ), which exhausts the gas 253 (such as Figure 5A and5B Exhaust gas 167 ) is directed to outlet port 166 .

[0334] Figure 17A and 17B is a perspective view of the cough assistance valve 204 . Figure 18A and 18B is a cross-sectional view of the cough assistance valve 204 . Figure 18A depicts the cough assistance valve 204 in a first configuration, Figure 18B The cough assistance valve 204 is depicted in a second configuration.

[0335] refer to Figure 17A The cough assist valve 204 includes a generally cylindrical housing 1020. In the illustrated embodiment, an air inlet 1006 is formed in a first open end 1022 of the housing 1020, and an exhaust outlet 1008 (see FIG. Figure 17B ) is located at the second open end 1024 of the housing 1020, wherein the second open end 1024 is located opposite the first open end 1022. The valve-blower outlet 1002, the blower-valve inlet 1004 and the hole 1010 (see Figure 17B ) is formed in the side wall 1026 of the housing 1020 and extends between the first open end 1022 and the second open end 1024.

[0336] A first end cap assembly 1032 can be coupled to the first open end 1022, and a second end cap assembly 1034 can be coupled to the second open end 1024. The first end cap assembly 1032 and the second end cap assembly 1034 are substantially identical to each other. Figure 19A , first end cap assembly 1032 and second end cap assembly 1034 (see Figure 17A , 17B, 18A and 18B) each includes a magnet 1040, a retaining member 1042, a sealing member 1044 (e.g., an O-ring) and a seat member 1046. The sealing member 1044 is positioned between the seat member 1046 and the retaining member 1042. Each of the first end cap assembly 1032 and the second end cap assembly 1034 can be coupled to the housing 1020 by one or more tabs 1048 and one or more fasteners 1049. Figure 17A and 17B In the illustrated embodiment, the housing 1020 includes outwardly extending mounting portions 1050 at each of the first open end 1022 and the second open end 1024 of the housing 1020 , each configured to receive one of each of the fasteners 1049 .

[0337] In the illustrated embodiment, magnet 1040 is generally cylindrical or disk-shaped. However, this is not required.

[0338] refer to Figure 19A, retaining member 1042 has an annular base 1052 defining an opening 1053. Sidewalls 1054 extend inwardly from base 1052 toward seat member 1046. Each tab 1048 is configured to abut base 1052 and avoid blocking opening 1053. Thus, gas (e.g., gas 252 or exhaust gas 253) can pass through opening 1053 without being blocked by tabs 1048.

[0339] refer to Figure 19B and 19C , the seat member 1046 has an annular peripheral portion 1056 defining an opening 1058 therein. A central magnet receiving portion 1060 is supported within the opening 1058 by radially extending support arms 1061-1063 connected to the peripheral portion 1056. The magnet receiving portion 1060, along with the support arms 1061, 1062, and 1063, only partially obstruct or block the opening 1058. Thus, gas (e.g., gas 252 or exhaust gas 253) can pass through the opening 1058 surrounding the magnet receiving portion 1060 and the support arms 1061, 1062, and 1063.

[0340] The seat member 1046 has a side surface 1071 (see Figure 19B ) opposite inward side 1070 (see Figure 19C ). refer to Figure 19C The peripheral portion 1056 along the inward side 1070 is configured to be at least partially received within the first open end 1022 and the second open end 1024 of the housing 1020 (see FIG. Figures 17A-18B ). Along an inwardly facing side 1070, the peripheral portion 1056 has an inwardly extending annular protrusion 1072 positioned adjacent the opening 1058. In the illustrated embodiment, the peripheral portion 1056 has a helical ramp portion 1074 extending longitudinally inwardly and annularly along the inwardly facing side 1070. As will be described in greater detail below, the ramp portion 1074 is used to adjustably longitudinally position the seat member 1046 of the first and second end cap assemblies 1032, 1034 within the housing 1020.

[0341] refer to Figure 19B In the illustrated embodiment, the peripheral portion 1056 has an annular recess 1076 along the outwardly facing side 1071. The recess 1076 is configured to receive the sealing member 1044 and at least the free end of the inwardly extending sidewall 1054 of the retaining member 1042, wherein the sealing member 1044 is sandwiched between the seat member 1046 and the retaining member 1042.

[0342] At the outward side 1071, the magnet receiving portion 1060 is configured to receive the magnet 1040 (see Figure 19A). In the embodiment shown, the magnet receiving portion 1060 has been implemented as an open cylinder. However, this is not required. Along the inward side 1070 (see Figure 19C ), the magnet receiving portion 1060 has an inner stop wall 1066 configured to prevent the magnet 1040 from passing through the central magnet receiving portion 1060 and entering the housing 1020. As a non-limiting example, the magnet 1040 (see Figure 19A ) can be held inside the magnet receiving portion 1060 by friction or adhesive.

[0343] refer to Figure 23A The first open end 1022 of the housing 1020 has a first internal spiral ramp portion 1092 extending longitudinally outward and annularly, and the first internal spiral ramp portion 1092 is configured to mate with the first end cap assembly 1032 (see Figure 17A , 18A and 18B) of the spiral ramp portion 1074 (see Figure 19C ) are matched. The annular inner seat member 1096 is placed inside the housing 1020 and is located near the first open end 1022 but inwardly on the inner wall 1185 extending circumferentially and radially protruding. The inner seat member 1096 has a substantially inward annular protrusion 1072 (see FIG. Figure 19C ) is similar to the annular protrusion 1097 and extends longitudinally outward.

[0344] See also Figure 19C , an annular protrusion 1072 formed on the inward side 1070 of the seat member 1046 of the first end cap assembly 1032 serves as the first seat "S1" (see Figure 18A and 18B ). The annular protrusion 1097 in the housing 1020 and located at the first open end 1022 serves as a second seat "S2" (see Figure 18A and 18B ).like Figure 18A and 18B As shown, the second seat "S2" is positioned longitudinally inward from the first cover assembly 1032. The first seat "S1" and the second seat "S2" extend toward each other.

[0345] refer to Figure 23B The second open end 1024 of the housing 1020 has a second inner spiral ramp portion 1094 extending longitudinally outward and annularly, which is configured to mate with the second end cap assembly 1034 (see Figure 17B , 18A and 18B) of the spiral ramp portion 1074 (see Figure 19C ) are matched. The housing 1020 has an inner wall 1100 that extends circumferentially inward near the second open end 1024 but inward. The inner wall 1100 has a substantially radially inwardly protruding inner wall 1100. Figure 19C) is similar to the annular protrusion 1102 and extends longitudinally outward. The annular protrusion 1102 located in the housing 1020 and at the second open end 1024 serves as a third seat "S3" (see Figure 18A and 18B ).like Figure 18A and 18B As shown, the third seat "S3" is placed longitudinally inward from the second end cap assembly 1034. The seat member 1046 of the second end cap assembly 1034 (see Figure 19C ) of the annular protrusion 1072 (see Figure 19C ) is used as the fourth seat "S4". The third seat "S3" and the fourth seat "S4" extend toward each other.

[0346] The first seat "S1" is positioned adjacent to the air inlet 1006, and the fourth seat "S4" is positioned adjacent to the air outlet 1008. The valve-blower outlet 1002 is positioned within the housing 1020 and between the first seat "S1" and the second seat "S2." Similarly, the blower-valve inlet 1004 is positioned between the third seat "S3" and the fourth seat "S4" formed in the housing 1020.

[0347] The cough assistance valve 204 includes a first poppet valve assembly 1112 and a second poppet valve assembly 1114 connected together by a shaft 1116 for moving together. As described below, the cough assistance valve 204 has a first internal chamber, a second internal chamber, and a third internal chamber. The first poppet valve assembly 1112 is placed in the first internal chamber between the first seat "S1" and the second seat "S2" and moves longitudinally between the first seat "S1" and the second seat "S2", and the second poppet valve assembly 1114 is placed in the third internal chamber between the third seat "S3" and the fourth seat "S4" and moves longitudinally between the third seat "S3" and the fourth seat "S4". The second internal chamber is placed between the second seat "S2" and the third seat "S3", respectively, and is therefore located between the first internal chamber and the third internal chamber. The second seat "S2" defines a first hole, the first internal chamber and the second internal chamber are in communication with each other through the first hole, and the first poppet valve assembly 1112 controls the flow through the first hole. The third seat "S3" defines a second hole, the second internal chamber and the third internal chamber are in communication with each other through the second hole, and the second poppet valve assembly 1114 controls the flow through the second hole. Figure 18A As shown, when the first poppet valve assembly 1112 is pressed against the second seat "S2", the cough assist valve 204 is in Figure 5A and 5CIn the first configuration, the first poppet valve assembly 1112 allows gas 252 from the accumulator 202 to flow through the gas inlet 1006 into the first internal chamber, then to the valve-blower outlet 1002, and into the blower 222, while preventing the gas 252 from flowing directly to the orifice 1010, thereby sealing the orifice 1010 from the gas inlet 1006 and the valve-blower outlet 1002. At the same time, the second poppet valve assembly 1114 is pressed against the fourth seat "S4" so that the second poppet valve assembly 1114 closes the exhaust outlet 1008 and directs the flow of gas 252 into the third internal chamber, then into the second internal chamber through the second orifice, for exit through the orifice 1010 and to the main ventilator connector 104. In this configuration, gas 252 from the accumulator 202 entering the gas inlet 1006 is directed to the blower 222 through the valve-blower outlet 1002. The gas 252 is then blown by the blower 222 to the blower-valve inlet 1004 and exits the cough assistance valve 204 through the orifice 1010 and to the main ventilator connection 104.

[0348] like Figure 18B As shown, when the first poppet valve assembly 1112 is pressed against the first seat "S1", the cough assist valve 204 is in Figure 5B and 5D The second configuration is shown. In the second configuration, the first poppet valve assembly 1112 allows exhaust gas 253 from the primary ventilator connector 104 to flow through the orifice 1010 into the second internal chamber, and then through the first orifice into the first internal chamber to exit through the valve-blower outlet 1002 and enter the blower 222, while preventing the exhaust gas from flowing into the air inlet 1006 and also preventing gas 252 from the accumulator 202 from reaching the valve-blower outlet 1002. At the same time, the second poppet valve assembly 1114 is pressed against the third seat "S3", causing the second poppet valve assembly 1114 to open the exhaust outlet 1008 and prevent the exhaust gas 253 from flowing through the second orifice into the second internal chamber and the orifice 1010. In this configuration, the exhaust gas 253 from the primary ventilator connector 104 and into the orifice 1010 is directed through the first chamber through the valve-blower outlet 1002 to the blower 222. The exhaust gas 253 is then blown by the blower 222 to the blower-valve inlet 1004 and enters the third chamber before exiting the cough assistance valve 204 through the exhaust outlet 1008 to the outlet port 166 .

[0349] The first poppet valve assembly 1112 and the second poppet valve assembly 1114 are coupled to opposite ends of the shaft 1116 to move together as a unit. Figure 22In the illustrated embodiment, a guide member 1120 (e.g., a pin, dowel, and the like) extends laterally outward from the shaft 1116. The shaft 1116 may include one or more circumferentially extending grooves 1122 and 1124, each configured to receive a different retaining ring 1126. The shaft 1116 has a first end 1132 opposite a second end 1134. Longitudinal channels 1136 and 1138 extend inwardly into the shaft at the first end 1132 and the second end 1134, respectively. Each of the channels 1136 and 1138 is configured to receive a fastener 1140 (see FIG. Figure 21 ).

[0350] The shaft 1116 is configured to be positioned within the housing 1020 in a first position (see Figure 18A ) and the second position (see Figure 18B ), wherein in the first position, the cough assistance valve 204 is in a first configuration, and in the second position, the cough assistance valve 204 is in a second configuration. Figure 18A and 18B , when the shaft 1116 moves, the first poppet valve assembly 1112 moves between the first seat "S1" and the second seat "S2", and the second poppet valve assembly 1114 moves between the third seat "S3" and the fourth seat "S4". When the shaft 1116 is in the first position (see Figure 18A ), the first poppet valve assembly 1112 is in a sealing position relative to the first seat "S1", and the second poppet valve assembly 1114 is in a sealing position relative to the third seat "S3". When the shaft 1116 is in the second position (see Figure 18B ), the first poppet valve assembly 1112 is in a sealing position relative to the second seat "S2", and the second poppet valve assembly 1114 is in a sealing position relative to the fourth seat "S4".

[0351] The ramp portion 1074 of the seat member 1046 of the first end cap assembly 1032 is in sliding engagement with the ramp portion 1092 within the first open end 1022 of the housing 1020, such that rotation of the seat member 1046 causes adjustable longitudinal movement relative to the housing 1020 to precisely adjust the position of the first seat S1 of the seat member 1046 relative to the first poppet valve assembly 1112 to achieve a desired seal and seating therewith during assembly and calibration. Similarly, the ramp portion 1074 of the seat member 1046 of the second end cap assembly 1034 is in sliding engagement with the ramp portion 1094 within the second open end 1024 of the housing 1020, such that rotation of the seat member 1046 causes adjustable longitudinal movement relative to the housing 1020 to precisely adjust the position of the fourth seat S4 of the seat member 1046 relative to the second poppet valve assembly 1114 to achieve a desired seal and seating therewith during assembly and calibration.

[0352] The first poppet valve assembly 1112 and the second poppet valve assembly 1114 are substantially identical to each other. Figure 21 Each of the first and second poppet valve assemblies 1112 and 1114 includes a fastener 1140 , a ferromagnetic member 1144 , a first sealing member 1146 (eg, an O-ring), a disc-shaped poppet member 1148 , a second sealing member 1150 (eg, an O-ring), and an optional gasket 1152 .

[0353] Fasteners 1140 of first poppet valve assembly 1112 secure the other components of first poppet valve assembly 1112 (i.e., ferromagnetic member 1144, first sealing member 1146, poppet member 1148, second sealing member 1150, and optionally, washer 1152) to first end 1132 of shaft 1116. Similarly, fasteners 1140 of second poppet valve assembly 1114 secure the other components of second poppet valve assembly 1114 to second end 1134 of shaft 1116. First and second sealing members 1146, 1150 of each of first and second poppet valve assemblies 1112, 1114 serve to seal the poppet valve assembly to the end of shaft 1116 and provide a flexible coupling between the shaft and the poppet valve assembly's poppet member 1148.

[0354] refer to Figure 18A , the magnet 1040 of the first end cap assembly 1032 attracts the ferromagnetic member 1144 of the first poppet valve assembly 1112 and, when in proximity thereto, maintains the shaft 1116 in the first position and holds the first poppet valve assembly 1112 in position at the first seat S1 of the first end cap assembly 1032 after the shaft has been moved to the first position. Similarly, with reference to Figure 18B , magnet 1040 of second end cap assembly 1034 attracts ferromagnetic member 1144 of second poppet valve assembly 1114 and, when in proximity thereto, maintains shaft 1116 in the second position after the shaft has been moved to the second position and holds second poppet valve assembly 1114 in position at fourth seat S4 of second end cap assembly 1034. Ferromagnetic member 1144 can hold poppet valve assemblies 1112 and 1114 in position at first seat S1 and fourth seat S4, respectively, even when no power is applied to an actuator for moving the poppet valve assemblies.

[0355] refer to Figure 20 The cough assistance valve 204 includes an actuator 1170 configured to be in a first position (see FIG. Figure 18A ) and the second position (see Figure 18B) selectively moves the shaft 1116 between the movable coil subassembly 1174 and the fixed magnet subassembly 1176. In the embodiment shown, the actuator 1170 is a linear actuator implemented using a voice coil including a movable coil subassembly 1174 and a fixed magnet subassembly 1176. The shaft 1116 is coupled to the movable coil subassembly 1174 and moves therewith as a unit. Figure 18A and 18B , the fixed magnet subassembly 1176 is coupled to the actuator mounting portion 1190 of the housing 1020 (eg, via one or more fasteners 1178 ).

[0356] refer to Figure 18A , the movable coil subassembly 1174 is connected to a printed circuit board ("PCB") 1064 mounted on the exterior of the housing 1020 via one or more wires 1059. In the embodiment shown, the wires 1059 provide power to the movable coil subassembly 1174. The housing 1020 includes one or more holes 1065 (see FIG. 1065 ) through which the wires 1059 pass. Figure 24A PCB 1064 is connected to control system 220 (see Figure 5E ). The actuator 1170 is configured to receive a control signal 1180 (see FIG. 1 ) from the control system 220 (via the PCB 1064 and the wires 1059). Figure 5E ) and moves according to one or more instructions in the control signal 1180. PCB 1064 acts as a connector and transmits the control signal 1180 to the movable coil subassembly 1174.

[0357] Control signal 1180 (see Figure 5E ) selectively powers the movable coil subassembly 1174 to move toward the first end cap assembly 1032 or the second end cap assembly 1034. When the movable coil subassembly 1174 moves toward the first end cap assembly 1032, the movable coil subassembly 1174 moves the shaft 1116 toward the first position. Figure 18A After the shaft 1116 has been moved to the first position, the movable coil subassembly 1174 is de-energized, and the magnet 1040 of the first end cap assembly 1032 (which, as described above, is attracted to at least a portion of the first poppet valve assembly 1112) holds the shaft 1116 in the first position. On the other hand, when the movable coil subassembly 1174 is moved toward the second end cap assembly 1034, the movable coil subassembly 1174 moves the shaft 1116 toward the second position. Figure 18BAfter the shaft 1116 has been moved to the second position, the movable coil subassembly 1174 is de-energized, and the magnet 1040 of the second end cap assembly 1034 (which, as described above, is attracted to at least a portion of the second poppet valve assembly 1114) holds the shaft 1116 in the second position. Thus, no additional power is required to hold the shaft 1116 in either the first or second position, which helps extend battery life in embodiments powered by one or more batteries.

[0358] See also Figure 24B , housing 1020 (see Figure 18A and 18B ) includes a first inner support member 1184 spaced inwardly from the first open end 1022. In the illustrated embodiment, the first inner support member 1184 extends radially inwardly from an inner wall 1185 extending inwardly from a circumference. The first inner support member 1184 has a longitudinally extending channel 1186 formed therein. Figure 18A and 18B , Channel 1186 (see Figure 24B ) is configured to allow the shaft 1116 to pass completely therethrough to position the first poppet valve assembly 1112 between the first inner support 1184 and the first end cap assembly 1032. Figure 23A As can be seen in FIG, the passage 1186 opens along the inner seat member 1096, as shown in FIG. Figure 18A and 18B As shown, the first poppet valve assembly 1112 is placed between the first seat "S1" and the second seat "S2". Figure 22 ) is located in a portion of the shaft 1116 near the first end 1132 of the passage 1186 (see Figure 24B ) and reciprocates therein. Figure 24A , an open, longitudinally extending guide groove 1188 is formed in the first inner support member 1184 along the channel 1186. The guide member 1120 (see Figure 22 ) is placed in and moves in guide groove 1188. (This prevents the poppet valve assembly from rotating, which could damage the wires.)

[0359] The first inner support 1184 has an actuator mounting portion 1190 that optionally includes one or more through holes configured to receive fasteners 1178 (see FIG. Figure 18A and 18B ). Fixed magnet subassembly 1176 (see Figure 18A and 18B ) is coupled to an actuator mounting portion 1190 that secures the fixed magnet subassembly to the housing 1020 (see Figure 18A and 18BIn the illustrated embodiment, the actuator mounting portion 1190 includes an inwardly extending circumferential sidewall 1192 that is configured to extend around a portion of the stationary magnet subassembly 1176 .

[0360] See also Figure 25 , housing 1020 (see Figure 18A and 18B ) includes a second inner support member 1194 spaced inwardly from the second open end 1044. In the embodiment shown, the second inner support member 1194 extends radially inwardly from the inner wall 1100. The second inner support member 1194 has a through hole 1196 formed therein. Figure 18A and 18B , through hole 1196 (see Figure 25 ) is configured to allow the shaft 1116 to pass therethrough to position the second poppet valve assembly 1114 between the second inner support 1194 and the second end cap assembly 1034. Figure 25 As can be seen in FIG, the through hole 1196 opens along the annular protrusion 1102 and as shown in FIG. Figure 18A and 18B As shown, the second poppet valve assembly 1114 is positioned between the third seat "S3" and the fourth seat "S4".

[0361] refer to Figure 17A , 17B, 18A, 18B, 23A and 23B, in the illustrated embodiment, the housing 1020 includes an intake body portion 1198 coupled to an exhaust body portion 1199. The valve-blower outlet 1002, the intake port 1006, the aperture 1010, the first open end 1022 and the first internal support 1184 are formed in the intake body portion 1198. The blower-valve inlet 1004, the exhaust outlet 1008, the second open end 1024 and the second internal support 1194 are formed in the exhaust body portion 1199.

[0362] In the illustrated embodiment, the cough assistance valve 204 includes ports 275A, 275B, and 275C (described below) formed in the housing 1020. Ports 275A and 275B can be formed in the exhaust body portion 1199, and port 275C can be formed in the intake body portion 1198. However, this is not required. Optionally, the cough assistance valve 204 includes a port 275D (see FIG. 1 ) configured to connect to a redundant airway pressure transducer (not shown). Figure 17B and 23A ).

[0363] Figure 34A and 34B is available for use with the breathing assembly 190 (see Figure 4 and 5A), instead of the cough assist valve 204 (see Figures 5A-5D and Figures 17A-18B ), a cross-sectional view of an alternative embodiment of the cough assistance valve 2000. Figure 5A and 5B , similar to the cough assist valve 204, the cough assist valve 2000 (see Figure 34A and 34B ) is configured to be connected to the accumulator 202 via flow line 214, to the outlet port 166 via flow line 215, and to the main ventilator connection 104 via flow line 273.

[0364] Figure 34A depicts the cough assistance valve 2000 in a first configuration, Figure 34B The cough assistance valve 2000 is depicted in a second configuration. The first and second configurations of the cough assistance valve 2000 correspond to and provide a second configuration for the cough assistance valve 204 (see FIG. Figures 5A-5D 17A-18B). Thus, during normal breathing and ventilation, the cough assistance valve 2000 remains in the first configuration. When the cough assistance function (described below) is used to perform a cough assistance operation, the cough assistance valve 2000 is in the first configuration during the insufflation phase of a cough, and the cough assistance valve 2000 is in the second configuration during the exsufflation phase of a cough.

[0365] refer to Figure 34A , 34B, 18A and 18B, the cough assist valve 2000 has a valve-blower outlet 2002, a blower-valve inlet 2004, an air inlet 2006, an exhaust outlet 2008, and an orifice 2010 that are substantially identical to the valve-blower outlet 1002, the blower-valve inlet 1004, the air inlet 1006, the exhaust outlet 1008, and the orifice 1010 of the cough assist valve 204, respectively. The valve-blower outlet 2002 and the blower-valve inlet 2004 are each connected to the blower 222. The air inlet 2006 is connected to the accumulator 202 via a flow line 214. The exhaust outlet 2008 is connected to the outlet port 166 via a flow line 215. The orifice 2010 is connected to the main ventilator connector 104 via a flow line 273. The cough assistance valve 2000 has seats "S1" to "S4" that are substantially identical to the seats "S1" to "S4" of the cough assistance valve 204, respectively.

[0366] refer to Figure 34A and 34BThe cough assistance valve 2000 includes a generally cylindrical housing 2020. An air inlet 2006 is formed in a first open end 2022 of the housing 2020, and an exhaust outlet 2008 is formed at a second open end 2024 of the housing 2020. A valve-blower outlet 2002, a blower-valve inlet 2004, and an aperture 2010 are formed in a sidewall 2026 of the housing 2020 and extend between the first open end 2022 and the second open end 2024 thereof.

[0367] The first end cap assembly 2032 and the second end cap assembly 2034 can be coupled to the first open end 2022 and the second open end 2024, respectively. The first end cap assembly 2032 and the second end cap assembly 2034 are substantially identical to each other. Figure 35 , first end cap assembly 2032 and second end cap assembly 2034 (see Figure 34A and 34B ) each includes a retaining member 2042, a sealing member 2044 (e.g., an O-ring), and a seat member 2046. Figure 34A and 34B , each of the first end cap assembly 2032 and the second end cap assembly 2034 is coupled to the housing 2020 by one or more fasteners 2049. In the illustrated embodiment, the housing 2020 includes one or more outwardly extending mounting portions 2050 located at each of the first open end 2022 and the second open end 2024 of the housing 2020, and each mounting portion 2050 is configured to receive one of the fasteners 2049.

[0368] refer to Figure 35 , the seat member 2046 has an annular peripheral portion 2056 defining an opening 2058. The seat member 2046 has an inwardly facing side 2070 opposite an outwardly facing side 2071. Along the inwardly facing side 2070, the seat member 2046 has an inwardly extending annular protrusion 2072 positioned adjacent the opening 2058. In the illustrated embodiment, the peripheral portion 2056 has an externally threaded portion 2074 along the inwardly facing side 2070 and an annular recess 2076 along the outwardly facing side 2071. The recess 2076 is configured to accommodate the sealing member 2044 and at least the free end portion of the inwardly extending sidewall 2054 of the retaining member 2042, with the sealing member 2044 sandwiched between the seat member 2046 and the retaining member 2042.

[0369] The first end cap assembly 2032 and the second end cap assembly 2034 (see Figure 34A and 34B ) does not include tab 1048 (see Figure 19A ). In contrast, the retaining member 2042 of the first end cap assembly 2032 (see Figure 34A and 34B) includes an outwardly extending mounting portion 2057 for being located at the first open end 2022 of the housing 2020 (see Figure 34A and 34B ) at each outwardly extending mounting portion 2050 (see Figure 34A , 34B and 37). Similarly, the second end cap assembly 2034 (see Figure 34A and 34B ) of the retaining member 2042 corresponds to an outwardly extending mounting portion 2050 located at the second open end 2024 of the housing 2020 (see Figure 34A , 34B and 38). Each mounting portion 2057 is configured to receive a fastener 2049 and thereby secure to the mounting portion 2050 corresponding to the mounting portion 2057 (see Figure 34A , 34B and 38).

[0370] See also Figure 37 , Housing 2020 (see Figure 34A and 34B ) has a first open end 2022 configured to mate with a first end cap assembly 2032 (see Figure 34A and 34B ) of the external threaded portion 2074 (see Figure 35 ) matches the first internal thread portion 2092. Housing 2020 (see Figure 34A and 34B ) has a circumferentially extending, radially inwardly projecting inner wall 2095 adjacent to but inwardly of the first open end 2022. The inner wall 2095 has a longitudinally outwardly extending annular protrusion 2097 substantially similar to the annular protrusion 2072 (see Figure 35 ).

[0371] See also Figure 35 , first end cap assembly 2032 (see Figure 34A and 34B ) of the seat member 2046 of the annular protrusion 2072 is used as the first seat "S1 '" (see Figure 34A and 34B ). refer to Figure 37 , the annular protrusion 2097 in the first open end 2022 of the housing 2020 serves as a second seat "S2'" (see Figure 34A and 34B ).like Figure 34A and 34B As shown, the second seat "S2'" is disposed longitudinally inward from the first cover assembly 2032. The first seat "S1'" and the second seat "S2'" extend relative to each other.

[0372] See also Figure 38 , the second open end 2024 of the housing 2020 (see Figure 34A and34B ) is configured to be compatible with the second end cap assembly 2034 (see Figure 34A and 34B ) of the external threaded portion 2074 (see Figure 35 ) matches the second internal thread portion 2094. Housing 2020 (see Figure 34A and 34B ) has an inner wall 2100 extending circumferentially and radially inwardly protruding near but inward of the second open end 2024. The inner wall 2100 has a substantially similar annular protrusion 2072 (see Figure 35 ) is an annular protrusion 2102 extending longitudinally outward. Figure 34A and 34B , an annular protrusion 2102 in the housing 2020 at the second open end 2024 (see Figure 38 ) is used as the third seat "S3'". The third seat "S3'" is placed longitudinally inward from the second end cover assembly 2034. The seat member 2046 (see Figure 35 ) serves as the fourth seat "S4'." The third seat "S3'" and the fourth seat "S4'" extend relative to each other.

[0373] refer to Figure 34A and 34B The cough assistance valve 2000 includes a first poppet valve assembly 2112 and a second poppet valve assembly 2114 connected together by a shaft 2116 for simultaneous movement. The first poppet valve assembly 2112 is longitudinally positioned and moved between a first seat "S1'" and a second seat "S2'", and the second poppet valve assembly 2114 is longitudinally positioned and moved between a third seat "S3'" and a fourth seat "S4'".

[0374] refer to Figure 34A and 34B , the shaft 2116 is configured to be within the housing 2020 and in a first position (see Figure 34A ) and the second position (see Figure 34B ), wherein in the first position, the cough assistance valve 2000 is in the first configuration, and in the second position, the cough assistance valve 2000 is in the second configuration. When the shaft 2116 moves, the first poppet valve assembly 2112 moves between the first seat "S1'" and the second seat "S2'", and the second poppet valve assembly 2114 moves between the third seat "S3'" and the fourth seat "S4'". When the shaft 2116 is in the first position (see Figure 34A ), the first poppet valve assembly 2112 is in a sealing position relative to the first seat "S1'", and the second poppet valve assembly 2114 is in a sealing position relative to the third seat "S3'". When the shaft 2116 is in the second position (see Figure 34B), the first poppet valve assembly 2112 is in a sealing position relative to the second seat "S2'", and the second poppet valve assembly 2114 is in a sealing position relative to the fourth seat "S4'".

[0375] refer to Figure 34A , longitudinal channel 2136 extends inwardly to shaft 2116 at each end thereof. Figure 36 , Channel 2136 (see Figure 34A ) are each configured to receive a fastener 2140 (see Figure 21 ). The first poppet valve assembly 2112 and the second poppet valve assembly 2114 are substantially identical to each other. Figure 36 Each of the first poppet valve assembly 2112 and the second poppet valve assembly 2114 includes a fastener 2140, an optional first washer 2146, a disc-shaped poppet member 2148, and an optional second washer 2152. Figure 36 Not visible, the first poppet valve assembly 2112 and the second poppet valve assembly 2114 each include a first sealing member 1146 and a second sealing member 1150, most of which are shown in FIG. Figure 21 As shown, it is used to seal the poppet valve assembly to the end of the shaft 2116 and provide a flexible coupling between the shaft and the poppet valve member 2148 of the poppet valve assembly. The fastener 2140 of the first poppet valve assembly 2112 fastens the other components of the first poppet valve assembly 2112 (i.e., the optional first washer 2146, the disc-shaped poppet member 2148, and the optional second washer 2152) to one end of the shaft 2116. Similarly, the fastener 2140 of the second poppet valve assembly 2114 fastens the other components of the second poppet valve assembly 2114 to the other end of the shaft 2116.

[0376] See also Figure 34A and 34B The cough assistance valve 2000 includes an actuator 2170 that is configured to move along a direction indicated by a double-headed arrow 2172 (see FIG. Figure 36 ) identifies the longitudinal direction in the first position (see Figure 34A ) and the second position (see Figure 34B ) to selectively move the shaft 2116 between the two positions. In the illustrated embodiment, the actuator 2170 is a linear actuator that includes a fixed coil subassembly 2174 and a movable magnet subassembly 2176. The shaft 2116 is coupled to the movable magnet subassembly 2176 and moves therewith as a unit.

[0377] refer to Figure 34A and 34B, the fixed coil subassembly 2174 includes a coil 2177 located within an outer shell 2179. The outer shell 2179 is coupled to the actuator mounting portion 2190 of the housing 2020 (e.g., by one or more fasteners 2178). The outer shell 2179 is constructed of a magnetic material. The coil 2177 is connected to a printed circuit board ("PCB") 2064 mounted on the outside of the housing 2020 via one or more wires 2062. In the embodiment shown, the wires 2062 provide power to the coil 2177. The outer shell 2179 and the housing 2020 each include one or more holes through which the wires 2062 can pass. The PCB 2064 is connected to the control system 220 (see FIG. 20 ) via one or more wires (not shown). Figure 5E ). The actuator 2170 is configured to receive a control signal 1180 (see FIG. 1 ) from the control system 220 (via the PCB 2064 and the wires 2062). Figure 5E ) and moves according to one or more instructions in the control signal 1180. PCB 2064 acts as a connector and transmits the control signal 1180 to the coil 2177.

[0378] See also Figure 36 The movable magnet subassembly 2176 has a main magnet 2150 having a first end 2151 opposite a second end 2153. A first latching magnet 2156 is mounted to the first end 2151 and a second latching magnet 2158 is mounted to the second end 2153. The first latching magnet 2156 and the second latching magnet 2158 are each attracted to a magnetic housing 2179 (see FIG. Figure 34A and 34B ). refer to Figure 34A , after the shaft 2116 has been moved to the first position (by energizing the coil 2177), the first latching magnet 2156 (see Figure 36 ) and the outer shell 2179, the attraction between the shaft 2116 is maintained in the first position. Figure 34B , after the shaft 2116 has been moved to the second position (by energizing the coil 2177), the second latching magnet 2158 (see Figure 36 ) and the outer shell 2179 holds the shaft 2116 in the second position. Thus, after the coil 2177 is de-energized, the shaft 2116 can remain in the desired position.

[0379] Control signal 1180 (see Figure 5E ) selectively energizes the coil 2177 to move the movable magnet subassembly 2176 toward the first end cap assembly 2032 or the second end cap assembly 2034. When the movable magnet subassembly 2176 moves toward the first end cap assembly 2032, the shaft 2116 moves toward the first position. Figure 34AAfter the shaft 2116 has moved to the first position, the coil 2177 is de-energized and the first latching magnet 2156 (see Figure 36 ) and the outer shell 2179, the shaft 2116 is held in the first position. On the other hand, when the movable magnet subassembly 2176 moves toward the second end cap assembly 2034, the shaft 2116 moves toward the second position. Figure 34B After the shaft 2116 has moved to the second position, the coil 2177 is de-energized and the second latching magnet 2158 (see Figure 36 ) and the outer shell 2179 maintains the shaft 2116 in the second position. Therefore, no additional power is required to maintain the shaft 2116 in the first position or the second position, which helps to extend battery life in embodiments powered by one or more batteries.

[0380] refer to Figure 37 The actuator mounting portion 2190 is spaced inwardly from the first open end 2022 and optionally includes one or more fasteners 2178 (see FIG. Figure 34A and 34B ) through hole. Figure 34A and 34B The outer housing 2179 is coupled to the inwardly facing side of the actuator mounting portion 2190 by fasteners 2178, which secure the fixed coil subassembly 2174 to the housing 2020. Figure 34A and 34B , the actuator mounting portion 2190 has a through hole 2186 (see Figure 37 ), the through hole 2186 is configured to allow the shaft 2116 to pass completely therethrough to position the first poppet valve assembly 2112 between the first seat "S1'" and the second seat "S2'".

[0381] See also Figure 38 , Housing 2020 (see Figure 34A and 34B ) includes an inner support member 2194 spaced inwardly from the second open end 2024. In the illustrated embodiment, the inner support member 2194 extends radially inwardly from the inner wall 2100. The inner support member 2194 has a through hole 2196 formed therein. Figure 34A and 34B , through hole 2196 (see Figure 38 ) is configured to allow the shaft 2116 to pass therethrough to position the second poppet valve assembly 2114 between the third seat "S3'" and the fourth seat "S4'". Figure 34A and 34B, the internal support member 2194 abuts and helps secure the outer housing 2179 of the actuator 2170. In the illustrated embodiment, the actuator mounting portion 2190 is coupled to one end of the outer housing 2179 proximate the second seat "S2'" and the internal support member 2194 is adjacent the opposite end of the outer housing 2179 proximate the third seat "S3'."

[0382] refer to Figure 34A and 34B , the housing 2020 includes a main exhaust body portion 2199 (also coupled to the Figure 38 The intake body portion 2198 (also shown in Figure 37 2006, the aperture 2010, the first open end 2022, and the actuator mounting portion 2190 are formed in the intake body portion 2198. The blower-valve inlet 2004, the exhaust outlet 2008, the second open end 2024, and the internal support 2194 are formed in the exhaust body portion 2199.

[0383] refer to Figure 34A In the first configuration, the first poppet valve assembly 2112 is pressed against the second seat "S2'" and the second poppet valve assembly 2114 is pressed against the fourth seat "S4'". Figure 5A and 34A In the first configuration, the first poppet valve assembly 2112 allows gas 252 from the accumulator 202 to flow through the inlet 2006, out of the valve-blower outlet 2002, and into the blower 222. Furthermore, the first poppet valve assembly 2112 blocks gas 252 from directly entering the orifice 2010, thereby sealing the orifice 2010 from the inlet 2006 and the valve-blower outlet 2002. Simultaneously, the second poppet valve assembly 2114, pressed against the fourth seat "S4'," closes the exhaust outlet 2008 and allows gas 252 to flow to the primary ventilator connector 104. In this configuration, gas 252 from the accumulator 202 entering the inlet 2006 is directed to the blower 222 through the valve-blower outlet 2002. The gas 252 is then blown by the blower 222 to the blower-valve inlet 2004 and flows out of the hole 2010 to the main ventilator connection 104.

[0384] Reference Figure 34B In the second configuration, the first poppet valve assembly 2112 is pressed against the first seat "S1'" and the second poppet valve assembly 2114 is pressed against the third seat "S3'". Figure 5B and 34BIn the second configuration, first poppet valve assembly 2112 allows exhaust gas 253 from primary ventilator connector 104 to flow through orifice 2010, out of valve-blower outlet 2002, and into blower 222. Furthermore, first poppet valve assembly 2112 blocks exhaust gas from flowing to air inlet 2006, thereby preventing gas 252 from accumulator 202 from reaching valve-blower outlet 2002. Simultaneously, second poppet valve assembly 2114, pressed against third seat "S3'," opens exhaust outlet 2008 and blocks exhaust gas 253 from flowing to orifice 2010. In this configuration, exhaust gas 253 from primary ventilator connector 104 entering orifice 2010 is directed to blower 222 through valve-blower outlet 2002. Exhaust gas 253 is then blown by blower 222 to blower-valve inlet 2004 and exhausted through exhaust outlet 2008.

[0385] In the embodiment shown, the cough assistance valve 2000 (see Figure 34A and 34B ) includes a housing 2020 (see Figure 34A and 34B ) in ports 275A, 275B, and 275C (described below and in Figure 5A and 5B ). See Figure 38 , ports 275A and 275B may be formed in the exhaust body portion 2199. Figure 34A and 34B , port 275C may be formed in the intake body portion 2198. However, this is not required. Alternatively, reference Figure 37 , the cough assistance valve 2000 includes a port 275D configured to connect to a redundant airway pressure transducer (not shown).

[0386] Whether it is the cough assist valve 204 or the cough assist valve 2000, the cough assist valve is designed to work in a balanced manner relative to the pressure of the first poppet valve assembly 1112 and the second poppet valve assembly 1114 of the cough assist valve 204, or the first poppet valve assembly 2112 and the second poppet valve assembly 2114 of the cough assist valve 2000. This results in the actuator 1170 of the cough assist valve 204 and the actuator 2170 of the cough assist valve 2000 never having to work relative to the patient pressure. Since all the seat areas of the seats S1-S4 of the cough assist valve 204 are the same as all the seat areas of the seats S1'-S4' of the cough assist valve 2000, the patient pressure in the cough assist valve is controlled by the port 1010 (e.g., see Figure 5C and 5D) operates relative to the poppet assembly of the cough assistance valve, generating equal and opposite forces. Thus, when abutting the first seat S1 and the third seat S3, respectively, the forces exerted on the first poppet assembly 1112 and the second poppet assembly 1114 of the cough assistance valve 204 are substantially equal and in opposite directions to the forces exerted on the first poppet assembly 1112 and the second poppet assembly 1114 of the cough assistance valve 204 when abutting the second seat S2 and the fourth seat S4, respectively. Similarly, when abutting the first seat S1' and the third seat S3', respectively, the forces exerted on the first poppet assembly 2112 and the second poppet assembly 2114 of the cough assistance valve 2000 are substantially equal and in opposite directions to the forces exerted on the first poppet assembly 2112 and the second poppet assembly 2114 of the cough assistance valve 2000 when abutting the second seat S2' and the fourth seat S4', respectively. If the forces exerted on the first and second poppet assemblies of the cough assistance valve are unbalanced, the actuator 1170 / 2170 of the cough assistance valve will need to be larger, and the electrical power required to drive the actuator will be greater.

[0387] As described above, the respiratory assembly 190 may include a cough assistance valve 204 or a cough assistance valve 2000. If the respiratory assembly 190 includes a cough assistance valve 204, then during normal ventilation, the cough assistance valve 204 is in Figure 5A and Figure 18A On the other hand, if the respiratory assembly 190 includes a cough assistance valve 2000 (see Figure 34A and 34B ), then during normal ventilation, the cough assist valve 2000 is in Figure 34A The first configuration is shown in .

[0388] refer to Figure 5A At the beginning of the inspiration phase of a breath (and at the beginning of the insufflation phase of a cough), air 114 may be drawn into the ventilator 100 through the patient air inlet 116 (see Figure 1 and Figure 4 ), the air inlet 116 can be configured to filter dust and / or other types of particles from the air. At least a portion of the air 114 flows into the accumulator 202, where the air 114 can be optionally mixed with oxygen 250 received from the oxygen assembly 210, the low pressure oxygen 128 (from Figure 1 18 (received from an external low pressure oxygen source 118 as shown), combinations and / or subcombinations thereof, and the like. Figure 4 As shown, high pressure oxygen 132 (from Figure 1 The high pressure external oxygen source 120 shown is received) flows into the oxygen assembly 210 and can be delivered to the accumulator 202 (see Figure 5A ).

[0389] refer to Figure 5A The accumulator 202 may also serve as a silencer for the patient air inlet 116 .

[0390] Inlet silencer 229 helps to eliminate the oxygen generated by oxygen assembly 210 (e.g., Figure 7A The sound produced by the compressor 302 shown.

[0391] The oxygen sensor 227 is connected to the accumulator 202 and measures the oxygen concentration value of the gas in the accumulator 202. This value is similar to the oxygen concentration value of the gas 252 leaving the accumulator 202. Figure 5E , the oxygen sensor 227 provides an oxygen concentration signal 276 encoding an oxygen concentration value to the control system 220. The control system 220 processes the oxygen concentration signal 276 to obtain a measure of how much oxygen is in the gas 252 (e.g., expressed as a percentage). Figure 4 , the output information 198 sent by the control system 220 to the user interface 200 may include a measure of how much oxygen is in the gas 252. The user interface 200 may provide the user (e.g., Figure 1 Patient 102 is shown displaying this measure.

[0392] refer to Figure 5A Optionally, the accumulator 202 includes or is connected to the low pressure oxygen inlet 126. When the low pressure oxygen 128 is supplied by the external low pressure oxygen source 118 (see Figure 1 ) supply, the control system 220 may not control the resulting oxygen concentration flowing to the patient 102. In other words, the low pressure oxygen 128 may simply flow into the accumulator 202, mix with the air 114, and be pushed into the patient circuit 110 by the blower 222 (see Figure 1 ). When this occurs, the ventilator 100 will not be controlled within the inspiratory gas 108 (see Figure 1 ) to the patient 102, but rather to control the delivery of inspiratory gas 108 during the inspiratory phase of each breath.

[0393] The gas 252 exiting the accumulator 202 includes air 114 and optionally one or more of oxygen 250 and oxygen 128. The gas 252 may be directed to the internal flow transducer 212 via a flow line 214. The gas 252 flows through the internal flow transducer 212, which measures the flow rate of the gas 252 and transmits a flow signal 270 (see FIG. 1 ) encoding the flow rate value. Figure 5E ) is provided to the control system 220 (see Figure 5E ). The flow signal 270 can be implemented as an analog electrical signal. Figure 5E, the control system 220 uses the flow signal 270 to control the blower 222. As a non-limiting example and as Figure 5A As shown, the internal flow transducer 212 may be implemented using a flow transducer having a fixed orifice differential pressure configuration.

[0394] The internal flow transducer 212 can be used to detect the patient 102 (see Figure 1 ) when breathing begins. In particular, when the patient circuit 110 (see Figure 1 ) is implemented as a passive patient circuit (e.g., passive patient circuit 170, passive patient circuit 440, etc.), the internal flow transducer 212 can be used in this manner. The flow of gas through the flow line 214 is not entirely determined by the blower 222. Instead, the patient's breathing effort may result in a change in the flow rate through the flow line 214. Thus, the control system 220 can recognize that the patient 102 has initiated a breath by identifying a change in the flow rate through the flow line 214 (encoded in the flow signal 270).

[0395] The internal flow transducer 212 may include or be connected to an auto-zero solenoid valve SV5 configured to be activated by a control signal 285 (see FIG. Figure 5E ) to selectively activate and deactivate the internal flow transducer 212. The internal flow transducer 212 may drift over time, causing errors in flow rate measurements. To compensate for this error, occasionally (e.g., periodically), the control system 220 energizes (or activates) the auto-zero solenoid valve SV5 (using control signal 285) and determines an offset value for the internal flow transducer 212. After determining the offset value, the control system 220 uses the offset value to compensate future readings (based on the flow signal 270) accordingly.

[0396] refer to Figure 5A After the internal flow converter 212, the gas 252 is directed to the blower 222 via the flow line 214 and the cough assistance valve 204 (or cough assistance valve 2000). Figure 5E , the blower 222 can be implemented as a radial blower driven by the motor 272. As a non-limiting embodiment, the motor 272 can be implemented as a brushless DC motor. As another non-limiting embodiment, the blower 222 can be implemented as a compressor, a pump, or the like. The motor 272 has an operating speed controlled by the control system 220. As a non-limiting embodiment, the control system 220 can continuously control the operating speed of the motor 272.

[0397] refer to Figure 5A, gas 252 flows out of the blower 222 and into the cough assistance valve 204 (or cough assistance valve 2000). Ports 275A-275C are each configured to provide access to the gas 252 located in the cough assistance valve 204 (or cough assistance valve 2000). Flow line 273 directs the gas 252 from the cough assistance valve 204 (or cough assistance valve 2000) to the internal bacterial filter 230.

[0398] refer to Figure 5A , the airway pressure transducer 224 measures the airway pressure of the gas 252 flowing from the blower 222 and flowing to the main ventilator connection 104. In the embodiment shown, the airway pressure transducer 224 is connected to port 275C. Figure 5E The airway pressure transducer 224 provides an electrical pressure signal 274 encoding these pressure values ​​to the control system 220. The electrical pressure signal 274 is used to control the patient pressure during the inspiration and expiration phases. The electrical pressure signal 274 is also passed to the monitoring and alarm system 221 (see Figure 4 ) to use. Optionally, the ventilator 100 (see Figure 1 and Figure 4 ) may include one or more redundant airway pressure transducers (not shown) similar to airway pressure transducer 224 to provide a fail-safe backup for airway pressure transducer 224. In embodiments including redundant airway pressure transducers (not shown), the redundant airway pressure transducers may be connected to port 275D (see Figure 17B ).

[0399] The airway pressure transducer 224 can be used by the control system 220 to detect pressure changes and, in response to the detected pressure changes, instruct the blower 222 to increase or decrease its speed to regulate the pressure within the flow line 273. Thus, the control system 220 can use the electrical pressure signal 274 to deliver pressure ventilation and / or help ensure that the pressure within the flow line 273 does not exceed a user-provided peak inspiratory pressure value (e.g., by Figure 6 ) as shown in the pressure control input terminal 237 input.

[0400] refer to Figure 5A The airway flow converter module 225 includes a differential pressure converter PT4, automatic zeroing solenoid valves SV1 and SV2, and cleaning solenoid valves SV3 and SV4. Figure 5E , the control system 220 can use control signals 281 - 284 to selectively activate or deactivate solenoid valves SV1 - SV4 , respectively.

[0401] refer to Figure 1 As described above, the patient circuit 110 may include one or more optional ports 111 . Figure 5AAn embodiment of a respiratory assembly 190 is shown that is configured to be used with a device implemented as an active patient circuit (e.g., Figure 3A , and the like). In a configuration configured for use with a patient circuit implemented as a passive patient circuit (e.g., Figure 2A The passive patient circuit 170 shown in FIG. Figure 2B In alternative embodiments for use with patient circuit 110 (e.g., passive patient circuit 440 shown in FIG. 4 , or the like), ports 275A and 275B, airway flow transducer module 225, and exhalation control assembly 226 may be omitted from respiratory assembly 190.

[0402] Figure 5A The airway flow transducer module 225 and the exhalation control assembly 226 are shown configured to be coupled to an airway flow transducer 648 (see FIG. Figure 3G ) of the active patient circuit (e.g., Figure 3A For use with the active patient circuit 600 shown in FIG. Figure 5A , the first port 111A and the second port 111B (see Figure 3C ) respectively sends the first pressure signal 109A and the second pressure signal 109B (for example, through isolated pipelines or channels) to the differential pressure transducer PT4. The differential pressure transducer PT4 has an input port PA and an input port PB, which are configured to receive the first pressure signal 109A and the second pressure signal 109B, respectively. The differential pressure transducer PT4 determines the differential pressure based on the first pressure signal 109A and the second pressure signal 109B, and converts the differential pressure into a signal 277 (see FIG. Figure 5E ), and (as Figure 5E 27) sends the signal 277 to the control system 220 for further processing. As a non-limiting example, the signal 277 can be an analog signal.

[0403] Signal 277 can be used to detect patient 102 (see Figure 1 ) when to start breathing. Figure 3A ) is not entirely determined by blower 222. Rather, the patient's respiratory effort may result in changes in the flow rate through active patient circuit 600. Thus, control system 220 can identify that patient 102 has begun breathing by identifying changes in the flow rate through active patient circuit 600 (encoded in signal 277).

[0404] The auto-zero solenoid valves SV1 and SV2 are connected to input port PA and input port PB of the differential pressure transducer PT4, respectively. In addition, each auto-zero solenoid valve SV1 and SV2 is connected to ambient pressure. The differential pressure transducer PT4 can drift over time, thereby causing flow measurement errors. To compensate for this error, occasionally (e.g., periodically), the control system 220 powers (or activates) the auto-zero solenoid valves SV1 and SV2 (using control signals 281 and 282, respectively) and determines an offset value for the differential pressure transducer PT4. The control system 220 then deactivates the auto-zero solenoid valves SV1 and SV2 (using control signals 281 and 282, respectively). After determining the offset value, the control system 220 uses the offset value to compensate future readings accordingly (based on signal 277).

[0405] Purge solenoid valves SV3 and SV4 are connected to port 275A. Figure 5E , the control system 220 occasionally (eg, periodically) powers (or activates) the purge solenoid valves SV3 and SV4 (using control signals 283 and 284, respectively), which allow the purge solenoid valves SV3 and SV4 to be removed from the Figure 5A The cough assist valve 204 shown (or Figure 34A 2000 ) flows through tubing, ports, and / or channels (e.g., optional multi-lumen tubing connector 103 , channels 626A and 626B, channels 632A and 632B, ports 111A and 111B, and the like) that conduct pressure signals 109A and 109B to purge any moisture that may condense from the humid patient respiratory gases.

[0406] refer to Figure 5E The exhalation control assembly 226 includes an accumulator A2, a pressure transducer PT8, and solenoid valves SV6-SV8. The accumulator A2 has three ports 267-269 and internal pressure (referred to as "pilot pressure"). The pressure transducer PT8 is connected to the accumulator A2, measures the internal pressure in the accumulator A2, and outputs the value as an electrical pressure signal 271 (see Figure 5E ) is transmitted to the control system 220.

[0407] refer to Figure 5E , solenoid valves SV6-SV8 are configured to be selectively activated and deactivated by control signals 286-288, respectively, sent to solenoid valves SV6-SV8, respectively, by the control system 220. Figure 5A , solenoid valve SV6 is connected to the active patient circuit 600 (see Figure 3A ) of the first port 267, port 275B and pilot port 111C of the accumulator A2 (see Figure 3CThe solenoid valve SV7 is connected to the second port 268 and the port 275B of the accumulator A2. The solenoid valve SV8 is connected between the third port 269 and the outlet port 166 of the accumulator A2.

[0408] The exhalation control assembly 226 provides pilot pressure (from accumulator A2) to the active patient circuit 600 (see Figure 3A ) of the pilot port 111C (see Figure 3C ), as described above, to control active exhalation valve assembly 604. At the beginning of the inspiratory phase of a breath, control system 220 activates solenoid valve SV6 (using control signal 286), which connects the pressure of gas 252 (via port 275B) to pilot port 111C. This closes active exhalation valve assembly 604. At the end of the inspiratory phase of a breath, control system 220 deactivates solenoid valve SV6 (using control signal 286), which connects the internal pressure of accumulator A2 (or pilot pressure) to active exhalation valve assembly 604, opening active exhalation valve assembly 604.

[0409] Similarly, at the beginning of the insufflation phase of a cough, the control system 220 activates solenoid valve SV6 (using control signal 286), which connects the pressure of gas 252 (via port 275B) to pilot port 111C. This closes the active exhalation valve assembly 604. At the end of the insufflation phase, the control system 220 deactivates solenoid valve SV6 (using control signal 286), which connects the internal pressure of accumulator A2 (or pilot pressure) to the active exhalation valve assembly 604. As discussed below, rather than opening the active exhalation valve assembly 604, this maintains the active exhalation valve assembly 604 in a closed configuration. It should be noted that during the beginning of the exhalation phase, due to the patient pressure applied to the dual bellows member being above ambient pressure, the dual bellows member 644 can move to the open position, but when the pressure provided by the patient 102 drops below ambient pressure, the dual bellows member 644 automatically closes.

[0410] The control system 220 uses solenoid valves SV7 and SV8 to control the pilot pressure in accumulator A2, using pressure transducer PT8 (via Figure 5EThe control system 220 uses feedback provided by the electrical pressure signal 271 (shown) to set the pilot pressure for the expiratory phase of a breath to achieve the desired PEEP. For example, the control system 220 can reduce the pilot pressure within accumulator A2 by activating solenoid valve SV8 (using control signal 288), thereby discharging some of the gas within accumulator A2 as exhaust 167 through outlet port 166. Conversely, the control system 220 can increase the pilot pressure by activating solenoid valve SV7 (using control signal 287) to add some gas 252 (obtained through port 275B) to the interior of accumulator A2.

[0411] refer to Figure 5E , the control system 220 uses the electrical pressure signal 274 (received from the airway pressure transducer 224) to help control the blower 222. The control system 220 sends a control signal 278 to the motor 272, which directs the blower 222 to provide a desired flow rate and / or a desired amount of pressure to the patient 102. As described above, the flow signal 270 is used to help control the flow rate of the gas 252 during the inspiration and expiration phases of breathing. Similarly, the electrical pressure signal 274 is used to control the patient pressure during the inspiration and expiration phases of breathing. The flow signal 270 can be used to help control the flow rate of the gas 252 during the insufflation phase and / or the flow rate of the exhaust gas 253 during the expiration phase of a cough. Similarly, the electrical pressure signal 274 is used to control the patient pressure during the inspiration phase and / or the expiration phase of a cough.

[0412] As explained above, the ventilator 100 regulates the patient circuit 110 (e.g., Figure 2B 274 ) to achieve a preset inspiratory pressure during the inspiratory phase, a baseline pressure or PEEP during the expiratory phase, and PEEP during the pause between the inspiratory and expiratory phases. These adjustments (as well as those performed during cough assist maneuvers) are made by the control system 220, which monitors the electrical pressure signal 274 and uses a control signal 278 to increase or decrease the speed of the motor 272 to achieve the desired pressure in the patient circuit 110.

[0413] The ambient pressure transducer 228 measures the atmospheric pressure value. The ambient pressure transducer 228 provides an ambient electrical pressure signal 280 encoded with the atmospheric pressure value to the control system 220. The control system 220 uses the ambient electrical pressure signal 280 to correct the flow rate value (received via the flow signal 270) and / or the exhaled tidal volume value (calculated by the control system 220) to achieve the desired standard conditions.

[0414] refer to Figure 5AAs described above, flow line 273 directs gas 252 from cough assist valve 204 (or cough assist valve 2000) to internal bacterial filter 230. After gas 252 passes through internal bacterial filter 230, it exits internal bacterial filter 230 as gas 112 and enters patient circuit 110 through main ventilator connection 104 (see FIG. Figure 1 Internal bacterial filter 230 helps prevent bacteria in patient circuit 110 from contaminating ventilator 100 .

[0415] user interface

[0416] Figure 6 is a block diagram illustrating some exemplary components of user interface 200. As described above, Figure 4 Output information 198 sent by the control system 220 to exemplary components of the user interface 200 , and input information 196 received by the control system 220 from exemplary components of the user interface 200 , are shown.

[0417] refer to Figure 6 , the user interface 200 is configured to receive operating parameter values ​​from a user (e.g., a clinician) and display information to the user. For example, the user interface 200 may include a display device 240 (e.g., a liquid crystal display), a mode input 235, an inspiratory time input 236, a pressure control input 237, a pressure support input 238, an activate oxygen generator input 239 for activating oxygen generation (described below), a tidal volume input 242, an oxygen flow equivalent 244, a fraction of inspired oxygen ("FIO2") input 246, a respiratory rate input 247, an oxygen pulse volume input 251, an activate cough assist input 241 for activating the suction component 152 (see Figure 1 ) and for activating the nebulizer assembly 162 (see Figure 1 ) activates the sprayer input 249.

[0418] The start of the inhalation phase is referred to as "start". Mode input 235 is configured to receive an indication as to whether the ventilator 100 determines when each breath begins, or whether the patient 102 determines when each breath begins. Respiratory rate input 247 is configured to receive the rate at which breaths are to be delivered (e.g., breaths per minute). If the user has instructed (using mode input 235) the ventilator 100 to determine when each breath begins, the ventilator 100 will deliver breaths according to the rate received by respiratory rate input 247 (e.g., at regular, timed intervals). On the other hand, if the user has instructed (using mode input 235) the patient 102 to initiate each breath, the ventilator 100 will automatically deliver breaths as needed to ensure that the patient 102 receives breaths at least as frequently as indicated by the rate received by respiratory rate input 247.

[0419] The ventilator 100 may identify the end of the inspiratory phase by using the time or flow rate of gas 112 to the patient 102. In the latter case, the patient 102 determines when the inspiratory phase ends. The inspiratory time input 236 is configured to receive a time duration T that may indicate the duration from the start of each breath to the end of the inspiratory phase. i The ventilator 100 can use this value (indicating the duration T i ) to identify the end of the inspiratory phase. The pressure support input 238 receives the flow rate of gas 112 to the patient 102 that the user wishes to use (rather than indicating the duration T i For example, ventilator 100 may terminate the inspiratory phase of a breath when the flow rate of gas 112 is only about 25% of the peak flow rate that occurs during the breath.

[0420] The ventilator 100 is configured to deliver gas 112 alone, or a combination of gas 112 and pulses of oxygen 140. As described above, the ventilator 100 can be configured to provide traditional volume-controlled breaths and pressure-controlled breaths. To use pressure control, the user can enter a peak inspiratory pressure value using the pressure control input 237. The ventilator 100 uses the peak inspiratory pressure value to configure gas 112 alone, or a combination of gas 112 and pulses of oxygen 140, so that the pressure during the inspiratory phase is at most the peak inspiratory pressure value.

[0421] The FIO2 input 246 is configured to receive an oxygen concentration value. The ventilator 100 uses the oxygen concentration value to configure the gas 112 to have an oxygen concentration that is equal to or close to the oxygen concentration value.

[0422] The oxygen pulse volume input 251 is configured to receive an oxygen pulse volume value (e.g., in milliliters, or a value within a predetermined range, such as 1 to 10, etc.). The ventilator 100 uses the oxygen pulse volume value to configure each pulse of oxygen 140 to have a volume equal to or close to the oxygen pulse volume value.

[0423] The tidal volume input 242 is configured to receive a desired total tidal volume value. Figure 15A , the ventilator 100 uses the desired total tidal volume during each breath to deliver a volume of gas 112 (represented by region 586 and described below) and a pulse of oxygen 140 (represented by region 584 and described below). For each breath delivered, the total tidal volume delivered is the combination of the volume of gas 112 and the pulse of oxygen 140 delivered during the breath.

[0424] The oxygen flow equivalent 244 is configured to receive a desired oxygen delivery rate (expressed in liters per minute) that identifies a hypothetical continuous flow of oxygen that could flow from an external source (e.g., a stand-alone oxygen concentrator) into a conventional ventilator or patient circuit 110 (see Figure 1 ) in the rate. The ventilator 100 uses this value to configure the oxygen 140 (see Figure 1 ) to deliver a certain amount of oxygen, which will be treated as a hypothetical continuous flow of oxygen to the patient 102 (see Figure 1 ) provides equivalent oxygenation.

[0425] Activating the cough assist input 241 indicates that the user wants to perform a cough assist operation (discussed below).

[0426] Oxygen components

[0427] Figure 7A is a schematic diagram illustrating some exemplary components of oxygen assembly 210 . Figure 7B Control signals 260 sent by control system 220 to exemplary components of oxygen assembly 210 and data signals 262 received by control system 220 from exemplary components of oxygen assembly 210 are shown.

[0428] refer to Figure 7A , oxygen assembly 210 is configured to receive high pressure oxygen 132 and / or generate oxygen 346 (see Figure 8B ) and provides oxygen 250 to the accumulator 202 of the breathing assembly 190 (see Figure 5A ), and / or provide pulses of oxygen 140 to the patient oxygen outlet 105. The oxygen assembly 210 can be configured to provide up to about two liters per minute ("LPM") of approximately 90% pure oxygen. In the illustrated embodiment, the oxygen assembly 210 includes an adsorbent bed 300, a compressor 302, a first rotary valve assembly 306, two pressure transducers PT2 and PT3, two pressure regulators R1 and R2, an outlet muffler 311, optional solenoid valves SV9 and SV10, an oxygen tank 312, an oxygen sensor 314, a metering valve 320, and an optional second rotary valve assembly 330. The compressor 302, the first rotary valve assembly 306, the adsorbent bed 300, and the pressure regulators R1 and R2 can be collectively characterized as an oxygen generator or an oxygen concentrator. The oxygen generator shown in the figures and described below implements a vacuum pressure swing adsorption ("VPSA") process. In alternative embodiments, the ventilator 100 can include an oxygen generator that implements at least one of a polymer membrane isolation process, an ion transport isolation process, a cryogenic process, or the like. Furthermore, the VPSA process described below is a subset of pressure swing adsorption (PSA), and the oxygen generator may be configured to implement a PSA process other than the VPSA process described below.

[0429] The adsorption bed 300 is configured to harvest oxygen from air 114 received through the patient inlet 116. As described below, the adsorption bed 300 can be configured to at least partially implement a VPSA process (as described below) comprising a four-phase cycle. The cycle alternately produces oxygen 346 (see Figure 8B ) and nitrogen-enriched gas 122. When the ventilator 100 is in operation, this cycle is repeated until enough oxygen is produced to fill the oxygen tank 312. When the oxygen tank 312 is full, the cycle stops or slows down until a sufficient amount of oxygen is removed from the oxygen tank 312. The cycle then resumes or is accelerated as appropriate. The nitrogen-enriched gas 122 produced by each cycle is exhausted to the outside environment through the outlet exhaust port 124.

[0430] Figures 8A-8D is a block diagram illustrating some exemplary components of the adsorption bed 300. Figures 8A-8D In the illustrated embodiment, the adsorption bed 300 includes at least one shell 340 having a first end 341 opposite a second end 343. Shell 340 contains a bed 344 of nitrogen adsorbent material (e.g., zeolite) between the first end 341 and the second end 343 thereof. The bed 344 of nitrogen adsorbent material preferentially adsorbs nitrogen. For ease of description, the adsorption bed 300 will be described as comprising a single shell containing a single bed of nitrogen adsorbent material. In alternative embodiments, the adsorption bed 300 may include two or more beds, such as the bed 344 of nitrogen adsorbent material, each mounted within an isolated shell similar to shell 340.

[0431] As mentioned above, the VPSA process consists of a four-stage cycle. Figure 8A The adsorption bed 300 is shown during the first stage. Figure 8A During the first stage, air 114 is pumped by compressor 302 into housing 340 (see Figure 7A When the housing 340 is pressurized with air 114 (by the compressor 302), nitrogen in the air is preferentially adsorbed by the nitrogen adsorbent bed 344, leaving unadsorbed oxygen. The nitrogen adsorbent bed 344 may include interstitial spaces where the unadsorbed oxygen is retained or captured.

[0432] Figure 8B The adsorbent bed 300 is shown during the second phase of the cycle of the VPSA process. During the second phase, oxygen 346 is pumped from the housing 340. The oxygen 346 flows from the interstitial space into the oxygen tank 312 (see FIG. Figure 7A ).

[0433] Figure 8C The adsorption bed 300 is shown during the third stage of the cycle of the VPSA process. During the third stage, the nitrogen-rich gas 122 is withdrawn from the nitrogen adsorbent bed 344 in the housing 340 (via Figure 7Acompressor 302) and is discharged to the external environment through the outlet exhaust port 124 (see Figure 7A ).

[0434] Figure 8D The adsorption bed 300 is shown during the fourth stage of the cycle of the VPSA process. During the fourth stage, a "purge" oxygen 348 (e.g., from Figure 7A The flow of oxygen tank 312 (as shown) is used to help withdraw the nitrogen-rich gas 122 and regenerate the nitrogen adsorbent material bed 344.

[0435] Back to Figure 7A , oxygen 346 removed from adsorption bed 300 (see Figure 8B ) flows through pressure regulator R2 and into oxygen tank 312, which stores oxygen 346. When this occurs, metering valve 320 can be closed and pressure regulator R1 can be closed to prevent backflow to adsorption bed 300. Alternatively, metering valve 320 can be at least partially opened to allow some oxygen 346 to flow to optional second rotary valve assembly 330.

[0436] During each cycle, the compressor 302 is configured to alternately push the air 114 into the adsorption bed 300 (through the first rotary valve assembly 306) and withdraw the nitrogen-rich gas 122 from the adsorption bed 300 (through the first rotary valve assembly 306). The compressor 302 can be driven by a motor 350 and can include a sensor 352 (e.g., an encoder) configured to provide a signal 354 encoding the rotational direction and rotational speed of the motor 350 to the control system 220. Figure 7B , the motor 350 is configured to receive instructions encoded in a control signal 356 from the control system 220. The instructions in the control signal 356 instruct the motor 350 to turn on or off, and / or in which direction the motor 350 rotates when turned on. In addition, the control signal 356 can instruct the motor 350 at which speed to operate. Figure 7A When the motor 350 is operated in a first direction, the compressor 302 pushes air into the adsorption bed 300. On the other hand, when the motor 350 is operated in a second direction, the compressor 302 pushes the nitrogen-rich gas 122 (see FIG. Figure 8C and 8D ) is drawn out from the adsorption bed 300. As a non-limiting example, the motor 350 may be implemented as a brushless DC motor.

[0437] Figure 9 is a diagram of the metering valve 320. Figure 9 , the pressure transducer PT3 is connected across the metering valve 320. Therefore, the pressure transducer PT3 can determine the pressure difference across the metering valve 320. Figure 7BThe pressure transducer PT3 provides a differential pressure signal 358 encoding the differential pressure value to the control system 220 .

[0438] refer to Figure 7B and 9 , the metering valve 320 can be driven by a stepper motor 322 that is configured to receive a control signal 360 encoded with a stepper position value from the control system 220. The stepper motor 322 is configured to move to the stepper position value encoded in the control signal 360. In the embodiment shown, the metering valve 320 is a stepper-driven proportioning valve that is characterized by three variables: (1) valve position, (2) pressure differential across the valve (measured by pressure transducer PT3), and (3) flow rate. When a specific flow rate is required (e.g., by the user via Figure 6 248 ), the control system 220 uses the differential pressure signal 358 (encoded with the differential pressure value) and the specific flow rate to "look up" the corresponding step position value in the representation table 362. In other words, the representation table 362 stores each step position value associated with a flow rate value and a differential pressure value. Thus, the control system 220 can use the specific differential pressure value and the specific flow rate value to determine the step position value. The control system 220 then encodes the step position value in the control signal 360 and sends it to the stepper motor 322. This process can be repeated occasionally (e.g., every few milliseconds) to provide the instantaneous desired oxygen flow rate.

[0439] refer to Figure 9 A position sensor 368 can be operably coupled to the metering valve 320 and used to determine the home position. The position sensor 368 provides a position signal 370 to the control system 220 that encodes whether the metering valve 320 is in the home position (e.g., yes or "open") or a position other than the home position (e.g., no or "closed").

[0440] refer to Figure 7A , the pressure regulator R2 can be characterized as a back pressure regulator. The pressure regulator R2 can be configured to prevent the pressure within the adsorption bed 300 from exceeding a first threshold pressure value (e.g., approximately 10 pounds per square inch ("PSIG")). For example, the pressure regulator R2 can be configured to allow oxygen to automatically flow out of the adsorption bed 300 when the pressure within the adsorption bed 300 reaches the first threshold. The pressure regulator R2 can also be configured to prevent gas from flowing into the adsorption bed 300. This allows the pressure regulator R2 to be used in the first stage (see Figure 8A ) and the second stage (see Figure 8B ) to control stress during this period.

[0441] The pressure regulator R1 can be characterized as a vacuum regulator. The pressure regulator R1 can be configured to prevent the pressure within the adsorption bed 300 from decreasing below a second threshold pressure value (e.g., approximately -7 PSIG). Thus, the pressure regulator R1 is in the third stage (see Figure 8C ) and the fourth stage (see Figure 8D ) during the adsorption bed 300 to a second threshold pressure. For example, the pressure regulator R1 can be configured to allow oxygen to automatically flow into the adsorption bed 300 (e.g., from the oxygen tank 312) when the pressure within the adsorption bed 300 drops below the second threshold. The pressure regulator R1 can also be configured to prevent the gas within the adsorption bed 300 from flowing out of the adsorption bed 300 to the metering valve 320 (see Figure 1 ).

[0442] Optional solenoid valves SV9 and SV10 can be configured to maintain the pressure within the oxygen tank 312 between a minimum threshold pressure value (e.g., approximately 4 PSIG) and a maximum threshold pressure value (e.g., approximately 10 PSIG). Solenoid valves SV9 and SV10 are connected in parallel to the high pressure oxygen 132 (e.g., incoming gas) supply. Figure 1 The control system 220 uses control signals 380 and 382 (see FIG. 1 ) to transmit the high pressure oxygen source 120 to the oxygen tank 312. Figure 7B ) to selectively activate and deactivate solenoid valves SV9 and SV10 to maintain the pressure in the oxygen tank 312 between a minimum threshold pressure value and a maximum threshold pressure value. Thus, the control system 220 and the solenoid valves SV9 and SV10 together perform the function of a digital (on / off) regulator.

[0443] When the high-pressure external oxygen source 120 is connected, the control system 220 can automatically stop the oxygen assembly 210 from performing the VPSA process. For example, when the pressure in the oxygen tank 312 exceeds an upper threshold (e.g., 10 PSIG), the control system 220 can slow down or shut down the VPSA process. In this manner, the control system 220 can slow down or shut down the VPSA process when the adsorption bed 300 is in operation or when the high-pressure external oxygen source 120 is connected. On the other hand, when the pressure in the oxygen tank 312 drops to a lower pressure threshold (e.g., 4 PSIG), the control system 220 can restart or accelerate the VPSA process.

[0444] The oxygen tank 312 may be implemented as a rigid chamber configured to store a predetermined amount of oxygen (eg, approximately 56 cubic inches of oxygen). The outlet muffler 311 helps muffle the sound produced by the compressor 302.

[0445] refer to Figure 7A and 7B, oxygen sensor 314 measures the oxygen concentration in oxygen tank 312 and encodes the oxygen concentration value in an oxygen concentration signal 378 that is provided to control system 220. Control system 220 can use oxygen concentration signal 378 to monitor oxygen assembly 210 to ensure that it is functioning properly. If oxygen concentration signal 378 indicates that the oxygen concentration is too low, control system 220 can conclude that oxygen assembly 210 is not functioning properly.

[0446] Pressure transducer PT2 monitors the pressure between the rotary valve assembly 306 and the second rotary valve assembly 330 (which can be characterized as the pump pressure supplied to the second rotary valve assembly 330). Figure 7B , the pressure transducer PT2 provides an electrical pressure signal 374 encoding a pressure value to the control system 220.

[0447] First rotary valve assembly

[0448] Figure 10A is a perspective view of a first side of an exemplary embodiment of a first rotary valve assembly 306 . Figure 10B is a perspective view of a second side of the first rotary valve assembly 306 opposite the first side. Figure 10A The first rotary valve assembly 306 includes a motor assembly 830 mounted to an outer housing 832. The motor assembly 830 includes a stepper motor 833 (see Figure 7B ) and shaft 836 (see Figure 10B and 10C ). The stepper motor 833 is configured to rotate the shaft 836.

[0449] refer to Figure 10B , the position sensor 834 can be mounted on a printed circuit board ("PCB") 837 that is secured to the outer housing 832 opposite the motor assembly 830. In such an embodiment, the PCB 837 can include an opening through which an end of the shaft 836 opposite the motor assembly 830 can pass.

[0450] Figure 10C The first rotary valve assembly 306 and a first side of the shaft 836 of the motor assembly 830 are shown. Figure 10C The other parts of the motor assembly 830 are omitted. Figure 10C In the embodiment shown, the housing 832 has a generally cross or cruciform-shaped configuration. Thus, the housing 832 has four arms 841-844 extending outwardly from a central region 845 of the housing 832. In the embodiment shown, the motor assembly 830 (see FIG. Figure 10A ) is installed in the center area 845.

[0451] Figure 10D The second side of the first rotary valve assembly 306 is shown with the outer housing 832 and PCB 837 removed. Figure 10D As shown, arms 841-844 (see Figure 10B ) are respectively provided with lift valves CV1-CV4. In the outer shell 832 (see Figure 10B ), the lift valves CV1 and CV3 are positioned opposite each other, and the lift valves CV2 and CV4 are positioned opposite each other. The first rotary valve assembly 306 includes a valve mounted on the shaft 836 (see Figure 10B and 10C ) on the cam 850, the cam 850 is configured to selectively drive the lift valves CV1-CV4. When the motor assembly 830 (see Figure 10A ) When the shaft 836 rotates, the cam 850 rotates along with the shaft 836. Figure 7B , the position sensor 834 provides a position signal 835 to the control system 220, and the position signal 835 is encoded as a cam 850, a stepper motor 833 (see Figure 10A and 10B ), and / or shaft 836 (see Figure 10B and 10C ) is in an original position (e.g., yes or “on”) or a position other than the original position (e.g., no or “off”).

[0452] refer to Figure 10C Each of the arms 841-844 is open at its distal end 846. The open distal ends 846 of the arms 841-844 are closed by end caps 851-854, respectively. The end caps 851-854 can be fastened to the outer shell 832 by fasteners 855.

[0453] refer to Figure 10B The arms 841 - 844 include inlet openings 856A- 856D and outlet openings 858A- 858D, respectively, wherein the inlet openings 856A- 856D are configured to receive a gas or a gas mixture, and the gas or gas mixture can exit through the outlet openings 858A- 858D.

[0454] refer to Figure 10D , each of the poppet valves CV1-CV4 includes an open housing 860 having a lateral inlet 862 and a lateral outlet 864. The lateral inlets 862 of the poppet valves CV1-CV4 are aligned with and in fluid communication with the inlet openings 856A-856D, respectively, of the outer housing 832. Similarly, the lateral outlets 864 of the poppet valves CV1-CV4 are aligned with and in fluid communication with the outlet openings 858A-858D, respectively, of the outer housing 832.

[0455] One or more seals 866 and 868 (e.g., O-ring type seals) can be positioned between the outer housing 832 and the housing 860. For example, seal 868 can be positioned between the side inlet 862 and the side outlet 864. By way of another non-limiting example, seal 866 can be positioned between each open distal end 846 of arms 841-844 and end caps 851-854, respectively.

[0456] The poppet valves CV1-CV4 are substantially identical to one another. For the sake of brevity, only the poppet valve CV1 will be described in detail. Figure 10E 851 and 855. Figure 10E , housing 860 has an open proximal end portion 870 opposite to an open distal end portion 872. When end cap 851 is fastened to outer housing 832, open distal end portion 872 is closed by end cap 851. Similarly, when end caps 852-854 are fastened to outer housing 832, housings 860 of poppet valves CV2-CV4 are closed at their open distal end portions 872 by end caps 852-854, respectively.

[0457] Figure 10F is a cross-sectional view of the first rotary valve assembly 306 with the cam 850 positioned to open the poppet valves CV2 and CV4. Figure 10G is a cross-sectional view of the first rotary valve assembly 306 with the cam 850 positioned to open the poppet valves CV1 and CV3.

[0458] refer to Figure 10F The generally cylindrical guide portion 876 extends from the open proximal end portion 870 of the housing 860 (see Figure 10E ) extends inwardly. An open passage 877 is formed in the guide portion 876. A shoulder 878 is formed on the inside of the housing 860 between the lateral inlet 862 and the lateral outlet 864.

[0459] Steering Figure 10E In the housing 860, the poppet valve CV1 has a push rod 880 that is biased away from the end cap 851 by a biasing assembly 884. Figure 10F , the push rod 880 extends through the passage 877 and opens the housing 860 through the open proximal portion 870 (see Figure 10E ). Turn Figure 10E , the push rod 880 can have a circumferential groove 879 formed near its proximal end portion 881.

[0460] An annular diaphragm 886 can extend around the push rod 880 near the proximal portion 881. In the illustrated embodiment, the diaphragm 886 has a circular center portion P2 having a center hole 887 through which the push rod 880 extends, with an inner edge portion of the center portion P2 resting in the groove 879 so that the center portion P2 securely grips the push rod 880. The diaphragm 886 can close and seal the open proximal portion 870 of the housing 860. However, the diaphragm 886 can bend or stretch longitudinally to allow the push rod 880 to move longitudinally relative to the housing 860. Figure 10F In the illustrated embodiment, the diaphragm 886 has a circular peripheral portion P1 that is positioned between the open proximal portion 870 of the housing 860 and the outer housing 832, thereby securely clamping the peripheral portion P1 in place.

[0461] refer to Figure 10E , the circular outer peripheral portion P1 of the diaphragm 886 is connected to the circular central portion P2 by a curved or contoured middle portion P3. Middle portion P3 can be characterized as a curl. The circle positioned midway between the outer peripheral portion P1 and the central portion P2 can be characterized as being located at the center of the curl. The diaphragm 886 has an active area extending from the circle at the center of the curl to the central portion P2.

[0462] Steering Figure 10E The push rod 880 has a distal end portion 882 opposite to the proximal end portion 881. The proximal end portion 881 has a cam follower 883 formed therein (see Figure 10C and 10E ). In the embodiment shown, the proximal portion 881 can taper outwardly and be generally conical. Cam follower 883 (see Figure 10C ) can be implemented as a planar or wavy lower surface of the proximal portion 881.

[0463] An annular seat 896 is fixedly attached to a shoulder 878 formed on the inside of the housing 860. In the embodiment shown, the seat 896 has a central through hole 897 through which the push rod 880 extends unimpeded.

[0464] The distal portion 882 of the push rod 880 has a longitudinally extending channel 885 formed therein. The channel 885 opens at the distal portion 882 of the push rod 880. A disc-shaped lifting member 892 is fastened to the distal portion 882 of the push rod 880 by a fastener 894 (e.g., a bolt, screw, or the like) that extends to the open end of the channel 885. Thus, the fastener 894 couples the lifting member 892 to the distal portion 882 of the push rod 880, and when the push rod 880 moves within the housing 860, the lifting member 892 moves therewith as a unit.

[0465] refer to Figure 10F When the lifting member 892 is pressed against the seat 896, the lifting member 892 closes the central through hole 897 and divides the interior of the housing 860 into a proximal chamber 900 and a distal chamber 902. Therefore, the lifting member 892 can seal the proximal chamber 900 and the distal chamber 902 from each other. The lateral inlet 862 is connected to the proximal chamber 900, and the lateral outlet 864 is connected to the proximal chamber 900. On the other hand, referring to Figure 10G When the poppet valve member 892 is spaced distally from the seat 896, the central through-hole 897 is uncovered, and the proximal chamber 900 and the distal chamber 902 are in communication with each other. Thus, in this configuration, a gas or gas mixture can flow between the proximal chamber 900 and the distal chamber 902. In other words, a passage is opened between the lateral inlet 862 and the lateral outlet 864.

[0466] The distal end portion 882 of the push rod 880 is adjacent to a biasing assembly 884. In the illustrated embodiment, the biasing assembly 884 includes a biasing member 888 (e.g., a coil spring) and an end cap 890. The biasing member 888 applies an inward force to the push rod 880, which helps ensure that the push rod 880 maintains contact with the cam 850. The end cap 890 rests on a fastener 894 and is located between a disc-shaped poppet valve member 892 and the end cap 851. The biasing member 888 extends between the end cap 890 and the end cap 851 and applies a biasing force to the end cap 890, which transfers the force to the fastener 894 and / or the poppet valve member 892. In turn, the fastener 894 and / or the poppet valve member 892 transfer the biasing force to the push rod 880.

[0467] The cam 850 can be characterized as having two protrusions or high points 910 and 912 that are opposite each other. When one of the high points 910 and 912 aligns with the cam follower 883 of the push rod 880 of the poppet valve CV1 (see FIG. Figure 10C and 10E ) adjacent, high point 910 or 912 pushes push rod 880 outward toward end cap 851. This pushes disc-shaped lifting member 892 away from seat 896 (such as Figure 10G As shown), and open the central through hole 897. This will open the poppet valve CV1 and allow the gas or gas mixture to flow through the poppet valve CV1. On the other hand, as Figure 10G As shown, when neither of the high points 910 nor 912 is in contact with the cam follower 883 of the push rod 880 of the poppet valve CV1 (see Figure 10C and 10E), the push rod 880 is biased inwardly away from the end cap 851 by the biasing assembly 884. The push rod 880 thereby pulls the disc-shaped lifting member 892 toward the seat 896, causing the lifting member 892 to cover or close the central through hole 897. This closes the poppet valve CV1 and prevents the flow of gas or gas mixture through the poppet valve CV1.

[0468] Because the ventilator 100 may need to be used for a long life (e.g., greater than about 30,000 hours), the first rotary valve assembly 306 may experience approximately 15,000,000 VPSA cycles. To meet this requirement, each poppet valve CV1-CV4 may have a "balanced" valve configuration. Whenever one of the poppet valves CV1-CV4 is closed, the pressure within the proximal chamber 900 acts on the active area of ​​the diaphragm 886, and a portion of the lift member 892 covers (or closes) the central through-hole 897 of the seat 896. The portion of the lift member 892 that covers (or closes) the central through-hole 897 of the seat 896 is approximately equal to the active area of ​​the diaphragm 886. When the pressure within the proximal chamber 900 is negative (or vacuum), an inward (toward the proximal chamber 900) directed force acts on the active area of ​​the diaphragm 886. At the same time, an inwardly directed force (toward the proximal chamber 900) acts on the portion of the lifting member 892 that covers the central through-hole 897 of the seat 896. Similarly, when the pressure within the proximal chamber 900 is positive, an outwardly directed force (away from the proximal chamber 900) acts on the active area of ​​the diaphragm 886, and an outwardly (or distally) directed force acts on the portion of the lifting member 892 that covers the central through-hole 897 of the seat 896. Thus, when the proximal chamber 900 is sealed by the lifting member 892, opposing forces act on the active area of ​​the diaphragm 886 and on the area of ​​the portion of the lifting member 892 that covers (or closes) the central through-hole 897 of the seat 896. Because (as described above) the active area of ​​the diaphragm 886 and the area of ​​the portion of the lifting member 892 that covers (or closes) the central through-hole 897 of the seat 896 are approximately equal, the net force on the push rod 880 is zero. This balancing feature helps reduce the force of the push rod 880 on the cam follower 883 and the cam 850, thereby reducing wear and extending service life.

[0469] As described above, each poppet valve CV1-CV4 is biased to a closed position by its biasing assembly 884. Each poppet valve CV1-CV4 includes a cam follower 883 adjacent to the cam 850 (see FIG. Figure 10C and 10E ). When the cam 850 rotates, it pushes the opposing poppet valves CV1-CV4 outward to open them. If poppet valves CV1 and CV3 are in the open position, poppet valves CV2 and CV4 are in the closed position, and vice versa. Figure 7BThe first rotary valve assembly 306 (e.g., the stepper motor 833) is configured to receive control information 376 encoding the cam position from the control system 220. The first rotary valve assembly 306 (e.g., the stepper motor 833) is also configured to rotate the cam 850 to the position encoded in the control information 376.

[0470] See also Figure 7A , lift valve CV3 (see Figure 10G ) is connected to the compressor 302 and the adsorption bed 300. The control system 220 configures the compressor 302 to provide suction to the distal chamber 902 so that the pressure in the distal chamber 902 of the poppet valve CV3 is lower than the pressure in the proximal chamber 900 of the poppet valve CV3.

[0471] Poppet valve CV1( Figure 10G ) is connected to the compressor 302 and the outlet exhaust port 124. The control system 220 configures the compressor 302 to convert the nitrogen-rich gas 122 (see Figure 8C and 8D ) is pushed into the proximal chamber 900, so that the pressure in the distal chamber 902 of the lift valve CV1 is lower than the pressure in the proximal chamber 900 of the lift valve CV1.

[0472] When the poppet valves CV1 and CV3 are Figure 10G When open as shown, poppet valve CV3 receives nitrogen-rich gas 122 from adsorption bed 300 (see FIG. Figure 8C and 8D ) and provides it to the compressor 302. At the same time, poppet valve CV1 allows nitrogen-rich gas 122, which is pumped from the adsorption bed 300 (via poppet valve CV3) by the compressor 302, to flow from the compressor 302 and exit the ventilator 100 through the outlet exhaust 124. Optionally, poppet valve CV3 can be connected to a second rotary valve assembly 330. As described below, the compressor 302 can provide suction force 154 to the suction assembly 152 through the second rotary valve assembly 330.

[0473] refer to Figure 7A , lift valve CV4 (see Figure 10F ) is connected to the compressor 302 and the patient inlet 116. The control system 220 configures the compressor 302 to provide suction to the proximal chamber 900 so that the pressure in the proximal chamber 900 of the poppet valve CV4 is lower than the pressure in the distal chamber 902 of the poppet valve CV4.

[0474] Poppet valve CV2 (see Figure 10F) is connected to the compressor 302 and the adsorption bed 300. The control system 220 configures the compressor 302 to provide pressurized air 114 pumped by the compressor 302 to the distal chamber 902, so that the pressure in the distal chamber 902 of the poppet valve CV2 is greater than the pressure in the proximal chamber 900 of the poppet valve CV2.

[0475] When the poppet valves CV2 and CV4 are Figure 10F When shown open, poppet valve CV4 allows air 114 to be pumped into compressor 302 through patient air inlet 116. Simultaneously, poppet valve CV2 provides pressurized air 114 from compressor 302 to adsorption bed 300. Optionally, poppet valve CV2 can be connected to a second rotary valve assembly 330. As described below, gas 164 provided to second rotary valve assembly 330 can be used to implement nebulizer assembly 162.

[0476] As described above, in the illustrated embodiment, the oxygen assembly 210 uses the VPSA process to generate oxygen 364 (see Figure 8B ), which may have a Figure 11 The four stages at the top are labeled "Stage 1," "Stage 2," "Stage 3," and "Stage 4."

[0477] exist Figure 11 , upper line 400 depicts the flow of nitrogen adsorbent material from the bed 344 (see FIG. Figures 8A-8D ) experienced. Figure 11 , line 400 may be controlled by the control system 220 based on the electrical pressure signal 374 provided by the pressure transducer PT2 (see Figure 7B ) is determined. The lower line 410 depicts the flow of nitrogen through the nitrogen adsorbent material bed 344 (see Figures 8A-8D ) feed flow rate.

[0478] Lines 421 and 423 respectively indicate that poppet valves CV1 and CV3, respectively, switch from open ("pass") to closed ("stop") at the start of the first phase, and then switch from closed ("stop") to open ("pass") at the start of the third phase. Thus, poppet valves CV1 and CV3 are closed during most of the first phase and all of the second phase. Furthermore, poppet valves CV1 and CV3 are open during most of the third phase and all of the fourth phase.

[0479] Conversely, lines 422 and 424 represent poppet valves CV2 and CV4, respectively, transitioning from closed ("no-go") to open ("go") at the start of the first phase, and then transitioning from open ("go") to closed ("no-go") at the start of the third phase. Thus, poppet valves CV2 and CV4 are open during most of the first phase and all of the second phase. Furthermore, poppet valves CV2 and CV4 are closed during most of the third phase and all of the fourth phase.

[0480] Figure 12 is a flow chart of a method 500 executed by the control system 220. The method 500 at least partially implements the VPSA process. When executing the method 500, the pressure transducer PT2 (see Figure 7A and 7B ) occasionally obtains a pressure value for the adsorption bed 300 and sends an electrical pressure signal 374 to the control system 220.

[0481] In the first block 502, the control system 220 begins the first phase of the VPSA process by opening poppet valves CV2 and CV4 and closing poppet valves CV1 and CV3. At this point, the pressure regulator R2 is closed.

[0482] In the next block 504, the control system 220 instructs the motor 350 of the compressor 302 to pump air 114 from the patient inlet 116 into the adsorption bed 300. The motor 350 of the compressor 302 can operate at a relatively high speed while drawing air 114 from the patient inlet 116.

[0483] In block 506, the control system 220 determines that the pressure within the adsorption bed 300 has reached a first threshold pressure value (e.g., approximately 10 PSIG). When the pressure within the adsorption bed 300 reaches the first threshold pressure value, the pressure regulator R2 automatically opens. At this point, the first stage ends and the second stage begins. During the second stage, nitrogen is adsorbed from the air 114 by the adsorption bed 300, as shown in FIG. Figure 8B Oxygen 346 (eg, 90% pure oxygen) flows out of the adsorption bed 300 through the pressure regulator R2. The oxygen that passes through the pressure regulator R2 during the second stage is stored in the oxygen tank 312.

[0484] Return to Figure 12 At the next block 508, the control system 220 reduces the speed of the motor 350 at the beginning of the second phase. Figure 8BDuring the second stage, the mass transfer zone 430 moves away from the first end 341 (in the direction identified by arrow "D1") to the second end 343. The gas on the first side 432 of the mass transfer zone 430 near the first end 341 is air, and the gas on the second side 434 of the mass transfer zone 430 near the second end 343 is approximately 90% oxygen. The compressor 302 may be operated relatively slowly during the second stage to promote efficient nitrogen adsorption. In block 510, the control system 220 detects the end of the second stage, which ends when the mass transfer zone 430 reaches the second end 343. The control system 220 may determine that the second stage has ended after a predetermined amount of time has passed (e.g., approximately one second). In some embodiments, the control system 220 may also use a secondary means (e.g., pressure) to help determine when the second stage has ended. At this point, the adsorption bed 300 is fully saturated with nitrogen, the second stage ends, and the third stage begins.

[0485] At the beginning of the third phase, the control system 220 opens poppet valves CV1 and CV3 and closes poppet valves CV2 and CV4 in block 512. At this time, the pressure regulator R1 is closed.

[0486] At the next block 514, the control system 220 instructs the motor 350 of the compressor 302 to pump nitrogen-rich gas 122 from the adsorbent bed 300 to the external environment through the outlet vent 124. The compressor 302 can be operated at a relatively high speed so that it draws nitrogen-rich gas 122 out of the adsorbent bed 300.

[0487] In block 516, the control system 220 determines that the pressure within the adsorption bed 300 has reached a second threshold pressure value (eg, approximately -7 PSIG). At this point, the third stage ends and the fourth stage begins.

[0488] At the beginning of the fourth phase, the control system 220 may reduce the speed of the motor 350 to a relatively slow speed in block 518 .

[0489] In box 520, the control system 220 uses oxygen from the oxygen tank 312 to purge the adsorption bed 300. In box 520, the pressure regulator R1 automatically opens to allow the "purged" oxygen 348 (see Figure 8D ) flows through the adsorption bed 300 (e.g., in the direction identified by arrow "D2"). The mass transfer zone 430 also moves from the second end 343 (in the direction identified by arrow "D2") to the first end 341. The low pressure within the adsorption bed 300 combines with the purified oxygen 348 to draw out the nitrogen and regenerate the adsorption bed 300. When the purge is complete, the fourth stage ends, completing a four-stage cycle, and the method 500 terminates. The control system 220 can begin another cycle by returning to block 502 of the method 500.

[0490] Figures 13A-13D 3 is a schematic diagram of the second rotary valve assembly 330. The second rotary valve assembly 330 can be substantially similar to the first rotary valve assembly 306 (see Figure 10A and 10B ). However, the second rotary valve assembly 330 includes a cam 530 having a single protrusion or high point 532, which differs from the cam 850 of the first rotary valve assembly 306, which has two high points 910 and 912 opposite each other (see FIG. Figure 10F ).

[0491] refer to Figures 13A-13D The cam 530 of the second rotary valve assembly 330 is configured to selectively actuate one of the four poppet valves CV5-CV8 at a time. Each of the poppet valves CV5-CV8 may be substantially similar to Figure 10E The poppet valve CV1 is shown.

[0492] In the second rotary valve assembly 330, poppet valves CV5 and CV7 are positioned opposite each other. Similarly, poppet valves CV6 and CV8 are positioned opposite each other. Poppet valves CV5-CV8 are biased to a closed position. Each poppet valve CV5-CV8 has a push rod 538 (substantially similar to Figure 10E 880 shown in FIG), which has a cam follower 540 (substantially similar to Figure 10C As the cam 530 rotates, it pushes only one of the push rods 538 of the poppet valves CV5-CV8 outward at a time and into the open position.

[0493] Furthermore, as explained above with respect to first rotary valve assembly 306, each of poppet valves CV5-CV8 can include a lift member (substantially equivalent to lift member 892) configured to move relative to a seat (substantially equivalent to seat 896) to selectively connect a proximal chamber (similar to proximal chamber 900) with a distal chamber (similar to distal chamber 902). In such an embodiment, after cam 530 pushes the push rod 538 of a selected one of poppet valves CV5-CV8 outward, the selected poppet valve is opened.

[0494] refer to Figure 7B, the second rotary valve assembly 330 includes a stepper motor 542 that is substantially similar to the stepper motor 833 and a position sensor 544 that is substantially similar to the position sensor 834 of the first rotary valve assembly 306. The second rotary valve assembly 330 (e.g., the stepper motor 542) is configured to receive a control signal 546 encoding a cam position from the control system 220. The second rotary valve assembly 330 (e.g., the stepper motor 542) is also configured to rotate the cam 530 to the position encoded in the control signal 546. The position sensor 544 provides a position signal 548 to the control system 220 that encodes whether the stepper motor 542 and / or the cam 530 is in a home position (e.g., yes or "open") or in a position other than the home position (e.g., no or "closed").

[0495] refer to Figure 13A , poppet valve CV5 has an inlet 550 connected to the suction connection 150 and an inlet 550 connected to the poppet valve CV3 (see Figure 10D , 10F and 10G). When the lift valves CV1 and CV3 are open, the lift valve CV5 can be open (e.g. Figure 13A ) to receive suction 154 from the compressor 302 and provide the suction 154 to the suction connection 150. The suction connection 150 is connected to the suction assembly 152 (see FIG. Figure 1 ) can be discharged from the outlet exhaust port 124 by the compressor 302 through the poppet valve CV1. While providing the suction force 154, the nitrogen-rich gas 122 can be pumped by the compressor 302.

[0496] refer to Figure 13B , poppet valve CV6 has an inlet 554 connected to the sprayer assembly 162 and an outlet 556 connected to poppet valve CV2. When poppet valves CV2 and CV4 are open, poppet valve CV6 may be open (e.g., Figure 13B ) to provide gas 164 to the sparger connection 160 instead of providing air 114 to the adsorption bed 300. Thus, the compressor 302 can power the sparger assembly 162 (see Figure 1 ).

[0497] refer to Figure 13C , the poppet valve CV7 has an inlet 558 connected to the metering valve 320 and an outlet 560 connected to the accumulator 202. Figure 13C When shown open, oxygen output from metering valve 320 is provided to accumulator 202 .

[0498] refer to Figure 13D , the poppet valve CV8 has an inlet 562 connected to the metering valve 320 and an outlet 564 connected to the patient circuit 110. Figure 13DWhen shown open, oxygen 364 (from the adsorbent bed 300 ) and / or oxygen from the oxygen tank 312 is provided directly to the patient circuit 110 .

[0499] control system

[0500] refer to Figure 5E and 7B , the control system 220 includes a memory 700 connected to one or more processors 710. The memory stores the table 362 and instructions 720 executable by the processor 710.

[0501] Processor 710 may be implemented by one or more microprocessors, microcontrollers, application-specific integrated circuits ("ASICs"), digital signal processors ("DSPs"), combinations or subcombinations thereof, or the like. Processor 710 may be integrated into a circuit that provides power to processor 710, such as a conventional circuit board. Processor 710 may include internal memory and / or memory 700 may be coupled thereto. The present invention is not limited by the specific hardware components used to implement processor 710 and / or memory 700.

[0502] The memory 700 is a computer-readable medium that includes instructions or computer-executable components executed by the processor 710. The memory 700 can be implemented using temporary and / or non-temporary memory components. The memory 700 can be coupled to the processor 710 via an internal bus 715.

[0503] Memory 700 may include random access memory ("RAM") and read-only memory ("ROM"). Memory 700 contains instructions and data that control the operation of processor 710. Memory 700 may also include a basic input / output system ("BIOS"), which contains basic routines that help transfer information between components within ventilator 100.

[0504] Alternatively, memory 700 may include internal and / or external storage devices such as a hard drive, a floppy disk drive, and optical storage devices (e.g., CD-ROM, R / W CD-ROM, DVD, and the like). Ventilator 100 may also include one or more I / O interfaces (not shown), such as a serial interface (e.g., RS-232, RS-432, and the like), an IEEE-488 interface, a universal serial bus ("USB") interface, a parallel interface, and the like, for communicating with removable storage devices such as a flash drive, an external floppy disk drive, and the like.

[0505] Processor 710 is configured to execute a VPSA process (which may include executing Figure 12500) and / or software for delivering oxygen according to the oxygen delivery method described below. Such software may be implemented by instructions 720 stored in memory 700.

[0506] Oxygen delivery

[0507] refer to Figure 1 As described above, the ventilator 100 delivers inspiratory gas 108 directly to the patient connection 106 (via the patient circuit 110). Oxygen can be delivered to the patient 102 in one of two ways: (1) as a pulse of oxygen 140 delivered directly to the patient connection 106, or (2) in a gas 112 comprising air 114, optionally mixed with oxygen 250 and / or low-pressure oxygen 128 in the accumulator 202.

[0508] Figures 14A and 14B are graphs illustrating conventional oxygen delivery by a conventional portable ventilator connected to an external low-pressure continuous flow source, such as a stand-alone oxygen concentrator. In Figure 14A, the conventional portable ventilator is delivering breaths using conventional volume-controlled ventilation. In Figures 14A and 14B, the x-axis is time. The inspiratory phase is of duration T. i The exhalation phase lasts for a period of T E The pause occurs during the duration T P period.

[0509] In FIG14A , the y-axis is the flow rate within the patient's airway. Referring to FIG14A , dashed line 570 illustrates the continuous flow of oxygen delivered during the inspiration and expiration phases. Solid line 572 illustrates the flow of air provided by a conventional portable ventilator during the inspiration and expiration phases. Solid line 572 is determined by a desired set of ventilator placements.

[0510] Region 574 shows the inspiratory volume of air received by the patient, and region 575 shows the expiratory volume of air expelled by the patient. Region 574 represents the desired total tidal volume selected by the user.

[0511] , tidal volume). 580 shows the amount of oxygen delivered by a conventional portable ventilator during the expiratory phase that is wasted by the conventional portable ventilator.

[0512] In Figure 14B, a conventional portable ventilator is using traditional pressure-controlled ventilation to deliver breaths. With reference to Figure 14B, the y-axis is the pressure in the patient's airway. The pressure value "PIP" represents the user input or the required peak inspiratory pressure. Solid line 581 shows the patient's airway pressure during the inspiration and expiration phases. Unfortunately, as shown in Figure 14B, the continuous flow of oxygen (shown by dotted line 570 in Figure 14A) causes the pressure in the patient's airway to exceed the peak inspiratory pressure (pressure value "PIP") input by the user.

[0513] As shown in Figures 14 A and 14B, conventional portable ventilator is inefficient.For example, conventional portable ventilator wastes all continuous oxygen flows (shown by dotted line 570 in Figure 14 A) that are delivered during non-inspiratory time.In addition, owing to the continuous oxygen flow that is delivered to the patient can not be controlled (for example, by ventilator amount or inspiratory pressure setting), the oxygen (shown by shaded area 576) that only a part is delivered is actually effective.In addition, when using pressure-controlled ventilation, continuous oxygen flow makes the inspiratory pressure peak value input by user be exceeded.One reason for this problem is that traditional ventilator does not know how much oxygen (for example, volume or rate) has been delivered to the patient.

[0514] Although Figures 14A and 14B depict conventional portable ventilators delivering breaths using conventional volume-controlled ventilation and conventional pressure-controlled ventilation, respectively, similar results can occur when conventional portable ventilators use other types of ventilation because the ventilator does not know how much oxygen (e.g., volume or rate) is being delivered to the patient. Therefore, the ventilator cannot accurately configure the breath delivered (e.g., to achieve a desired flow rate or pressure in the patient's airway).

[0515] Figure 15A and 15B It is shown by Figure 1 and Figure 4 A graph of oxygen delivery provided by the ventilator 100 is shown. Figure 15A In , the ventilator 100 is using volume-controlled ventilation to deliver breaths. Figure 15A and 15B In the figure, the x-axis is time. The inspiration phase occurs during the duration T i The exhalation phase occurs during the duration T E Period. The pause occurs for a duration of T P period.

[0516] refer to Figure 15A , solid line 582 shows the air flow provided by the ventilator 100 during the inspiration and expiration phases. Solid line 582 is a set of desired ventilator placements (e.g., by Figure 6200). Shaded area 584 shows the effective amount of oxygen provided to patient 102 at the beginning of the inspiratory phase. Area 586 shows the amount of air provided to patient 102 during the inspiratory phase. Areas 584 and 586 together form the total inspiratory volume (oxygen and air) delivered by ventilator 100. As described above, this volume is also referred to as the total tidal volume. Area 588 shows the expiratory volume of air expelled by patient 102.

[0517] Figure 15A It is shown that when providing gas 112 (see Figure 1 ) before the start of the inspiration phase, an oxygen 140 (see Figure 1 ) pulse. For example, before delivering gas 112, the ventilator 100 may wait until after the pulse of oxygen has been delivered. Thus, at the beginning of each inspiratory phase of each breath, the patient 102 (see Figure 1 ) may only receive a pulse (or bolus) of oxygen from the ventilator 100. However, this is not required. In alternative embodiments, the flow of gas 112 may begin before the delivery of the oxygen bolus is complete. In any case, the flow of gas 112 begins before the end of the inspiratory phase.

[0518] exist Figure 15B In the embodiment of the present invention, the ventilator 100 uses pressure-controlled ventilation to deliver breaths. Figure 15B The y-axis is the pressure in the patient's airway. The solid line 589 shows the patient's airway pressure during the inspiration and expiration phases. Figure 15B As shown, the pressure in the patient's airway does not exceed the peak inspiratory pressure (pressure value "PIP") input by the user, using pressure to control input 237 (see Figure 6 ).

[0519] like Figure 15A and 15B As shown, the ventilator 100 is more efficient than conventional portable ventilators. For example, the ventilator 100 does not provide a continuous flow of oxygen, thereby avoiding wasting oxygen during non-inspiratory times. In addition, the total inspiratory volume is consistent with (and does not exceed) the desired ventilator placement. In addition, oxygen is delivered during the first portion of the breath where it provides better oxygenation, as opposed to during the last portion of the breath when oxygen is trapped in anatomical dead space. In addition, because the ventilator 100 knows the total tidal volume delivered, the ventilator 100 can configure breaths that do not exceed the peak inspiratory pressure provided by the user (e.g., when pressure ventilation is used). Therefore, one of ordinary skill in the art, by applying the present teachings, can configure the ventilator 100 to deliver any desired type of ventilation that delivers oxygen in the first portion of the breath. In addition, oxygen 140 (see Figure 1 )'s delivery can begin before each breath is initiated.

[0520] refer to Figure 13D For pulsed dose delivery, the control system 220 instructs the second rotary valve assembly 330 (via Figure 7B The control signal 546 shown in FIG. 4A rotates the cam 530 to open the poppet valve CV8. The inspiratory phase can be initiated by the control system 220 or the patient 102. After detecting the initiation of the inspiratory phase, the control system 220 instructs the stepper motor 322 of the metering valve 320 to deliver the desired dose or pulse of oxygen, called a "bolus," to the patient circuit 110. Thus, the ventilator 100 is configured to synchronize the oxygen bolus with the patient's breathing. For example, the ventilator 100 can be configured to provide a bolus of oxygen supplied by the patient. Figure 15A The amount of oxygen (or gas) is depicted in area 584 .

[0521] User interface 200 can be used to determine the parameter values ​​of the group. For example, if the oxygen flow equivalent input 244 (see Figure 6 ) allows the user to select a numerical value (e.g., from 1 to 10), and each successive number can represent an amount of "equivalent oxygenation" relative to the continuous oxygen flow. For example, the number "2" can provide an oxygen bolus at the beginning of a breath that will provide the same amount of oxygen as that provided by an external source (e.g., Figure 1 As another non-limiting example, a user may select a value representing a predetermined range of about 0.2 liters / minute to about 9 liters / minute in increments of about 0.1 liters / minute.

[0522] Because at least some of the oxygen delivered using a hypothetical continuous flow of oxygen is wasted, the control system 220 is configured to deliver a bolus amount of oxygen that is less than the amount of oxygen delivered by a continuous flow of oxygen during the inhalation phase.

[0523] In an alternative embodiment, the user may specify the size of the bolus by using the oxygen pulse volume input 251 (see Figure 6 ) to enter the pulse amount. The pulse amount can be expressed in milliliters, or a dimensionless value within a predetermined numerical range (e.g., from 1 to 10). In such an embodiment, each successive number can represent a larger amount of oxygen.

[0524] The control system 220 regulates the delivery of breaths to account for the bolus and ensures that breaths are delivered according to the tidal volume set by the user (via Figure 6 ) or peak inspiratory pressure (e.g., via Figure 6As a non-limiting example, the control system 220 can configure the bolus to have a volume that is less than about 75% of the total tidal volume delivered. As another non-limiting example, the control system 220 can configure the bolus to have a volume that is between about 50% and about 75% of the total tidal volume.

[0525] In addition, the ventilator 100 is configured to adjust the parameter values ​​(e.g., volume, pressure, etc.) of the inspiratory gas 108 to ensure that the inspiratory gas 108 is accurately delivered. For example, if a user (e.g., a clinician) uses the tidal volume input 242 (see Figure 6 ) Set the total tidal volume to 500 ml and the oxygen pulse volume to 25 l (see Figure 6 ) sets the pulse volume value to 100 ml, the control system 220 sets the air delivered from the accumulator 202 to 400 ml, thereby providing the exact total volume (500 ml=400 ml+100 ml) to the patient circuit 110.

[0526] The control system 220 can deliver a user-placed bolus of oxygen (e.g., in gas 112 and / or pulses of oxygen 140) to the patient connection 106. The bolus size is controlled by the metering valve 320. The controller system 220 reduces the gas 252 measured by the internal flow transducer 212 (see Figure 5A ) of traffic (and is encoded in Figure 5E 270 ) to meet a user-set tidal volume value (when volume ventilation is used) or a user-set peak inspiratory pressure value (when pressure ventilation is used).

[0527] Gas 112 (see Figure 1 ) of the total inspiratory flow rate and volume using flow signal 270 (see Figure 5E ) and the pulse volume can be determined by using signal 358 (see Figure 7B ) and the step position value of the metering valve 320 (as described above). In addition, the control system 220 controls the stepper motor 322 (see FIG. Figure 7B ) of the control signal 360 (see Figure 7B ) of the pulse (or bolus) volume. The control system 220 controls the blower 222 by using a control signal 278 (see FIG. Figure 5E ) to accommodate the air delivered from the accumulator 202.

[0528] refer to Figure 13CFor mixed oxygen delivery, the cam 530 of the second rotary valve assembly 330 is positioned so that the poppet valve CV7 is in the open position. The control system 220 determines the oxygen flow required at a given time to achieve the FIO2 input by the user (e.g., via Figure 6 200. The control system 220 may use the control signal 360 (see FIG. Figure 7B ) to position the metering valve 320 to achieve the desired oxygen flow. The control system 220 can use the oxygen concentration signal 276 from the oxygen sensor 227 (see Figure 5E ) to monitor the gas 252 that passes through the internal bacterial filter 230 and appears as gas 112.

[0529] Suction components

[0530] refer to Figure 16 The suction assembly 152 can include a filter 800, a conventional suction canister 810, a conventional suction conduit 812, and a tube 820 configured to be connected to the suction conduit 812. The suction conduit 812 can be configured to be inserted into the interior of the patient connector 106.

[0531] refer to Figure 1 , the suction assembly 152 provides a way to use the gravitational force provided by the ventilator 100 to "vacuum clear" secretions from the patient's airway. Figure 10G , the control system 220 positions the cam 850 of the first rotary valve assembly 306 to open the poppet valves CV1 and CV3, and refers to Figure 13A , the control system 220 positions the cam 530 of the second rotary valve assembly 330 to open the poppet valve CV5. In this configuration, the compressor 302 draws gas and secretions from the suction conduit 812 through the conduit 820 and into the suction canister 810, where liquid secretions are discharged (see FIG. Figure 16 ) is captured in the suction canister 810. A filter 800 (e.g., a hydrophobic filter) can be used to further prevent patient secretions from entering the ventilator 100 through the suction connection 150. However, gas drawn into the ventilator 100 continues to pass through the first rotary valve assembly 306 and the second rotary valve assembly 330 and enter the compressor 302. The control system 220 controls the speed of the motor 350 of the compressor 302 to achieve the user-set inspiratory pressure, as measured by the pressure transducer PT2.

[0532] Atomizer components

[0533] refer to Figure 1The nebulizer assembly 162 provides a means to use the gas 164 provided by the ventilator 100 for delivering aerosolized medication to the patient's lungs 142. Figure 10F , the control system 220 positions the cam 850 of the first rotary valve assembly 306 to open the poppet valves CV2 and CV4, and, with reference to Figure 13B , the control system 220 positions the cam 530 of the second rotary valve assembly 330 to open the poppet valve CV6. In this configuration, gas flows from the compressor 302 through the first rotary valve assembly 306 and the second rotary valve assembly 330 and flows to the nebulizer assembly 162. The control system 220 controls the speed of the motor 350 of the compressor 302 to maintain the required pressure (e.g., about 12 PSIG) measured by the pressure transducer PT2. The first rotary valve assembly 306 can be cycled to synchronize drug delivery with the inhalation phase as needed. In a manner similar to that used for pulse dose oxygen delivery, the control system 220 can compensate (or adjust) the breath delivered to account for the additional volume delivered by the nebulizer assembly 162.

[0534] Cough Assistance

[0535] As described above, a normal cough can be characterized as having an insufflation phase followed by an exhaust phase. During the insufflation phase, the patient 102 (see Figure 1 ) Inhale the gas into the patient's lungs 142 (see Figure 1 During the exhalation phase, the patient 1...

Claims

1. A ventilator system, comprising: A portable ventilator having a housing and a breathing assembly in the housing, wherein the breathing assembly includes a ventilator connection, a ventilator portion that directs air flow from within the ventilator to the ventilator connection, a cough assistance valve, and wherein the ventilator is configured to switch between (i) a breathing mode in which the breathing assembly provides a breath having an inhalation phase and an exhalation phase, and (ii) a cough-assist mode in which the breathing assembly provides a cough having an insufflation phase and an exhalation phase, and wherein the cough assistance valve is in a first state during the insufflation phase and then moves to a second state during the exhalation phase of the cough, in which the cough assistance valve transmits positive pressure to the ventilator connection, and in which the cough assistance valve transmits negative pressure to the ventilator connection; a conduit extending between the ventilator connection and a patient connection, wherein during the breathing mode, the conduit is configured to communicate inspiratory gas received from the respiratory component to the patient and to communicate expiratory gas received from the patient to the respiratory component, and wherein during the cough assist mode, the conduit is configured to communicate insufflation gas received from the respiratory component to the patient and to communicate expiration gas received from the patient to the respiratory component; a secretion collection chamber in fluid communication with the interior of the conduit, wherein the secretion collection chamber is configured to capture and retain secretions contained in the exhaust gas before the exhaust gas reaches the respiratory assembly; and An input device is configured to receive a user input for selectively switching operation of the ventilator from the breathing mode to the cough-assist mode without disconnecting the patient from the ventilator.

2. The ventilator system according to claim 1, wherein: Insufflation gas received from the respiratory assembly during the insufflation phase of the cough and exhalation gas received from the patient during the exsufflation phase of the cough are both delivered through a portion of the conduit having the secretion collection chamber.

3. The ventilator system according to claim 1, wherein: Inspiratory gas received from the respiratory assembly during an inspiratory phase of the respiration and exhaled gas received from the patient during an exhalation phase of the respiration are both conveyed through a portion of the conduit having the secretion collection chamber.

4. The ventilator system according to claim 1, wherein: The user input is a first user input, and the system further comprises: a suction assembly in fluid communication with the secretion collection chamber, wherein the suction assembly is configured to provide suction to remove the secretions captured and retained in the secretion collection chamber, Wherein, the input end device is also configured to receive a second user input for selectively activating the suction component.

5. A ventilator system according to claim 4, wherein: The suction assembly is configured to provide suction to remove the secretions without disconnecting the patient from the ventilator.

6. The ventilator system according to claim 1, wherein: The secretion collection chamber is longitudinally aligned with the interior of the conduit and has an inner diameter, and wherein the conduit has: a first portion extending from the secretion collection chamber toward the respiratory assembly, wherein the first portion has a first inner diameter that is smaller than the inner diameter of the secretion collection chamber, and A second portion extends from the secretion collection chamber toward the patient connector, wherein the second portion has a second inner diameter that is smaller than the first inner diameter.

7. The ventilator system of claim 1, wherein: The secretion collecting chamber is unobstructed.

8. A ventilator system comprising: A ventilator having a housing and a respiratory component in the housing, wherein the respiratory component includes a ventilator connection, a ventilator portion that directs air flow from within the ventilator to the ventilator connection, a cough assistance valve, and wherein the ventilator is configured to switch between (i) a breathing mode in which the respiratory component provides a breath having an inhalation phase and an exhalation phase, and (ii) a cough-assist mode in which the respiratory component provides a cough having an insufflation phase and an exhalation phase, and wherein the cough assistance valve is in a first state during the insufflation phase and then moves to a second state during the exhalation phase of the cough, in which the cough assistance valve transmits positive pressure to the ventilator connection, and in which the cough assistance valve transmits negative pressure to the ventilator connection; a conduit extending between the ventilator connection and a patient connection, wherein during the breathing mode, the conduit is configured to communicate inspiratory gas received from the respiratory component to the patient and to communicate expiratory gas received from the patient to the respiratory component, and wherein during the cough assist mode, the conduit is configured to communicate insufflation gas received from the respiratory component to the patient and to communicate expiration gas received from the patient to the respiratory component; a secretion collection chamber in fluid communication with the interior of the conduit, wherein the secretion collection chamber is configured to capture and retain secretions contained in the exhaust gas before the exhaust gas reaches the respiratory assembly; and A user input is provided for selectively switching operation of the ventilator between the breath mode and the cough-assist mode without disconnecting the patient from the ventilator.

9. A ventilator system according to claim 8, wherein: Insufflation gas received from the respiratory assembly during the insufflation phase of the cough and exhalation gas received from the patient during the exsufflation phase of the cough are both delivered through a portion of the conduit having the secretion collection chamber.

10. The ventilator system of claim 8, wherein: Inspiratory gas received from the respiratory assembly during an inspiratory phase of the respiration and exhaled gas received from the patient during an exhalation phase of the respiration are both conveyed through a portion of the conduit having the secretion collection chamber.

11. The ventilator system of claim 8, further comprising a suction assembly in fluid communication with the secretion collection chamber, wherein: The suction assembly is configured to provide suction to remove the secretions captured and retained in the secretion collection chamber.

12. The ventilator system of claim 8, wherein: The secretion collection chamber is longitudinally aligned with the interior of the conduit and has an inner diameter, and wherein the conduit has: a first portion extending from the secretion collection chamber toward the respiratory assembly, wherein the first portion has a first inner diameter that is smaller than the inner diameter of the secretion collection chamber, and A second portion extends from the secretion collection chamber toward the patient connector, wherein the second portion has a second inner diameter that is smaller than the first inner diameter.

13. The ventilator system of claim 8, wherein: The secretion collecting chamber is unobstructed.

14. A ventilator system comprising: A ventilator having a housing and a respiratory component in the housing, wherein the respiratory component includes a ventilator connection, a ventilator portion that directs air flow from within the ventilator to the ventilator connection, and a cough assist valve; a conduit extending between the respiratory assembly and a patient connection, wherein the conduit is configured to deliver gas received from the respiratory assembly to a patient and to deliver gas received from the patient to the respiratory assembly; a secretion collection chamber in fluid communication with the interior of the conduit, wherein the secretion collection chamber is configured to capture and retain secretions contained in gas received from the patient before the gas reaches the respiratory assembly; and a suction assembly in fluid communication with the secretion collection chamber, The ventilator includes (i) a breathing mode, wherein the breathing component provides breathing having an inhalation phase and an exhalation phase, (ii) a cough-assist mode, wherein the breathing component provides a cough having an insufflation phase and an exhalation phase, wherein the cough assist valve is in a first state during the insufflation phase and then moves to a second state during the exhalation phase of the cough, wherein the cough assist valve transmits positive pressure to the ventilator connection and wherein the cough assist valve transmits negative pressure to the ventilator connection during the exhalation phase, and (iii) a suction mode, wherein the suction component provides suction to remove the secretions captured and retained in the secretion collection chamber.

15. A ventilator system according to claim 14, wherein: The suction mode is activatable during the cough assistance mode.

16. The ventilator system of claim 14, wherein: The suction mode is activated during the cough assistance mode.

17. The ventilator system of claim 14, wherein: The suction mode is activated after the cough assistance mode.

18. The ventilator system of claim 14, wherein: The gas received from the respiratory component includes insufflation gas during an insufflation phase of the cough, and wherein the gas received from the patient includes exhalation gas during an exhalation phase of the cough, and wherein the insufflation gas and the exhalation gas are passed through a portion of the conduit having the secretion collection chamber.

19. The ventilator system of claim 14, wherein: The gas received from the respiratory component includes inhaled gas during an inhalation phase of the respiration, and wherein the gas received from the patient includes exhaled gas during an exhalation phase of the respiration, and wherein the inhaled gas and the exhaled gas are passed through a portion of the conduit having the secretion collection chamber.

20. The ventilator system of claim 14, wherein: The secretion collection chamber is longitudinally aligned with the interior of the conduit and has an inner diameter, and wherein the conduit has: a first portion extending from the secretion collection chamber toward the respiratory assembly, wherein the first portion has a first inner diameter that is smaller than the inner diameter of the secretion collection chamber, and A second portion extends from the secretion collection chamber toward the patient connector, wherein the second portion has a second inner diameter that is smaller than the first inner diameter.

21. The ventilator system of claim 14, wherein: The secretion collecting chamber is unobstructed.

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