User interface and system for supplying gas to an airway

Abstract

This invention relates to a respiratory therapy system, comprising: a first patient interface for delivering a gas flow to a patient; a second patient interface for delivering a gas flow to a patient; and means and / or sensing arrangements configured to facilitate switching of the system between a first breathing mode and a second breathing mode, wherein in the first breathing mode, when the second patient interface is not present on the patient, the means allow delivery of a first gas flow to the outlet of the first patient interface, and in the second breathing mode, when the second patient interface is positioned on the patient together with the first patient interface, the means reduce or stop delivery of the first gas flow to the outlet of the first patient interface.

Description

[0001] This invention is a divisional application of the invention patent application filed on March 31, 2016, with application number 201680020287.1 (international application number PCT / IB2016 / 051819) and titled "User interface and system for supplying gas to a gas duct". Technical Field

[0002] This disclosure relates to user interfaces and respiratory therapy systems including user interfaces for delivering gases to and / or from a user, and specifically, but not limited to: respiratory systems adapted to provide a variety of types of respiratory therapy to a user; and patient interfaces and devices for such systems. Background Technology

[0003] Patients may lose respiratory function during anesthesia or sedation, or more generally during certain medical procedures. Prior to the procedure, a medical professional may pre-oxygenate the patient to provide an oxygen saturation reserve; this pre-oxygenation is typically performed using a bag and mask. Once general anesthesia is complete, intubation must be performed to ventilate the patient. In some cases, intubation is completed within 30 to 60 seconds, but in others, especially if traversing the patient's airway is difficult (e.g., due to cancer, severe injury, obesity, or neck muscle spasm), intubation will take significantly longer. While pre-oxygenation provides a buffer against a drop in oxygen saturation, prolonged intubation procedures require interruptions and re-application of the mask to restore the patient's oxygen saturation to an adequate level. Difficult intubation procedures may involve several interruptions, which is time-consuming and puts the patient at serious health risk. The procedure is usually abandoned after approximately three attempts at intubation.

[0004] In procedures requiring multiple respiratory support systems, there may be concerns that this or a combination of these support systems could lead to excessive pressure delivery (e.g., when an intubation is in place on the patient and the anesthesiologist wants to deliver support through a hood on the tip of the intubation).

[0005] Furthermore, switching between different support systems can be time-consuming or difficult. Therefore, it may be desirable to have a configuration that allows easy interchangeability between respiratory support (e.g., support via high flow rates and support via masks and bags). It may also be desirable to allow for rapid and easy shut-off or reduction of gas flow.

[0006] In this specification, external sources of information, including patent specifications and other documents, have been referenced, generally for the purpose of providing background for discussing these features of the invention. Unless otherwise stated, references to such sources of information in any jurisdiction should not be construed as an admission that such sources are prior art or part of common general knowledge in the art. Summary of the Invention

[0007] Therefore, the purpose of this disclosure is to provide a respiratory therapy system or device or patient interface that will at least play a role in providing an alternative or will provide a useful option for industry / the public.

[0008] In one aspect, this disclosure relates to a respiratory device for providing respiratory support to a patient, the device comprising:

[0009] A nasal inlet and a gas conduit for delivering a gas flow to an outlet of the nasal inlet; and a device and / or sensing arrangement adapted to be configured between a first configuration for providing a first level of gas flow to the outlet and a second configuration for providing a second level of gas flow to the outlet, wherein the device and / or the sensor arrangement is located at or near the nasal inlet or at the patient end of the conduit.

[0010] In another aspect, this disclosure relates to a respiratory device for providing respiratory support to a patient, the device comprising:

[0011] A nasal inlet and a gas conduit for delivering a gas flow to an outlet of the nasal inlet; and a device adapted to configure the gas conduit between a first configuration for providing a first level of gas flow to the outlet and a second configuration for providing a second level of gas flow to the outlet.

[0012] The sensing arrangement includes a first pressure sensor located downstream of the device and a second pressure sensor located upstream of the device, thereby enabling the determination of the first or second configuration of the catheter based on signals or outputs generated from the first and second sensors.

[0013] The first configuration may be an open configuration, and the second configuration may be a partially or substantially closed configuration, wherein the gas flow at the second level is significantly less than that at the first level, or is substantially zero.

[0014] The device may include a collapsible portion of the gas conduit, the collapsible portion being configured to switch between a first configuration and a second configuration.

[0015] The gas conduit may include baffles or pairs of baffles within the collapsible portion.

[0016] In the first configuration, the conduit includes a gap between the septum and the sidewall of the conduit, or between the paired septums, to allow the gas flow at the first level, and

[0017] In the second configuration, the baffles are moved toward the sidewall of the duct, or the baffles are moved toward each other to allow the gas flow to reach the second level.

[0018] The collapsible portion can be adapted to change from the first configuration to the second configuration when (i) the second patient interface is positioned on the collapsible portion, or when (ii) the user presses down on the collapsible portion.

[0019] The device may include a valve that can be configured between the first configuration and the second configuration.

[0020] In the second configuration, the valve can discharge or redirect at least a portion of the gas flow from the device.

[0021] The device may include a pressure relief device and is in a closed or non-ventilated configuration in the first configuration and in an open or ventilated configuration in the second configuration to discharge or redirect at least a portion of the gas flow from the device.

[0022] The valve can discharge or redirect the gas flow away from the patient.

[0023] The valve can be adapted to switch from the first configuration to the second configuration when (i) the second patient interface is positioned on at least a component of the valve; or when (ii) the user presses down on at least a component of the valve.

[0024] The nasal interface may include the device, or the gas conduit may be connected to or be able to be connected to the nasal interface and include the device.

[0025] In another aspect, this disclosure relates to a system for providing respiratory support to a patient, comprising:

[0026] A first respiratory support system, the first respiratory support system including a first patient interface for providing a first gas flow to the patient.

[0027] The first patient interface is independently locatable on the patient.

[0028] The system includes a device and / or sensing arrangement such that, by positioning the first patient interface on the patient, the device and / or sensing arrangement is configured to facilitate switching between different breathing modes:

[0029] - In the first breathing mode, when the second patient interface is absent or removed from the patient, and / or when the second gas flow is blocked from being delivered to the patient through the second patient interface, the device allows delivery of the first gas flow to the outlet of the first patient interface.

[0030] - In the second breathing mode, when the second patient interface is positioned on the patient together with the first patient interface, and / or when the second gas flow is delivered to the patient through the second patient interface, the device reduces or stops delivering the first gas flow to the outlet of the first patient interface.

[0031] The system may include:

[0032] The second respiratory support system includes a second patient interface for providing the second gas flow to the patient.

[0033] The first interface and the second interface are each independently locatable on the patient.

[0034] In another aspect, this disclosure relates to a system for providing respiratory support to a patient, comprising:

[0035] A first respiratory support system, the first respiratory support system including a first patient interface for providing a first gas flow to the patient.

[0036] A second respiratory support system, comprising a second patient interface for providing a second gas flow to the patient.

[0037] The first interface and the second interface are each independently locatable on the patient.

[0038] The first respiratory support system includes devices and / or sensing arrangements such that, by positioning the first patient interface on the patient, the devices and / or sensing arrangements are configured to facilitate switching between different breathing modes:

[0039] - In the first breathing mode, when the second patient interface is absent or removed from the patient, and / or when the second gas flow is blocked from being delivered to the patient through the second patient interface, the device allows delivery of the first gas flow to the outlet of the first patient interface.

[0040] - In the second breathing mode, when the second patient interface is positioned on the patient together with the first patient interface, and / or when the second gas flow is delivered to the patient through the second patient interface, the device reduces or stops delivering the first gas flow to the outlet of the first patient interface.

[0041] The first patient interface may be a nasal interface, such as a nasal cannula, and the second patient interface may be a face shield or mask.

[0042] The device or sensing arrangement can be adapted to switch the system from the first mode to the second mode by shutting off or partially shutting off the gas conduit that provides the first gas flow to the outlet of the first patient interface.

[0043] The device or sensing arrangement can be adapted to switch the system from the second mode to the first mode by opening the gas conduit or allowing the gas conduit to provide the first gas flow to the outlet of the first patient interface.

[0044] The first respiratory support system may include a first gas conduit and the device, the device including a collapsible portion of the first gas conduit configured to switch between a first configuration for providing a first level of the first gas flow to the outlet and a second configuration for providing a second level of the first gas flow to the outlet, the second level being smaller than the first level, and having one or both of the following:

[0045] Specifically, by changing the collapsible portion from the first configuration to the second configuration, the system switches from the first breathing mode to the second breathing mode.

[0046] Specifically, by changing the collapsible portion from the second configuration to the first configuration, the system switches from the second breathing mode to the first breathing mode.

[0047] The first configuration may be an open configuration, and the second configuration may be a partially or substantially closed configuration, wherein the first gas flow at the second level is significantly smaller than that at the first level, or is substantially zero.

[0048] The collapsible portion can be adapted to transform from the first configuration to the second configuration when the second patient interface is positioned on the collapsible portion.

[0049] The second patient interface may be a face mask, and the collapsible portion is adapted to collapse into the second configuration by means of the cover seal of the face mask.

[0050] The collapsible portion may be adapted to form a seal with the cover seal when in the second configuration, and / or wherein the collapsible portion is adapted to collapse to allow the cover seal to form a seal with the patient's face.

[0051] The collapsible portion may include a cross-section comprising a hinged, accordion-shaped, or bellows-shaped conduit wall arrangement, thereby allowing the collapsible portion to collapse from the first configuration to the second configuration under conditions where a force or load is applied to the collapsible portion.

[0052] The first patient interface may include the collapsible portion of the first catheter, or the first gas catheter may be connected to or be accessible to the first patient interface and include the collapsible portion of the first catheter.

[0053] The first respiratory support system may include the device, which may include a valve for controlling the delivery of the first gas flow to an outlet of the first patient interface, wherein the system switches from the first breathing mode to the second breathing mode, the second level being less than the first level, by switching the valve between a first configuration for providing a first level of the first gas flow to the outlet and a second configuration for providing a second level of the first gas flow to the outlet.

[0054] The first patient interface may include the valve, or the first respiratory support system may include a first gas conduit for providing the first gas flow to the first patient interface, the first gas conduit including the valve.

[0055] The first configuration may be an open configuration, and the second configuration may be a partially or substantially closed configuration, wherein the first gas flow at the second level is significantly smaller than that at the first level, or is substantially zero.

[0056] In the second configuration, the valve can discharge or redirect at least a portion of the first gas flow from the first respiratory support system.

[0057] The valve may be a pressure relief device and may be in a closed or non-ventilated configuration in the first configuration and in an open or ventilated configuration in the second configuration to discharge or redirect at least a portion of the first gas flow from the first respiratory support system.

[0058] The valve can discharge or redirect the first gas flow away from the patient.

[0059] The valve can be adapted to switch between the first configuration and the second configuration by applying a portion of the second patient interface against at least a component of the valve.

[0060] The second patient interface may be a face mask, and the portion thereof is the cover seal of the face mask.

[0061] The system or device may include the sensing arrangement, which generates signals or outputs to facilitate switching of the device between the first configuration and the second configuration.

[0062] The system or device may include the sensing arrangement, which generates a signal or output in response to a sensed condition to facilitate switching between a first breathing mode and a second breathing mode.

[0063] One or more sensors in the sensing arrangement may be associated with one or more of the following:

[0064] i. The first patient interface or the nasal interface

[0065] ii. The second patient interface,

[0066] iii. Both the first patient interface and the second patient interface,

[0067] iv. Objects associated with the first patient interface,

[0068] v. The object associated with the second patient interface.

[0069] vi. Objects associated with both the first patient interface and the second patient interface.

[0070] vii. Objects associated with the patient.

[0071] The one or more sensors may generate the signal or output when they sense a change in conditions in the gas conduit, or the first respiratory support system may include a first gas conduit, and the one or more sensors may generate the signal or output when they sense a change in conditions in the first gas conduit.

[0072] The sensor can sense pressure changes in the gas conduit or the first gas conduit, and / or blockage of the gas conduit or the first gas conduit.

[0073] The first respiratory support system may include the device, and the sensor arrangement includes: a first pressure sensor located downstream of the device; a second pressure sensor located upstream of the device; and a controller configured to determine when or will the system switch between the first breathing mode and the second breathing mode based on signals or outputs generated by the first sensor and the second sensor.

[0074] The sensor can sense the in-situ combination of the second patient interface with the first patient interface or the nasal interface.

[0075] The sensor can be arranged to sense pressure outside the first patient interface or the nasal interface and pressure inside the second patient interface when the first patient interface or the nasal interface and the second interface are in an in-situ combination.

[0076] The system may include a controller adapted to receive the signal or output and, in response, activate or control one or more of the following system outcomes:

[0077] One or more of the following: visual, auditory, tactile, or sensory alarms or warnings:

[0078] - Indicates one or the other of the first breathing mode and the second breathing mode, or

[0079] - Indicates switching between the first breathing mode and the second breathing mode, or

[0080] - Remind the user to switch between the first breathing mode and the second breathing mode, or

[0081] A flow controller device, comprising a valve, a flow generator, or a pressure relief device, for controlling the first gas flow to the outlet of the first patient interface.

[0082] The system may include a spacer component as a barrier or mounting component, wherein the spacer component may include a channel or groove or passage for receiving the gas conduit and includes a sealing surface on which the seal of the second patient interface forms a seal with the patient's face.

[0083] The spacer component may be an object associated with the first patient interface, the second patient interface, both the first patient interface and the second patient interface, or the patient.

[0084] The second patient interface may include:

[0085] The body includes an aperture or port to allow access to and / or communication of gas from a gas supply or gas source to the internal volume of the second patient interface, the internal volume being defined by the interior of the body and the patient's face.

[0086] A seal is provided to create or form a seal between the body and the patient's face, such that the internal volume is a sealed internal volume, and

[0087] The seal may be adapted or configured to allow the creation or formation of a seal between the body and the patient's face, and to facilitate the extension of a gas conduit or the first patient interface into the internal volume of the seal between the body and the patient's face.

[0088] The first respiratory support system may include a pressure relief device located upstream of the device to discharge or redirect at least a portion of the first gas flow from the first respiratory support system.

[0089] The first respiratory support system may include a one-way valve to prevent or reduce backflow from the second respiratory support system into the first respiratory support system.

[0090] The second patient interface can be a handheld patient interface.

[0091] In another aspect, this disclosure relates to a patient interface comprising:

[0092] The first gas cavity is adapted for receiving gas from a gas source.

[0093] The first portion of the first gas cavity is configured to change from a first configuration to a second configuration. In the first configuration, a first level of gas can pass through the first portion of the first gas cavity, and in the second configuration, a second level of gas can pass through the first portion of the first gas cavity.

[0094] The first portion of the first gas cavity can transform or evolve between the first configuration and the second configuration based on the relative level of forces applied to the outer wall of the first portion of the first gas cavity or experienced by its inner wall.

[0095] The first portion of the first gas cavity can transition or evolve between the first configuration and the second configuration based on the pressure level of the gas passing through the first portion of the gas cavity.

[0096] When gas with a pressure higher than the first predetermined pressure level passes through the first gas cavity, the first portion of the first gas cavity may be in the first configuration, and when gas with a pressure lower than the first predetermined pressure level passes through the first gas cavity, the first portion of the first gas cavity may be in the second configuration.

[0097] The first configuration can be a substantially open configuration, and the second configuration is a substantially closed configuration.

[0098] The first level of the gas can be greater than the second level of the gas.

[0099] The walls of the first portion of the first gas cavity may be thinner than the walls of one or more other portions of the first gas cavity.

[0100] The patient interface may further include a substantially smooth or substantially linear thickness transition between the wall of a first portion of the first gas cavity and the walls of one or more other portions of the first gas cavity.

[0101] The first portion of the first gas cavity includes a wall that may be more flexible than the walls of other portions of the first gas cavity, preferably the (more flexible) wall is formed at least in part from a material that is more flexible than the one or more walls of other portions of the first gas cavity.

[0102] The wall of the first portion of the first gas cavity may be configured to collapse significantly or be collapsible when in the second configuration, or be unable to maintain a gas or fluid passage or be substantially unsupported.

[0103] When in the second configuration, the cross-sectional area of ​​the first portion of the first gas cavity when cut along the length of the first gas cavity can be significantly reduced (e.g., reduced to zero), and optionally, when in the second configuration, it can present a substantially flat or planarized shape.

[0104] The first portion of the first gas cavity may include, around, within, or below, the wall of the first portion of the first gas cavity, elements adapted to restrict compression of the first portion of the first gas cavity.

[0105] Regardless of the configuration of the first portion of the first gas cavity, the element can be configured to facilitate a minimum level of gas flow through the first portion of the first gas cavity. Alternatively, such an element can be a reinforcing element.

[0106] The first gas cavity may include, at or near the wall of the first gas cavity, elements adapted to limit compression of the first gas cavity, wherein the strength, thickness, and / or width of the elements decrease at or near a first portion of the first gas cavity.

[0107] The patient interface may be comprised of a portion of the element at or near the first part of the first gas cavity to one or more portions of the element or another element away from the first part of the first gas cavity, and the element has a substantially smooth or substantially linear transition in strength, thickness, and / or width.

[0108] The patient interface may further include a second gas cavity that extends through at least the interior region of the first gas cavity at or near a first portion of the first gas cavity.

[0109] The second gas cavity may be less compressible or more resistant to compression than the first portion of the first gas cavity. In some such configurations, the walls of the second gas cavity are at least partially formed of a material that is more rigid or less flexible than the walls of the first portion of the first gas cavity. Optionally, the second gas cavity may be formed by the one or more elements (e.g., reinforcing elements) coming together. For example, reinforcing elements may be shaped or configured or otherwise adapted to interact with the walls of the first gas cavity to provide the second gas cavity; alternatively, reinforcing elements may be brought together in a configuration to form the second gas cavity and optionally close the first gas cavity.

[0110] The first portion of the first gas cavity may be wider or larger than other portions of the first gas cavity, or have a wider or larger cross-sectional surface area.

[0111] The patient interface may further include a portion from a first part of the first gas cavity to a portion of the first gas cavity that is remote from the first part of the first gas cavity, and includes a substantially smooth or substantially linear transition in width, cross-sectional area, or side surface.

[0112] The patient interface may further include a pressure relief arrangement adapted to reduce the gas pressure in the first gas cavity when a first portion of the first gas cavity is in the second configuration.

[0113] In another aspect, this disclosure relates to a nasal cannula. The nasal cannula may include: a first tubular segment; and at least one nasal delivery element (e.g., at least one nasal fork) in fluid (e.g., actuation) communication with the first tubular segment, one or more of the at least one nasal delivery element being adapted for placement in one or both nostrils of a user; wherein the first tubular segment includes a first gas cavity adapted for receiving gas from a gas source; and wherein a first portion of the first gas cavity has a greater tendency to evolve from a first configuration to a second configuration compared to other portions of the first gas cavity, in the first configuration in which a first level of gas is permissible through the first portion of the first gas cavity, and in the second configuration in which a second level of gas is permissible through the first portion of the first gas cavity.

[0114] The at least one nasal delivery element can be adapted to be unsealed and placed or positioned in one or more of the user's nostrils.

[0115] The flow manifold may be located between the first tubular section and the at least one nasal delivery element.

[0116] The at least one nasal delivery element may extend from the flow manifold.

[0117] The first portion of the first gas cavity can evolve between the first configuration and the second configuration based on the level of force applied to the outer or inner wall of the first portion of the first gas cavity (e.g., as experienced by the inner wall).

[0118] The first portion of the first gas cavity may evolve between the first configuration and the second configuration based at least in part on the pressure level of the gas passing through the first portion of the gas cavity.

[0119] When gas with a pressure higher than the first predetermined pressure level passes through the first gas cavity, the first portion of the first gas cavity may be in the first configuration, and when gas with a pressure lower than the first predetermined pressure level passes through the first gas cavity, the first portion of the first gas cavity may be in the second configuration.

[0120] The first configuration can be a substantially open configuration, and the second configuration is a substantially closed configuration.

[0121] The first level of the gas can be greater than the second level of the gas.

[0122] The walls of the first portion of the first gas cavity may be thinner than the walls of one or more other portions of the first gas cavity.

[0123] The nasal cannula may further include a substantially smooth thickness transition between the wall of a first portion of the first gas cavity and the walls of one or more other portions of the first gas cavity.

[0124] The walls of the first portion of the first gas cavity may be formed, at least in part, of a material that is more flexible than the walls of other portions of the first gas cavity.

[0125] The wall of the first portion of the first gas cavity can be configured to collapse significantly or become unsupportable when in the second configuration.

[0126] When in the second configuration, the cross-sectional area of ​​the first portion of the first gas cavity when cut along the length of the first gas cavity can be significantly reduced (e.g., reduced to zero). Optionally, when in the second configuration, it can present a substantially flat or planarized shape or configuration.

[0127] The first portion of the first gas cavity may include reinforcing elements around, within, or below the wall of the first portion of the first gas cavity, which are adapted to limit compression of the first portion of the first gas cavity.

[0128] Regardless of the configuration of the first portion of the first gas cavity, the reinforcing element can be configured to facilitate a minimum level of gas flow through the first portion of the first gas cavity.

[0129] The first gas cavity may include, at or near the wall of the first gas cavity, a reinforcing element adapted to limit compression of the first gas cavity, wherein the strength, thickness, and / or width of the reinforcing element decreases at or near a first portion of the first gas cavity.

[0130] The nasal cannula may be comprised of a portion of the reinforcing element located at or near the first part of the first gas cavity, or of one or more portions of the reinforcing element located away from or adjacent to the first part of the first gas cavity, wherein the reinforcing element has a substantially smooth or substantially linear transition in strength, thickness, and / or width.

[0131] The first portion of the first gas cavity may have a greater tendency to transition from the first configuration to the second configuration compared to other portions of the first gas cavity, in which a first level of gas can pass through the first portion of the first gas cavity, and in the second configuration, a second level of gas can pass through the first portion of the first gas cavity.

[0132] The nasal cannula may further include a second gas cavity that extends at least along the interior region of the first gas cavity at or near a first portion of the first gas cavity.

[0133] The second gas cavity may be less compressible than the first portion of the first gas cavity.

[0134] The wall of the second gas cavity may be formed at least partially of a material that is more rigid or less flexible than the wall of the first portion of the first gas cavity.

[0135] The first portion of the first gas cavity may be wider or larger than other portions of the first gas cavity, or have a wider or larger cross-sectional surface area.

[0136] The nasal cannula may further include a substantially smooth or substantially linear transition in width from a first portion of the first gas cavity to a portion of the first gas cavity that is away from the first portion of the first gas cavity.

[0137] The nasal cannula may further include a pressure relief valve, device, or arrangement adapted to reduce or alleviate the gas pressure in the first gas cavity when a first portion of the first gas cavity is in the second configuration.

[0138] The nasal cannula may further include one or more attachment structures that are secured, attached, or connected to one or more user-facing portions of the nasal cannula, and the one or more attachment structures are adapted to secure, attach, or connect the nasal cannula to the user's face (optionally in a removable manner).

[0139] The one or more attachment structures can be adapted to interact with one or more fixation structures attached to the face in order to secure the nasal cannula to the face, for example, in a removable manner.

[0140] The at least one nasal delivery element may be shaped or angled such that it extends inward toward the user's nasal septum.

[0141] The at least one nasal delivery element may be shaped or angled such that the tip of the at least one nasal delivery element, when in use, is directed toward the back of the user's head, or angled to direct the supplied gas flow toward the back or more internal region of one or more of the user's nostrils.

[0142] A respiratory support system is disclosed, the respiratory system may include a first respiratory support subsystem and a second respiratory support subsystem, wherein the first respiratory support subsystem includes a patient interface as described, and wherein the system is configured to switch respiratory support delivery to the patient from the first subsystem to the second subsystem when a first portion of a first gas chamber of the patient interface changes from the first configuration to the second configuration.

[0143] The first respiratory support subsystem may be a high-flow system.

[0144] The first respiratory support subsystem may further include the described nasal cannula.

[0145] The second respiratory support subsystem may include a face mask.

[0146] The first portion of the first gas cavity can be transformed from the first configuration to the second configuration when compressed by the seal of the mask.

[0147] A method for switching between two respiratory support modes is disclosed, wherein a first respiratory support mode delivers respiratory support to a patient using a described patient interface, and includes the steps of: changing a first portion of a first gas chamber from a first configuration to a second configuration, wherein in the first configuration, the first respiratory support mode delivers respiratory support to the patient, and in the second configuration, the second respiratory support mode delivers respiratory support to the patient.

[0148] The first mode can be a high-flow treatment mode.

[0149] In another aspect, this disclosure relates to a conduit including a collapsible portion, wherein the cross-section of the collapsible portion comprises a hinged, accordion-shaped, or corrugated conduit wall arrangement, thereby allowing the collapsible portion to collapse from a first condition to a second condition when a force or load is applied to the collapsible portion.

[0150] The cross-section may include a single folded portion on the side of the collapsible portion extending between the outer and inner sides of the catheter, wherein, during use, the inner side of the catheter contacts the patient's face, and wherein...

[0151] The folded portion includes a pair of side portions that, under the first condition, branch out from the fold point to present an outward-facing acute or obtuse angle, and under the second position, the cross section deforms at the fold point, causing the pair of side portions to come together, thereby causing the collapsible portion to collapse into the second condition.

[0152] The cross section may include a first single fold portion on a first side of the collapsible portion and a second single fold portion on a second side of the collapsible portion, the second side being opposite to the first side, the first fold portion and the second fold portion extending between the outer side and the inner side of the conduit.

[0153] The cross section may include the single fold portion on the first side of the collapsible portion and a second fold point on the second side of the collapsible portion, the second side being opposite to the first side, and the outer side and inner side of the conduit branching from the second fold point.

[0154] When the catheter changes from the first configuration to the second configuration, its inner and outer sides can fold together at the second folding point.

[0155] The angle can be an acute angle.

[0156] The angle can be less than 60 degrees, or 55 degrees, or 50 degrees, or 45 degrees, or 40 degrees, or 35 degrees.

[0157] Under the second condition, the collapsible portion can collapse such that the outer surfaces of these side portions come into contact.

[0158] Under the second condition, the inner surfaces of these side portions are in contact with the inner and outer inner surfaces of the conduit.

[0159] On the other hand, according to this disclosure, a catheter, or at least a portion of the length of a catheter, is provided for use as part of a respiratory therapy delivery system, said catheter or the portion of the length of said catheter comprising:

[0160] At least one configuration or array of configurations of the catheter wall is a supporting or partially forming catheter wall, the inner surface of which forms the lumen of the catheter or a gas flow path.

[0161] The at least one configuration or array of configurations is biased to preferably maintain the lumen or gas flow path under a first condition, which is a substantially open or substantially uncollapsed conduit wall condition.

[0162] Furthermore, the conduit or a portion of the length of the conduit including at least one configuration or array of configurations is configured to twist or buckle from a first condition to a second condition in response to a force or load applied to the outer surface of the conduit wall including at least one configuration or array of configurations.

[0163] The second condition is a substantially closed or substantially collapsed conduit wall condition, or under the second condition, the lumen or gas flow path is substantially blocked or gas flow is impeded.

[0164] The at least one configuration or array of configurations can be twisted or buckled substantially without restriction in response to an applied force or load.

[0165] The twisting or buckling of the at least one configuration or array of configurations from the first condition to the second condition can be a predetermined twisting or buckling of the orientation, arrangement, or configuration of the at least one configuration or array of configurations.

[0166] The force or load applied to the outer surface of the conduit during use may be sufficient to overcome the bias.

[0167] The force or load applied to the outer surface of the conduit during use may be sufficient to cause twisting or buckling of the at least one configuration or array of configurations.

[0168] The second condition may be a preferred predetermined reconfiguration (or rearrangement or reorientation) of the at least one configuration or configuration array.

[0169] Under the second condition, the inner surfaces of the catheter walls may come together on themselves, or at least partially together on themselves, to contact or substantially adjacent to each other, to provide substantially closed or substantially collapsed catheter wall conditions, or under said condition, the lumen or gas flow path is substantially blocked or gas flow is impeded therethrough.

[0170] The configuration or configuration array may be biased toward the first condition.

[0171] When a force or load is applied, the configuration or array of configurations can twist or buckle from a first condition to a second condition, but the reduction or removal of the force or load also allows the configuration or array of configurations to return the conduit to or restore it to the first condition.

[0172] The configuration or array of configurations may be independent of the catheter wall or inner wall surface. That is, the one or more configurations are not attached to or connected to the catheter wall or its inner surface.

[0173] The configuration may be a spiral or spirally wound or coiled component, the component forming a helix angle of about 20° to about 70°, or about 25° to about 65°, or about 35° to about 55°, or about 45° with respect to the conduit wall, the helix angle being the angle between the individual windings or coils of the component.

[0174] The configuration may have a helical or spirally wound or coiled component having a pitch ranging from about 1 / 4 to about 10 times the inner diameter of the conduit, or from about 1 / 2 to about 8 times the inner diameter of the conduit, or from about 2 / 3 to about 6 times the inner diameter of the conduit, or from about 1 to about 4 times the inner diameter of the conduit, or the pitch being substantially the length of the inner diameter of the conduit, and the pitch being the center-to-center distance between adjacent helical or spiral windings or coils of the component.

[0175] The configuration may be a helical or spirally wound or coiled component having a helical angle or pitch (or both) such that applying a load or force to the outer surface of the conduit allows the configuration to fold onto itself or be reoriented such that, under the second condition, the configuration is in a substantially flat orientation.

[0176] The configuration may be a series of rings, each ring in the series including a hinged interconnection with at least one other ring.

[0177] The hinged interconnection can facilitate the twisting or buckling of the configuration.

[0178] The configuration may be a series of hinged connecting parts arranged to provide substantially continuous support for the conduit wall at least along the length of the conduit including the configuration.

[0179] The catheter wall may include at least one configuration or array of configurations that extends substantially longitudinally along the catheter wall, or substantially at least longitudinally along the portion of the catheter wall that includes the configuration.

[0180] The at least one configuration or configuration array may be a flap or hinge formed as part of the catheter wall or provided at or within the catheter wall.

[0181] The flaps or hinges allow the catheter wall to fold onto itself.

[0182] The configuration or array of configurations may be an accordion-type arrangement or a bellows-type arrangement, which allows the conduit to twist or buckle from the first condition to the second condition when a force or load is applied.

[0183] The configuration may be a hinge that forms or integrates into the catheter wall or is provided at or within the catheter wall.

[0184] Multiple hinges can be formed as part of the duct wall.

[0185] The hinge may extend substantially longitudinally along the catheter wall, or substantially at least longitudinally along the portion of the catheter wall that includes the hinge.

[0186] On the other hand, this disclosure relates to a catheter provided as part of a breathing circuit or used in a respiratory therapy delivery system, wherein the catheter has no additional support structure to maintain the catheter in a condition where gas can flow, and the wall of the catheter defines an inner lumen through which it passes, the wall being sufficiently flexible and therefore non-self-supporting.

[0187] The catheter can maintain a gas flow configuration by providing positive pressure gas to the inner lumen of the catheter.

[0188] In another aspect, this disclosure relates to a catheter for supplying or delivering gas to a patient interface, said catheter comprising:

[0189] One-way valve, and

[0190] A venting or pressure relief valve is provided upstream of the one-way valve relative to the gas flow being delivered to the interface for venting or releasing pressure that has accumulated within the lumen of the conduit and exceeds a preset or predetermined pressure level (e.g., the venting or pressure relief valve may be configured to "open" or release pressure once a preset or predetermined pressure within the conduit is reached).

[0191] Furthermore, the one-way valve prevents the upstream gas flow from the patient interface.

[0192] The pressure may accumulate during subsequent respiratory therapy delivered to the patient, including but not limited to: a full-face mask that delivers respiratory therapy to the patient at a pressure P2, while the pressure within the conduit including the exhaust or pressure relief device and the one-way valve is pressure P1, wherein P1 is less than P2.

[0193] The one-way valve can be operated to significantly prevent gas otherwise supplied to the patient from flowing back from the patient interface or subsequent patient interfaces.

[0194] In another aspect, this disclosure relates to a pressure relief device for use with a catheter that delivers pressurized gas from a gas source to a patient, the pressure relief device comprising:

[0195] A first wall and a generally opposite second wall, wherein, during normal use, the first wall is substantially flush with the adjacent wall of the conduit, such that substantially all gas from the gas source passes through the conduit, and when a force is applied to the first wall, the first wall moves toward or away from the second wall to provide a passage for gas to flow out of the conduit into the atmosphere.

[0196] The first wall may be relatively rigid, and the second wall may be relatively flexible.

[0197] The pressure relief device may further include a tongue extending from the first wall, such that the tongue can overlap with the adjacent wall of the conduit.

[0198] The first wall may be relatively flexible, and the second wall may be relatively rigid.

[0199] The force may be generated by the object pressing against the first wall.

[0200] The force can be the gas pressure inside the conduit that reaches a threshold pressure.

[0201] In another aspect, this disclosure relates to a pressure relief device for use with a component of a respiratory support system for delivering pressurized gas from a gas source to a patient, the component of the respiratory support system having an orifice, the pressure relief device comprising: a biasing member engageable with the orifice, wherein, during normal use, the biasing member is biased toward the orifice in the component of the respiratory support system to substantially seal the orifice, such that substantially all gas from the gas source passes through the conduit, and when the pressure of the gas within the conduit reaches a threshold pressure, the biasing member moves away from the orifice in the component of the respiratory support system to provide a pathway for gas to exit through the component of the respiratory support system to the atmosphere.

[0202] The components of the respiratory support system may include filters.

[0203] The components of the respiratory support system may include the catheter.

[0204] The components of the respiratory support system may include a chamber.

[0205] In another aspect, this disclosure relates to a pressure relief device for use with a catheter that delivers pressurized gas from a gas source to a patient, the catheter having an orifice, the pressure relief device comprising:

[0206] A lever installed within the conduit, the lever comprising a pivot, an operating portion, and a sealing portion, the sealing portion substantially sealing an orifice in the conduit such that substantially all gas from the gas source passes through the conduit.

[0207] When the operating part moves, the lever pivots about the pivot and the sealing part moves away from the orifice to provide a passage for gas to flow from the conduit through it to the atmosphere.

[0208] The operating portion may be located on one side of the pivot, and the sealing portion may be located on the other side of the pivot.

[0209] The operating portion may be located on one side of the pivot, and the sealing portion may be located on the same side of the pivot.

[0210] In another aspect, this disclosure relates to a flow-limiting device for use with a catheter for delivering pressurized gas from a gas source to a patient, the flow-limiting device including a gate that is movable laterally across the catheter from a first position to a second position, in the first position in which a first level of gas from the gas source substantially passes through the catheter, and in the second position in which a second level of gas passes through.

[0211] The first position can be a substantially open configuration, and the second position is a substantially closed configuration. In some configurations, the first level of the gas is greater than the second level of the gas.

[0212] The second position can be a completely closed, blocked, or obstructed gas flow path, or it can be a partially closed, blocked, or obstructed gas flow path, including but not limited to a restricted or suppressed gas flow path.

[0213] The flow limiting device may include two gates with complementary, engageable features.

[0214] In another aspect, this disclosure relates to a pressure relief device for use with a component of a respiratory support system for delivering pressurized gas from a gas source to a patient, the component of the respiratory support system having an orifice, the pressure relief device comprising: a movable member engageable with the orifice, wherein, during normal use, the movable member is biased toward sealing the orifice in the component of the respiratory support system such that substantially all gas from the gas source passes through the conduit, and when the pressure of the gas within the conduit reaches a threshold pressure, the movable member retracts the orifice in the component of the respiratory support system to provide a pathway for gas to escape from the component of the respiratory support system through it to the atmosphere.

[0215] In another aspect, this disclosure relates to a combination of a pressure relief device and a catheter as described herein.

[0216] The pressure relief device may be integrally formed with the conduit.

[0217] In another aspect, this disclosure relates to a patient interface comprising: one or two side arms extending from a manifold; and one or two outlets (e.g., nose forks) at or extending from the manifold, wherein one or two side arms include: an inner lumen for supplying a flow of gas from a breathing tube to the manifold; and a ventilation arrangement for discharging gas from the inner lumen to determine a maximum pressure in the user's airway or at the patient interface.

[0218] The side arm may include a sealing portion, on which a mask seal may be pressed against the user's face for sealing, and wherein the vent is positioned on the side arm outside the sealing area of ​​the mask.

[0219] The contour of the sealing portion allows the mask's seal to abut against the portion while simultaneously abutting against the user's face for a seal.

[0220] The side arm can be configured to resist external forces so that it is not compressed or collapsed during use.

[0221] The side arm can be formed of a relatively rigid material.

[0222] In another aspect, this disclosure relates to an object, such as a barrier or mounting element, for use with a patient interface, said object being or to be positioned in contact with a patient's face, said object comprising: at least one cavity passing through it for allowing a gas supply conduit to pass through or for creating a gas supply conduit connection at each end of said cavity, wherein the supplied gas is fluidly connected to said patient interface; and a ventilation arrangement for venting gas from said cavity in order to determine maximum pressure at the user's airway or said patient interface.

[0223] The object may include a sealing portion, on which a mask seal may be pressed against the user's face for sealing, and wherein the vent is positioned on the object outside the sealing area of ​​the mask.

[0224] The contour of the sealing portion allows the mask's seal to abut against the portion while simultaneously abutting against the user's face for a seal.

[0225] The object can be configured to resist external forces so that it is not compressed or collapsed during use.

[0226] The object can be formed from a relatively rigid material.

[0227] The object can be integrally formed with, for example, the side arm of a patient interface for intubation.

[0228] The patient interface or object may include a filter to prevent contamination of the breathing circuit that provides gas flow to the object or interface, and the filter includes the ventilation arrangement.

[0229] In another aspect, this disclosure relates to a breathing tube for use with a patient interface, the breathing tube including a window in the wall of the tube, and the peripheral portion of the window being configured to be sealed against the user's face.

[0230] The conduit may include a seal around the perimeter of the window to seal against the user's face.

[0231] Compared to a conventional circular cross-section, the pipe can have a relatively flat cross-section.

[0232] The pipe may be formed of an elastic material in this portion of the pipe forming window.

[0233] The patient interface can be a nasal cannula.

[0234] The conduit may include a membrane on the window.

[0235] In another aspect, this disclosure relates to a breathing system adapted to provide a flow of breathing gas to a user, the breathing system including an air bladder in fluid communication with the lumen of a breathing gas conduit, the air bladder being configured to reduce pressure fluctuations in the lumen of the conduit and / or slow down pressure increases of the gas supplied to the user.

[0236] The airbag can form or provide a portion of the inner cavity of the tube.

[0237] The airbag may be a section of the conduit with a reduced wall thickness and / or formed of a material that may be more elastic than the rest of the conduit.

[0238] The airbag may be integrally formed with a portion of the tubing extending from each end of the airbag, or may be releasably attached to the breathing tubing.

[0239] The airbag can be releasably attached to a breathing duct, each end of the airbag being configured to attach to a duct to form a breathing duct assembly, the breathing duct assembly including a first length of duct attached to one end of the airbag, the airbag, and a second length of duct attached to the other end of the airbag.

[0240] The airbag can provide an indication of increased pressure within the cavity of the tube.

[0241] The system may include a ventilation arrangement such that, once an increased pressure is reached, the ventilation arrangement operates to expel breathing gas from the lumen of the tubing into the airbag.

[0242] The airbag can be configured to contain a total predetermined volume and pressure of gas at a predetermined flow rate and pressure.

[0243] The airbag can be configured to store a volume of gas at a flow rate of 70 L / min for 3 to 5 minutes for the desired therapeutic delivery under typical operating pressure.

[0244] The system may include a release valve or vent to release gas from the airbag to the atmosphere once the airbag reaches a predetermined exhaust pressure.

[0245] In another aspect, this disclosure relates to a breathing conduit adapted to provide a flow of breathing gas to a user, the breathing conduit including an air bladder configured to reduce pressure fluctuations within the conduit's interior and / or slow the pressure increase of the gas supplied to the user.

[0246] The airbag can form or provide a portion of the inner cavity of the tube.

[0247] The airbag may be a section of the pipe with reduced wall thickness and / or formed of a material that is more elastic than the rest of the pipe.

[0248] The airbag may be integrally formed with a portion of the tubing extending from each end of the airbag, or may be releasably attached to the breathing tubing.

[0249] The breathing conduit may be a breathing conduit assembly, and each end of the airbag may be configured to be attached to the conduit to form the breathing conduit assembly, the breathing conduit assembly including a first length conduit attached to one end of the airbag, the airbag, and a second length conduit attached to the other end of the airbag.

[0250] The airbag can provide an indication of increased pressure within the cavity of the tube.

[0251] The breathing duct may include a ventilation arrangement such that, once an increased pressure is reached, the ventilation arrangement operates to expel breathing gas from the lumen of the duct into the air bag.

[0252] The airbag can be configured to contain a total predetermined volume and pressure of gas at a predetermined flow rate and pressure.

[0253] The airbag can be configured to store a volume of gas at a flow rate of 70 L / min for 3 to 5 minutes for the desired therapeutic delivery under typical operating pressure.

[0254] The system may include a patient interface, valves, and air vents.

[0255] In another aspect, this disclosure relates to a patient interface comprising: a device and / or sensing arrangement, the device being for blocking flow between an inlet for receiving a gas flow and an outlet for delivering a gas flow to a patient. The device may be a catheter, a collapsible portion between the inlet and outlet, or a valve between the inlet and outlet. The sensing arrangement may include a first sensor upstream of the device and a sensor downstream of the device. The patient interface may include a pressure relief valve upstream of the device. The device may be a pressure relief device.

[0256] The interface can be a nasal cannula.

[0257] The breathing duct may include a release valve or vent to expel gas from the airbag to the atmosphere once the airbag reaches a predetermined exhaust pressure.

[0258] The valve may be a switch, a collapsible part of a conduit, or a check valve.

[0259] The vent can be a pressure relief valve.

[0260] Breathing therapy delivery systems may include any one or more of those mentioned above.

[0261] The patient interface may be provided to be in fluid communication with a gas supply conduit or conduit, including any one or more of those described above.

[0262] A catheter or conduit may be provided as part of a respiratory therapy delivery system for supplying gas to a patient interface, the catheter or conduit including any one or more of those described above.

[0263] The system may include any one or more of the above, wherein the system is provided as part of a respiratory delivery therapy system for use by a patient undergoing a medical procedure.

[0264] In one embodiment, a system for providing respiratory support to a patient is provided, comprising:

[0265] A nasal cannula comprising: a body portion that is positioned on a patient's face in an operating position; at least one nasal fork extending from the body portion, the nasal fork being adapted to introduce a flow of gas into the nostrils of the patient's nose when the body portion is in the operating position; and

[0266] A flow controller for selectively controlling the flow of gas from the nasal fork into the nostrils of a patient, the flow controller being adapted to function to limit or prevent the flow of gas from the nasal fork into the patient's nostrils when the pressure in the system is higher than a predetermined value.

[0267] A system may include:

[0268] Pressure sensors or pressure sensing or sampling conduits used to measure or sample pressure within the system, and

[0269] The flow controller operates in response to the measured or sampled pressure when the measured or sampled pressure is higher than a predetermined value.

[0270] The pressure sensor may be located at or near the nasal cannula, or at or near the nasal fork, or on a catheter adapted to deliver gas to the nasal cannula, or at a humidifier adapted to humidify the gas flow, or at the flow controller, or at a pressure sampling line that samples the pressure at any of these locations.

[0271] The pressure sensor may be located at or near the at least one nose fork.

[0272] The pressure sensor may be located on a catheter adapted to deliver gas into the nasal cannula.

[0273] The flow controller may include a mechanical valve.

[0274] The mechanical valve may be a pressure relief device.

[0275] The system may include at least one processor to control the flow controller based on the pressure sensed by the pressure sensor.

[0276] The pressure relief device may include a valve member, and pressure acting on the valve member causes the pressure relief device to operate to restrict or prevent gas flow from the nasal fork into the patient's nostrils.

[0277] The pressure relief device may include a cover or housing to house the valve component outside the gas cavity of the system.

[0278] The valve component can be biased to a closed position to provide a flow of gas from the nasal fork into the patient's nostrils.

[0279] The valve component may be or may include a piston or a shuttle, and the pressure acting on the piston or shuttle causes the pressure relief device to operate to limit or prevent the flow of gas from the nasal fork into the patient's nostrils.

[0280] The predetermined value can be the maximum pressure.

[0281] The predetermined value can be an adjustable value.

[0282] The flow controller can be operated to deliver maximum flow while maintaining pressure below a predetermined value.

[0283] The system can deliver a set flow rate continuously unless the set pressure is exceeded, in which case it maximizes the possible flow rate to keep it below the pressure.

[0284] The flow controller can be positioned away from the nasal cannula.

[0285] The system may further include a cover that is to be positioned together with the nasal cannula during use.

[0286] The nasal cannula may be an unsealed patient interface.

[0287] The mechanical valve may include a valve member and a spring that biases the valve member into an open position to allow delivery of a gas flow to the patient.

[0288] The valve component can be adapted such that when the pressure in or near the patient's nostrils is greater than the force of the spring, the valve component is pushed to a closed position by the flow pressure and no gas flow is delivered to the patient.

[0289] The mechanical valve may have an overflow outlet.

[0290] The tension of the spring can be a fixed spring tension. In other embodiments, the tension of the spring can be an adjustable spring tension.

[0291] The flow controller may include at least one processor and a user interface.

[0292] The predetermined value can be a fixed value.

[0293] The predetermined value can be an adjustable value.

[0294] The system may further include an anesthesia mask.

[0295] The nasal cannula may be an unsealed patient interface.

[0296] The system may further include a second respiratory support system for introducing a gas stream into the patient's airway. The gas stream may be a breathing gas or another gas. The secondary respiratory support system may include a mask.

[0297] The flow controller can control the flow of gas from one or more gas sources.

[0298] In one embodiment, a method for providing respiratory support to a patient is provided, the method comprising:

[0299] The nasal cannula is placed in a maneuvering position on the patient's face. The nasal cannula has a body portion and at least one nasal fork extending from the body portion.

[0300] The gas is introduced into the patient's nostrils through the nose fork.

[0301] Measure or sample the pressure in the system.

[0302] When the measured or sampled pressure is higher than a predetermined value, the flow of gas from the nasal fork into the patient's nostrils is restricted or prevented, and

[0303] When the pressure in or near the patient's nostrils is below a predetermined value, gas flow is allowed from the nasal fork into the patient's nostrils.

[0304] In some embodiments, step iv) includes preventing the gas flow from the nasal fork into the nostrils of the patient's nose.

[0305] When the measured pressure exceeds the limit value, flow can be prevented from entering the system.

[0306] The method may further include using a second respiratory support system to introduce a gas stream into the patient's airway. The gas stream may be a breathing gas or another gas. The gas may be delivered to the patient via a mask.

[0307] The system may include a total pressure relief system that takes into account total pressure and controls one or more flow generators or one or more gas sources (because sometimes there may be no flow generator and only gas sources may be present).

[0308] The pressure sensor may be located at or near the nasal cannula, or at or near the nasal fork, or on a catheter adapted to deliver gas to the nasal cannula, or at a humidifier adapted to humidify the gas flow, or at the flow controller, or at a pressure sampling line that samples the pressure at any of these locations.

[0309] The pressure sensor can be located on the humidifier.

[0310] The pressure sensor can be located on the flow control valve.

[0311] The mechanical valve may be a pressure relief device.

[0312] The system may include a flow controller and a user interface, the flow controller being controlled by at least one processor to control the flow controller based on the pressure sensed by the pressure sensor.

[0313] The pressure relief device may include a valve member, and pressure acting on the valve member causes the pressure relief device to operate to restrict or prevent gas flow from the nasal fork into the patient's nostrils.

[0314] The pressure relief device may include a cover or housing to house the valve component outside the gas cavity of the system.

[0315] The valve component can be biased to a closed position to provide a flow of gas from the nasal fork into the patient's nostrils.

[0316] The valve component may be or may include a piston or a shuttle, and the pressure acting on the piston or shuttle causes the pressure relief device to operate to limit or prevent the flow of gas from the nasal fork into the patient's nostrils.

[0317] The flow controller can be operated to deliver a maximum flow rate while maintaining pressure below a predetermined value, with the delivered flow rate maximized to set the pressure at the location.

[0318] The system can deliver a set flow rate continuously unless the set pressure is exceeded, in which case it maximizes the possible flow rate to keep it below the pressure.

[0319] The flow controller can be positioned away from the nasal cannula.

[0320] In another aspect, this disclosure relates to a user interface device that enables a user to control the flow of gas in a respiratory therapy system for delivering high-flow-rate gas to a patient, the user interface device comprising: at least one user-actuable controller for controlling the flow rate and / or concentration of two gases passing through a patient interface, and for significantly blocking or reducing the flow rate of at least one gas passing through the patient interface.

[0321] The gas is a high-flow-rate gas. In some configurations, another gas is an anesthetic gas.

[0322] In some configurations, the patient interface is a nasal cannula, and the user-actuated controller includes a switch located on the cannula.

[0323] In another aspect, this disclosure relates to a respiratory therapy system comprising: a cannula for delivering a high-flow-rate gas to a patient; a hood for delivering the gas to the patient; and a pressure sensor associated with the cannula, wherein the system is configured to adjust the flow rate of the high-flow-rate gas through the cannula in response to at least one type of pressure change sensed by the sensor.

[0324] The pressure sensor can be provided on the outer surface of the cannula or on the outer surface of a pipe in fluid communication with the cannula.

[0325] The system can be configured to reduce or significantly block the flow of high-flow-rate gas when the pressure sensor detects an increase in pressure.

[0326] The pressure sensor can be configured to detect an increase in pressure in response to a shroud being placed on the patient, the patient exhaling, or an actuation of an anesthesia bag.

[0327] The system may further include a valve to partially or significantly block the flow of high-velocity gas through the cannula in response to a detected increase in pressure.

[0328] In another aspect, this disclosure relates to a respiratory therapy system comprising: an intubation circuit for delivering a high-flow-rate gas to a patient via an intubation tube; a bag circuit enabling a user to manually deliver gas to the patient via an actuated bag; and a connector connecting the bag circuit to the intubation circuit, the connector including a separator to significantly prevent the high-flow-rate gas from advancing into the bag circuit.

[0329] The connector can be configured to allow both high-flow-rate gas and gas from the bag circuit to be delivered to the patient via the cannula.

[0330] The connector can be configured to significantly prevent high-flow-rate gas delivery to the cannula when the bag circuit is connected to the cannula circuit.

[0331] The separator may include one or more walls in the connector.

[0332] The cannula may be a nasal cannula having at least one fork received in a patient's nostril, the cannula including one or more inflatable ferrules associated with the one or more forks to assist in creating a seal in one or more of the patient's nostrils.

[0333] The system can be configured to inflate one or more sleeves in response to actuation of the bag.

[0334] In another aspect, this disclosure relates to an intubation circuit for delivering a high-flow-rate gas to a patient via an intubation tube; a bag circuit that allows a user to manually deliver gas to a patient by actuating a bag, the bag circuit being in fluid communication with the intubation circuit; and a valve arranged to allow high-flow-rate gas delivery to the intubation tube when the bag is not actuated, and to allow gas delivery from the bag circuit to the cannula when the bag is actuated.

[0335] The valve can be arranged such that, in response to actuation of the bag, it significantly blocks or reduces the flow of high-flow-rate gas into the cannula.

[0336] The cannula may be a nasal cannula having at least one fork received in a patient's nostril, the cannula including one or more inflatable ferrules associated with the one or more forks to assist in creating a seal in one or more of the patient's nostrils.

[0337] The system can be configured to inflate one or more sleeves in response to actuation of the bag.

[0338] In another aspect, this disclosure relates to a cannula comprising at least one fork received in a patient's nostril, the cannula comprising one or more inflatable sleeves associated with the one or more forks to assist in creating a seal in one or more of the patient's nostrils.

[0339] In another aspect, this disclosure relates to a respiratory therapy system comprising: a patient interface for delivering gas to a patient; and a processor configured to control a gas flow through the patient interface during spontaneous breathing to deliver gas to the patient at a first flow rate and / or pressure, and configured to deliver gas to the patient at a second flow rate and / or pressure when the patient is not breathing spontaneously.

[0340] The system can be configured to detect the presence of apnea and to deliver gas at the second flow rate and / or pressure in response to the detection of apnea.

[0341] The system can be configured to detect the presence of apnea based on interruptions in brain activity signals, diaphragm signals, airway pressure, or CO2 measurements.

[0342] The first flow rate and / or pressure may include a relatively low flow rate and / or pressure, and the second flow rate and / or pressure may include a relatively high flow rate and / or pressure.

[0343] The processor may be a remote processor.

[0344] In another aspect, this disclosure relates to a respiratory therapy system comprising: a patient interface for delivering gas to a patient; a sensor arranged to sense pressure fluctuations in the patient interface or in a conduit in fluid communication with the patient interface; and a processor configured to adjust the gas flow to the patient interface to deliver gas to the patient interface at an increased flow rate if a decrease in airway pressure is sensed.

[0345] The processor can be configured to adjust the gas flow to the patient interface to deliver gas to the patient interface at an increased flow rate if a decrease in airway pressure is determined to be occurring during and / or after apnea.

[0346] In another aspect, this disclosure relates to a patient interface comprising: a cannula for delivering gas to a patient; a connector portion in fluid communication with the cannula and configured to removably connect the cannula to a complementary connector portion on a main gas conduit for delivering a high flow rate of gas to the cannula; and a secondary conduit in fluid communication with the cannula, the secondary conduit being configured to provide fluid communication between the cannula and an alternative gas source.

[0347] The connector portion that is in fluid communication with the cannula can be configured to seal when the connector portion is disconnected from the complementary connector portion on the main gas conduit.

[0348] On the other hand, a patient interface is provided that includes a mechanically activated switch or valve for controlling the flow of gas from the patient interface to one or more outlets.

[0349] The mechanical activation switch can be activated by a user, or alternatively by placing a component of the respiratory therapy delivery system (e.g., a subsequent patient interface that contacts the patient interface including the switch) into contact with the switch.

[0350] The patient interface including the switch may include a vent or pressure relief device for releasing pressure that has accumulated due to the activation of the switch and for partially or completely blocking or preventing gas flow to the one or more outlets.

[0351] When activated, the switch can partially block the gas flow path through the patient interface or completely block the flow path.

[0352] In another aspect, a catheter is provided for use with a patient interface or as part of a respiratory therapy delivery system, the catheter including a mechanically activated switch or valve for controlling the flow of gas through the catheter and from the catheter to an outlet (e.g., to a patient interface that can be connected to the catheter).

[0353] The mechanical activation switch can be activated by a user or, alternatively, by placing a component of the respiratory delivery system (e.g., a subsequent patient interface that contacts the catheter including the switch) into contact with the switch.

[0354] The conduit including the switch may include a vent or pressure relief device for releasing pressure that has accumulated due to the activation of the switch and for partially or completely blocking or preventing gas flow from the conduit to the outlet.

[0355] When activated, the switch can partially block the gas flow path through the conduit or completely block the flow path.

[0356] The catheter may be a self-supporting catheter (i.e., the catheter is not a collapsible catheter).

[0357] In another aspect, this disclosure relates to a respiratory therapy system comprising:

[0358] The first patient interface for delivering a gas flow to the patient, and

[0359] A second patient interface for delivering a gas flow to the patient.

[0360] The sensor is associated with one or more of the following:

[0361] The first patient interface,

[0362] The second patient interface,

[0363] Both the first patient interface and the second patient interface

[0364] Objects associated with the first patient interface,

[0365] Objects associated with the second patient interface,

[0366] Objects associated with both the first patient interface and the second patient interface.

[0367] Objects associated with the patient

[0368] The first patient interface may include one or a pair of first patient interface outlets for directing a flow of gas to the patient's nose.

[0369] The first patient interface may be an unsealed interface type.

[0370] The first patient interface may not form a seal with one or more nostrils of the patient's nose.

[0371] The first patient interface can be a sealed interface.

[0372] The first patient interface can form a seal with one or more nostrils of the patient's nose.

[0373] The first patient interface can deliver a first gas flow to the patient.

[0374] The first gas flow may have a first flow velocity and / or pressure.

[0375] The percentage of oxygen in the delivered first gas stream may be between about 20% and about 100%, or between about 30% and about 100%, or between about 40% and about 100%, or between about 50% and about 100%, or between about 60% and about 100%, or between about 70% and about 100%, or between about 80% and about 100%, or between about 90% and about 100%, or about 100%, or 100%.

[0376] The first patient interface can be configured to deliver the gas flow into one or more nostrils of the patient's nose.

[0377] The first patient interface may include one or a pair of nose forks.

[0378] The one or more nose forks can deliver and / or direct the supplied gas flow to one or more nostrils of the patient's nose.

[0379] The first patient interface may include a face mounting portion and at least one (preferably paired) side arm extending from the face mounting portion.

[0380] The side arm can be configured to assist in positioning the face mount or the first patient interface onto the patient.

[0381] The side arm may include a connection system for connecting to a headgear or a face-mounted connection system.

[0382] The connection system can be a releasable or reusable connection system.

[0383] The headgear may include at least one head strap.

[0384] The at least one head strap may be split or branched, or at least a portion of the head strap may be separable along a weak line or preferred split or separation region.

[0385] The at least one head strap may include a single connection point with the at least one side arm or each side arm.

[0386] The first patient interface may include a removable manifold portion.

[0387] In another embodiment, when attached to the face mounting portion, the removable manifold portion provides fluid connection between the one or a pair of first patient interface outlets and a gas source.

[0388] The manifold portion can be configured to be attached to the face mount portion from the left or right side of the first patient interface.

[0389] The removable manifold portion may be a downstream connector of the gas supply conduit for supplying gas flow to the first patient interface.

[0390] The manifold portion can form a push-fit connection with the face mounting portion.

[0391] The manifold portion can be removably attached to the face mount portion, configured to be removably attached via a connection to the face mount portion, and to rotate or rotate relative to the face mount portion from a first operative connection orientation and to at least one other (preferably second) operative connection orientation.

[0392] The first operative connection orientation can provide for the removable manifold portion and associated gas supply catheter to extend from the patient's right or left side in use, or vice versa; and wherein the second operative connection operation can provide for the removable manifold portion and associated gas supply catheter to extend from the patient's right or left side in use, or vice versa.

[0393] The first patient interface can be a nasal cannula.

[0394] The second patient interface may include at least one second patient interface outlet for directing gas flow to the patient's airway.

[0395] The second patient interface can direct the gas flow to the patient's nose, or mouth, or both nose and mouth.

[0396] The second patient interface may be an unsealed interface. In another embodiment, the second patient interface may be a sealed interface.

[0397] The second patient interface may be a substantially sealed interface, wherein a seal is created with the patient's face when the second patient interface is in place.

[0398] The second patient interface can deliver a second gas flow to the patient.

[0399] The second gas flow may have a second pressure.

[0400] The percentage of oxygen in the gas delivered in the second gas stream may be between about 20% and about 100%, or between about 30% and about 100%, or between about 40% and about 100%, or between about 50% and about 100%, or between about 60% and about 100%, or between about 70% and about 100%, or between about 80% and about 100%, or between about 90% and about 100%, or about 100%, or 100%.

[0401] The second patient interface may include a body having a sealing portion that substantially engages or seals with the patient when in place.

[0402] The sealing portion may be molded onto the body or otherwise attached to the body.

[0403] The second patient interface may include a frame to which the body can be attached.

[0404] The patient interface may include an inlet connected thereto via a gas supply conduit for supplying a gas flow to a second patient interface.

[0405] The second patient interface can be a handheld patient interface.

[0406] The inlet can be a connector.

[0407] The connector may be a ball joint, a rotary or pivotal joint, a hinged joint, or a joint that can move relative to the body.

[0408] The second patient interface can be a handheld interface.

[0409] The second patient interface may include a connection system for connecting a headgear for supporting or positioning the second patient interface on the patient's face.

[0410] The connection system may be a releasable connection system, allowing the headgear to be removed from or disconnected from the second patient interface during use.

[0411] The second patient interface can be a cover.

[0412] The mask may be one of the following: a nasal mask, a face mask, a mouth and nose mask, a full-face mask, a nasal pillow mask, a tube in the trachea, a combination of these, or some other gas delivery system that provides a second gas flow to the patient.

[0413] The object may be a barrier or mounting that comes into contact with the patient's face, or is to be placed in contact with the patient's face, the barrier or mounting including at least one cavity through which to allow a gas supply conduit to pass, or to create a gas supply conduit connection at each end of the cavity, wherein the supplied gas is fluidly connected to the first patient interface.

[0414] The object can co-locate at least one gas supply conduit to supply gas to the first patient interface.

[0415] The at least one gas supply conduit may extend through or through the body of the object.

[0416] The at least one gas supply conduit may be a component that extends through the object and is sealed and engaged by the object.

[0417] A gas supply conduit can be accommodated through the inner cavity of the object.

[0418] The cavity through the object can form a partial fluid passage for delivering gas to the first patient interface.

[0419] The object may include compressible portions or portions that can be flattened or deformed under applied force or pressure.

[0420] One or more of the at least one inner cavity may be located within the compressible portion or the portion that can be flattened or deformed. The compressible portion may be made of any suitable material, such as polymers or silicone.

[0421] The lumen and / or conduit located within the compressible portion or the portion that can be flattened or deformed may be compressible or deformable to block or obstruct (or prevent) or partially block the gas flow supplied to the first patient interface.

[0422] The object may be an integral part of the side arm of the first patient interface.

[0423] The object can be removably attached to the supply catheter leading to the first patient interface.

[0424] The object can be removably attached to the side arm of the first patient interface.

[0425] The object may be a separately positioned component, or a component that can be located on the patient, more specifically on the patient's face.

[0426] The object may be a gas conduit in fluid connection with a first patient interface or a second patient interface, or a gas conduit in fluid communication with each of the first and second patient interfaces.

[0427] The object may be an attachment or placeable patch, pad, or wearable device on a patient for sensing the in-situ combination of a first patient interface and a second patient interface on the patient during gas delivery to the patient, wherein such sensing combination generates a signal or output.

[0428] The signal or output may be fed to or may activate or control (or activate and control) one or more of the following system results:

[0429] Visual alarms or warnings

[0430] Audible alarms or warnings, including but not limited to whistles,

[0431] Tactile or haptic feedback fed or directed to wearable electronic devices, including but not limited to: watches, telephones, head-mounted displays, or other items incorporating such electronic devices.

[0432] A flow controller (including a flow valve or a flow generator), preferably used to control the gas flow directed to a first patient interface; additionally, optionally or separately, it includes a component for controlling the gas flow directed to a second patient interface.

[0433] A pressure regulator or pressure control device, preferably used to control the pressure of gas directed to the first patient interface; additionally, optionally or separately, includes a device for controlling the pressure of gas directed to the second patient interface.

[0434] A deflector, used to redirect a gas flow that would otherwise be controlled toward a vent.

[0435] A microprocessor associated with the flow controller or the pressure regulator (or both).

[0436] Graphical User Interface (GUI).

[0437] The sensed in-situ combination signal or output can provide control over the flow (or pressure) of the gas directed to the first patient interface.

[0438] The sensor may use any one or any combination of the following in sensing the in-situ combination:

[0439] Optical sensors (including infrared, IR)

[0440] Acoustic (including sound or ultrasound) sensors

[0441] A pressure sensor or flow sensor, said pressure sensor or flow sensor being sensitive to the pressure or flow rate of gas supplied to a supply conduit for supplying gas to a first patient interface or a second patient interface, or both the first patient interface and the second patient interface; or being sensitive to the pressure or flow rate (or both) of gas delivered to or partially delivered to a patient's respiratory system.

[0442] Conductive or resistive electrodes embedded in or placed on one or more of the following:

[0443] The first patient interface,

[0444] Or the second patient interface,

[0445] Or both the first interface and the second interface,

[0446] Objects that are associated with the first patient interface, the second patient interface, or both the first patient interface and the second patient interface.

[0447] Or objects associated with the patient,

[0448] The radio frequency or proximity sensing sensor of the in-situ combination is sensed.

[0449] Mechanically activated or triggered sensors, including but not limited to: mechanical switches that are activated or triggered by pressing or placing them into contact with another surface; pressure relief valves or pressure-sensitive valves; solenoid valves; mechanical valves having a predetermined spring constant (optionally, but not limited to, a spring constant that is relatively high when the valve is closed and relatively low when the valve is open); and pressure relief valves that optionally include a whistle element activated by releasing gas when the valve moves from a closed position to an open position.

[0450] The sensor may be located on or within the first patient interface, or the second patient interface, or both the first and second patient interfaces, and the sensor senses:

[0451] The second patient interface may be present on or placed on the patient in conjunction with or on the first patient interface.

[0452] The presence or placement of the first patient interface on the patient's face and the subsequent placement or presence of the second patient interface in combination with it on the patient.

[0453] The sensor may be located on or inside the first patient interface.

[0454] The sensor may be located on or inside the second patient interface.

[0455] The sensor can sense when the second patient interface is in place or "in position" on the patient and generate a signal or output.

[0456] The sensor can detect the placement of the second patient interface on the patient.

[0457] The sensor used can be one or more of the following: optical sensor (including IR), acoustic sensor (sound or ultrasound), mechanically activated or triggered sensor (e.g., a mechanical switch that is activated when in contact with another object).

[0458] The acoustic sensing system may include a transmitter or a receiver, the transmitter emitting a predetermined code (e.g., a modulated acoustic signal) and the receiver receiving and detecting the code. The transmitter may send an acoustic signal, and if the second patient interface is present, the signal is reflected back to a receiver located near the transmitter. For example, the transmitter and receiver may be located on or within the first patient interface, and the signal may be reflected through the second patient interface. Alternatively, the transmitter and receiver may be located on or within the second patient interface, and the signal may be reflected through the patient's face or the first patient interface.

[0459] The optical sensing system may include a transmitter or a receiver, the transmitter emitting a predetermined code (e.g., a specific binary signal) and the receiver receiving and detecting the code. For example, the transmitter and receiver may be located on or within the first patient interface and may reflect the signal through the second patient interface. Alternatively, the transmitter and receiver may be located on or within the second patient interface and may reflect the signal through the patient's face or the second patient interface.

[0460] The sensor can sense the in-situ combination and control the gas flow to the first patient interface. Controlling the gas flow to the first patient interface involves terminating or stopping the gas supply.

[0461] The sensor can sense the patient's face, or the first patient interface, or both the patient's face and the first patient interface, and use the sensor to control the gas flow to the first patient interface, or generate signals or outputs to control or regulate the gas flow to the first patient interface, or generate alarms or warnings.

[0462] The sensor can be selected or adjusted to sense components located on or embedded in the first or second patient interface, or on or within each of the first and second patient interfaces.

[0463] The sensor can be selected or adjusted to avoid accidental positive or negative sensing.

[0464] The sensor may be located on or embedded in an object that is in contact with the patient's face, or a barrier or mount to be placed in contact with the patient's face (or optionally attached to or mounted thereon). The barrier or mount may include at least one cavity passing through it to allow a gas supply conduit to pass through, or to create a gas supply conduit connection at each end of the cavity, wherein the supplied gas is fluidly connected to the first patient interface.

[0465] The second patient interface can be placed in contact with the object, and a sensor located or embedded in the object can sense the presence of the second patient interface and generate a signal or output.

[0466] The sensor may be at least one pair of electrodes that generate a signal or output based on a change in dielectric constant or a change in capacitance between the electrodes. The signal or output is used to feed, activate, or control (or activate and control) any one or more of the system results as defined above.

[0467] The sensor may be a mechanical switch that is activated by placing a second patient interface in contact with the sensor and generating a signal or output.

[0468] The mechanical switch may include an actuable protrusion or fork extending from the object at a point that contacts the second patient interface when the second patient interface is provided in an operating configuration relative to a patient.

[0469] The actuable protrusion or fork may be a pressable button, which is actuated and generates a signal or output once pressed.

[0470] The mechanical switch may include a strain gauge that generates a signal or output once it senses a predetermined amount of strain, the predetermined amount of strain indicating that the second patient interface is positioned to contact the object when it is in an operational configuration for the patient.

[0471] The object may include an optical transmission portion (e.g., but not limited to a light-transmitting window segment), wherein an optical sensor is displaced within the transmission portion, and the optical sensor optically senses the presence of the second patient interface when the second patient interface is positioned to substantially contact at least a portion of the portion.

[0472] The sensing system can sense total internal reflection before the second patient interface is substantially present or placed on the optical transmission portion; and when the second patient interface is present or placed on the optical transmission portion, the sensing system can sense suppressed internal reflection.

[0473] The sensor may be a pressure-sensitive switch or a sensing system that senses or detects an increase in pressure when the second patient interface is placed in contact with an object.

[0474] The pressure-sensitive switch or sensing system may include a pressure sensor in the gas-filled chamber of the object, and a flexible membrane or pressure-sensitive membrane provided as a barrier or outer surface. When a second patient interface is provided for a patient, the flexible membrane or pressure-sensitive membrane is to be placed on the second patient interface, and placing the barrier or outer surface on the second patient interface generates a pressure change in the chamber.

[0475] The pressure changes in the room can be sensed by sensors, and a signal or output indicating the presence of the second patient interface in combination with the object can be generated.

[0476] The pressure-sensitive switch or sensing system may include a pressure sensor within the seal of the second patient interface, and placing the second patient interface on the patient causes a pressure change within the seal. The sensor senses the pressure change and generates a signal or output indicating the presence of the second patient interface on the patient.

[0477] The sensor can be located on or embedded in the first patient interface.

[0478] The sensor may use one or more of the following: acoustic (sound or ultrasonic) sensing system, beam sensing system (including IR), and temperature sensing system.

[0479] The sensor may be a temperature sensing system that senses temperature changes, specifically a predetermined temperature or temperature range associated with the temperature of the patient or their skin, in order to sense when the first patient interface is in place on the patient or in an operational position.

[0480] The temperature sensing system can be activated to allow other sensors to become operational. This will prevent other sensors from operating when the first patient interface is not in place on the patient or in an operational position.

[0481] The object associated with the first patient interface, or the second patient interface, or both the first patient interface and the second patient interface, may be a gas supply conduit.

[0482] The sensor can be associated with the object.

[0483] The sensor associated with the object can be an acoustic sensing system.

[0484] The sensor can sense changes in the parameters or characteristics of an object, which indicate an increase in pressure in or through the object, or a decrease in gas flow.

[0485] The parameter or feature may be a shape change of the gas supply catheter caused by one or more of the following: increased pressure within the catheter; reduced gas flow through the catheter; shape change of the catheter due to an applied external force or pressure (e.g., a force or pressure applied to the catheter by a second patient interface, whether the force or pressure is applied directly or indirectly).

[0486] The sensor may include an acoustic signal transmitter and an acoustic signal receiver, such that the transmitted acoustic signal is altered or modified by a shape change in the gas supply conduit that indicates an increase in pressure or a decrease in gas flow in or through the conduit.

[0487] The sensor can sense reflected signals (e.g., due to the closure of the catheter, or changes or deviations in the shape of the catheter outside a predetermined operating range) or can sense resonant changes (e.g., due to the formation of a standing wave waveform within the catheter when the catheter is closed, or when the shape of the catheter changes or deviates from the predetermined operating range).

[0488] In another aspect, this disclosure relates to a respiratory system comprising:

[0489] Controller

[0490] Flow generator,

[0491] Sensor systems, such as pressure sensor systems, flow sensor systems, and / or motor speed sensor systems,

[0492] First patient interface, and

[0493] Second patient interface.

[0494] The controller can be adapted to detect changes in pressure, flow, or motor speed of the mechanical blower, and in response to the detected changes, the controller activates or controls (or activates and controls) any one or more of the 'system results' as defined above.

[0495] The respiratory system may include a humidifier and a chamber having a chamber inlet and a chamber outlet, and a pressure sensor system is positioned at the chamber outlet.

[0496] The system may include flow sensors at the chamber inlet and / or chamber outlet. The flow sensor may be a heated bead sensor. Alternatively, the flow sensor may be an ultrasonic flow sensor integrated with the controller.

[0497] In another aspect, this disclosure relates to a respiratory therapy system comprising:

[0498] Nasal cannulas used to deliver a stream of air to a patient.

[0499] A hood used to deliver a gas stream to the patient.

[0500] The sensor can be associated with one or more of the following:

[0501] The nasal cannula,

[0502] The cover,

[0503] Both the nasal cannula and the mask

[0504] Objects associated with the nasal cannula,

[0505] The objects associated with the cover,

[0506] The objects associated with both the nasal cannula and the mask,

[0507] Objects associated with the patient.

[0508] The sensor can sense the in-situ combination of the nasal cannula and the covering on the patient during gas delivery, and the sensed combination generates a signal.

[0509] In another aspect, this disclosure relates to a patient interface including sensors associated with the interface for determining dual operation applied to a patient's airway by a pair of patient interfaces.

[0510] The patient interface can be a nasal cannula.

[0511] The patient interface can be a cover.

[0512] The mask may be one of the following: a nasal mask, a face mask, a mouth and nose mask, a full-face mask, a nasal pillow mask, a tube in the trachea, a combination of these, or some other gas delivery system that provides a second gas flow to the patient.

[0513] The first patient interface in this pair of interfaces can be a nasal cannula.

[0514] The second patient interface in this interface can be a cover.

[0515] The sensor may be associated with a first patient interface, or a second patient interface, or both the first patient interface and the second patient interface.

[0516] The sensor may be associated with an object that is to be provided in an operative combination with a first patient interface, or a second patient interface, or both the first patient interface and the second patient interface.

[0517] In another aspect, this disclosure relates to a user interface for supplying gas to a user's airway, said user interface comprising:

[0518] The body includes an opening or port to allow access to and / or communication of gas from a gas supply or gas source to an internal volume defined by the interior of the body and the patient's face during use.

[0519] A face seal is provided to create or form a seal between the user interface and the user's face and / or a spacer provided on the user's face, such that the internal volume is a sealed internal volume, and

[0520] The face seal and / or the spacer provided on the user's face are adapted or configured to allow a seal to be created or formed between the user interface and the user's face and / or the spacer provided on the user's face, and to facilitate the insertion of a gas conduit extending between the body and the user's face into the sealed internal volume.

[0521] The face seal includes one or more receiving portions or sections adapted to facilitate the insertion of the gas conduit into the sealed internal volume while maintaining a seal between the user interface and the user's face.

[0522] The seal may be located substantially at or provided on the edge or periphery of the body, or around or adjacent to it.

[0523] The one or more receiving portions or parts in the face seal or the face seal and body include cutouts or suitably shaped portions.

[0524] The cut or suitably shaped portion can be adapted to accommodate the contours of a gas conduit or spacer component.

[0525] The spacer component may include a channel, groove, or passage for receiving the gas conduit, and includes a sealing surface on which the face seal forms a seal with the user's face.

[0526] The spacer component may be a sleeve that wraps around or at least partially surrounds a portion of the gas conduit.

[0527] The spacer may include a first part and a second part, the two parts being adapted to receive, clamp, accommodate or retain the gas conduit between the two parts.

[0528] The first and second portions may be hinged or pivotally connected on one side and openable from the other side to receive, clamp, accommodate or retain the gas conduit between the two portions.

[0529] The first portion and / or the second portion includes a groove, channel, or passage to accommodate or assist in positioning the catheter between the first portion and the second portion.

[0530] The interface may also include a connection arrangement for connecting the spacer component to the interface.

[0531] The connection arrangement may include a protrusion and a complementary groove, the protrusion being provided on one of the face seal and the spacer, and the groove being provided on the other of the face seal and the spacer.

[0532] The spacer component allows the gas conduit to partially collapse when the user wears the interface, and the spacer component is adapted to collapse under the force applied to the face seal on the user's face.

[0533] In another aspect, this disclosure relates to a spacer for use in a gas supply system that delivers breathable gas to and / or from a user via a user interface of any of the above-described embodiments; and a gas conduit for delivering breathable gas to and / or from a user via a separate gas supply system or source, wherein the spacer is configured and adapted to be positioned on the user's face and allows a seal to be created or formed between the user interface and the user's face, and facilitates the insertion of a gas conduit extending between the face seal and the user's face into the sealed internal volume.

[0534] The spacer component may be provided along a portion of the length of the conduit, preferably along the length of the conduit's engagement or contact with the face seal of the user interface.

[0535] The cannula may include a first part and a second part, the two parts being adapted to receive, clamp, accommodate or retain the gas conduit between the two parts.

[0536] These two parts can be pivotally or hingedly connected along one side and can be opened along the other side to receive the conduit between the two parts.

[0537] The spacer component can be removably snapped into, clipped onto, or otherwise removably fitted onto the catheter.

[0538] The spacer component may include a channel, groove, or passage for receiving the catheter.

[0539] The spacer component allows the gas conduit to partially collapse when the user wears the interface, and the spacer component can be adapted to collapse under the force applied to the face seal on the user's face.

[0540] According to at least one embodiment of the embodiments disclosed herein, a system for providing respiratory support to a patient is disclosed, the system comprising:

[0541] A nasal cannula, the nasal cannula being used to deliver gas into the patient's nostrils via a gas catheter, and

[0542] User interface based on any of the above aspects.

[0543] The system can be configured to deliver a general anesthetic to a user via the user interface, and, alone or additionally, deliver a high flow of oxygen to the user's nostrils via the nasal cannula.

[0544] In another aspect, this disclosure relates to a system for providing respiratory support to a patient, the system comprising an assembly of an oronasal mask and a nasal cannula, each of the mask and the nasal cannula being provided with separate gas flow supplies from one or more sources, the nasal cannula being positioned on the user independently of the mask.

[0545] As used in this specification and claims, the term "comprising" means "consisting of at least a portion of...". In interpreting each statement containing the term "comprising" in this specification and claims, features other than the one or more features following the term may also exist. Related terms such as "comprise" and "comprises" will be interpreted in the same manner.

[0546] The intention is that references to the numerical ranges disclosed herein (e.g., 1 to 10) also combine references to all rational numbers within that range (e.g., 1, 1.1, 2, 3, 3.9, 4, 5, 6, 6.5, 7, 8, 9, and 10) and to any range of rational numbers within that range (e.g., 2 to 8, 1.5 to 5.5, and 3.1 to 4.7), and therefore all subranges of all ranges explicitly disclosed herein are explicitly disclosed herein. These are merely examples specifically contemplated, and all possible combinations of values ​​between the lowest and highest values ​​are considered to be clearly indicated in a similar manner in this application.

[0547] As used herein, the term “and / or” means “and” or “or” or both.

[0548] The “(s)” following a noun used here refers to the plural and / or singular form of that noun.

[0549] For those skilled in the art, numerous structural modifications and a wide variety of embodiments and applications of the invention will be apparent to them without departing from the scope of the invention as defined in the appended claims. The disclosure and description herein are entirely illustrative and are not intended to be limiting in any way.

[0550] This disclosure is based on the foregoing and also envisions several other constructions, of which only examples are given below. Attached Figure Description

[0551] From the detailed description of the following accompanying drawings, those skilled in the art will understand specific embodiments and modifications thereof, in which:

[0552] Figure 1 A respiratory therapy system is shown.

[0553] Figure 2 A patient wearing a patient interface is shown.

[0554] Figure 3 A patient wearing a patient interface (first patient interface) and a mask (second patient interface) is shown.

[0555] Figure 4 A cross-section of a portion of the patient interface or catheter is shown.

[0556] Figure 5 A cross-section of a portion of the patient interface or catheter is shown.

[0557] Figure 6 The patient interface is shown.

[0558] Figure 7 The patient interface is shown.

[0559] Figure 8 Some patient interfaces or catheters are shown.

[0560] Figure 9 A cross-section of a portion of the patient interface or catheter is shown.

[0561] Figure 10 A cross-section of a portion of the patient interface or catheter is shown.

[0562] Figure 11 The patient's typical airway is shown.

[0563] Figure 12a A partial cross-section of the collapsible conduit is shown, while Figure 12b The same catheter is shown in a more "closed" or second condition.

[0564] Figure 13a A cross-section of another embodiment of a collapsible conduit is shown, which is shown in a generally first “open” lumen or gas flow path condition.

[0565] Figure 13b A cross-section of another embodiment of a collapsible conduit is shown, which is shown in a generally first “open” lumen or gas flow path condition.

[0566] Figure 14A , Figure 14B A cross-section of another embodiment of a collapsible conduit is shown; Figure 14A This illustrates a catheter with such collapsible capability, in the condition of a first "open" lumen or gas flow path, while Figure 14B The same catheter is shown in a more "closed" lumen or gas flow path or a second condition.

[0567] Figure 15A Figure B shows a cross-section of a partially collapsed conduit according to another embodiment; Figure 15A This illustrates a catheter with such collapsible capability, in the condition of a first "open" lumen or gas flow path, while Figure 15BThe same catheter is shown in a more "closed" lumen or gas flow path or a second condition.

[0568] Figure 16A An embodiment of a collapsible conduit is shown, the collapsible conduit including a gate for closing the lumen of the conduit.

[0569] Figures 16B(i) to 16C(ii) A cross-section of a valve arrangement for preventing flow, for example, from reaching a patient interface, is shown.

[0570] Figure 17 This is an exploded view of the cannula including the side arms, which provide an inner cavity for supplying a gas flow to the user and have vents in the side arms.

[0571] Figure 18 The pipe shown includes a window in the wall of the pipe and has a peripheral portion around the window, the peripheral portion being configured to seal against the user's face.

[0572] Figure 19 A conduit for providing a flow of breathing gas to a user is shown, the conduit including an air sac to accumulate gas volume to reduce pressure build-up within the conduit's interior.

[0573] Figure 20 The diagram shows a cross-section of a pipe that includes a check valve (or flow regulator) combined with a pressure relief device (or vent).

[0574] Figures 21A to 21C An embodiment of the pressure relief device is shown.

[0575] Figure 21D An embodiment of the pressure relief device is shown.

[0576] Figure 21E A cross-section of an embodiment of the pressure relief device is shown.

[0577] Figure 22A and 22B A cross-section of an embodiment of the pressure relief device is shown.

[0578] Figures 23A to 23D An embodiment of the pressure relief device is shown.

[0579] Figures 23E to 23G An embodiment of the pressure relief device is shown.

[0580] Figure 24A and 24B A cross-section of an embodiment of the pressure relief device is shown.

[0581] Figure 25A and 25B A cross-section of an embodiment of the pressure relief device is shown.

[0582] Figure 26A and 26B A cross-section of an embodiment of the pressure relief device is shown.

[0583] Figures 27A to 27D An embodiment of the pressure relief device is shown.

[0584] Figures 27E to 27F A cross-section of an embodiment of the pressure relief device is shown.

[0585] Figures 27G to 27H An embodiment of the pressure relief device is shown.

[0586] Figure 27I and 27J An embodiment of the pressure relief device is shown.

[0587] Figure 28 A cross-section of an embodiment of the pressure relief device is shown.

[0588] Figure 29 A cross-section of an embodiment of the pressure relief device is shown.

[0589] Figure 30A and 30B A cross-section of an embodiment of the pressure relief device is shown.

[0590] Figure 31 A cross-section of an embodiment of the pressure relief device is shown.

[0591] Figure 32 This is a schematic perspective view of the nasal cannula and associated catheters.

[0592] Figure 33 It is the cross-section of a mechanical valve or pressure relief device located in a position that allows the delivery of gas flow to a patient or user.

[0593] Figure 34 It is positioned to prevent the gas flow from being delivered to the patient or user. Figure 33 The cross-section of the mechanical valve.

[0594] Figure 35 It is a perspective view that, together with the graphical user interface, shows the patient interface in the user's operating position (similar to...). Figure 2 Or 3).

[0595] Figure 36 An embodiment of the pressure relief device is shown in a closed configuration, and Figure 37 The same device is shown in either the ventilated or open configuration.

[0596] Figure 38A An embodiment of the pressure relief device is shown in a closed configuration, and Figure 38B The same device is shown in either the ventilated or open configuration.

[0597] Figure 39 An embodiment of a valve for closing a conduit is shown, the valve being shown in an open configuration, and Figure 40 The same valve is shown in the closed position.

[0598] Figure 41A and 41B An embodiment of a pressure relief valve is shown.

[0599] Figure 42A A respiratory therapy system (e.g., such as) is shown. Figures 1 to 3 The user interface device in the system shown.

[0600] Figure 42B A partially collapsible conduit (e.g., cannulation) for delivering high-flow-rate gas to a patient interface is shown.

[0601] Figures 43A-43C An alternative switch configuration for a user interface device is shown.

[0602] Figure 44A A pressure-actuated conversion configuration for use in a respiratory therapy system is shown.

[0603] Figure 44B The pressure-actuated valve is shown in the open position.

[0604] Figure 44C The pressure-actuated valve is shown in the closed position.

[0605] Figure 44D An exemplary plot of intubation flow rate and pressure versus time is shown during the use of a pressure-actuated changeover configuration.

[0606] Figure 45A A connection-actuated transformation configuration for use in a respiratory therapy system is shown.

[0607] Figure 45B It shows Figure 45A The connection of the part is an actuated transformation configuration. Figure 45B-i It shows the method for using Figure 45A The connection-actuated, change-configuration sleeve is arranged with a pressure relief valve and a check valve that selectively release air. Figure 45B-ii It shows Figure 45B-i The pressure relief valve and check valve are arranged such that the relief valve is in the open configuration and the check valve is in the closed position.

[0608] Figure 45B-iii It shows the use of Figure 45AAlternative pressure relief valves and check valves with connection-actuated changing configurations. Figure 45B-iv The pressure relief valve and check valve are shown in a vented configuration.

[0609] Figure 45C-i A connector with a connection-actuated transformation configuration is shown, which is positioned to allow for the acquisition of high flow rates of gas. Figure 45C-ii The connector is shown in a condition where it blocks high-flow-rate gas while allowing gas flow through the bag.

[0610] Figure 45D-i An exemplary plot of the cannula flow rate, bag flow rate, high gas flow rate, and fork port status versus time is shown during the use of the connection-actuated changeover configuration. Figure 45D-ii An exemplary plot of the cannula flow rate, bag flow rate, high gas flow rate, and fork port status versus time is shown during the use of a connected actuated switching configuration while maintaining at least a low level of high flow rate gas.

[0611] Figure 45E An alternative connector for a connection-actuated transformation configuration is shown.

[0612] Figure 45F It is shown that when using with Figure 45E An exemplary plot of high flow rate, bag flow rate, and cannula flow rate versus time during the connector's connection actuation-driven configuration change.

[0613] Figure 46A A bag-actuated transformation configuration for use in a respiratory therapy system is shown.

[0614] Figure 46B An exemplary plot of high flow rate, bag flow rate, cannula flow rate, and fork port status versus time is shown during the use of a bag-actuated changeover configuration.

[0615] Figure 47 This is a side view showing the combined nasal cannula, which is integrated with a full-face mask and positioned on the user in an operating position.

[0616] Figure 48 An enlarged view of the combination of a nasal intubation patient interface and a full-face mask is shown, wherein a sensing system is integrated into at least one object and the mask is placed close to or in contact with said object.

[0617] Figure 49 An object in the form of a barrier or pad is shown, which may be mounted or positioned on or in contact with a user (e.g., their face), and a gas supply conduit passes through the object to provide a gas flow to a patient interface (e.g., a first patient interface in the form of a nasal cannula), and wherein the object includes at least one sensing system.

[0618] Figure 50 Another embodiment of an object in the form of a barrier or pad is shown, in which a mechanically activated or triggered switch or sensing system is provided, such a switch or sensing system to be activated or triggered when the protrusion is physically engaged or contacted by another patient interface, such as a second patient interface (not shown) in the form of a cover.

[0619] Figure 51 Another embodiment of an object in the form of a barrier or pad is shown, wherein the area of ​​the object includes a sensing system, such as a pressure-sensitive sensing system.

[0620] Figure 52 An application of an acoustic or optical sensing system utilizing at least one transmitter and at least one receiver, along with associated sensors, is demonstrated. Such a sensing system can be used in combination with a patient interface to determine the location of the interface on a patient, or its location near or relative to another patient interface.

[0621] Figure 53 It is a generalized cross-section through an object in the form of a barrier or pad, which can be mounted on or placed in contact with a patient, wherein a sensing system embedded within the object is provided, for example, in the form of an optical sensing system, which is used to determine the placement of a patient interface on the object (e.g., placing a second patient interface on the patient in an operating position).

[0622] Figure 54A -C illustrates, for example, how the parameters or characteristics of a gas supply conduit can be changed or altered due to conduit closure caused by pressure or force applied to the object through which the gas passes, such as deformation or change in the shape of the conduit due to changes in flow rate or pressure within it. More specifically:

[0623] Figure 54A A first patient interface in the configuration of a nasal cannula, positioned on a patient in an operating position, is shown. The first patient interface includes a gas supply conduit that provides a gas flow to the interface, wherein a gas source provides the flow rate, and a sensor (e.g., an acoustic sensor) is used to sense parameters or characteristics of the conduit.

[0624] Figure 54B Next, a second patient interface, such as a full-face mask, is shown in combination with the first patient interface and positioned on the patient in an operating position. A portion of the second patient interface (e.g., a seal) contacts the object and applies a contact force or pressure, which in turn closes or at least partially closes the conduit supplying gas to the first patient interface, resulting in a change in shape (e.g., bulging) and is sensed by a sensing system associated with the conduit.

[0625] Figure 54C It shows Figure 54B Further iterations, but in this case, the shape of the catheter may be further altered or bulged, for example, due to the complete closure of the catheter and / or due to pressure buildup within the catheter.

[0626] Figures 55A to 55B A sensor arrangement including a contact sensor is shown.

[0627] Figures 56A to 56B A sensor arrangement including a capacitive sensor is shown.

[0628] Figure 57 A sensor arrangement including a contact sensor located within the lumen of the catheter is shown.

[0629] Figures 58A to 58B A sensor arrangement including a sensing sensor is shown.

[0630] Figure 59 A sensor arrangement including a pressure sensor is shown.

[0631] Figure 60 A sensor arrangement including a pressure sensor is shown.

[0632] Figure 61 A sensor arrangement including at least two pressure sensors is shown.

[0633] Figure 62A A user interface for delivering gas to and / or from a user, configured as a shield placed on the user's nose and / or mouth area, is shown according to one embodiment of this disclosure; and a gas conduit that extends into the volume formed by the interior of the interface and the user's face when the interface is worn by the user.

[0634] Figure 62B A user interface according to another embodiment is shown.

[0635] Figure 63A The component provided as a liner sleeve to a portion of the catheter is shown.

[0636] Figure 63B It shows Figure 56A Another configuration in which the liner includes an upper portion and a second portion, which are pivotally or hingedly connected on one side and can be opened from the other side to receive the conduit between the two portions.

[0637] Figure 63CAnother configuration of the component is shown, in which the component is a monolithic member that includes channels along its length to receive a conduit, and the component can be snapped or clamped onto the conduit at a desired longitudinal position.

[0638] Figure 64 Another configuration is shown, in which a connection arrangement is provided to connect components to an interface.

[0639] Figure 65a A flowchart illustrates exemplary steps that can be performed in a respiratory therapy system through conscious / apnea therapy setup configurations and methods.

[0640] Figure 65b The pressure sampling line is shown to be incorporated into the cannula for use in conscious / apnea therapy setups and methods.

[0641] Figure 65c An exemplary drawing of pressure and gas flow rate versus time is shown for a setup and method for conscious / apnea therapy.

[0642] Figure 65d An exemplary plot of pressure and gas flow rate versus post-anesthesia time is shown for a setup and method for conscious / apnea therapy.

[0643] Figure 66a A flowchart illustrating exemplary steps that can be performed in a respiratory therapy system via a suction compensation configuration and method is shown.

[0644] Figure 66b Exemplary plots of pressure and gas flow rate versus time are shown for a pumping compensation configuration and method.

[0645] Figure 67a A patient interface configuration that facilitates treatment during transport is shown.

[0646] Figure 67b A detailed cross-sectional view of the connector for the patient interface is shown when it is connected.

[0647] Figure 67c A detailed cross-sectional view of the connector is shown when it is disconnected.

[0648] Figure 67d A detailed cross-sectional view of the connector or coupling on the secondary catheter of the patient interface configuration is shown.

[0649] Figure 67e A detailed cross-sectional view of an alternative connector or coupling on a secondary catheter of the patient interface configuration is shown.

[0650] Figure 67f A closure is shown, which can replace... Figure 67d One of the valves, or 67e, is used on secondary pipelines. Detailed Implementation

[0651] The above description of these different embodiments and disclosures includes their preferred forms. Modifications may be made thereto without departing from the scope of this disclosure.

[0652] Figure 1 A respiratory therapy system 100 is shown. The respiratory therapy system 100 includes a flow generator 102. The flow generator 102 is configured to generate a gas flow through the respiratory therapy system 100. The flow generator 102 delivers air to a humidifier 104. The humidifier 104 is configured to heat and humidify the gas flow generated by the flow generator 102. In some configurations, the flow generator 102 includes a blower adapted to receive gas from the environment outside the respiratory therapy system 100 and drive it through the respiratory therapy system 100. In some configurations, the flow generator 102 may include several other gas generating devices. For example, in some configurations, the flow generator 102 may include one or more containers of a source available from a hospital gas outlet (e.g., oxygen or air), or compressed air and / or another gas; and one or more valve arrangements adapted to control the rate at which the gas exits the one or more containers. As another example, in some configurations, the flow generator 102 may include an oxygen concentrator. In some configurations, the flow generator 102 can be adapted for delivering high-flow-rate therapy.

[0653] Depending on the various configurations and embodiments described herein, the flow rate of gas supplied or provided to the interface or passing through the system, such as through a flow path, may include, but is not limited to, flow rates of at least about 5, 10, 20, 30, 40, 50, 60, 70, 80, 90, 100, 110, 120, 130, 140, or 150 L / min or greater, and a useful range may be selected between any of these values ​​(e.g., about 40 to about 80, about 50 to about 80, about 60 to about 80, about 70 to about 100 L / min, about 70 to 80 L / min). In some embodiments, flow rates above about 15 L / min (particularly, but not limited to, about 60-70 L / min) may be used in such configurations or embodiments. 'High flow' or 'high flow therapy' can refer to delivering gas to a patient at the following flow rates: between about 5 or 10 L / min and 100 L / min, or between about 15 L / min and about 95 L / min, or between about 20 L / min and about 90 L / min, or between about 25 L / min and about 85 L / min, or between about 30 L / min and about 80 L / min, or between about 35 L / min and about 75 L / min, or between about 40 L / min and about 70 L / min, or between about 45 L / min and about 65 L / min, or between about 50 L / min and about 60 L / min.

[0654] The delivered gas may include a certain percentage of oxygen. In some configurations, the percentage of oxygen in the delivered gas may be between about 20% and about 100%, or between about 30% and about 100%, or between about 40% and about 100%, or between about 50% and about 100%, or between about 60% and about 100%, or between about 70% and about 100%, or between about 80% and about 100%, or between about 90% and about 100%, or about 100%, or 100%.

[0655] High-flow therapy has been found to effectively meet or exceed a patient's normal peak inspiratory demand, thereby increasing oxygenation and / or reducing the work of breathing. Additionally, high-flow therapy can create a flushing effect in the nasopharynx, flushing away anatomically dead spaces in the upper airway with a high-flow-rate gas. This creates a reserve of fresh gas available for each breath, while minimizing the amount of carbon dioxide, nitrogen, etc., inhaled again.

[0656] Because a relatively high gas delivery flow rate can be used with the embodiments or configurations described herein, the gas supplied to or delivered to the user or patient can be delivered to different parts of the user's or patient's airway.

[0657] Such relatively high gas flow rates can help deliver the supplied gas into the user's airway, or to different parts of the user's airway; for example, such flow rates can allow the gas to be delivered to the upper airway region or the lower airway region. The upper airway region typically includes the nasal cavity, pharynx, and larynx, while the lower airway region typically includes the trachea, main bronchi, and lungs.

[0658] Figure 11 It shows a typical human airway and includes arrows to indicate how the relatively high flow rate of gas supplied to the user can be used to effectively propel or drive the supplied gas to enter the user's airway further or deeper than under normal or typical self-driven breathing conditions, or when the patient's respiratory power is reduced.

[0659] The respiratory therapy system 100 includes a housing 106 that at least partially houses both a flow generator 102 and a humidifier 104 (e.g., the respiratory therapy system 100 may include an integrated flow generator / humidifier device). In other configurations, the flow generator 102 and the humidifier 104 may have separate housings. A hardware controller 108 is shown to be electrically connected to both the flow generator 102 and the humidifier 104, but in some configurations, the hardware controller 108 may communicate only with either the flow generator 102 or the humidifier 104. The hardware controller 108 may include a microcontroller or some other configuration configured to direct the operation of controllable components of the respiratory therapy system 100, including but not limited to the flow generator 102 and / or the humidifier 104. An input / output module 110 is shown to be electrically connected to the controller 108. The input / output module 110 can be configured to allow a user to interact with the controller 108 to control controllable components of the respiratory therapy system 100 (including, but not limited to, the flow generator 102 and / or the humidifier 104) and / or view data related to the operation of the respiratory therapy system 100 and / or its components. The input / output module 110 may include, for example, one or more buttons, knobs, dials, switches, levers, touchscreens, speakers, displays, and / or other input or output peripherals that the user can use to view data and / or input commands to control components of the respiratory therapy system 100.

[0660] As in Figure 1As further illustrated, one or more supplementary gases can be added to the gas flowing through the respiratory therapy system 100 using a supplementary gas source 124. The one or more supplementary gases merge with the gas flow generated by the flow generator 102. The supplementary gas source 124 can be configured to deliver one or more supplementary gases, including but not limited to air, oxygen (O2), carbon dioxide (CO2), nitrogen (N2), nitric oxide (NO), and / or a helium-oxygen mixture (a mixture of helium and oxygen). The supplementary gas source 124 can deliver the one or more supplementary gases via a first supplementary gas cavity 128 to a location upstream of the flow generator 102, and / or can deliver the one or more supplementary gases via a second supplementary gas conduit 132 to a location downstream of the flow generator 102 and / or upstream of the humidifier 104. One or more supplementary flow valves 126, 130 can be used to control the flow rate of the one or more supplementary gases from the supplementary gas source 124 and through the first supplementary gas conduit 128 and / or the second supplementary gas conduit 132. One or more of the supplementary flow valves 126 and 130 may be electrically connected to the controller 108, which in turn allows control of the operation and / or state of one or more of the supplementary flow valves 126 and 130. In other configurations, the supplementary gas source 124 may be configured to add one or more supplementary gases downstream of the humidifier 104.

[0661] like Figure 1 As shown, a conduit 112 extending from the humidifier 104 links the humidifier 104 to the patient interface 200. The conduit 112 may include a conduit heater 114 adapted to heat gas passing through the conduit 112. In other configurations, the conduit heater 114 may be absent. The patient interface 200 is shown as a nasal cannula; however, it should be understood that other patient interfaces may be suitable in some configurations. For example, in some configurations, the patient interface 200 may include a sealed or unsealed interface and may include a nasal mask, face mask, oronasal mask, full face mask, nasal pillow mask, nasal cannula, endotracheal tube, tracheostomy tube, a combination of the above, or some other gas delivery system. In a preferred embodiment, the patient interface 200 is an unsealed interface that allows gas exchange with the surrounding environment, such as a nasal cannula. For example, when a patient receives flow therapy from system 100, the unsealed cannula allows the removal of carbon dioxide from the patient's airway and / or its exit. Additionally, in a preferred embodiment, the patient interface 200 is configured as a nasal interface, so that the system does not interfere with other oral airway equipment and / or devices, such as endotracheal tubing during intubation procedures. Accordingly, the patient can continue to receive flow therapy throughout the intubation procedure.

[0662] As shown in the figure, in some configurations, the patient interface 200 may further include a gas sensing module 120 adapted to measure the characteristics of gases passing through the patient interface 200. In other configurations, the gas sensing module 120 may be positioned and adapted to measure the characteristics of gases at or near other parts of the respiratory therapy system 100. The gas sensing module 120 may include one or more sensors adapted to measure a variety of different gas characteristics, including but not limited to pressure, flow rate, temperature, absolute humidity, relative humidity, enthalpy, gas composition, oxygen concentration, carbon dioxide concentration, and / or nitrogen concentration. The gas characteristics determined by the gas sensing module 120 can be utilized in a variety of ways, including but not limited to closed-loop control of gas parameters. For example, in some configurations, the flow rate data acquired by the gas sensing module 120 can be used to determine the instantaneous flow rate, which can then be used to determine the patient's respiratory cycle to facilitate flow rate delivery in partial synchronization with the respiratory cycle. The gas sensing module 120 may communicate with the controller 108 via a first transmission line 122. In some configurations, the first transmission line 122 may include a data communication connection adapted for transmitting data signals. This data communication connection may include a wired data communication connection (e.g., but not limited to a data cable) or a wireless data communication connection (e.g., but not limited to Wi-Fi or Bluetooth). In some configurations, both power and data can be transmitted via the same first transmission line 122. For example, the gas sensing module 120 may include a modulator that allows a data signal to be "overlaid" on a power signal. The data signal may be superimposed on the power signal, and the combined signal may be demodulated before being used by the controller 108. In other configurations, the first transmission line 122 may include a pneumatic connection adapted for transmitting a gas flow for analysis at a portion of the respiratory therapy system 100.

[0663] Additionally, as shown, a physiological sensor module 121 may be present. The physiological sensor module 121 may be configured to detect various characteristics of the patient or their health condition, including but not limited to heart rate, EEG signals, EKG / ECG signals, inertial sensors attached to the patient (e.g., chest) to detect movement, blood oxygen saturation (e.g., via a pulse oximeter), blood CO2 concentration, transcutaneous CO2 (TcCO2), and / or blood glucose. Similarly, the physiological sensor module 121 may communicate with the controller 108 via a second transmission line 123. The second transmission line 123 may, similar to the first transmission line 122, include a wired or wireless data communication connection and may similarly transmit power and data. The physiological sensor module 121 may be used, for example, to determine the patient's blood oxygen saturation.

[0664] Figure 2 It shows a patient wearing an interface 200, for example Figure 1 The patient P of the respiratory system patient interface 200. In the shown non-limiting configuration, the patient interface 200 is a nasal cannula. The patient interface 200 includes a first gas lumen 202 defined by a tubular wall. The first gas lumen 202 is adapted to receive gas from the respiratory therapy system 100 (e.g., via...). Figure 1 The gas is introduced into the catheter 112 and directed to the patient P. The first gas cavity 202 shown may be at least partially defined by a wall therein that guides the gas. The first gas cavity 202 may include a reinforcing element 203 adapted to strengthen the first gas cavity and / or add rigidity to it to prevent deformation or collapse of the first gas cavity 202 due to forces applied to it. The reinforcing element 203 may include a plurality of structures, including but not limited to plastic or metal reinforcing beads located in or on the wall of the first gas cavity 202.

[0665] The first gas cavity 202 is in pneumatic communication with the flow manifold 206. The flow manifold 206 receives gas from the first gas cavity 202 and delivers it to one or more nasal delivery elements 208 (e.g., forks). The one or more nasal delivery elements 208 extend outward from the flow manifold 206. The one or more nasal delivery elements 208 are adapted to be unsealed and positioned in one or more nostrils of the patient P. As shown, the patient interface 200 includes two nasal delivery elements 208 adapted to be positioned in each nostril of the patient. Each nasal delivery element 208 may be shaped or angled such that it extends inward toward the patient's nasal septum. Alternatively, the first patient interface 200 may be a sealed nasal interface.

[0666] Additionally, each nasal delivery element can be shaped or angled such that, in use, the tip of each nasal delivery element faces the posterior aspect of the patient's head. Figure 2 In the illustrated embodiment, the flow manifold 206 receives flow from one lateral side of the flow manifold 206 (e.g., relative to a fictitious vertical plane bisecting the face of patient P) and directs the flow to the respective nasal delivery elements 208. In other configurations, the patient interface 200 may include more (e.g., three or four) or fewer (e.g., one) nasal delivery elements 208.

[0667] In other configurations, each nasal delivery element 208 may have different characteristics. For example, one of a pair of nasal delivery elements 208 may be relatively long, and the other nasal delivery element 208 may be relatively short. In some configurations, the flow manifold 206 may be configured to receive fluid from the lateral sides of the flow manifold 206 (e.g., the 'left' and 'right' sides of the flow manifold 206), rather than as... Figure 2 The flow is received only from the 'left side' of the flow manifold 206. In some such configurations, multiple gas cavities can be used to provide pneumatic communication between the flow manifold 206 and the respiratory therapy system 100. In some configurations, the flow manifold 206 can be configured to receive flow from a non-lateral side of the flow manifold 206 (e.g., from the 'bottom' or 'top' of the flow manifold 206).

[0668] The patient interface may further include a plurality of mounts and / or supports, such as cheek supports 210, for attaching and / or supporting the gas cavity 202 to and / or supporting the patient’s face. Alternatively, the patient interface may be held in place via one or more head straps or headgear.

[0669] Additionally, the first gas cavity 202 may include a first portion 204 configured to transition from a first configuration to a second configuration, in which a first level of gas can pass through the first portion 204, and in the second configuration, a second level of gas can pass through the first portion 204. This feature will be described in more detail below.

[0670] Figure 3 It shows that patient P will... Figure 2 The illustrated patient interface 200 (first patient interface) is worn under the mask 300 assembly (second patient interface) in a non-limiting exemplary embodiment. Figure 3 The mask is schematically shown as a so-called transparent structure to show the patient interface 200 underneath.

[0671] The system can benefit from selectively delivering individual treatments to patients using different patient interfaces. Specifically, the systems and devices described have found applications in emergency resuscitation, intubation of patients receiving high-flow-rate treatment, in surgeries near the ear, nose, and throat (ENT), in assisting with preoperative patient conditioning before administration of anesthetics, and in post-extubation and recovery.

[0672] The mask assembly 300 can be used as a second respiratory support subsystem or in conjunction with it; and / or for delivering one or more substances to the patient, in addition to those delivered by the cannula 200, such as anesthetics or oxygen; or for delivering the same substance at different flow rates and / or pressure levels. Accordingly, Figure 3The embodiment shown allows for the delivery of gas from multiple sources via two respiratory support subsystems. Additionally, this configuration allows the patient interface 200 to remain on the patient throughout the surgical procedure and / or into recovery (regardless of whether the patient continuously receives flow through the patient interface 200 throughout the procedure).

[0673] In the illustrated embodiment, the mask assembly 300 includes a full-face mask 302 configured to cover the patient's nose and mouth. In other configurations, the mask 300 may be a nasal mask or a face mask placed on the patient interface 200 to cover only the patient's nasal area or only the patient's mouth.

[0674] As shown, the mask 302 includes a sealing region 304 adapted to seal against a patient's face. The mask assembly 300 is connected, for example, via a filter element 400 to a second gas source that supplies the patient with one or more other gases via the mask. That is, the second gas source is preferably different from the source supplying gas to the patient interface 200 (e.g., supplemental gas source 124 / flow generator 102).

[0675] In a preferred embodiment, the mask assembly 300 is connected to a separate gas source or a separate respiratory support device. For example, the respiratory support device may be a ventilator, CPAP, high-flow therapy device, or manual resuscitation device (e.g., a handheld mask with a bag).

[0676] Alternatively, the shroud assembly 300 can be connected to an anesthesia device and can deliver anesthetic gas, or air, or oxygen, or a combination of gases via the shroud 302.

[0677] Figure 3 The illustrated embodiments allow for the delivery of gas from multiple sources through at least two different respiratory support modes, and further allow physicians, clinicians, or medical professionals to quickly and easily change the type of respiratory support mode.

[0678] In one specific application, patients preparing for anesthesia may be pre-oxygenated by delivering high-flow-rate oxygen via a nasal cannula. In some cases, anesthesiologists managing patient sedation may want to switch between delivering a gas flow from one patient interface (e.g., a nasal cannula) and another (e.g., via a face mask). Delivering gas from the nasal cannula along with, or even solely from, the mask while it is sealed over the cannula can cause increased pressure, potentially damaging the patient's lungs. Anesthesiologists also use masks with bags for oxygenation, and in some cases, it has been found that bag masks are more comfortable if a patient's vital signs begin to decline. In such cases, as described earlier, the flow through the cannula and the pulsed gas flow from the bag mask can cause overpressure in the lungs and potential lung injury. In some situations, healthcare professionals may want to switch between different respiratory systems or support modes. In a first mode, respiratory support may be provided by a first respiratory support system (e.g., via the patient interface 200), and in a second mode, respiratory support may be provided by a second respiratory support system (e.g., via the patient interface 300) while support from the first system is shut off. For example, additional flow from a high flow rate can also modify the desired behavior of the anesthesia circuit, and thus may advantageously allow the additional flow from the first respiratory system to be shut off.

[0679] In some configurations, the structure of the first gas cavity (first conduit 202) can facilitate switching between two respiratory support modes or subsystems. The first gas cavity may include a first portion 204 configured to transition from a first configuration to a second configuration. In the first configuration, a first level of gas can pass through the first portion 204, and in the second configuration, a second level of gas can pass through the first portion 204.

[0680] Preferably, the first portion 204 is configured to be more collapsible or otherwise better adaptable than other portions of the lumen 202 when the gas flow through the first portion 204 is altered (therefore, reducing the gas flow through the lumen and toward the patient).

[0681] In other embodiments, the first configuration or first condition is a substantially open configuration and the second configuration or second condition is a substantially closed configuration. That is, the cavity 202 is configured to be more collapsible, deformable, or otherwise adapted to completely shut off the flow at the first portion 204 compared to other portions of the cavity 202. Figure 4 An example of this configuration is shown, wherein the cavity (e.g., Figure 3The inner cavity 202 of the first gas cavity is substantially closed at the first portion 204 by the seal 304 of the mask 302. In such an embodiment, the first portion of the first gas cavity (i.e., the more collapsible or deformable section) should have a length greater than the width of this section of the mask seal that rests on the first portion of the first gas cavity. This ensures that the mask seal is not supported on a non-collapseable section of the first gas cavity. For example, the first portion may extend from a distance of 35 mm or less from the center of the user's nose to at least 50 mm from the center of the user's nose, and the first portion may have a length of at least 15 mm. In some embodiments, the length of the first portion may be at least 15 mm, 20 mm, 25 mm, 30 mm, 35 mm, 40 mm, 45 mm, 50 mm, or greater.

[0682] The first portion 204 can be developed between the first configuration and the second configuration based on the relative levels of forces applied to its outer wall or experienced by its inner wall. For example, as Figure 3 As shown, force can be applied via the seal 304 of the mask 302. In this example, the first portion 204 is configured to be located below the seal 304 of the mask 302. Alternatively, force can be applied to the first portion 204 via other devices, such as clips (not shown). In some embodiments, the seal of the mask acting on the first portion of the gas cavity causes the first portion to form a seal or at least a partial seal between the first patient interface and the flow generator. Additionally, the seal of the mask forms a seal or at least a partial seal on the first portion of the gas cavity. Thus, switching between respiratory support therapies is simply achieved by applying the mask to the patient's face such that the seal of the mask causes the first portion of the gas cavity to collapse (partially or completely), so that the therapy supplied by the first interface is 'turned off' or reduced, and also provides a seal between the mask and the outer surface of the first portion, so that therapy can be provided by the mask alone or at least primarily. In some embodiments, removing the mask from the patient's face allows the therapy to be resumed by the first interface.

[0683] according to Figures 12a-15BThe following disclosures relate to catheters as part or part of a catheter, or to catheters provided as interconnections between other catheters or components associated with a patient interface, such as a nasal cannula or nasal mask. These figures illustrate further examples of collapsible catheters capable of being in a first configuration or condition in which the lumen or gas flow path of the catheter remains open or maintains gas flow capability, but deforms, twists, or buckles into a second configuration or condition when force or load is applied, in which the lumen or gas flow path is substantially closed, blocked, or obstructs gas flow through it. Additionally, in the second configuration or condition, the collapsible catheter provides a collapsed configuration that helps ensure that the seal of the cap can form a seal or at least a partial seal on the catheter and the patient's face.

[0684] Figures 12a to 15B The configuration or array of configurations can be independent of the catheter wall or inner wall surface. That is, the one or more configurations may not be attached to or connected to the catheter wall or its inner surface. Alternatively, Figures 12a to 15B The configuration or array of configurations may be attached only to a portion of the inner circumference (lateral periphery) of the catheter along the wall of the catheter. This allows the one or more configurations to move independently of or relative to the catheter wall, thereby allowing for twisting or buckling or other changes in shape or orientation to enable reconfiguration from a first condition to a second condition.

[0685] Figures 12a to 15B Provided as part of a respiratory therapy delivery system (e.g., but not limited to) Figure 1 A cross-sectional side view (or a view where the catheter wall is transparent) of a catheter 400 or at least a portion of the length of the catheter 400 (system). The catheter or a portion of the length of the catheter 400 includes at least one configuration or array 401 of a supporting or forming portion of the catheter wall 402. The inner surface 403 of the catheter wall 402 forms the lumen of the catheter 400 or a gas flow path 404.

[0686] The at least one configuration or configuration array 401 is biased to preferably maintain the cavity or gas flow path under a first condition (e.g., Figure 12a , 13a (As shown in 13b, 14A, 15A). The first condition is a substantially open or substantially uncollapsed catheter wall condition that allows unimpeded gas flow to other components (e.g., patient interface) or other sections of the catheter associated with the respiratory therapy delivery system.

[0687] A portion of the length of the catheter or catheter 400, including at least one configuration or configuration array 401, is configured to twist or buckle from a first condition to a second condition (e.g., by force or load 405 applied to the outer surface 406 of the catheter wall 402 including the at least one configuration or configuration array 401) in response to a force or load 405 applied to the outer surface 406 of the catheter wall 402 including the at least one configuration or configuration array 401. Figure 12b , 14B (as shown in 15B).

[0688] The configuration or condition of the second condition is that there is a substantially closed or substantially collapsed conduit wall condition, or under said condition, the lumen or gas flow path 404 is substantially closed, blocked, blocked, or otherwise impedes gas flow therethrough, or there may be intermediate positions of these conditions, such as partially closed or collapsed, or partially closed, blocked, blocked, or otherwise partially impeding gas flow therethrough, thereby restricting gas flow. It should be understood that the second condition can be referenced and alternatively, the gas flow path can be placed within these partial stages as described above. Such partial stages can be applied across these different embodiments and configurations disclosed herein, except where complete closure is required for additional reasons.

[0689] Depending on some configurations, at least one configuration or configuration array 401 can be twisted or buckled substantially without restriction in response to an applied force or load 405.

[0690] As long as the configuration "unrestricted" or substantially "unrestricted" allows the configuration to twist or buckle or other shape changes, it means that the "configuration" does not actually prevent the shape / configuration of the configuration from being changed when a force / load is applied.

[0691] For example, a force or load can be applied to the outer surface 406 of the catheter wall 402 by positioning a portion of the patient interface (e.g., the seal of a full-face mask) in contact with the catheter 400. For example, in the case where a nasal cannula is located on a patient in the operating position as the first patient interface and a second patient interface (e.g., a mask) is additionally provided to deliver respiratory therapy to the patient, the second patient interface can apply a force or load to the catheter 400.

[0692] The load or force can be applied manually by a user, such as a medical professional. This can be achieved by squeezing the catheter.

[0693] The relative twisting or buckling of at least one configuration or configuration array 401 from the first condition to the second condition is a predetermined twisting or buckling of the orientation or arrangement or configuration of the at least one configuration or configuration array.

[0694] In use, the force or load 405 applied to the outer surface of the catheter must be sufficient to overcome the biasing force exerted by the configuration 401 to support or maintain the catheter 400 in a first configuration or condition (i.e., the "open" lumen condition). Thus, the force or load 405 applied to the outer surface 406 of the catheter 400 must be sufficient to induce twisting or buckling of at least one configuration or configuration array 401 and to resist gas pressure within the catheter causing the catheter to change from the first condition to the second condition. Furthermore, the force must be sufficient to resist internal pressure within the catheter to hold the catheter in the second condition.

[0695] The second condition may be a preferred predetermined reconfiguration (or rearrangement or reorientation) of the at least one configuration or configuration array 401. For example, configuration 401 may be designed or configured such that, when transitioning from the first condition to the second condition, the final second condition takes into account the ability of configuration 401 to be twisted or buckled or otherwise reconfigured.

[0696] Under the second condition, the inner surfaces 403 of the catheter walls 402 can effectively come into contact with themselves, either by bringing them together completely or partially. For example, see [link to relevant documentation]. Figure 14B and 15B The conduit 400 is in a "closed" configuration. The inner surfaces 403 can be brought together to contact each other, or substantially adjacent to each other, or to provide substantially closed or substantially collapsed conduit wall 402 conditions, or conditions under which the lumen or gas flow path 404 is substantially blocked or obstructs gas flow through it. These substantially "closed" conditions can also be partially configured, for example, to suppress or limit gas flow, rather than completely blocking or closing the gas flow path.

[0697] Configuration 401 is configured to support the catheter wall 402 and is biased toward a first condition to maintain the catheter or to maintain it under a first condition.

[0698] When force or load 405 is applied, the configuration or configuration array 401 is able to twist or buckle (or rearrange or reconfigure) from the first condition to the second condition, but the reduction or removal of force or load 405 also allows the configuration or configuration array 401 to return or restore the conduit 400 to or toward the first condition.

[0699] The catheter may be made of a single material that has suitable elasticity to maintain a first condition or configuration while being compressible into a second condition or configuration. Alternatively, the catheter may be made of two materials, with the second material providing a structure that allows the catheter to maintain or sustain the first condition and then move to the second condition under force or load. In such embodiments, a polymer catheter may be present comprising a series of structures or configurations located within, embedded in, or surrounding the catheter wall. In another embodiment, such as when the catheter is made of a single material, these structures or configurations are not required because the material should possess the necessary properties to maintain the first condition.

[0700] Configuration 401 may be a helical or spirally wound or coiled component that forms a helix angle greater than about 20° to about 70°, or about 25° to about 65°, or about 35° to about 55°, or about 45° with respect to the conduit wall, the helix angle being the angle between the individual windings or coils of the component.

[0701] Configuration 401 may be a helical or spirally wound or coiled component having a pitch ranging from about 1 / 4 to about 10 times the inner diameter of the conduit, or from about 1 / 2 to about 8 times the inner diameter of the conduit, or from about 2 / 3 to about 6 times the inner diameter of the conduit, or from about 1 to about 4 times the inner diameter of the conduit, or the pitch being substantially the same as the length of the inner diameter of the conduit, the pitch being the center-to-center distance between adjacent helical or spiral windings or coils of the component.

[0702] Configuration 401 may be a helical or spirally wound or coiled component having a helical angle or pitch (or both) such that applying a load or force 405 to the outer surface 406 of the conduit 400 allows configuration 401 to fold onto itself or be reoriented such that, under the second condition, configuration 401 is in a substantially flat orientation.

[0703] Configuration 401 can be a series of rings or ring components, for example, such as Figure 13a , Figure 13b As shown. Each ring in the series includes a hinged interconnection with at least one other ring. The hinged interconnection can facilitate the twisting or buckling of configuration 401 (e.g., hinged twisting from the first conditional shape).

[0704] The configuration may be a series of hinged connecting parts arranged to provide substantially continuous support for the conduit wall 402 at least along the length of the conduit 400, including the configuration 401.

[0705] The spiral or helical wound or coiled component, or the ring component, can be formed of a relatively rigid material capable of elastically deforming between a first configuration and a second configuration of the conduit. Suitable materials may include plastic materials, or metallic materials (e.g., steel or stainless steel), or high tensile strength metals also known to those skilled in the art.

[0706] In another configuration, the catheter wall 402 may include at least one configuration or array of configurations 401 that extends substantially longitudinally along the catheter wall 402, or substantially at least longitudinally along the portion of the catheter wall 402 that includes the configuration 401. Thus, the at least one configuration or array of configurations 401 may be a flap or hinge formed as part of the catheter wall 402 or provided at or within the catheter wall. See, for example, [link to relevant documentation]. Figure 14A-15B These figures show the cross-section of the conduit being adapted to collapse under applied external force.

[0707] The flaps or hinges allow the conduit wall 402 to fold effectively onto itself. In such an arrangement, the configuration or array of configurations 401 can be an accordion-type arrangement (e.g., see...). Figure 14A(B) or a corrugated arrangement (e.g., see 15A, B). Such an arrangement allows the conduit 400 to twist or buckle from a first condition to a second condition after a force or load 405 is applied. In such a configuration, where, for example, configuration 401 is a hinge, such a hinge or other hinge element may be formed as part of the conduit wall 402 or provided at or within the conduit wall. It should be understood that the above-described configuration can be utilized by employing multiple such hinges formed as parts of the conduit wall 402, wherein these configurations extend substantially longitudinally along the conduit wall, or substantially at least partially along the longitudinal length of the conduit wall including such a configuration. In such an embodiment, the conduit may be made of a single material that has suitable elasticity to maintain the first condition or configuration while being compressible into the second condition or configuration. Alternatively, the conduit may be made of two materials, and the second material provides a structure that allows the conduit to maintain or sustain the first condition and then move to the second condition under force or load. In such embodiments, a polymer conduit may include a series of structures or configurations located within, embedded in, or surrounding the conduit wall. In another embodiment, such as when the conduit is made of a single material, these structures or configurations may not be necessary because the material has the necessary properties to maintain the first condition while being able to collapse into the second condition. In some configurations, the thickness of the wall sections can be varied to achieve a change in collapseability between the collapsible portion of the conduit and the rest or non-collapsible portion, as described in the following additional embodiments.

[0708] See you again Figures 14A to 15B In some embodiments, the cross-section of the collapsible portion of the catheter 400 includes a single fold on one side of the collapsible portion. The fold extends between an outer side 406a and an inner side 406b of the catheter. In use, the inner side of the catheter contacts the patient's face. The fold includes a pair of side portions 407. These side portions branch from the fold point 407a to present an outward-facing acute or obtuse angle 407b under a first condition. Under a second condition, the cross-section deforms at the fold point 407b such that the pair of side portions 407 come together, thereby collapsing the collapsible portion to the second condition.

[0709] exist Figure 14A In the cross-section, the cross-section includes a first single fold portion on a first side of the collapsible portion and a second single fold portion on a second side of the collapsible portion, the second side being opposite to the first side. The first and second fold portions extend between the outer side 406a and the inner side 406b of the catheter.

[0710] exist Figure 15AIn the cross-section, the section includes a single folded portion (including side portion 407) on a first side of the collapsible portion and a second fold point 408 on a second side of the collapsible portion, the second side being opposite to the first side. The outer side 406a and the inner side 406b of the catheter bifurcate from the second fold point 408. When the catheter changes from a first configuration to a second configuration, its inner and outer sides fold together at the second fold point.

[0711] In some embodiments, the angle 407b between these side portions 407 is an acute angle. For example, the angle may be less than 60 degrees, or 55 degrees, or 50 degrees, or 45 degrees, or 40 degrees, or 35 degrees.

[0712] Under the second condition, such as Figure 14B and 15B As shown, the collapsible portion collapses such that the outer surfaces of these side portions 407 contact each other, and the inner surfaces of the side portions 407 contact the inner surfaces of the inner side 406a and the outer side 406b of the conduit.

[0713] See Figures 16A to 1 6C. In some embodiments, a valve may be provided in the conduit. The valve may be actuated by an external force provided by a shroud or by a user pressing down on the conduit or valve. See, for example, [link to relevant documentation]. Figure 16AAnother alternative embodiment is a gate within the catheter. The gate may include a pair of doors or partitions 1075 that move toward each other and preferably close when the catheter is pressed down or squeezed. In some embodiments, these doors may overlap and / or each door may have a complementary shape to fit together without overlapping. These doors may be positioned within the catheter and may be attached to or integrally formed with the catheter such that when the catheter is squeezed, these doors move together to close the lumen of the catheter. Alternatively, these doors may protrude through the wall of the catheter and move (slide) relative to the catheter. The gate may have a recess 1077 on one of these doors and a complementary protrusion 1079 on the other door. One or more of the provided gates may be present. In an alternative embodiment, the gate may be a single door or partition that slides across the catheter or is attached to one side of the catheter, and a gap exists between the door and the opposite side of the catheter such that when the catheter is squeezed, the door closes against the opposite side of the catheter. The gate may have an opening to provide a minimum flow level through the gate when in the closed position. One or more gates of the gate may be moved laterally across the conduit from a first position to a second position, in which a first level of gas from the gas source substantially flows through the conduit, and in the second position, a second level of gas flows through the conduit. For example, the one or more gates may be perpendicular to the longitudinal axis of the conduit / flow path or may be angled (e.g., 45 degrees) to the flow path. The first position may be a substantially open configuration, and the second position may be a substantially closed configuration. The first gas level may be greater than the second gas level. The direction of the gate seal may be transverse to or substantially transverse to the direction of gas flow, which can help reduce the force required to close the gate and close the cavity, since the flow force is not opposite to the gate closing direction. In some embodiments, the contact area where the gates meet or where one gate closes against one side of the conduit may be relatively small, making it possible to require low actuation force to create a seal. For example, the width of the contact area where the gates meet or where the gate contacts the sidewall of the conduit may be 10%-20% of the diameter of the conduit.

[0714] In one location, the gate will allow gas to pass through the conduit. In another location, the gate will restrict gas flow through the conduit. Such a gate can completely close the conduit or partially close or inhibit a gas flow path.

[0715] In Figures 16B(i) and 16B(ii), valve 549 may include a pressable valve member 550. A user / medical professional, or shroud 300, may press the valve member 550 to extend it through the sidewall of conduit 553 to move the valve member 550 into conduit 553. The valve member 550 may act on a diaphragm or other resilient member 551 to press the resilient member 551 across the lumen of conduit 553, thereby blocking flow through conduit 553. In some embodiments, the resilient member 551 is stretched to block flow, and the resilient member biases the valve member 550 to an open position. In other embodiments, the valve member 550 is biased to an open state by the internal pressure of gas flow in conduit 553. Figure 16B(i) shows valve 549 in an open configuration, with valve member 550 and resilient member 551 extending from the sidewall of conduit 553. Figure 16B(ii) shows the valve member 550 being pressed into the conduit 553 and blocking the flow. Figure 16C(i) and 16C(ii) A similar arrangement is shown. Valve 548 also includes a valve seat 552 that is biased against valve member 554, thereby biasing valve member 554 away from the closed position.

[0716] In other embodiments, the system may include additional valve arrangements for preventing flow to the patient interface. For example, a butterfly valve may be provided, featuring a valve element that can be manually rotated (e.g., 90 degrees) between an open and closed position by the user.

[0717] Accordingly, in some embodiments as described above, a device including a collapsed portion of the catheter or patient interface 200, or a valve located within the catheter or patient interface, provides means for switching respiratory therapy between two modes, wherein the patient interface 200 provides a first respiratory therapy mode and the hood assembly 300 provides a second respiratory mode. These modes can be switched when the first portion 204 of the lumen 202 changes from the first configuration to the second configuration.

[0718] In one embodiment, this transition is provided via a mask 302. That is, when the mask is placed on the patient, the mask's seal 304 can apply force to the first portion 204, causing the first portion 204 to transition from its first configuration to its second configuration, and preferably reducing or preventing the delivery of the first treatment mode, and preferably also forming a seal with the mask's seal, such that the mask seals against the first portion of the conduit and the patient's face. Accordingly, the structure of the patient interface 200 or the conduit providing gas flow to the patient interface 200 allows healthcare professionals to quickly change the type of respiratory support delivered to the patient without having to remove the interface providing the first breathing mode.

[0719] In some embodiments, when the first respiratory support mode is a high-flow support mode, the structure of the patient interface 200 allows medical professionals to easily and simultaneously stop or minimize the flow rate and initiate a second respiratory therapy (e.g., via a ventilator, CPAP, high-flow therapy device, or anesthesia device). Additionally, this allows anesthesiologists or medical professionals managing patient sedation to have accurate knowledge of the flow rate delivered to the patient, since the gas delivered by the second patient interface is not diluted by the gas supplied by the first patient interface.

[0720] In some embodiments, the first portion 204 may evolve between a first configuration and a second configuration based on the pressure level of the gas passing through the first portion of the gas cavity. That is, the first portion of the first gas cavity may be in the first configuration when the flow pressure is higher than a first predetermined pressure level, and in the second configuration when the flow pressure decreases to below or increases to above the first predetermined pressure level.

[0721] In another embodiment, the first portion 204 may be self-collapsed. That is, the first portion may partially or completely collapse (second configuration) when there is no gas or a low / reduced flow of gas through it and expand (first configuration) when a certain level of gas flows through it.

[0722] Figures 6 to 8 Various alternative instances of providing the first portion 204 to the cavity 202 through one or more variations in geometry, material properties, structure, and / or composition are shown.

[0723] In one instance, such as Figure 8 As shown, the wall 209 of the first portion 204 is thinner than one or more walls 207 of other portions of the first gas cavity. 8. Preferably, there is a substantially smooth or substantially linear thickness transition between the wall 209 of the first portion 204 of the first gas cavity and the one or more walls 207 of other portions of the first gas cavity 202. A smooth transition can help prevent or reduce turbulence, improve hygiene, and / or reduce the likelihood of gas conduit kinking.

[0724] Additionally or alternatively, the walls of the first portion 204 are more flexible than the walls of other portions of the first gas cavity 202. In one embodiment, the change in flexibility is due to the material of the walls. In another embodiment, additionally or alternatively, the change in flexibility may be due to reinforcement elements 203 (such as...) provided along substantially the entire length of the cavity other than the first portion 204. Figure 7(As shown). Preferably, for example, by providing reinforcing elements that taper toward the first portion 204, there is a substantially smooth or substantially linear flexible transition between the wall 209 of the first portion 204 and the walls 207 of the other portions of the first gas cavity 202.

[0725] exist Figure 6 In the alternative configuration shown, the first portion 204 may include a wider section (i.e., a larger cross-sectional area) compared to the other portions of the cavity 202. This can reduce the amount of force and / or internal pressure required to deform and / or collapse this portion.

[0726] according to Figure 6-8 Alternatively, a conduit could be provided without a structure or reinforcement supporting the conduit wall or other configuration. Such a configuration would allow the conduit to be relatively easily flattened or collapsed. That is, the conduit has no helical or spiral beaded rim or other reinforcement. The conduit can be maintained in an "open" or first condition or configuration by gas pressure supplied to the conduit itself. Applying force or load to the conduit wall may cause the force- or load-bearing portion of the conduit to be flattened, wrinkled, or otherwise collapsed. Such a conduit could form a portion of a more general gas supply conduit (e.g., the first portion 204 of the first gas conduit 202), or it could be provided as a relatively short conduit length to be provided as an interconnect between other components within a respiratory therapy delivery system. For example, a collapseable conduit could be provided as a short section of the conduit connecting two other conduit segments or connecting them to a patient interface. Such catheters can be provided in such systems or in breathing circuits close to the patient's face, such that another interface subsequently applied to the patient (e.g., in cases where the catheter supplies gas to a nasal cannula and applies a full mask on top of it) can be partially used to provide force or load on such unstructured or unsupported catheters, as seen above. Figure 3 As described.

[0727] In alternative configurations, the entire conduit defining the first gas cavity 202 can be configured to collapse or otherwise altered to change the gas level passing through the cavity. Accordingly, in one instance, a force can be applied to any portion of the first gas cavity to reduce the gas flow through it. However, it should be understood that this configuration may cause undesirable collapse of the cavity due to kinks or other external forces on it. Accordingly, it is preferable that only a portion of the cavity (i.e., the first portion 204) has this characteristic.

[0728] Although only one first section 204 has been described, it should be understood that more than one similar section may be provided. For example, in the case where the flow manifold 206 is configured to receive flow from both sides of the flow manifold 206 via two gas chambers, two first sections 204 may be provided, one on each gas chamber, and these two first sections may be configured such that the seal 304 of the mask 302 collapses (partially or completely).

[0729] Figure 5 , 9 Alternative configurations are shown in figures 10 and 10, wherein the first portion 204 is equipped with elements around, within, or below its walls to limit the compression of the first portion 204. Preferably, regardless of the configuration of the first portion 204, the elements are configured to allow a minimum level of flow through the lumen. For example, in the non-collapsed condition, a flow greater than the minimum level can flow through the lumen (the first portion of the lumen). In the collapsed condition, the elements define a minimum flow level that the lumen can deliver at the pressure delivered by the flow generator. Alternatively, the minimum flow level can be a level controlled, for example, by a controller 108 based on one or more physiological characteristics measured from the patient.

[0730] exist Figure 9 In this configuration, the element is a reinforcing element 220, which maintains a small opening or a second gas cavity 232 within the first portion 204 to maintain a minimum flow level even when the first portion 204 is maximally compressed or collapsed. As shown, the reinforcing element is significantly less compressible than the wall of the first portion 204 to maintain a smaller opening in the portion when the external force and / or the lower flow pressure passes through the conduit. In the illustrated configuration, the reinforcing element 220 comprises a plurality of substantially rigid portions on opposite inner surfaces of the wall of the first portion 204. In this example, these rigid portions 220 are not continuous such that the surrounding wall can collapse and seal around these rigid portions, thereby forming a smaller opening. The rigid element may be integrally formed with, overmolded with, or otherwise attached to the wall of the first portion 204. In this configuration, the second cavity 232 is formed when the element 220 comes together, for example, during compression of the first portion by the mask seal 304.

[0731] exist Figure 10In this design, the element is an inner conduit 230 defining a second gas cavity 232, which passes through, or is located in or near, the internal region of the first portion 204. As shown, the conduit 230 is significantly more rigid than the wall of the first portion 204 to maintain a minimum flow rate through the cavity even when the first portion 204 is maximally compressed or collapsed. The inner conduit 230 may be substantially coaxial with the first gas cavity 202 and may be connected to the same gas supply as the first gas cavity 202, or may be supplied by a different gas supply.

[0732] Figure 5 Another embodiment is shown, wherein element 212 is provided on an inner section of the wall of the first portion 204. Element 212 maintains these walls spaced apart to form or maintain small openings or a second gas cavity 232 within the first portion 204 to maintain a minimum flow rate even when the first portion 204 is maximally compressed or collapsed. Element 212 may include a hollow cross-sectional area (e.g., Figure 5 As shown), in this case, gas can also flow through element 212. Alternatively, element 212 can have a solid cross-sectional area and be spaced apart from the surrounding walls of the first portion 204, so that some gas can flow around element 212.

[0733] In some embodiments, the conduit or conduit includes a window portion that opens toward the user's face during use. Figure 18 An exemplary embodiment is illustrated herein. In use, the window portion 610 of the conduit 600 is positioned on the user's face such that the periphery 611 of the window portion of the conduit abuts against the user's face for sealing. The conduit may include a seal around the periphery of the window for sealing against the user's face; for example, the conduit may include a lip or other sealing arrangement positioned around the window for sealing against the user's face. During use, the periphery 611 of the window 600 abuts against the user's face for sealing, such that the user's face substantially forms a wall of the conduit that blocks the window, thereby providing a sealed cavity for gas flowing into the patient's airway via the patient interface 620. In use, the patient interface 620 may be used with a face mask, wherein the seal of the face mask extends on the conduit 600 at a position corresponding to the window 610 of the conduit. As with other embodiments described herein, the force provided by the seal of the face mask abutting against the user's face can occlude the conduit, thereby preventing gas from flowing to the patient via the patient interface. By providing a window on one side of the conduit, the conduit contains less material to be compressed by the force of the mask pressed against the user's face. Therefore, the window portion of the conduit reduces the amount of force required to compress the conduit and close the cavity provided by it. Figure 18The diagram provides a lateral cross-section of the conduit 600. As shown, in some embodiments, the conduit includes a relatively flat cross-section, reducing the distance the conduit must be flattened to close it compared to a conventional circular cross-section. In some embodiments, the conduit may include a membrane covering the window. The membrane is thinner than the wall of the conduit. Because the membrane is thin, the amount of material in the conduit wall that needs to be compressed to close the conduit lumen is reduced, thereby reducing the conduit's collapse pressure.

[0734] In some embodiments, the breathing gas conduit or tubing may include a balloon or accumulator or a sac (here, a sac). The sac may form or provide a portion of the lumen of the conduit, for example, as... Figure 19 As shown in the diagram. The airbag 710 is a section of the conduit 700 having a reduced wall thickness and / or formed of a material more elastic than the rest of the conduit 720. In some embodiments, the airbag may be integrally formed with a portion of the conduit extending from each end of the airbag. In some embodiments, the airbag may be releasably attached to the conduit. For example, each end of the airbag may be attached to the conduit such that the conduit includes a first length of conduit attached to one end of the airbag, the airbag, and a second length of conduit attached to the other end of the airbag.

[0735] The conduit 700, including the airbag 710, can be used to provide a flow of gas to a user via a patient interface. The airbag 710 can act as a gas accumulator, causing the airbag to inflate as the gas pressure within the conduit increases. Figure 19 The image shows the uninflated configuration, in which Figure 19 The inflatable configuration is indicated by a dashed line. The cuff can function to reduce pressure fluctuations seen at the patient interface because pressure spikes in the lumen of the tubing are eliminated by the cuff's expansion in response to increased pressure. Additionally, when a patient interface, such as a nasal cannula, is used in conjunction with a mask to provide more than one respiratory gas flow to a user, there is a risk of increased gas pressure being supplied to the user, as the pressure of the gas flow supplied from each interface may combine to cause an increase in gas pressure at the user's airway. The cuff can reduce the increased pressure at the patient by inflating under increased pressure, which in turn reduces the pressure increase at the patient. The cuff, if used with the collapsible tubing described above, can be used to accumulate gas flow. In some embodiments, the lumen provides a visual indication or indicator of increased pressure in the tubing lumen, thereby signaling to the user or others (e.g., caregivers) that a reduction in the flow rate or pressure supplied to the user may be necessary.

[0736] In some embodiments, the conduit 700 may include a ventilation arrangement that, upon reaching an increased pressure, operates to expel breathing gas from the lumen of the conduit into a cuff. For example, the cuff may be configured to communicate with the lumen via the vent when the vent is open or in a ventilated configuration. Once a pressure threshold is reached, the vent can open to expel gas into the cuff. Thus, the cuff acts as an accumulator to prevent breathing gas from being expelled into the atmosphere. The cuff may also act as a visual indicator or indication of an increase in lumen pressure corresponding to an increase in pressure at the patient's airway or patient interface.

[0737] In some embodiments, the airbag can be configured to contain a specific volume and pressure of gas at a specific flow rate and pressure. Additional pressure relief valves or vents can be used so that the airbag releases gas to the atmosphere once it reaches a specific exhaust pressure.

[0738] When one or more of the devices or arrangements described above are used to reduce or block the flow of gas into the nasal cannula, the gas pressure within the catheter (e.g., catheter 202) may increase. Accordingly, it may be advantageous to provide one or more pressure relief devices to release the pressure within the catheter. As described in more detail below, the pressure relief device may be a pressure-relieving device only and may be used in conjunction with a separate device that blocks or inhibits flow. Alternatively, these devices may relieve pressure and also limit or block flow.

[0739] The patient interface 200 or the conduit providing gas flow to the patient interface 200 may include a pressure relief valve, device, or arrangement, the pressure relief valve being adapted to reduce or alleviate the gas pressure in the first gas cavity if the flow through the cavity 202 is reduced or blocked due to the collapse or partial collapse of the first portion 204.

[0740] For example, such as Figure 20As shown, a conduit 1300 can be provided for delivering gas (gas flow 1301) to a patient interface 1302. The conduit may include a collapsible portion that collapses (e.g., by means of a cover seal 1307) into a closed configuration. The conduit includes a one-way valve 1304, and upstream of the one-way valve 1304, with respect to the direction of the gas flow 1301 delivered to the interface 1302, is a vent or pressure relief valve 1305 for venting or releasing pressure accumulated within the conduit's inner cavity 1306. For example, the pressure relief valve can release pressure in the conduit once the collapsed portion is in the closed configuration. The one-way valve 1304 can prevent gas supplied to the patient from the second patient interface from flowing back out of the pressure relief device 1305 as a backflow from the patient interface 1302. Furthermore, the pressure relief valve or device may provide additional mechanisms to ensure that pressure delivered by the second patient interface does not flow back through interface 1302 due to the collapsible portion of the tubing that does not completely seal and separate interface 1302 from vent valve 1305. In an alternative arrangement, the catheter may include a valve to close catheter 1308 instead of including a collapsible portion.

[0741] The one-way valve 1304 can be implemented in any system described herein. For example, in the case where a second patient interface is combined with a first patient interface and dual treatments are delivered to the patient, the one-way valve allows a healthcare professional to deliver gas via the second patient interface without backflow through the gas supply tubing leading to the first patient interface (i.e., the nasal cannula). Without the one-way valve 1304, the desired pressure may not be created through the second patient interface on the patient due to the backflow pressure relief valve 1305.

[0742] In some embodiments, when using more than one respiratory support device (patient interface), such as a nasal cannula and a full-face mask, to provide more than one type of respiratory gas flow to a user, one or more of the respiratory support devices may include one or more vents to relieve pressure provided by the support device. When using more than one device to provide more than one type of respiratory gas flow, there may be a risk of increased gas pressure being provided to the user, as the pressure of each gas flow provided to the user may combine to cause an increase in gas pressure at the user's airway. Vents may be provided at one or more of the respiratory support devices to mitigate or reduce the risk of overpressure in the user's airway. Alternatively or additionally, a controller (e.g., controller 108) may be adapted to block or reduce gas flow to the patient interface when a pressure increase is measured in the system.

[0743] For example, a nasal cannula may include an airway to allow for operation to limit the pressure provided by the cannula. In some embodiments, a cannula including one or more side arms may include a ventilation arrangement in one or both side arms. Figure 17 An exemplary embodiment is illustrated. The side arm 505 of the cannula 500 may include a portion 516 (a sealing portion) against which a mask seal is abutted and against the user's face for sealing. The side arm 505 includes or is provided with an inner cavity for allowing gas to flow to a manifold 506 having the cannula and to the user via one or more outlets, such as a nose fork 508. The contour of the side arm portion 516 allows the mask seal to simultaneously abut against the portion and against the user's face, for example... Figure 17 The possible cross-sections are provided. The side arm 505 may include a vent 510 at a location within the side arm, the vent being located outside the sealing portion 516 of the side wall. In other words, the vent is positioned on the side arm outside the sealing area of ​​the mask on the user's face. When the pressure within the mask reaches a desired maximum pressure level, the gas pressure within the lumen of the cannula side arm increases to the level at which the vent in the side arm operates to release pressure or limit the pressure at the user's airway to the corresponding level of the desired maximum pressure. When the vent 510 is operated to the open or ventilated position, the vent diverts the gas flow to outside the cannula and mask, while in the closed or non-ventilated position, the gas flow is supplied to the cannula.

[0744] In some embodiments, a mask seal 304, spanning the side arm, applies force to the side arm, causing it to collapse or compress, thereby closing the lumen of the side arm. For example, in some embodiments, a mask seal pressed against a portion 516 causes the lumen of the side arm to be blocked. The portion 516 of the side arm is inside (downstream) of the vent 510, such that increased pressure in the breathing tubing used to supply gas flow to the side arm due to the blockage or pinching of the side arm lumen is released via the vent 510. For example, the side arm of the cannula may include a collapsible catheter portion as described herein. The collapsible portion of the cannula may include, for example,... Figures 14A to 15B The cross section with hinge points shown, or any other collapsible configuration described herein.

[0745] In some embodiments, the patient interface may include an object sealed thereon by a mask seal or used therewith. Figures 47 to 54C Various embodiments of an object sealed thereon are shown in 63A to 63C. The object may be a barrier or mounting 96 that contacts or is positioned to contact the patient's face. The barrier or mounting may include at least one cavity passing through it to allow a gas supply conduit to pass through or to connect a gas supply conduit to a patient interface.

[0746] The object 96 may receive a gas supply conduit and / or may form part of a fluid passage for delivering gas to a patient interface. In some embodiments, the object includes a compressible portion or a portion capable of being flattened or deformed under applied force or pressure (e.g., from a mask seal). Figures 54A to 54C In some embodiments, one or more lumens of the at least one lumen are located within the compressible portion or the portion that can be flattened or deformed. The compressible portion may be made of any suitable material, such as polymers or silicone. The lumens and / or conduits located within the compressible portion or the portion that can be flattened or deformed may be compressed or deformed to block or obstruct (or prevent) or partially obstruct the gas flow to the patient interface 91. In some embodiments, the object 96 is an integral part of the side arm of the patient interface, or may be removably attached to a supply conduit leading to the patient interface, or may be removably attached to the side arm of the patient interface. In some embodiments, the object is a separately positioned or placeable component on the patient, more specifically on the patient's face. The object may be an attachable or placeable patch, pad, or wearable device for sensing the in-situ combination of the patient interface and mask on the patient during gas delivery to the patient, wherein such sensing combination generates a signal or output.

[0747] The article may include a ventilation device that, when in a collapsed configuration to prevent or reduce gas flow to the user, discharges increased pressure in the conduit that provides gas flow to the patient interface via the article.

[0748] In some embodiments, the object resists external forces so that it does not compress or collapse during use. In such embodiments, the object may include a ventilation device to prevent or reduce the pressure at the user's airway from increasing above the desired maximum pressure, or to prevent or reduce the flow rate delivered to the patient's airway. The ventilation device or airway of the object or patient interface may be any or more of the airways or ventilation devices described herein.

[0749] In some embodiments, the patient interface and / or objects associated with or used with the patient interface include a filtering device to prevent contamination of the breathing circuit that provides gas flow to the object or interface, and the filtering device includes the vent or ventilation device.

[0750] See below Figures 47 to 54C as well as Figures 63A to 63C Further description of object 96 is provided.

[0751] Figure 21AAn embodiment of device 1000 is shown, which releases pressure and also restricts gas flow through catheter 1001. Flow restriction can completely block gas flow, substantially block gas flow, or partially block gas flow. In a ventilated or open configuration, device 1000 expels or redirects gas flow from the catheter. In a non-ventilated or closed configuration, the device allows gas flow to a patient interface, such as… Figure 2 The cannula 200. This embodiment of the pressure relief device 1000 is in a collapsible conduit configuration with a lift valve 1002. Specifically, the lift valve 1002 has a valve stem 1003 and a valve disc 1004. The valve stem 1003 and the valve disc 1004 are relatively rigid and will not collapse or deform when surrounding parts or components move, collapse, or deform.

[0752] A portion 1005 of the conduit 1001 can be configured to collapse or deform and restrict flow. The collapseable portion of the portion can be a first wall configured as a relatively rigid member 1006. The relatively rigid member 1006 can have an orifice (not visible) through which a valve stem 1003 extends.

[0753] The conduit also has a generally opposite second wall 1007. During normal use, the rigid member 1006 is substantially flush with the adjacent wall 1008 of the conduit, allowing substantially all gas from the gas source to pass through the conduit. When a force is applied to the rigid member 1006, the rigid member moves toward the second wall 1007 to provide a passage 1009 through which gas can flow from the conduit into the atmosphere. In this embodiment, the passage is provided by the orifice. In some embodiments, a portion 1005 of the conduit may not include an orifice or vent, so that it can be operated to close the lumen of the conduit airlessly. A separate vent or pressure relief valve may be located separately upstream of portion 1005.

[0754] In one embodiment, the catheter can be collapsed by pressing the cover seal 1010 against the rigid member 1006. Alternatively, the catheter can be collapsed by another suitable mechanism (e.g., a clamp or clip), or in another alternative, the catheter can be collapsed by a medical professional pressing or squeezing it. When the catheter collapses, the rigid portion collapses and moves towards... Figure 21C The position is moved as shown. Gas then flows freely from the orifice, thereby releasing the pressure in the conduit. It should be understood that the gas flow can be completely, substantially, or partially restricted by pressing a shroud or other device against the conduit. In any of these cases, the lift valve 1002 will open and allow gas to flow from the orifice. The amount of gas flowing from the orifice will depend on the pressure of the gas in the conduit and whether the gas flow is completely, substantially, or partially restricted.

[0755] In an alternative embodiment, the pressure relief device may not have a lift valve. The pressure relief device may have another type of valve, such as one of those described herein with respect to other embodiments of this specification.

[0756] For example, Figure 21D and 21E The embodiment shown does not have a lift valve. The features and operation of this embodiment are similar to... Figure 21B and 21C The embodiment shown is the same, but it does not have a lift valve.

[0757] Figure 21D The embodiment has a first wall 1011 and a generally opposite second wall 1012. During normal use, the first wall is substantially flush with the adjacent wall 1013 of the conduit, such that substantially all gas from the gas source passes through the conduit. When a force is applied to the first wall, the first wall moves toward or away from the second wall to provide a pathway for gas to flow through the conduit and out into the atmosphere.

[0758] Figure 21E The features and operation of the embodiments are similar to Figure 21D In one embodiment, a lip 1015 is added, which abuts against an adjacent wall for sealing during normal use. The lip 1015 may be formed of an elastic material and attached to a relatively rigid member 1006, against which a cover seal 1010 abuts to act to move the lip away from the sidewall of the conduit to open a vent. The rigid member may be L-shaped, wherein a first portion of the L-shape is transverse to the longitudinal axis of the conduit, and a second portion of the L-shape against which the cover seal abuts is arranged longitudinally relative to the conduit.

[0759] Figure 22A and 22B An embodiment of a device for relieving pressure and blocking or inhibiting flow is shown. This embodiment is a conduit configuration having a collapsible portion 1017 and a non-collapsible portion 1019.

[0760] The collapsible portion 1017 comprises a relatively flexible or soft material that collapses under applied pressure, or portion 1017 may have a rigid portion connected via a pivot to an adjacent non-collapsible portion of the conduit, the pivot allowing the collapsible portion to open and close. The collapsible portion 1017 preferably includes a relatively rigid portion 1023 that prevents the collapsible portion from collapsing until an intentional external force is applied, such as pressing a cover against the collapsible portion. The flexible or soft portion 1027 is located at one end of the collapsible portion to provide a seal against the non-collapsible portion 1021. The non-collapsible portion may optionally include a rigid portion 1025. In an alternative embodiment, the rigid portion may be omitted, such that the tongue 1027 of the collapsible portion abuts against the wall of the conduit for sealing. The collapsible portion has an extended tongue 1027 that secures the collapsible portion below the wall of the conduit to prevent the collapsible portion from opening outward under pressure from a gas flow. During normal use, the collapsible portion is substantially flush with the adjacent wall of the conduit, allowing substantially all gas from the gas source to pass through the conduit. The collapsible portion can act as a flap to... Figure 22A The closing position shown in the image is the same as Figure 22B Move between the open or ventilated positions shown in the diagram.

[0761] The collapsible portion is arranged such that it will collapse when an external force is applied, such as when the cover is placed on the patient's face. The non-collapseable portion is relatively rigid and will not collapse or deform when the collapsible portion moves, collapses, or deforms.

[0762] When the collapsible portion of the catheter collapses, the rigid portion 1023 faces... Figure 22B The position shown is shifted to provide a passage for gas to flow through the conduit and out into the atmosphere. Gas can then freely flow out from the orifice created between the tongue 1027 and the non-collapseable portion 1019, thereby releasing pressure in the conduit. It should be understood that gas flow can be completely, substantially, or partially restricted by adding a hood or other device to the conduit. In any of these cases, the collapsible portion collapses or deforms and allows gas to flow out from the orifice. The amount of gas flowing out of the passage will depend on the pressure of the gas in the conduit and whether the gas flow is completely, substantially, or partially restricted. The amount of collapse of the collapsible portion into the conduit (and thus the resulting ventilation) can be controlled by the user changing the sealing force provided by the hood 300 to the collapsible portion.

[0763] Figures 23A to 23CAnother pressure relief device is shown. In this embodiment, the pressure relief device includes a flexible portion or valve member 1031 that extends through an orifice 1033 in the conduit and closes the orifice. When viewed from above, the flexible portion has an elliptical shape. When viewed from the side, the flexible portion is curved to conform to the shape of the conduit. The flexible portion is also curved when viewed from the end and matches the curve of the conduit. Alternatively, the curvature of the flexible portion may not substantially match the curvature of the conduit, or it may be substantially flat. In these alternative embodiments, the flexible portion may have a natural or undeformed position and will be biased toward the natural position to close the orifice. The relief pressure that causes the flexible portion to rise away from the orifice may be determined by the material properties of the flexible portion and / or by the size and shape of the flexible portion.

[0764] Figure 23B A valve without the flexible portion 1031 is shown. The flexible portion has a rod 1032 that fits into a hole in a member extending through an orifice. A retention mechanism (e.g., an enlarged diameter portion) 1032a on the rod 1032 holds the flexible portion in place.

[0765] The flexible portion 1031 is or includes a flexible or elastic material, such as silicone. Under standard operating gas pressure, such as... Figure 23C As shown, the flexible portion covers the orifice and prevents or at least substantially inhibits gas from flowing out of the conduit through the orifice. When the gas pressure in the conduit reaches a threshold pressure, the edge of the flexible portion moves away from the conduit, and the flexible portion will have Figure 23D The shape shown.

[0766] The orifice 1033 may have a shape similar to that of the flexible member, i.e., the shape may be elliptical when viewed from above. In another alternative embodiment, two or more orifices may be present, each of which is closed by the flexible member. Figure 23A As shown, the advantage of having more than one flexible member is that there will always be at least one flexible member that is not resting on the surface or being closed and is free to move and open.

[0767] Figures 23E to 23G It shows something similar to Figures 23A to 23DThe pressure relief device is shown, but it is located within chamber 1035. Positioning the pressure relief device within this chamber may be advantageous because it does not vent gas near the patient. The pressure relief device is protected because it is not on the flexible catheter, but rather located in a separate chamber in fluid communication with the catheter. Furthermore, the pressure relief device is kept away from bedding and other objects that may be near the patient and could obstruct or interfere with the ventilation opening.

[0768] Figure 24A and 24B An embodiment of a device for releasing pressure and blocking or inhibiting flow is shown. In this embodiment, the pressure-relieving device has a lever 1037 mounted within the conduit. The lever includes a pivot 1039, an operating portion 1041, and a sealing portion 1043, which substantially seals an orifice 1045 in the conduit such that substantially all gas from the gas source passes through the conduit. In this configuration, the operating portion 1041 is located on one side of the pivot 1039, and the sealing portion 1043 is located on the same side of the pivot. In this embodiment, the lever 1037 is a spring plate located within the conduit. The conduit may have multiple sizes and be formed of one or more soft or flexible materials, such that the conduit cannot maintain its shape without the support of other components. The spring plate 1037 will prevent or at least significantly inhibit the conduit from collapsing, deforming, or closing unless an external force is applied.

[0769] The sealing portion 1043 is configured as a boss or ridge that engages with the orifice 1045 in the conduit. When the boss or ridge engages with the orifice, it prevents or at least significantly inhibits the flow of gas from the conduit.

[0770] When the operating part 1041 moves, for example by pressing directly on the conduit above the operating part via a cover, the lever 1037 pivots about the pivot 1039 and the sealing part 1043 moves away from the orifice 1045 to provide a passage for gas to flow through the conduit to the atmosphere.

[0771] Figure 25A and 25B Another embodiment of the pressure relief device is shown. This embodiment is intended for use with a collapsible catheter or a catheter having a collapsible portion.

[0772] In this embodiment, the pressure relief device has a lever 1047 mounted within the conduit. The lever includes a pivot 1049, an operating portion 1048, and a sealing portion 1050, which substantially seals an orifice 1052 in the conduit, allowing substantially all gas from the gas source to pass through the conduit. In this embodiment, the lever 1047 is a rigid component located within the conduit. In this configuration, the operating portion 1048 is located on one side of the pivot 1049, and the sealing portion 1050 is located on the other (opposite) side of the pivot 1049. The sealing portion acts against one side of the conduit to act against the operating portion, thereby causing the lever to pivot at a pivot point. The pivoting of the lever causes the sealing portion to move and disengage from the orifice on the opposite side of the conduit. The sealing portion 1050 may have a boss or ridge that engages with the orifice 1052.

[0773] When the collapsible portion of the catheter collapses, lever 1047 moves towards... Figure 25B The position shown is moved. Gas then flows freely from the orifice 1052, thereby releasing pressure in the conduit. It should be understood that the gas flow can be completely, substantially, or partially restricted by adding a hood or other device to the conduit. In any of these cases, lever 1047 moves and allows gas to flow from orifice 1052. The amount of gas flowing from the orifice will depend on the pressure of the gas in the conduit and whether the gas flow is completely, substantially, or partially restricted. In some embodiments, lever 1047 is biased toward a closed position in which the orifice is closed. To open the orifice, a force (e.g., by applying a mask seal) is required to move the lever against the bias. Figure 25A and 25B One advantage of the arrangement shown is that the flow is discharged from the side of the conduit away from the person applying the hood to the patient. In some embodiments, it is preferable to discharge or direct the gas flow in a direction away from the patient and / or caregiver.

[0774] In alternative embodiments, another component or portion of the patient interface may be equipped with a lever. For example, the cannula may have a lever.

[0775] Figure 26A and 26B Another pressure relief device is shown. In this embodiment, the conduit has a movable portion 1051, which is positioned to connect to an adjacent portion 1053 of the conduit via a thin connecting portion or web 1055. The movable portion has one or more orifices 1057. A disc or valve member 1059 extends through the conduit and seals, or at least significantly seals, the conduit. Figure 26AAs shown, the disc 1059 abuts against the portion of the conduit adjacent to the movable portion and is sealed. The disc 1059 has a rod 1052 for connecting the disc to the movable portion 1051 of the conduit.

[0776] A thin connecting portion or web 1055 is created such that the pressure relief device remains in the closed position until the pressure inside the conduit reaches a threshold pressure. When the pressure of the gas in the conduit reaches the threshold pressure, the movable portion 1051 changes to a second configuration in which the connecting portion flips upward, thereby allowing flow to exit from the orifice 1057.

[0777] Figures 27A to 27D Another pressure relief device is shown. In this embodiment, the pressure relief device includes a valve member (i.e., a flexible arm 1061) and a body portion 1062 that is partially or completely wrapped around the conduit. The flexible arm and the body portion are preferably integrally formed as a single component. When the gas pressure in the conduit reaches a threshold pressure, the pressure will force the flexible arm 1061 to bend. Figure 27A The upward bend is shown in dashed lines. Gas then flows freely from the orifice 1063, releasing pressure in the conduit. In some embodiments, the arm can be rotated / repositioned by the user on the conduit so that the vent orifice 1063 remains uncovered if venting is desired continuously or for extended periods. The arm can be made of, for example, a sheet of silicone, spring steel, or other suitable plastic or metal material.

[0778] Figure 27E and 27F Another pressure relief device is shown. In this embodiment, the pressure relief device includes a sliding member 1098 provided in the wall of the conduit 1099. The member 1098 is in an open position where the orifice 1097 in the wall of the conduit is not covered (e.g., Figure 27F (as shown) and the closed position of the cover orifice 1097 (as shown) Figure 27E The member 1098 can be slid between the two sides (as shown). When a user wants to use the cover with the first patient interface, the user can slide the member 1098 to the open position to release pressure from the catheter that the cover may cause to collapse.

[0779] Figure 27G Figures H and H illustrate another pressure relief device. In this embodiment, the pressure relief device includes a sleeve or ring member 1095 provided on the wall of the conduit. Member 1095 may be in an open position where an opening in the wall of the conduit 1094 is not covered (e.g., Figure 27H (as shown) and the closed position of the cover orifice 1096 (as shown) Figure 27ERotatable between (as shown). Alternatively, the sleeve 1095 may be slidable to cover and not cover the orifice 1096. The sleeve or ring element 1095 may have an orifice aligned with the orifice 1096 in the wall of the conduit 1094, or may extend partially around the conduit 1094 such that the sleeve 1095 can be positioned such that the orifice 1096 of the conduit 1094 is located between the circumferential ends of the sleeve 1095, as shown. Figure 27H As shown.

[0780] Figure 27I Figures J and J illustrate another pressure relief device. This pressure relief device includes a silicone valve component 1092. Excess pressure in the system can be released by creating a slot in the silicone component 1092 to open it. The silicone component may be a diaphragm including the slot.

[0781] Figure 28 A cross-section of another pressure relief device is shown. This embodiment can be positioned in a relatively rigid component, such as in a filter.

[0782] In this embodiment, the pressure relief device includes a flexible portion or valve member 1065 that extends through an orifice 1067 in the conduit and closes the orifice. The flexible portion is or comprises a flexible or elastic material, such as silicone. These flexible portions have... Figure 28 The flexible portion is shown in its natural position and will be biased toward said natural position. In an alternative embodiment, the flexible portion can be replaced by a relatively rigid portion, which is biased (e.g., by a spring) to return to its natural position. Figure 28 The location shown.

[0783] At standard operating gas pressure, the flexible portion 1065 covers the orifices and prevents or at least substantially inhibits gas from flowing out of the conduit through the orifices. When the gas pressure in the conduit reaches a threshold pressure, the flexible portion moves away from the orifices, thereby allowing gas to flow through the orifices and releasing the pressure in the conduit.

[0784] Figure 28 Two openings 1067 closed by the flexible member are shown. In another alternative embodiment, one or more openings may be present, each such opening being closed by a corresponding flexible member. A flexible member may close two or more openings. The openings may be formed as circumferentially extending slits.

[0785] Figure 29Another pressure relief device is shown. This embodiment is shown positioned within a conduit. This embodiment has a valve member 1069 that closes an orifice 1071 to prevent or at least significantly inhibit gas flow through the orifice. The pressure relief device has a pair of legs 1073 between the conduit and the valve member 1069. These legs are biased to positions shown in solid lines. The shape and composition of these legs are selected and designed such that they hold the valve member in the closed position until the pressure reaches a threshold point that would open the valve (position shown in dashed lines). When the pressure decreases and the force on the valve member is reduced, the valve member will return to the closed position shown in solid lines. Alternatively, when the cover is removed, the user can manually press the valve to the closed position.

[0786] Figure 30A , 30B Another pressure relief device is shown. This embodiment can be positioned in a relatively rigid component, such as in a filter.

[0787] This embodiment of the pressure relief device includes a valve member 1081 having a plurality of outwardly extending valve discs 1083. These valve discs close orifices 1084 in a rigid member. The valve has a central orifice 1085 through which gas can flow into a conduit. When the pressure of the gas in the conduit reaches a threshold pressure, these valve discs rise. These valve discs are preferably flexible and resilient.

[0788] This embodiment of the pressure relief device can be located, for example, within the filter 1087. However, it should be understood that this embodiment of the pressure relief device can be located anywhere within the gas flow path of the rigid portion.

[0789] Figure 31 A pressure relief device is shown located at the end of the filter, but this is not necessary. It can be located anywhere in the system.

[0790] This embodiment of the pressure relief device is for use with a component of a respiratory support system for delivering pressurized gas from a gas source to a patient. The component of the respiratory support system has an orifice. The pressure relief device includes a valve body 1091 that engages with a conduit for delivering pressurized gas from a gas source to a patient. The valve body is located within the component of the respiratory support system and has a portion that sealably engages with the orifice. During normal use, the valve body is biased toward sealing the orifice in the component of the respiratory support system, allowing substantially all gas from the gas source to pass through the conduit. When the pressure of the gas within the conduit reaches a threshold pressure, the valve body retracts the orifice in the component of the respiratory support system to provide a pathway for gas to escape from the component of the respiratory support system and into the atmosphere. In this embodiment, a spring 1089 holds the valve body 1091 in the normal use position (closed position) until the gas pressure within the conduit reaches the threshold pressure.

[0791] The various pressure relief devices described above are combined with, or include or provide, the collapsible portion of the catheter, and are actuated by this portion of the catheter, which collapses under the influence of an external force, between a closed or non-ventilated configuration and an open or ventilated configuration. The external force can be provided by a seal of a mask placed on the collapsible portion of the catheter, or by a user or healthcare professional pressing on the collapsible portion. See, for example, [link to relevant documentation]. Figures 21B to 22B and Figures 24A to 25B The described embodiments are pressure relief devices actuated by applying an external force to the collapsible portion. In such embodiments, these ventilators can be activated by a component of the device (e.g., in...) with a second interface abutting against the device. Figure 25A In one embodiment, lever 1050 is pressed down to operate between the ventilated and non-ventilated positions. Alternatively, a user or medical professional can operate the device by pressing down on a component of the device.

[0792] The various pressure relief devices described above are actuated by system pressure between a closed or non-ventilated configuration and a ventilated or open configuration, for example, Figures 23A to 23G as well as Figures 26A to 3Examples of 0. These embodiments operate once the system pressure increases above a threshold. These devices can directly sense pressure, such as pressure acting on a valve member of a pressure relief device. Alternatively, these devices can be operated by a controller that receives pressure indications from sensors located within the system, such that once the sensed pressure reaches a threshold, the controller actuates an actuator (e.g., a solenoid) to actuate the valve member between a non-ventilated and ventilated configuration. Alternatively, a mechanical switch or actuator can be provided that can be manipulated by a user or medical professional to actuate the valve member between a non-ventilated and ventilated configuration.

[0793] See Figures 32 to 34 Another pressure relief device is described. Figure 33 and 34 The pressure relief device 89 is shown, and Figure 32 The image shows a nasal cannula 81 adapted for use with a pressure relief device. The cannula 81 and the pressure relief device can be used together in a respiratory support system, for example, Figure 1 System 100. A pressure relief device 89 is adapted to sense system pressure, such as the pressure delivered to the patient via cannula 81. The nasal cannula 81 has a body portion 83 operably positioned on the patient's face. The nasal cannula 81 also has at least one nasal fork 85 extending from the body portion 83, the nasal fork 85 being adapted to introduce a flow of gas into the nostrils of the patient's nose when the body portion is in the operably positioned position. In the illustrated embodiment, the nasal cannula has two nasal forks 85.

[0794] The system also includes a pressure sensing or sampling line or conduit 829. In the illustrated embodiment, the sensing line 829 has an opening or inlet 87 at or near the patient's nostril or the user's nose to sample / sensor pressure at said location; however, the pressure sensing line can be used to sense system pressure at another location within the system. The pressure relief device 89 is a mechanical valve. In the illustrated embodiment, the pressure relief device includes a shuttle or piston 813. The pressure relief device 89 selectively controls the flow of gas from the nose fork 85 into the patient's nostril. The outlet end 821 of the pressure sensing line opens toward the piston 813, such that the piston 813 senses or is acted upon by the pressure sensed by the pressure sensing line, as described in more detail below. In the illustrated embodiment, the piston 813 senses pressure at the nostril via the pressure line 829. In such an embodiment, the pressure relief device can serve as a safety pressure limiting device to ensure that the maximum permissible pressure for the patient is not exceeded. In an alternative embodiment, pressure can be measured to provide an indication that a second support system has been applied to the patient. For example, a mask can be applied to the patient, which can partially occlude catheter 831. Due to the application of the mask or catheter occlusion, the system pressure within the catheter may increase. A pressure sensor can sense this pressure to provide an indication that a mask has been applied. The increased pressure can operate device 89 to release pressure in catheter 831. Nasal cannula 81 is configured to allow the simultaneous use of a second respiratory support system. For example, a mask (in...) Figure 35 (Indicated by dashed lines and reference number 8100) It can be placed on the patient's mouth, nose, and intubation tube 81, as previously seen. Figure 3 As described.

[0795] exist Figures 32 to 34 In the illustrated example, pressure line 829 and valve 89 are arranged such that when the pressure in or near the patient's nostrils is higher than a predetermined value, the pressure acting on the piston causes valve 89 to move to a closed or partially closed configuration to restrict gas flow from nose fork 85 into the patient's nostrils. When the pressure in or near the patient's nostrils is lower than the predetermined value, valve 89 will be in an open configuration to allow gas flow from nose fork 85 into the patient's nostrils.

[0796] The flow rate can be controlled to ensure that the system pressure does not exceed a predetermined value. The predetermined value can be:

[0797] ■Default value

[0798] ■ The 'security' value set by the user,

[0799] ■ The pressure maintained by the intubation flow rate before the mask is placed on the intubation cannula, or

[0800] ■ Related to flow velocity, i.e., allowable pressure = A x flow velocity^B + C x flow velocity^B-1..., where A, B, C, etc. are constants.

[0801] The predetermined value can be a fixed value or an adjustable value. If the value is adjustable, it can be adjusted by a user, a controller, or both.

[0802] See Figure 33 and 34 The valve 89 has a housing 811, a valve component or piston 813, a compression spring 815, and a rotatable knob 817. Figure 33 and 34 The arrow in the middle indicates the rotation of the knob.

[0803] The housing 811 has a flow source inlet 819, a pressure measurement inlet 821, a flow source outlet 823, and an overflow outlet 825. The flow source inlet receives flow from a flow source (e.g., from...) via a flow source conduit 827. Figure 1 The flow generator 102 receives a high flow rate. The pressure received at the pressure measuring inlet 821 depends on the pressure sensed at the sensing end 87 of the pressure catheter 829. The flow source outlet 823 delivers gas to the patient via the cannula 831. In the illustrated embodiment, the cannula 831 and the pressure measuring catheter 829 extend between the cannula 81 and the pressure relief device 89. In the illustrated embodiment, the two catheters 829, 831 are aligned together.

[0804] Spring 815 causes valve component 813 to face towards Figure 33 The positional bias shown, and the pressure in or near the patient's nostrils relative to the spring force, controls whether flow from the fluid source is delivered to the patient. See also Figure 33 If the pressure in or near the patient's nostrils is less than the opposing pressure provided by spring 815, valve member 813 is pushed by the spring to the open position, delivering a flow of gas from the flow source to the patient. See also Figure 34 If the pressure in or near the patient's nostrils is greater than the opposing pressure of the spring 815 (and the friction within the device), the valve member 813 is pushed to the closed position by the flow pressure sensed by the pressure line 829, and no gas flow is delivered to the patient. In the illustrated embodiment, the flow from the flow source is discharged via the overflow outlet 825.

[0805] The tension of spring 815 can be a fixed spring tension or an adjustable spring tension, such as... Figure 33As shown. An example of an adjustable spring tension is an adjustable positive end-expiratory pressure (PEEP) valve. By rotating the knob 817, the preload can be adjusted relative to the measured patient pressure, thereby controlling the opposite force of the spring 815. Adjustment can also be achieved using other methods, such as a linear actuator.

[0806] The system can operate in an on / off manner. That is, valve 89 can have an open position and a closed position, in which gas flow is unimpeded through the valve, and in the closed position, gas flow is blocked through the valve. In an alternative embodiment, the system can have a valve member having one or more intermediate positions that partially restrict the flow rate. The one or more intermediate positions provide variable control of the flow rate. A discharge signal may be given to the user, for example, through audible noise generated by a restricted orifice at the vent when the flow is discharged.

[0807] In an alternative embodiment, the system may have a valve component having one or more intermediate positions that partially discharge the flow. These one or more intermediate positions provide variable control of the flow rate.

[0808] In an alternative embodiment, pressure relief can also be controlled electronically, wherein an electrical signal controls a valve that controls the flow of gas to the patient.

[0809] See Figure 35 Pressure release can be controlled via a software-enabled processor. In addition to what is described below, Figure 35 The features and operation of the second embodiment shown are related to... Figures 32 to 34 The same as described. In this embodiment, the system further includes at least one processor and a user interface 833. Predetermined values ​​can be set by the user and / or displayed to the user via the user interface 833. For example, the user sets a maximum pressure (P target). Additionally or alternatively, the system may have default values. Typical default values ​​may be 20-40 cm H2O, or in some configurations about 0 cm H2O.

[0810] Pressure sensor 835 detects pressure in or near the patient's nostrils or at a point in the system and transmits data indicating said pressure to a controller. The controller compares the data indicating the measured pressure with data indicating a predetermined value, such as a maximum pressure (P target). The flow rate (Q) delivered to the patient via the nasal cannula is adjusted accordingly to ensure that it does not exceed the P target. Specifically, the processor is adapted to control a valve (e.g., pressure relief valve 89) or flow generator to restrict the flow of gas from the nasal fork into the patient's nostrils when the pressure in or near the patient's nostrils is higher than the predetermined value, and to allow gas to enter the patient's nostrils from the nasal fork when the pressure in or near the patient's nostrils is lower than the predetermined value.

[0811] In an alternative embodiment, the controller may have two pressure sensors with a known obstruction (i.e., an orifice plate) between them. The flow rate can be determined using the pressure difference between the two pressure sensors. By using this flow rate, the system can control the flow rate to be achieved, as long as the pressure does not exceed the allowable Pmax for a given flow rate. This can be described using mathematical equations, stepwise functions, or lookup tables in software.

[0812] When valve 89 is closed and the controller knows there is no flow, calibration can be performed to account for pressure sensor drift and adjust the flow sensor offset accordingly. This calibration routine can be performed on any electrically controlled pressure relief device described herein. When valve 89 is controlled by the controller, valve member 813 may not be a piston sensing the pressure of the sampling system. The position of the valve member is actuated by an actuator (e.g., a solenoid) controlled by the controller in response to the pressure measured by sensor 835.

[0813] The pressure sensor 835 can be located in a variety of different locations. For example, the pressure sensor 835 can be located at or near the nasal cannula, or in an area that can be covered by a mask.

[0814] In some configurations, the pressure sensor 835 is located at or near the at least one nasal fork 85. For example, on the nasal fork, inside the patient's nostril (e.g.) Figure 35 (as shown), or on the patient interface. In some configurations, the pressure sensor is located on a catheter adapted for delivering gas to a nasal cannula. In some configurations, the pressure sensor is located at or near a flow generator or pressure relief device. In some configurations, the pressure sensor is located on the humidification chamber, the drying line (the conduit from the flow generator to the humidifier), or the gas line. In some configurations, the pressure sensor 835 or pressure line 829 is remotely mounted, and the pressure is connected from any of these locations via a conduit.

[0815] The described system may include a mask 8100 (e.g., anesthesia mask) placed over a nasal cannula 81, the patient's nose, and / or the patient's mouth. The mask 8100 delivers a flow of gas or pressurized gas in addition to the flow (e.g., high-flow therapy) received by the user through the nasal cannula 81. Accordingly, the pressure delivered to the patient's airway may exceed the permissible pressure. This can occur when using a sealed mask. Therefore, pressure relief features or flow reduction can be used to prevent exceeding the permissible pressure.

[0816] The pressure relief device may be a flow controller located within the system to limit the flow / pressure delivered to the patient. The flow controller may be operable based on input from a pressure sensor or pressure provided / sensed within the system via a pressure sampling line. In some configurations, the flow controller controls the flow rate of the high-flow-rate treatment device. Alternatively, the flow controller controls a second gas source or flow generator. For example, the flow controller may control the gas flow to a mask. In further alternatives, the flow controller controls both the high-flow-rate treatment device and the gas flow to the second gas source or flow generator.

[0817] The flow source of the shroud (not shown) can be controlled by its own adjustable pressure relief valve (not shown). The independent pressure relief on the cannula, which can be set by the user, means that the user has more control over the pressure delivery of each flow source.

[0818] The specific pressure relief device embodiments described herein are designed to limit the amount of pressure delivered to the patient. Specifically, these specific embodiments described can be used in situations involving the simultaneous use of multiple respiratory support systems, such as nasal intubation and anesthesia masks.

[0819] The specific embodiments described herein can also be used in situations where no other respiratory support system is available; that is, nasal intubation may be the only respiratory support system used on the patient. The described embodiments can limit the amount of pressure delivered from a high-flow-rate source.

[0820] A method for providing respiratory support to a patient will now be described. The nasal cannula 81 is placed in the operating position on the patient's face, such as... Figure 35 As shown. Gas is directed through the nose fork 85 into the patient's nostrils. Pressure at a point in the system is measured or sensed, for example, by a sensor in or near the patient's nostrils, or by a valve component of a pressure relief valve (e.g., via pressure line 829). If the pressure exceeds a predetermined value, gas flow from the nose fork into the patient's nostrils is restricted. The flow rate may be reduced or prevented.

[0821] When a pressure change (increase) is sensed, the flow rate can be limited. Alternatively, if the sensor is positioned outside the cannula rather than inside the patient's nostril, such that it is covered by the mask 8100 when placed on the patient, the flow rate can be limited when the measured pressure exceeds zero. Alternatively, if a sensor / pressure line is used to sense the pressure within the system, the flow rate can be limited when the pressure exceeds a predetermined threshold pressure for a certain flow rate, where the system pressure may be affected by applying the mask to the cannula, which creates back pressure in the system. In the last two alternatives described, it is assumed that the mask 8100 has already been applied.

[0822] If the pressure is lower than the predetermined value, gas is allowed to flow from the nasal fork into the patient's nostrils.

[0823] Controlling / restricting the flow of gas into a patient's nostrils will result in an excessive / undesirable flow of gas from the gas source. This excessive / undesirable flow can be handled in various ways. For example, it can be vented outside the nasal cannulation area. Alternatively, the excessive / undesirable high flow of gas can be redirected back to the flow source. In other embodiments, if the flow source can be shut off by blocking the flow; or if the source is a flow generator, such as a blower, which can be turned off, it may not be necessary to vent the excessive / undesirable high flow of gas. In alternative embodiments, a pressure relief device can control / restrict the total flow to the patient. A sensor can measure the flow and vent gas according to the flow restriction.

[0824] Figure 36 Another embodiment of the pressure relief device 8000 in the closed state is shown. Figure 37 The same pressure relief device 8000 in the open state is shown. The device includes a valve member 8001. The valve member 8001 seals over an orifice 8002 in the sidewall of a conduit 8003. When the pressure in the breathing conduit 8003 exceeds a predetermined pressure, the valve member 8001 moves away from the orifice 8002 to allow air to escape through the orifice 8002, as... Figure 37 As shown. The pressure relief device 8000 may also include a biasing member 8004 (e.g., a spring) for biasing the valve member 8001 to a closed position, thereby sealing the orifice 8002. When the pressure in the breathing tube exceeds a predetermined pressure, the valve member 8001 moves away from the orifice 8002 against the biasing member 8004. The pressure relief device 8000 preferably includes a cap or housing 8005 for receiving the valve member 8001 on the outside of the conduit 8003. The cap or housing 8005 can help prevent the valve from being improperly blocked.

[0825] Figure 38A and 38BA pressure relief device 8010 is shown, comprising a main valve 8011 and a pilot valve 8012 for controlling the operation of the main valve 8011. When the pressure (Pc) in the conduit 8013 is less than a predetermined value, the pilot valve 8012 closes. With the pilot valve 8012 closed, Pc is applied to both sides of the piston 8014 of the main valve 8011. The piston 8014 has a first side and a second side, the first side having a first area (A) and the second side having a second area (a) smaller than the first area (A). When the pilot valve 8012 is closed, pressure Pc acts directly on the first side of the piston 8014, and pressure Pc acts on the second side of the piston 8014 via the pilot valve 8012. The larger area of ​​the first side of the piston 8014 results in a larger force being applied to this side of the piston 8014, keeping the piston 8014 in the closed position. When the pressure Pc exceeds the predetermined value, the pilot valve 8012 opens, allowing the flow to be discharged through the conduit 8013. Figure 38B As shown. This causes the pressure on the second side of piston 8014 to be less than the pressure on the first side of piston 8014, in which case the piston moves from the closed position to the open position. This allows gas to be discharged from conduit 8013 via the main discharge port 8015 of the main valve 8011 of the pressure relief device 8010.

[0826] Figure 39 Valve 8020 is shown; if the pressure Pc is higher than a predetermined value, the valve shuts off the flow. The pressure may be local to valve 8020, or it may be generated by valve 8020 at another location within the system via pressure line 8025, or similarly as shown in [reference 1]. Figure 32 The pressure is sensed by the described pressure line 829. When the force provided by the pressure is less than the spring reaction force, the plug 8021 is in the retracted position and gas can flow downward along the conduit. Figure 40 A plug 8021, extended and blocking conduit 8023, is shown. This occurs when the force provided by the pressure Pc exceeds the spring reaction force. Plug 8021 prevents flow through the system until the pressure decreases, in which case plug 8021 retracts and gas flow resumes. When the flow is blocked, it can be discharged further upstream via any of the pressure relief devices described herein, or the flow can be stopped by a controller.

[0827] Figure 41A and 41B Another embodiment of the pressure relief valve 8030 is shown. Figure 41A The device is shown in its off state. Figure 41BThe same device in its open state is shown. When the pressure in the breathing tube 8034 exceeds a predetermined pressure, the plunger 8031 ​​moves upward against the reaction force provided by the spring, and provides a path for the gas to proceed downward along the breathing tube 8034 and be discharged.

[0828] In any embodiment, the spring need not take the configuration of a helical spring as shown. Instead, the spring may be, but is not limited to, a leaf spring, a diaphragm spring, or a compliant material.

[0829] Any of the pressure relief devices described above can be located anywhere in the system, between the flow source and the cannula. Preferably, the pressure relief device is located downstream of the humidifier so that the humidifier controller does not need to handle large flow rate variations within the humidification chamber. Examples of suitable locations for the pressure relief device include at the humidification chamber outlet, in the loop connector, or as an attachment to the flow source in a filter. The pressure relief device may be located in or near the cannula. In some embodiments, it may be preferred to locate the pressure relief device at or near the patient interface. The advantage of locating the pressure relief device at or near the patient interface compared to locating it further upstream or within the system is that the pressure delivered to the patient can be estimated more accurately.

[0830] In some embodiments, venting the catheter via the pressure relief device before applying the shroud to the collapsible portion of the catheter can make the catheter more likely to collapse when the shroud is applied.

[0831] A pressurized catheter that delivers a gas flow to a patient may include a certain level of hysteresis. This hysteresis in the catheter may cause the pressure relief device to open at a higher pressure than would cause it to close. This feature would prevent, or at least significantly inhibit, the pressure relief device from moving in a constant, fluctuating manner between an open and closed configuration.

[0832] As previously described, see, for example Figure 3 As described, a respiratory system can be provided to allow delivery of gas from multiple sources via at least two different respiratory support modes, and further allows physicians, clinicians, or medical professionals to quickly and easily change the type of respiratory support mode. The following provides a further summary of several different system functions and embodiments, and outlines the benefits of these embodiments.

[0833] The following embodiments can be used in the respiratory therapy system described above or other suitable respiratory therapy systems to allow for high-flow operation while easily allowing switching between multiple respiratory support modes and / or obtaining additional functionality or benefits. These embodiments can be configured to deliver gas to a patient at high flow rates as described herein.

[0834] Function 1 - Switch between treatment methods

[0835] The following switching configuration allows for high-volume operation via the first patient interface, and has the capability to perform one or more of the following:

[0836] ●Using a second patient interface, precise concentrations of volatile drugs can be delivered via an anesthesia machine using the smallest possible amount of medication.

[0837] ● Manually deliver breathing to the patient via the bag when needed through a second patient interface.

[0838] ● Quickly and easily switch between respiratory support provided by the first patient interface and the second patient interface.

[0839] ● Check airway patency with a bag and cover (second patient interface).

[0840] ● Enables clinicians to regain control of manual ventilation using the bag when desired.

[0841] Currently, there is no simple way to integrate high-flow usage into anesthesia practice. While it may be possible to obtain high flow from completely separate systems / flow sources, a configuration that allows easy interchange between high-flow respiratory support and machine-assisted respiratory support is desirable. It is also desirable to allow high flow to be quickly and easily shut off or reduced.

[0842] In current practice, users may obtain high flow rates from a separate flow meter attached to the wall gas supply. There is no integration with the anesthesia machine, and there is no specific design for using high flow rates in anesthesia practice.

[0843] In some embodiments, the switching configuration (switching configuration 1) includes a user interface device to enable a user to control the gas flow in a respiratory therapy system used to deliver high-flow-rate gas to a patient, the user interface device including:

[0844] At least one user-actuable controller or device for controlling the flow rate and / or concentration of at least one gas passing through the patient interface, and for significantly blocking or reducing the flow rate of the at least one gas passing through the patient interface, or shutting off the flow.

[0845] The gas may be a high-flow-rate gas. Another gas in the gas mixture may be an anesthetic gas, a supplementary gas, or any other suitable gas.

[0846] The patient interface may be a nasal cannula. The user-actuated controller may include a switch. In some embodiments, the switch is located at the patient interface. Alternatively, the patient interface may be another unsealed patient interface. In other alternative configurations, a combination of multiple patient interfaces may be used, such as a combination of an unsealed interface and a sealed interface, or two sealed interfaces.

[0847] In some configurations, the user interface device is a separate device located away from the patient interface. Figure 42A This configuration is shown in the image. The gas flow rate is preset by the user via the user interface device 2500. The patient interface (e.g., Figure 3 Before placing the 200 or 300 (or similar) flow meter on the patient, the user uses a first user-actuable controller, which can be coupled to the rotor flow meter, to set the desired oxygen and / or air flow rate (e.g., set to 40 LPM or 70 LPM). A second user-actuable controller includes a user-actuable switch 2502 that controls valves to one or more flow sources 2102. The switch is shown as a toggle switch but can be in any suitable configuration. In a preferred embodiment, the switch includes two states and can be a 'one-touch' switch or other on / off button or lever. The switch provides a quick way to turn the flow on / off or rapidly increase the flow rate to a preset value, rather than the potentially time-consuming, circuitous increase or decrease of flow rate found in the prior art.

[0848] Turning on switch 2502 opens the valve, allowing gas (preferably oxygen) to be delivered to the patient via cannula 2200 at a preset flow rate. User interface device 2500 has a gas connector 2503 for connecting fluid to a patient interface used for gas delivery to the patient. Turning off switch 2502 closes the valve, blocking flow to the patient or at least reducing the flow rate to the patient. In one alternative, flow to only one patient interface (e.g., a high-flow interface) can be blocked or reduced. In another alternative, flow to more than one patient interface can be blocked or reduced. The valve can be closed when the user decides to begin providing respiratory support to the patient from the anesthesia machine. User-actuable controllers 2504, 2506 enable the user to mix multiple gases (e.g., air and oxygen) and / or to independently set the flow rates of these two gases. Alternatively, only one gas, such as oxygen, can be provided. The user interface device may include further user-actuable controllers to allow three or more gases to be mixed in desired proportions. Alternatively, the functions of two or more of the user-actuated controllers 2502, 2504, and 2506 can be combined. For example, a single user interface, such as a touchscreen, can be provided to enable the user to mix these gases and to block or reduce the flow to the patient.

[0849] The on / off switch 2502 can also control the power of the humidity generator 2104. For example, if the moisture is generated by electricity in the pipe, the pipe can be powered using the electrical connection 2508. When the switch 2502 is closed, this may also shut off the power to the electrical connection and therefore to the pipe. In this way, humidity and flow can be turned on / off simultaneously.

[0850] Instead of being completely 'off', when the switch is switched to 'off' mode, the flow rate can be reduced to 5 LPM. This can be advantageously used as a minimum 'backup' flow rate. For example, if a clinician forgets to immediately turn on the high flow rate after extubation, the low flow rate will provide the patient with at least some oxygenation. The minimum flow rate can be preset to a value that may meet the patient's inspiratory needs (e.g., 30 LPM). The maximum flow rate can be 70 LPM or greater, such as 100 LPM or 150 LPM. Multiple preset values ​​may exist, such as more than two, for example, 0, 30, and 70 LPM. These can be actuated using a switch or mechanism with three or more positions corresponding to different preset values.

[0851] Alternatively, switch 2502' may be located on insertion tube 2200 for easy access, such as Figures 43A-43C As shown. In this case, switch 2502' can be the following mechanism: the mechanism is in the on / off configuration ( Figure 43BWhen in a shutdown / off configuration, it allows flow to pass through to the interface, or blocks flow to the cannula. Figure 43C In other words, switch 2502' is a valve, and the terms switch and valve may be used interchangeably to refer to a valve unless otherwise indicated herein. See above, for example, [example missing]. Figures 21A to 22B Several different valve arrangements have been described. When blocked, the delivered flow can be discharged along the gas conduit 2512 via the pressure relief valve 2510 (e.g., Figure 43C (As shown) or return to the gas supply, or the valve may have a venting arrangement.

[0852] This configuration can be provided as a mechanical switch or valve 2502', which, when activated, allows for restriction, closure, or complete blockage (i.e., closure or blockage) of the flow path through a gas conduit or through a patient interface (e.g., a nasal cannula).

[0853] Activation of switch 2502' can be performed manually by the user, or alternatively, it can be activated by placing a second patient interface on the switch (i.e., when the patient interface, such as a cover, is placed on the patient, or when the patient interface is placed on the patient and comes into contact with switch 2502', the switch may be provided as part of the first patient interface, such as a nasal cannula or catheter, as previously referred to). Figures 21A to 22B (As described).

[0854] Switch 2502' can partially or completely block the gas flow path to partially or completely prevent gas from passing through the catheter or the gas flow path through the patient interface (e.g., nasal cannula). This prevents gas from flowing to the end of the catheter or the outlet of the first patient interface. Switch 2502' can be provided as a part or component of the catheter or patient interface.

[0855] In some configurations, the catheter or patient interface including the switch may include a vent or pressure relief device for releasing pressure that has built up due to activation of the switch and for partially or completely stopping or preventing gas from flowing from the catheter to the outlet, or to one or more outlets of the patient interface.

[0856] In some configurations, when activated, the switch partially or completely blocks the gas flow path through the catheter or patient interface. The switch can be located or positioned in several different useful locations, such as a foot pedal operated by the user's foot, or a remote control switch that can be attached to a bed, anesthesia mask, a stand, or an anesthesiologist's clothing.

[0857] Switch 2502' may be specifically provided for use in conjunction with a self-supporting pipe (i.e., the pipe is not a self-collapsed or collapsible pipe).

[0858] Alternatively, the configuration of switch 2502' can be used in conjunction with collapse conduit 2202. Figure 42B (or according to any other collapsible conduit embodiment described herein) to provide a high flow rate of gas to the cannula. The conduit is configured to collapse and allows a shroud to seal across it. In one instance, as previously described, the conduit can be collapsed by adding a shroud to it. Alternatively, the conduit can be collapsed by any suitable mechanism (e.g., physical structure) or by altering or controlling the flow rate and / or pressure delivered via the conduit. In such embodiments, the collapsed conduit may not be completely closed; a switch or valve 2502' may be used to close the conduit.

[0859] The advantages of combining configuration 1 with collapsible tubing include one or more of the following:

[0860] ●No need to remove the cannula - allows for sealing the cannula over the face for patients using bags.

[0861] ● The flow has been blocked, so suppressing the flow through the cannula does not depend on the pressure of the shroud seal on the collapsible tubing. Furthermore, it is not necessary to resist the force of the gas flow accumulating in the tubing to push the shroud.

[0862] ●Clinicians can use existing bag / cover consumables.

[0863] ● A switch at the gas supply source can stop or reduce (rather than expel) high flow rates, which helps conserve oxygen supply.

[0864] In one embodiment, at least one section of the cannula 2202 is patent (open and unobstructed) only when delivering gas flow. If the high-flow gas source is shut off (e.g., Figure 1 If the flow rate is significantly reduced (e.g., source 124), the duct will collapse more easily. High flow rates can be shut off / reduced because the user wants to ventilate with the mask. In some embodiments, causing the duct to collapse allows the mask to seal more effectively on the face.

[0865] The wall thickness of pipe 2202 in the collapsible section ( Figure 42B The area shown and previously described may be reduced to decrease structural stiffness and allow collapse, or other features may be used to allow the pipe or cavity to be reduced, closed, or blocked.

[0866] In some embodiments, a switching configuration (switching configuration 2) includes a respiratory therapy system, the respiratory therapy system comprising:

[0867] Intubation tubes used to deliver high-flow-rate gas to patients;

[0868] A hood used to deliver gas to the patient;

[0869] and the pressure sensor associated with the cannula;

[0870] The system is configured to adjust the flow rate of the high-flow-rate gas through the cannula in response to at least one type of pressure change sensed by the sensor.

[0871] The pressure sensor can be provided on the outer surface of the cannula or on the outer surface of a pipe in fluid communication with the cannula.

[0872] The system can be configured to reduce or significantly impede the flow of high-flow-rate gas when the pressure sensor detects an increase in pressure. The pressure sensor can be configured to detect the increase in pressure in response to a mask being placed on a patient, the patient exhaling, or an actuation of an anesthesia bag.

[0873] The system may further include a valve to partially or significantly block the flow of high-velocity gas through the cannula in response to a detected increase in pressure.

[0874] like Figure 44A As shown, high-flow gas is supplied from an auxiliary gas supply, for example via flow meter 2124, through cannula 2200. Ventilation of mask 2300 is provided via an anesthesia machine 2404 and bag 2406 through a suitable lumen or tubing 2306. A pressure sensor 2238 is provided on the outer surface of the tubing 2200 / cannula 2200 interface for measuring the system pressure P1. During high-flow delivery, pressure sensor 2238 will normally read P1 = 0, where P1 = 0 is the ambient pressure. When mask 2300 is applied to the top of cannula 2200 (e.g., when a clinician wants to perform mask ventilation on a patient), pressure P1 will increase slightly above the ambient pressure. This pressure change can be pneumatically or electrically transmitted back to the high-flow gas source. In response, the high flow is then adjusted by a processor, for example, shut off or reduced.

[0875] If the pressure is pneumatically transmitted, the pressure change can activate valve 2240, thereby blocking the flow source, such as... Figure 44C As shown. When P1 = 0, valve 2240 opens (as shown). Figure 44B(As shown), this allows a high flow rate of gas to reach the cannula 2200. When the pressure P1 increases to >0, this causes the plunger 2242 in the flow path to be pressed, thereby blocking or partially blocking the high flow rate of gas. Blocking the flow can either open the vent 2250 in the high flow rate gas conduit 2202 to allow excess flow to escape, or it can shut off the flow source providing the gas flow. The pressure P1 will further increase when the bag 2406 is squeezed and additional flow is forced into the hood 2300, and also during exhalation (where the bag is not squeezed, but the patient's exhaled air will be trapped in the hood).

[0876] Figure 44D The potential flow patterns resulting from the 44A configuration are shown. Initially, a high flow rate / cannula flow rate 2426 is delivered, and the pressure P1 = 0. Upon application of the shroud 2300 ('shroud in place'), the pressure P1 increases, and the cannula flow rate 2200 is blocked. Figure 44D (2425 in the middle). The user begins to squeeze the anesthetic bag 2406 ( Figure 44D (2426 in the image), thus causing P1 to increase further during inspiration. If the pressure in the hood 2300 increases beyond the APL (Adjustable Pressure Limit) valve setting, this may cause the APL valve on the anesthesia machine 2410 to ventilate and cause pressure flattening. When the user stops squeezing the bag 2406, P1 first increases when the patient begins to passively exhale (…). Figure 44D (2427) and then decreases at the end of the patient's exhalation.

[0877] Alternatively, the high / intubation flow rate can be reduced when the 'hood is in place', and this reduction can be varied depending on the pressure measured at P1. For example, a higher pressure measured at P1 can result in a significant reduction in the delivered flow rate, while a lower pressure measured at P1 can result in a slight reduction in the delivered flow rate.

[0878] If the pressure change is instead electrically transmitted back to the high-flow-rate gas supply 2102, this can be achieved by blocking or reducing the flow rate, i.e., by activating a valve, a flow limiter, or opening a vent that allows flow delivery through a relatively low-resistance orifice. Alternatively, the pressure can be pneumatically transmitted, for example, via a pressure line terminating at pressure sensor 2238, but the actuation of the flow reduction / blocking is performed in software by controller 2108 or another processor.

[0879] To ensure only partial flow restriction of the high-flow-rate gas, the spring force in the flow limiter valve 2240 can be designed not to compress under pressures up to 40 cmH2O. It is possible that the APL valve would be set below 40 cmH2O. Therefore, the APL valve 2410 would discharge any additional pressure above 40 cmH2O measured in the canopy 2300, and the spring would never be subjected to pressures >40 cmH2O. This ensures that the high-flow-rate gas supply valve remains open, thus always allowing some high flow to be delivered to the patient. Alternatively, a relatively light spring can be used in valve 2240, such that only a small pressure is needed to completely block the high-flow-rate gas (e.g., 1-2 cmH2O that can be applied simply by moving the canopy 2300 over the top of the cannula).

[0880] The advantages of switching to configuration 2 include one or more of the following:

[0881] ●Clinicians can use existing bag / cover consumables.

[0882] ●No need to remove the cannula - allows for sealing the cannula over the face for patients using bags.

[0883] ● The system automatically stops high traffic – users do not need to manually turn high traffic on / off.

[0884] ● The system can stop or reduce (rather than discharge) high flow rates, which helps conserve oxygen supply.

[0885] ● Allows users to set the 'minimum' level for high-volume delivery or pressure at any time.

[0886] ●The cap does not need to completely seal the tubing leading to the cannula to block / reduce high flow. It can be easier compared to a completely collapsed tubing.

[0887] ●If the high flow rate is completely blocked, the hood flow rate does not need to overcome the return pressure from the high flow rate gas source.

[0888] ●Pressure measurement can be quite sensitive – independent of the user creating a good seal with the cover.

[0889] In some embodiments, a switching configuration (switching configuration 3) includes a respiratory therapy system, the respiratory therapy system comprising:

[0890] An intubation circuit for delivering a high-flow-rate gas to a patient via an intubation tube;

[0891] A bag circuit that allows a user to manually deliver gas to a patient via an actuated bag;

[0892] And a connector that connects the bag circuit to the cannula circuit, the connector including a separator to significantly prevent high-flow-rate gas from advancing into the bag circuit.

[0893] The connector can be configured to allow both high-flow-rate gas and gas from the bag circuit to be delivered to the patient through the cannula. Alternatively, the connector can be configured to significantly prevent high-flow-rate gas delivery to the cannula when the bag circuit is connected to the cannula circuit.

[0894] The separator may include one or more walls or valves in the connector.

[0895] The cannula may be a nasal cannula having at least one fork received in a patient's nostril, the cannula including one or more inflatable ferrules associated with the one or more forks to assist in creating a seal in one or more of the patient's nostrils.

[0896] The system can be configured to inflate one or more sleeves in response to actuation of the bag.

[0897] This configuration additionally or alternatively includes a nasal cannula for delivering gas to a patient, the cannula including at least one fork received in the patient's nostril, the cannula including one or more inflatable sleeves associated with the one or more forks to assist in creating a seal in one or more of the patient's nostrils.

[0898] See Figure 45A For example, during the pre-oxygenation phase, a high flow rate is delivered from the auxiliary gas supply / flow meter 2124 through the intubation circuit, which includes the cannula 2200. When the user wants to manually deliver gas to the patient, i.e., to provide manual breathing (e.g., if the patient has experienced respiratory arrest and the user wants to maintain lung re-expansion), the bag circuit 2412 is attached to the high-flow gas supply line of the intubation circuit (at connection area C). The high-flow gas supply line has a valve to prevent leakage when the bag circuit is not attached.

[0899] Bag circuit 2412 includes connector 2420 ( Figure 45C-i and Figure 45C-ii(As shown in the diagram). An upstream constraint opening 2422 limits the amount of high-flow gas that can travel along the conduit 2202 through the connector to the patient (any excess gas can be discharged further upstream via a vent 2250). The connector 2420 has a valve 2424 for separating the high-flow gas HFG from the gas from the bag flow source (BF). This allows gas to be delivered to the patient from either the high-flow gas (HFG) or the bag flow source (BF) and prevents the high-flow gas HFG from traveling back towards the bag flow source (BF) and inflating the bag 2406. This means that the clinician has control over bag inflation using only the fresh gas supply from the anesthesia machine 2404.

[0900] Users may want complete control over the inspiratory gas flow to the patient via bag 2406 and allow only high-flow delivery during expiration. When bag 2406 is squeezed to deliver gas, the increased pressure caused by the forced gas flow from the bag can close a valve in the high-flow gas supply line, thus completely blocking or confining the high-flow gas during inhalation. This valve can be allowed to open when there is no bag flow, allowing high-flow gas delivery during expiration.

[0901] See now Figure 45A When bag 2406 is inflated with fresh gas from anesthesia machine 2404 and then actuated by squeezing the bag, the bag gas (BF) flows through connector 2420 and out to the patient. Squeezing bag 2406 causes the valve to block, or at least reduce, the high flow rate of gas and prevent HFG from being delivered to the patient. The HFG can then be discharged from further upstream. The valve is designed to require less force from the BF flow pressure to overcome the HFG pressure. For example: in Figure 45C-i and Figure 45C-ii In this configuration, there is a large surface area on which the BF flow acts, and the direction of the obstruction of the HFG flow is perpendicular (not parallel) to the HFG flow. This means that the valve does not need to resist the opposite HFG flow to close. The valve can be easily kept open by its own weight (in the lower position shown in the figure), or it can also have a spring on top to increase the level of force required to close. Squeezing the bag 2406 can also deliver flow-measuring gas (SG) via conduit 2430 to inflatable sleeves 2260 on the insertion fork 2208 (these sleeves can be in fluid communication for simultaneous inflation), as... Figure 45A As shown. Gas SG to these forks inflates the sleeves 2260 on these forks, thereby creating a seal over the nostrils. A seal is needed to effectively achieve this when clinicians want to have control over a patient's breathing (normal practice uses a sealed mask).

[0902] When bag 2406 is released, the valve is opened and HFG can flow to the patient (see...). Figure 45C-iFlow is no longer supplied to port 2260, and these ports are deflated. This releases the interface seal, and the patient is able to exhale passively, with the gas flow exiting around fork 2208. Releasing the seal is important if a minimum level of high-flow gas (through the restraint orifice) is always delivered continuously. Without releasing the seal, continuous gas delivery could lead to overinflation of the patient. Moreover, releasing the interface seal means that additional high-flow gas is not forced back down to the fork during exhalation, which could potentially inflate the bag more than a clinician anticipates. In this way, the forks are always inflated while delivering flow from the bag and always deflated when the bag is not compressed and a high flow is being delivered.

[0903] These caps 2260 can be designed to inflate at very low pressure so that they remain inflated throughout the inhalation process (even at the end of any inhalation phase at the bag flow rate BF), or they can be inflated at a higher level. This second option can result in a higher level of inflation as the bag 2406 is squeezed harder / more flow is delivered. This can help clinicians regulate the pressure delivered to the patient, as greater inflation creates a greater seal and thus results in more pressure delivery.

[0904] Alternatively, the conduit 2430 leading to the sleeve 2260 may be fitted with a check valve to maintain constant inflation throughout the use of the bag and prevent deflation unless opened at a high flow rate. See, for example, Figure 45B , 45B-i ,as well as Figure 45B-ii When the bag is squeezed and the SG flows, the check valve 2261 (shown as a ball check valve) opens, thereby allowing the sleeves 2260 to be inflated. The pressure (P) in the HFG flow can be measured. HFG The pressure measurement interface (line) 2501 is used to block or open the flow of SG through valve 2340 to these ports. When there is no HFG delivery, PHFG is approximately 0. This allows SG to flow through valve 2340 to these ports. Figure 45B-i When the bag stops being squeezed, check valve 261 closes, thus preventing the forks from releasing air back into the bag. This stops the flow from the bag by opening valve 2240. Figure 44C (As shown) to allow HFG flow. The HFG flow causes an increase in PHFG, and via pressure line 2501, valve 2340 is operated to open venting device 2262 and thus allow these sleeves to release air through this vent, as shown. Figure 45B-ii As shown.

[0905] Figure 45D-iThe flow pattern is shown. A fork (cannula) 2200 flow is delivered to the patient. Initially, a high flow is delivered. Then, connector 2420 is inserted, and the bag 2406 is squeezed to create a positive bag flow and reduce the high flow. The fork flow is the total flow delivered to the patient as a combination of the high flow and the bag flow. These forks are inflated until full and then maintained at a constant inflation level (preventing deflation via a check valve). When the bag flow is stopped, the high flow is increased again. When the bag flow stops and a high flow is delivered, these forks are deflated.

[0906] As an additional option, an inflatable mouth insert can be attached to the nose fork 2208. This can be useful for mouth respirators to prevent pressure loss when they open the mouth during breathing support.

[0907] Even when using the bag on a patient, a minimum high-flow-rate gas supply is maintained to ensure PEEP (positive end-expiratory pressure) delivery. This ensures that the patient always receives a certain level of positive pressure, which helps prevent atelectasis. Figure 45D-ii The waveform is shown when at least a low level of HFG is maintained at all times. Figure 44C The valve in the middle only partially blocks HFG.

[0908] If a user wants to administer a volatile medication to a patient, a high-flow delivery will affect the concentration, requiring dilution and the addition of additional medication to achieve the correct concentration. This can be expensive. In an alternative embodiment, the high-flow gas supply can be completely blocked when the bag loop connector 2420 is inserted. In this case, there will be no hole on the right-hand side of the connector, as... Figure 45E As shown. This means that when connected, ventilation is provided solely from bag 2406, which is controlled by the clinician. This may be more intuitive for clinicians who know when the bag, as the sole source of ventilation, is connected and will not provide a high flow rate.

[0909] If the fork 2208 is not sealed throughout the entire breathing cycle, volatile agents may still leak into the atmosphere, which is undesirable. When a hood is used in existing technology systems, volatiles can recirculate through a closed (sealed) system.

[0910] Figure 45B-iii and Figure 45B-iv A possible embodiment is shown in which the sleeve gas supply includes a check valve 2261 that opens upon high-flow activation. Here, once gas flows into the sleeve 2260, it cannot escape again. This maintains sleeve inflation after the bag 2406 has been initially compressed. When the high flow is blocked, i.e., when using... Figure 45EIn the embodiment of connector 2420, it is safe because the patient's exhaled air can return to the bag 2406 / anesthesia machine 2404. The clinician can control this, and the risk of overinflation is limited. Returning exhaled air to the machine 2404 helps conserve medication, saves money, and thus prevents potentially dangerous delivery of medication to the room. The cannula 2260 will remain inflated via check valve 2261 unless actively deflated, for example, via user-actuable release valve 2262 shown on the left-hand side of check valve 2261. This can be actuated by the user pressing down a portion of valve 2262 to release the pressure inflating these cannulas. Alternatively, this release valve 2262 can be connected to the bag tubing connector 2420 so that the valve is released when the bag tubing is disconnected from the system. Maintaining the cannula seal also means that the clinician has complete control over the patient's breathing throughout the cycle.

[0911] Figure 45F The flow pattern for this is shown. Once connector 2420 is inserted and HFG is blocked, the high flow rate drops to zero. The fork flow rate is the final flow rate delivered to the patient.

[0912] Even when bag 2406 is connected, the APL valve can still be set by the user to control pressure release. If these forks are inflated / sealed, excess pressure delivery will be released via the APL. If these forks are deflated due to the lack of connection to bag 2406, the risk of barotrauma is limited. If these forks are deflated while connected to the bag but during unsealed exhalation, minimal pressure will be delivered to the anesthesia machine, but again, the risk of barotrauma is limited because these forks are deflated.

[0913] The advantages of switching to configuration 3 include one or more of the following:

[0914] ●No shield - Only cannulation interface:

[0915] ● No need to change the interface on the patient.

[0916] ● There are no difficulties in achieving a good seal.

[0917] ● More comfortable intubation - increases patient tolerance

[0918] ● When using the bag, the system automatically discharges high flow – no manual on / off switching of high flow is required from the user.

[0919] ● When using the bag, the fork can remain sealed throughout the entire breathing cycle. Volatile medications will return to the anesthesia machine, thus conserving medication and preventing them from escaping into the room.

[0920] ● Improved visibility of the patient's airway and the user does not need to keep the mask on the patient.

[0921] In some embodiments, a switching configuration (switching configuration 4) includes a respiratory therapy system, the respiratory therapy system comprising:

[0922] An intubation circuit for delivering a high-flow-rate gas to a patient via an intubation tube;

[0923] A bag circuit that allows a user to manually deliver gas to a patient via an actuated bag, the bag circuit being in fluid communication with the cannulation circuit; and

[0924] A valve is configured to allow a high flow rate of gas to be delivered to the cannula when the bag is not actuated, and to allow gas to be delivered from the bag circuit to the sleeve when the bag is actuated.

[0925] This configuration additionally or alternatively includes a nasal cannula for delivering gas to a patient, the cannula including at least one fork received in the patient's nostril, the cannula including one or more inflatable sleeves associated with the one or more forks to assist in creating a seal in one or more of the patient's nostrils.

[0926] See Figure 46A A bag circuit 2412, including bag 2406, is permanently connected to a high-flow cannula circuit 2202. A valve system 2470 controls whether flow is delivered from a high-flow source 2124 or from bag 2406 / anesthesia machine 2404. When bag 2406 is actuated by compression, the flow from the bag actuates the switching between support. The bag acts as the master controller. If the bag is actuated, bag ventilation is the primary respiratory support. If the bag is not used, a high flow is delivered to cannula 2200. Much of the description above of the previous configuration also applies to this configuration.

[0927] See Figure 46B This typically delivers a high flow rate to the patient (when bag 406 is not squeezed). When the bag is squeezed, this closes valve 2470, which may be... Figure 45C-i or Figure 45C-ii The type shown. This blocks or at least reduces the high flow rate of gas supplied to the patient. This allows gas to be delivered to the patient only from bag 2406 (the bag gas can also be inflated to the fork opening, as described above). Squeezing the bag also delivers gas to gas reservoir 2472 (in Figure 46A In the diagram, the gas reservoir is shown below the valve.

[0928] The reservoir 2472 has a check valve 2473, allowing it to be filled from the bottom by bag flow (BF), but flow can only exit from the top orifice 2474. The reservoir can be made of a rigid or alternatively expandable material that increases in size to accommodate more air as BF flows. The orifice has a constrained opening to control the rate of gas leakage. When the bag 2406 is released / depressed, flow is no longer delivered from the bag, and the patient is able to exhale passively. During this time, the flow reservoir 2472 begins to discharge, and the flow from the reservoir 2472 continues to keep valve 2470 closed, thus blocking the high-flow-rate gas source. The size of orifice 2474 can be determined such that when the reservoir 2472 is full, it takes approximately the time of one exhalation (e.g., 3 seconds) to empty. Therefore, valve 2470 also remains closed throughout the exhalation process. Alternatively, valve 2470 can be activated by a controller to hold the valve for a period of time, such as the duration of exhalation. The reservoir 2472 can also be connected to the fork openings 2260 to provide flow to these openings during exhalation and to keep them inflated throughout the respiratory cycle. This means that the patient's expiratory flow will be returned to the tubing leading to the bag / anesthesia machine.

[0929] If bag 2402 is not squeezed after this period, this indicates that the clinician has completed the bag administration to the patient. Reservoir 2472 will be emptied, allowing high-flow gas valve 2470 to open and the fork openings to release gas, after which high-flow gas will resume flow (see [link]). Figure 46B (See the ★ above). If you restart using the bag, the high flow will be blocked again.

[0930] While the patient is being treated with the bag, the system blocks high flow rates throughout the breathing process while maintaining a seal at the interfaces. Therefore, the clinician has control over the gases delivered to the patient during this time and can also precisely control the delivery of volatile medications. If these forks remain sealed throughout the exhalation process, all exhaled flow returns to the anesthesia machine. This means that volatile medications are returned to the anesthesia machine, conserving medication and preventing them from escaping into the room.

[0931] Similarly, when bag 2406 is used, the user can still set APL valve 2410 to control the main pressure release. If the bag is not used, the forks will release air, thus limiting the risk of barotrauma.

[0932] The advantages of switching configuration 4 include:

[0933] ●Integrated design - Faster, user-input-free switching between systems (no need to insert pipes).

[0934] ● Automatically switches between treatments when the bag is squeezed.

[0935] ●When using bags, the system automatically discharges high flow rates.

[0936] ● No need for users to manually turn high traffic on / off.

[0937] ● When using a bag, the fork can remain sealed throughout the entire breathing cycle.

[0938] ● Volatile drugs will be returned to the anesthesia machine, thus conserving drugs and preventing them from escaping into the room.

[0939] ● The fork-shaped port automatically releases at the end of exhalation; no cover - only the intubation interface.

[0940] One or more of the advantages of the switching configurations include one or more of the following:

[0941] ● Allows easy switching of high traffic on / off

[0942] ● When turned on, the flow rate immediately increases to a preset value, thus preventing treatment delays (e.g., in emergency situations).

[0943] ● The switching mechanism allows for a rapid reduction of high flow / pressure when shutting down.

[0944] ●Stop flow and humidity when not needed to save gas and electricity.

[0945] ● Allows cannulas / interfaces to remain in place.

[0946] ● Partially blocking the high-flow-rate gas supply means that a minimum flow rate can still be delivered to the patient. This can be useful for ensuring that PEEP (positive end-expiratory pressure) is properly delivered at the end of expiration. Current manual bag-mask ventilation strategies from anesthesia machines cannot deliver PEEP at that final point.

[0947] ●Easy to switch between multiple breathing systems (high flow and bag-mask ventilation)

[0948] ● Allows users to have control over ventilation and drug delivery of the hermetically sealed interface in accordance with their existing practices.

[0949] ● Control the seal of the interface to allow exhalation during high-flow delivery.

[0950] ●No shield - Only cannulation interface:

[0951] ○Simpler / Easier, no need to change the interface on the patient

[0952] There are no difficulties in achieving a good seal.

[0953] ○ Intubation is more comfortable than a cannula - increasing patient tolerance.

[0954] Function 2 - Conscious / Pneumoaperosis Treatment Settings

[0955] ● Clinicians must manually adjust respiratory support settings as the patient's condition changes.

[0956] ● The existing interface does not allow for use throughout the intubation procedure, therefore it typically does not provide support during intubation attempts during periods of apnea.

[0957] ●Minimum ventilation support can be provided after extubation.

[0958] Current respiratory support systems cannot automatically change the support type when spontaneous breathing or apnea is detected. This is because clinicians typically change or remove the interface at this point.

[0959] The goal would be to provide different treatment settings while the patient is conscious and then once the patient falls into apnea.

[0960] A respiratory therapy system suitable for use in conscious / apnea treatment settings, the respiratory therapy system comprising:

[0961] A patient interface for delivering gas to a patient; and

[0962] A processor configured to control the flow of gas through the patient interface during spontaneous breathing in order to deliver gas to the patient at a first flow rate and / or pressure, and configured to deliver gas to the patient at a second flow rate and / or pressure when the patient is not breathing spontaneously.

[0963] The system can be configured to detect the presence of apnea and to deliver gas at the second flow rate and / or pressure in response to the detection of apnea. The system can also be configured to detect the presence of apnea based on a decrease in brain activity signals, diaphragm signals, airway pressure, or CO2 measurements.

[0964] The first flow rate and / or pressure may include a relatively low flow rate and / or pressure, and the second flow rate and / or pressure may include a relatively high flow rate and / or pressure.

[0965] The processor may be a controller 108, or any other suitable type of processor. The processor may be a remote processor.

[0966] Figure 65a Several exemplary steps can be performed using methods and systems with this configuration.

[0967] This method and configuration can have one or more of the following characteristics:

[0968] The treatment can be switched between a low flow / low pressure setting when the patient is awake and a high flow / pressure setting when the patient is asleep. For example, delivering 30-40 LPM (or a flow rate that may meet inspiratory needs) during spontaneous breathing, increasing to 70 LPM for oxygenation in response to apnea.

[0969] • The presence of sleep apnea can be based on a decrease in brain signaling (EEG) activity, diaphragm signaling (EMG), airway pressure, or CO2 measurements:

[0970] ○EEG: The medulla oblongata of the brainstem includes inspiratory centers composed of neurons that send signals to the diaphragm and external intercostal muscles. EEG sensors on the scalp can monitor activity in the medulla oblongata to detect when inspiratory signals are being sent or cease to be sent. Alternatively, frequency analysis can be used to detect changes in certain EEG frequencies. For example, delta waves have a 0.5–4 Hz band with amplitudes of 20–400 μV and are encountered in cases of very low brain activity (e.g., during general anesthesia). An increase in the amplitude or presence of the delta band can indicate that anesthesia has taken effect and that respiratory apnea has therefore begun.

[0971] ○EMG: Respiratory muscle EMG signal. (e.g., via an Edi probe down the airway, or an EMG sensor placed on the diaphragm or intercostal muscles). Spontaneous inspiration creates negative lung pressure and generates a positive electrical signal as the respiratory muscles move. Regular EMG fluctuations can indicate respiration. A decrease in EMG fluctuations can indicate that anesthesia has taken effect and respiratory arrest has begun.

[0972] ○ Airway pressure measurement: for example, via patient interface 200. Figure 65b This illustrates an example of how pressure line 280 can be integrated with cannula 200. Regular pressure fluctuations indicate respiration. Figure 65c Possible flow patterns are shown. The flow delivered during spontaneous breathing can fluctuate to meet the patient's inspiratory needs and deliver only a basic level of flow during expiration to provide PEEP, or other desired flow characteristics, or a constant flow, such as 30 L / min, can be delivered during spontaneous breathing. A decrease in fluctuation indicates apnea when anesthesia takes effect. At this point, the flow increases.

[0973] ○CO2 measurement: For example, via end-expiratory monitoring. Similar to the airway pressure method, fluctuations indicate breathing, and relative stability in the recording indicates apnea.

[0974] ●as Figure 65c As shown, after a decrease in breathing is detected before treatment change, there may be a suitable 'waiting period' or delay (e.g., 5 seconds).

[0975] ●Alternatively, for patients at risk of inspiratory apnea, the treatment may instead reduce delivery pressure at the onset of apnea to mitigate the risk of regurgitation (e.g., during rapid sequence induction). In this case, the flow rate may be reduced or maintained at a low level during apnea, and oxygen concentration may instead be maximized.

[0976] Similarly, when spontaneous breathing is detected to have resumed at the end of anesthesia, therapeutic changes may occur, such as an increase or decrease in flow rate or pressure. Once the apnea has resolved and spontaneous breathing is detected, the flow rate and / or pressure can be adjusted back to the initial flow rate and / or pressure, or adjusted to a different flow rate and / or pressure than during the apnea, for example, considering the following factors:

[0977] It is known that respiratory function can be challenging postoperatively in many patients. For example, obese patients may experience a rapid deterioration in gas exchange after extubation for the same reasons that occur preoperatively. Reduced inflatable lung volume due to atelectasis, small airway narrowing, and difficulty in moving airway secretions can lead to so-called postoperative pulmonary restriction syndrome, resulting in hypoxemia.

[0978] Furthermore, after a period of mechanical ventilation, the threshold for spontaneous ventilation recovery stimulated by PaCO2 increases, thus delaying the recovery of spontaneous ventilation. Moreover, in response to acidosis, the ventilatory response is sluggish, thereby reducing the patient's compensatory capacity. Anesthetic drugs also reduce the normal protective response to hypoxia, even at low concentrations of volatile drugs. Therefore, because low concentrations of volatile drugs can persist for several hours postoperatively, patients may remain at risk of hypoxemia.

[0979] Once spontaneous breathing has been restored, postanesthesia delivery of high-flow-rate and / or high-concentration oxygen can help reduce the work of breathing, increase arterial oxygenation, and compensate for reduced respiratory drive that may persist into the postanesthesia period. See also Figure 65d .

[0980] Any change in flow / pressure can follow a ramp-up rather than a step-up, such as Figure 65d As shown.

[0981] The advantages of this conscious / apnea therapy setting feature include one or more of the following:

[0982] ● Improves patient comfort and tolerance during conscious treatment, and thus improves treatment outcomes because treatment can be delivered continuously. Additional pressure support may not be required, as the patient's respiratory dynamics will function normally.

[0983] ●Additional therapeutic support is provided once the patient is unconscious, which is useful when the patient's respiratory drive weakens during apnea. It also helps to increase oxygenation before attempting intubation.

[0984] ● Increased oxygenation during sleep apnea should begin automatically as quickly as possible, rather than waiting for the user to initiate it. Maximize the oxygenation period before intubation.

[0985] Function 3 - Compensate for suction effect

[0986] Clinicians typically perform suctioning in the patient's airway immediately before intubation to remove secretions, improve visibility, and reduce the risk of inspiration. If the patient has just undergone a pre-oxygenation period, this suctioning may be effective in removing oxygen-rich gas from the airway, thus reducing their oxygen reserves. Current respiratory support systems do not automatically compensate for the effects of suctioning.

[0987] A suitable respiratory therapy system for compensating for suction effects includes:

[0988] Patient interface for delivering gas to a patient;

[0989] Sensors, the sensors being arranged to sense pressure fluctuations in the patient interface or in a catheter in fluid communication with the patient interface; and

[0990] A processor configured to adjust the gas flow to the patient interface to deliver gas to the patient interface at an increased flow rate if a decrease in airway pressure is sensed.

[0991] The processor can be configured to adjust the gas flow to the patient interface to deliver gas to the patient interface at an increased flow rate if it is determined that a decrease in airway pressure is occurring during and / or after apnea, or at any other time when the patient’s breathing pattern is considered not to be a natural breathing pattern.

[0992] The processor may be a controller 108, or any other suitable type of processor. The processor may be a remote processor.

[0993] Figure 66a Several exemplary steps can be performed using methods and systems with this configuration.

[0994] This method and configuration can have one or more of the following characteristics:

[0995] The patient interface (e.g., cannula 200) has a pressure sensor 280 located thereon, which is arranged to sense or detect airway pressure fluctuations in the patient interface or in a catheter in fluid communication with the patient interface. The pressure sensor 280 may alternatively be located on the catheter rather than on the cannula itself. Once apnea has been detected as having begun (using one of the methods described in the preceding sections), a decrease in airway pressure should indicate a decrease in pressure due to spontaneous breathing or suction. If this is detected immediately after apnea, it is most likely due to suction. At this point, the delivered flow rate and / or oxygen concentration can be relatively increased (e.g., to 70 LPM 100% oxygen) to compensate for the oxygen removed by suction. Figure 66b The illustration shows the patient initially breathing spontaneously at a set delivery flow rate. Once breathing is suppressed (apnea occurs), the delivered flow rate increases. Pressure sensor 280 records this increase as indicated by P1. After a short time, the pressure begins to decrease. Although the flow rate increases, the pressure may become negative if a large suction pressure is used. This is a strong indication that the suction is being used. The flow rate then increases again to compensate, and P1 returns to a higher level. Alternatively, the delivered flow rate can be increased proportionally to the decrease in airway pressure (i.e., the greater the suction, the greater the compensation). Alternatively, a signal from the suction device can be used to increase the flow rate at a high velocity when suction is initiated.

[0996] The advantages of the suction compensation configuration include:

[0997] ● Minimize the impact of aspiration on the patient's oxygen reserves.

[0998] ●Oxygenation is automatically increased upon detection of aspiration, instead of waiting for the user to initiate it. Maximize oxygenation before intubation.

[0999] Function 4 - Facilitates continued treatment during transport

[1000] ● Minimal ventilation support may be considered during transport, as current high-flow systems are not easily transportable. Instead, a low-flow oxygen cannula attached to a barb on an oxygen cylinder is typically used. As described above, patients are at risk of respiratory distress after anesthesia, and low-flow oxygen may not be sufficient to support them.

[1001] ● Current high-flow systems cannot be directly connected to flow meters, such as those on oxygen cylinders. They may be able to be connected via another tube and a humidifier, but this can be considered cumbersome and requires transporting the humidifier along with the patient.

[1002] ● After being transported to the rehabilitation ward, caregivers may continue to use a low flow rate because they may not want to change the connection again, and this is often done via a barbed connection to the flow meter wall. This may again provide insufficient respiratory support.

[1003] A suitable configuration for facilitating continued treatment during transport includes a patient interface for use in a respiratory therapy system, the patient interface comprising:

[1004] Intubation tubes used to deliver gas to patients;

[1005] A connector portion, which is in fluid communication with the cannula and is configured to removably connect the cannula to a complementary connector portion on the main gas conduit for delivering a high flow rate of gas to the cannula;

[1006] And a secondary conduit in fluid communication with the cannula, the secondary conduit being configured to provide fluid communication between the cannula and an alternative gas source.

[1007] The connector portion that is in fluid communication with the cannula can be configured to seal when the connector portion is disconnected from the complementary connector portion on the main gas conduit.

[1008] This configuration advantageously provides a direct connection between the high-flow interface and the barb on the flow meter. Because transport may be short and therefore the impact of humidity loss on the patient's condition is negligible, a humidifier is not required.

[1009] See Figure 67a High-flow-rate gas (HFG) is typically delivered via the main gas conduit 204. When transporting a patient, the intubation conduit 202 is disconnected from the main gas conduit 204, and a secondary conduit 280 is connected to the gas supply. The secondary conduit may be, for example, a tubing. Figure 67b The connection between the cannula 202 and the main gas conduit 204 is shown. The main gas conduit 204 and the conduit 202 coupled to the cannula have complementary connector portions 202a and 204a. When disconnected, these two connector portions 202a and 204a are sealed. Upon disconnection, the gas supply can be returned to the high-flow gas source, or there can be some control to shut off the high flow. When connector portions 202a and 204a are engaged, the cannula connector 202a forces open the gas conduit valve 204b, and the gas flow through the gas conduit 204 opens the valve 202b on the cannula connector.

[1010] Figure 67d and 67e The valve at the end of the secondary gas conduit 280 is shown. Figure 67dIn the middle, the single-sided valve 282 is forced to open by the gas supply hook 284 entering the connection part. Figure 67e A duckbill valve 286 is shown. When the main gas conduit is connected, both are naturally kept closed by the gas supply.

[1011] Alternatively, Figure 67f A cover 288 is shown that can be used to seal the end of the secondary pipe and can be removed when the user wants to connect it to the gas supply.

[1012] While the collapsible catheter or other switching methods described above may be useful options for blocking or preventing gas from flowing into the patient interface (e.g., using, being positioned to contact, or being attachable to or mountable to the patient, such as collapsible barriers or pads), if gas continues to flow into the collapsed catheter leading to the nasal cannula, pressure may build up in the catheter, and eventually the catheter may burst, or gas may be forced through the collapsed portion of the catheter and into the nasal cannula. This could create undesirable pressure in the patient's lungs or airway.

[1013] As described above, the system can be equipped with pressure relief devices to avoid these problems. However, in addition to or as an alternative to the embodiments described above, a mask detection arrangement can be particularly useful. For example, when using a patient interface to deliver a gas flow to a patient's airway, caution may be required when utilizing two routes to the patient's airway. For example, the likelihood of overpressure situations may increase when using a nasal cannula to deliver a gas flow to the nasal passage and using a mask to deliver a ...

Claims

1. A respiratory therapy system, the respiratory therapy system comprising: A first patient interface for delivering a first gas flow to a patient, and A second patient interface for delivering a second gas flow to the patient. The sensor is associated with one or more of the following: -The first patient interface, -The second patient interface, - Both the first patient interface and the second patient interface - Objects associated with the first patient interface, - Objects associated with the second patient interface, - Objects associated with both the first patient interface and the second patient interface. - Objects associated with the patient, and in The sensor senses the presence or placement of the first patient interface and the second patient interface combined on the patient and generates a sensor signal. - In response to the sensor signal, the respiratory therapy system controls the first gas flow provided to the first patient interface.

2. The respiratory therapy system according to claim 1, wherein, The first patient interface includes one or a pair of first patient interface outlets for directing a first gas flow to the patient's nose.

3. The respiratory therapy system according to claim 1, wherein, The first patient interface is an unsealed interface type.

4. The respiratory therapy system according to claim 1, wherein, The first patient interface does not form a seal with one or more nostrils of the patient's nose.

5. The respiratory therapy system according to claim 1, wherein, The first patient interface is a sealed interface.

6. The respiratory therapy system according to claim 1, wherein, The first patient interface forms a seal with one or more nostrils of the patient's nose.

7. The respiratory therapy system according to claim 1, wherein, The first gas flow has a first velocity and / or pressure.

8. The respiratory therapy system according to claim 1, wherein, The percentage of oxygen in the first gas stream delivered is between 50% and 100%.

9. The respiratory therapy system according to claim 1, wherein, The first patient interface includes a face mounting portion and a pair of side arms extending from the face mounting portion.

10. The respiratory therapy system according to claim 9, wherein, The side arm is configured to assist in positioning the face mount or the first patient interface onto the patient.

11. The respiratory therapy system according to claim 10, wherein, The side arm includes a connection system for connecting to a headgear or a face-mounted connection system.

12. The respiratory therapy system according to claim 11, wherein, The connection system is a releasable or reusable connection system.

13. The respiratory therapy system according to claim 2, wherein, The first patient interface includes a removable manifold portion and a face mounting portion.

14. The respiratory therapy system according to claim 13, wherein, When attached to the face mounting portion, the removable manifold portion provides fluid connection between the one or a pair of first patient interface outlets and a gas source.

15. The respiratory therapy system according to claim 14, wherein, The removable manifold portion is configured to be attachable to the face mount portion from the left or right side of the first patient interface.

16. The respiratory therapy system according to claim 1, wherein, The first patient interface is a nasal cannula.

17. The respiratory therapy system according to claim 1, wherein, The second patient interface includes at least one second patient interface outlet for directing a second gas flow to the patient's airway.

18. The respiratory therapy system according to claim 1, wherein, The second patient interface is a sealed interface.

19. The respiratory therapy system according to claim 1, wherein, The second patient interface is a sealed interface, wherein when the second patient interface is placed on the patient, it creates a seal with the patient's face.

20. The respiratory therapy system according to claim 1, wherein, The second gas flow has a second pressure.

21. The respiratory therapy system according to claim 1, wherein, The percentage of oxygen in the gas delivered in the second gas stream is between 20% and 100%, or between 30% and 100%, or between 40% and 100%, or between 50% and 100%, or between 60% and 100%, or between 70% and 100%, or between 80% and 100%, or between 90% and 100%, or 100%.

22. The respiratory therapy system according to claim 1, wherein, The second patient interface includes a body with a sealing portion that engages or seals with the patient when placed on the patient.

23. The respiratory therapy system according to claim 1, wherein, The second patient interface is a handheld patient interface.

24. The respiratory therapy system according to claim 1, wherein, The second patient interface is a cover.

25. The respiratory therapy system according to claim 24, wherein, The mask is one of the following: a nasal mask, a face mask, a mouth and nose mask, a full-face mask, a nasal pillow mask, a tube inside the trachea, a combination of these, or some other gas delivery system that provides a second gas flow to the patient.

26. The respiratory therapy system according to claim 1, wherein, The object is a barrier or mounting that comes into contact with, or is to be placed in contact with, the patient's face, the barrier or mounting including at least one cavity through which a gas supply conduit passes, or for creating a connection of the gas supply conduit at each end of the cavity, wherein the supplied gas fluid is connected to the first patient interface.

27. The respiratory therapy system according to claim 1, wherein, The object co-positions at least one gas supply conduit to supply gas to the first patient interface.

28. The respiratory therapy system according to claim 27, wherein, The at least one gas supply conduit extends through or through the body of the object.

29. The respiratory therapy system according to claim 27, wherein, The at least one gas supply conduit is a component that extends through the object and is sealed and engaged by the object.

30. The respiratory therapy system according to claim 26, wherein, A gas supply conduit can be received through the inner cavity of the object.

31. The respiratory therapy system according to claim 26, wherein, A fluid passage is formed through the inner cavity of the object to deliver gas to the first patient interface.

32. The respiratory therapy system according to claim 1, wherein, The object includes compressible portions or portions that can be flattened or deformed under applied force or pressure.

33. The respiratory therapy system according to claim 32, wherein, At least one cavity is located within a compressible portion or a portion that can be flattened or deformed.

34. The respiratory therapy system according to claim 32, wherein, The compressible portion is made of polymer or silicone.

35. The respiratory therapy system according to claim 32, wherein, The lumen and / or conduit located within the compressible portion or the portion that can be flattened or deformed are compressed or deformed to block or obstruct or partially block the first gas flow from being supplied to the first patient interface.

36. The respiratory therapy system according to claim 1, wherein, The object is an integral part of the side arm of the first patient interface.

37. The respiratory therapy system according to claim 1, wherein, The object can be removably attached to the supply catheter leading to the first patient interface.

38. The respiratory therapy system according to claim 1, wherein, The object can be removably attached to the side arm of the first patient interface.

39. The respiratory therapy system according to claim 1, wherein, The object is a separate component that can be positioned independently or located on the patient.

40. The respiratory therapy system according to claim 1, wherein, The object is a gas conduit fluidly connected to a first patient interface or a second patient interface, or a gas conduit fluidly connected to each of the first patient interface and the second patient interface.

41. The respiratory therapy system according to claim 1, wherein, The object is a patch, pad, or wearable device that can be attached to or located on a patient for sensing the placement of a combination of a first patient interface and a second patient interface on the patient during gas delivery, wherein such sensing combination generates a signal or output.

42. The respiratory therapy system according to claim 1, wherein, The sensor signal is fed to or activates or controls one or more of the following respiratory therapy system outcomes: Visual alarms or warnings Sound alarm or warning Tactile or haptic feedback fed or directed to wearable electronic devices A flow controller, comprising a flow valve or flow generator, is used to control a first gas flow directed to a first patient interface. Pressure regulator or pressure control device A deflector, used to redirect the first gas flow to be controlled toward the vent. A microprocessor associated with the flow controller or the pressure regulator, or both. Graphical User Interface (GUI).

43. The respiratory therapy system according to claim 1, wherein, The sensed combined sensor signals provide control over the flow rate or pressure of the first gas flow directed to the first patient interface.

44. The respiratory therapy system according to claim 41, wherein, The wearable device is selected from one or more of the following: a watch, a telephone, a head-mounted display, or other clothing incorporating such a wearable device.

45. The respiratory therapy system according to claim 1, wherein, In response to the sensor signal, the respiratory therapy system controls a flow controller, which is a flow valve or a flow generator.

46. ​​The respiratory therapy system according to claim 45, wherein, The flow controller is used to control the first gas flow directed to the first patient interface.

47. The respiratory therapy system according to claim 45, wherein, The flow controller is used to control the second gas flow directed to the second patient interface.

48. The respiratory therapy system according to claim 45, wherein, The flow controller is used to control the first gas flow directed to the first patient interface and the second gas flow directed to the second patient interface.

49. The respiratory therapy system according to claim 1, wherein, The sensor uses one of the following or a combination of the following in terms of sensing combinations: Optical sensors Acoustic sensors, A pressure or flow sensor that measures the pressure or flow rate of gas supplied to a supply conduit for a first patient interface or a second patient interface, or both the first and second patient interfaces; or measures the pressure or flow rate of gas delivered to or a portion thereof to a patient's respiratory system. Conductive or resistive electrodes embedded in or placed on one or more of the following: -The first patient interface, -or the second patient interface, -Or both the first patient interface and the second patient interface. -Or an object associated with the first patient interface, or the second patient interface, or both the first patient interface and the second patient interface. - or objects associated with the patient, A radio frequency or proximity sensing sensor is placed on the patient, combining the first and second patient interfaces. Mechanically activated or triggered sensors.

50. The respiratory therapy system according to claim 49, wherein, The mechanically activated or triggered sensor is selected from: a mechanical switch that is activated or triggered by pressing or placing it into contact with another surface; a pressure relief valve or a pressure-sensitive valve; a solenoid valve; or a mechanical valve having a predetermined spring constant.

51. The respiratory therapy system according to claim 1, wherein, The sensor is located on or within the first patient interface, or the second patient interface, or both the first patient interface and the second patient interface, and the sensor senses: The presence or placement of the first patient interface on the patient's face and the subsequent placement or presence of the second patient interface in combination with it on the patient.

52. The respiratory therapy system according to claim 1, wherein, The sensor is located on or inside the first patient interface.

53. The respiratory therapy system according to claim 1, wherein, The sensor is located on or inside the second patient interface.

54. The respiratory therapy system according to claim 1, wherein, The sensor used is one or more of the following: optical sensor, acoustic sensor, mechanically activated or triggered sensor.

55. The respiratory therapy system according to claim 54, wherein, The acoustic sensor includes a transmitter and a receiver, wherein the transmitter transmits a predetermined code and the receiver receives and detects the predetermined code.

56. The respiratory therapy system according to claim 55, wherein, The transmitter sends an acoustic signal, and if the second patient interface is present, the acoustic signal is reflected back to a receiver located near the transmitter.

57. The respiratory therapy system according to claim 56, wherein, The transmitter and receiver are located on or within the first patient interface and reflect the acoustic signal through the second patient interface.

58. The respiratory therapy system according to claim 56, wherein, The transmitter and receiver are located on or within the second patient interface and reflect the acoustic signal through the patient's face or the first patient interface.

59. The respiratory therapy system according to claim 54, wherein, An optical sensor includes a transmitter and a receiver, wherein the transmitter transmits a predetermined code and the receiver receives and detects the predetermined code.

60. The respiratory therapy system according to claim 59, wherein, The transmitter and receiver are located on or within the first patient interface and reflect signals through the second patient interface.

61. The respiratory therapy system according to claim 59, wherein, The transmitter and receiver are located on or within the second patient interface and reflect signals through the patient's face or the second patient interface.

62. The respiratory therapy system according to claim 1, wherein, The sensor senses the placement of the first patient interface and the second patient interface combined on the patient and controls the first gas flow to the first patient interface.

63. The respiratory therapy system according to claim 1, wherein, In response to a sensor signal corresponding to the placement of the first patient interface and the second patient interface on the patient, the supply of the first gas flow to the first patient interface is terminated or stopped.

64. The respiratory therapy system according to claim 1, wherein, The sensor senses the patient's face, or the first patient interface, or both the patient's face and the first patient interface, and uses the sensor to control the first gas flow to the first patient interface or to generate a signal or output to control or regulate the first gas flow to the first patient interface or to generate an alarm or warning.

65. The respiratory therapy system according to claim 1, wherein, The sensor is located on or embedded in an object that is in contact with the patient's face, or is a barrier or mount to be placed in contact with the patient's face, the barrier or mount including at least one cavity through which a gas supply conduit is allowed to pass, or to create a connection of the gas supply conduit at each end of the cavity, wherein the supplied gas is fluidly connected to the first patient interface.

66. The respiratory therapy system according to claim 1, wherein, The second patient interface is placed in contact with the object, and a sensor located or embedded in the object senses the presence of the second patient interface and generates a signal or output.

67. The respiratory therapy system according to claim 1, wherein, The sensor is a pressure-sensitive switch or sensing system that senses an increase in pressure when the second patient interface is placed in contact with the first patient interface or object.

68. The respiratory therapy system according to claim 67, wherein, The pressure-sensitive switch or sensing system includes a pressure sensor inside a gas-filled chamber within the object, and a flexible membrane or pressure-sensitive membrane that, when provided for use with a patient, serves as a barrier or outer surface on which a second patient interface will be placed, thereby generating pressure changes within the gas-filled chamber.

69. The respiratory therapy system according to claim 68, wherein, Pressure changes within the gas-filled chamber are sensed by sensors, generating signals or outputs indicating the combined presence of the second patient interface and the object.

70. The respiratory therapy system according to claim 67, wherein, The pressure-sensitive switch or sensing system includes a pressure sensor, and placing the second patient interface on the patient causes a pressure change sensed by the pressure sensor and a sensor signal or output indicating the presence of the second patient interface on the patient.

71. The respiratory therapy system according to claim 1, wherein, The sensor is located on or embedded in the first patient interface.

72. The respiratory therapy system according to claim 1, wherein, The sensor uses one or more of the following: Acoustic sensing system, Beam sensing system.

73. The respiratory therapy system according to claim 1, wherein, The sensor is a temperature sensing system that senses temperature changes.

74. The respiratory therapy system according to claim 1, wherein, The object associated with the first patient interface, or the second patient interface, or both the first patient interface and the second patient interface, is a gas supply conduit.

75. The respiratory therapy system according to claim 1, wherein, The sensor associated with the object is an acoustic sensing system.

76. The respiratory therapy system according to claim 1, wherein, The sensor senses changes in parameters or characteristics of the object, which indicate an increase in pressure or a decrease in gas flow in or through the object.

77. The respiratory therapy system according to claim 76, wherein, The parameter or feature is a change in the shape of the gas supply conduit caused by one or more of the following: The pressure inside the gas supply conduit increases; The gas flow through the gas supply conduit is reduced; The gas supply conduit undergoes shape changes due to the application of external force or pressure.

78. The respiratory therapy system according to claim 77, wherein, The shape change is caused by the force or pressure applied to the patient via the second patient interface on the gas supply catheter, whether the force or pressure is applied directly or indirectly to the gas supply catheter.

79. The respiratory therapy system according to claim 76, wherein, The sensor includes an acoustic signal transmitter and an acoustic signal receiver, such that the transmitted acoustic signal is altered or modified by a change in the shape of the gas supply conduit, the change in shape of the gas supply conduit indicating an increase in pressure or a decrease in gas flow in or through the gas supply conduit.

80. The respiratory therapy system according to claim 77, wherein, The sensor detects reflected signals or changes in resonance.

81. The respiratory therapy system according to claim 77, wherein, The sensor detects reflected signals generated due to the closure of the gas supply conduit, or changes in the shape of the gas supply conduit or deviation from the predetermined operating range.

82. The respiratory therapy system according to claim 77, wherein, The sensor senses the resonant changes that occur when the gas supply conduit is closed, or when the shape of the gas supply conduit changes or deviates from the predetermined operating range, resulting in a standing wave waveform formed within the gas supply conduit.

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