Substance delivery device for a gas therapy device

Abstract

The present application relates to a substance delivery device for a gas therapy apparatus. A mount provides a structure that facilitates coupling of a nebulizer downstream of a humidifier chamber and upstream of a conduit that delivers treated breathing gas to a patient or user. The mount can couple the chamber, humidifier, and conduit together.

Description

[0001] This application is a divisional application of the invention patent application 201580073012.X filed on 25 November 2015, entitled "Substance delivery device for a gas therapy apparatus".

[0002] By reference incorporated

[0003] Any and all applications for foreign or domestic priority to be filed with the instant application are incorporated herein by reference under 37 CFR 1.57. This application claims the priority benefit of U.S. Provisional Patent Application No. 62 / 084,359, filed November 25, 2014, which is incorporated herein by reference in its entirety.

[0004] In addition, WO 2012 / 164407, filed May 30, 2012, teaching several different smooth-bore conduit configurations and claiming priority from U.S. Provisional Patent Application No. 61 / 492,970, filed June 3, 2011, and U.S. Provisional Patent Application No. 61 / 610,109, filed March 13, 2012, are incorporated herein by reference in their entireties.

[0005] Further, PCT / NZ 2013 / 000222, filed December 4, 2013, teaching several different smooth-bore conduit configurations and claiming priority from U.S. Provisional Patent Application No. 61 / 733,360, filed December 4, 2012, U.S. Provisional Patent Application No. 61 / 733,359, filed December 4, 2012, U.S. Provisional Patent Application No. 61 / 877,622, filed September 13, 2013, U.S. Provisional Patent Application No. 61 / 877,566, filed September 13, 2013, U.S. Provisional Patent Application No. 61 / 877,784, filed September 13, 2013, and U.S. Provisional Patent Application No. 61 / 877,736, filed September 13, 2013, are incorporated herein by reference in their entireties. BACKGROUND TECHNICAL FIELD

[0006] The present disclosure relates generally to respiratory therapy. More particularly, the present disclosure relates to nebulizer configurations for use with respiratory therapy systems.

[0007] Description of the Related Art

[0008] Patients suffering from respiratory diseases, such as chronic obstructive pulmonary disease (COPD), can have difficulty breathing effectively. This difficulty can be the result of a variety of physiological problems, including weakened lung tissue, small airway dysfunction, excess mucus buildup, infection, genetic disorder, or cardiac insufficiency. In cases where such diseases are present, it is useful to provide the patient with a therapy that can improve the patient's ventilation. In some cases, the patient can be equipped with a respiratory therapy system that includes a gas source, an interface that can be used to deliver the gas to the patient's airway, and a conduit that extends between the gas source and the interface. The gas delivered from the gas source to the patient's airway can help to facilitate adequate ventilation of the patient. The gas source can be, for example, a container of air and / or another gas suitable for inhalation (e.g., oxygen or nitric oxide), a mechanical blower capable of propelling the gas through the conduit to the interface, or some combination of the above. The respiratory therapy system can include a gas humidifier that can humidify and heat the gas passing through the respiratory therapy system in order to improve patient comfort and / or improve the prognosis of the patient's respiratory disease. The gas humidifier can include a reservoir of water and a heating element for heating the water in the reservoir. As the water is heated and the temperature increases, water vapor is formed that can be drawn into the flow of gas passing through the gas humidifier.

[0009] It can be advantageous to use a nebulizer with a respiratory therapy system to deliver a medicinal substance to a patient's airway, for example, along with the delivery of breathing gas to the patient's airway. In some cases, the nebulizer can be actuated to propel a nebulized substance along a conduit that extends between a gas source and a patient interface. The flow passing from the gas source along the conduit to the patient interface can help to direct the substance to the patient's airway. However, the efficiency of the substance delivery can be less than desired. A significant portion of the dose of medicinal substance can, for example, adhere, settle, or become trapped on the interior walls of the conduit and not progress to the patient's airway, especially when moisture (e.g., introduced by a humidifier used with the respiratory therapy system) has deposited on the interior walls of the conduit. The reduced amount of substance delivered to the patient can reduce the efficacy of the therapy. SUMMARY

[0010] Certain features, aspects and advantages of at least one of the configurations disclosed herein include enabling the use of a heated, smooth-bore conduit to deliver breathing gas and a nebulized substance to a patient's airway. The smooth bore of the conduit can improve the efficiency of the substance transport by reducing the tendency of the substance to adhere or become trapped on the interior walls of the conduit. Furthermore, especially when a gas humidifier is used, the heat applied to the conduit can reduce the condensation of moisture along the interior walls of the conduit, which also reduces the tendency of the substance to fail to travel the length of the conduit to the interface. When the conduit is dry, the conduit is hydrophobic, but when the conduit becomes wet due to condensation, the conduit loses its hydrophobicity, making the conduit more prone to retain droplets of the substance on the walls of the conduit.

[0011] According to one aspect of the disclosure, there is provided a mounting configured for use within a respiratory system, the mounting being configured to bring together a chamber, a flow generating respiratory device, and a third component, the mounting comprising a conduit defining a tee port, the conduit being configured for connection to an outflow port of the chamber, and the conduit comprising an auxiliary port for interaction with flow passing through the conduit.

[0012] The auxiliary port can be configured for connection to at least one of a nebulizer, a sensor, and a tracer gas source.

[0013] The conduit can comprise an elbow.

[0014] The mounting can further comprise a second conduit, which can have an elbow and be configured for connection to an inflow port of the chamber.

[0015] The auxiliary port can receive a cap, which can form a removable sealed closure for the port.

[0016] The auxiliary port can be sized and configured to receive a nebulizer. The auxiliary port can be sized and configured to receive at least one of a sensor and a tracer gas source.

[0017] According to another aspect of the disclosure, there is provided a respiratory therapy system comprising: a flow generator adapted to deliver gas to a patient; a patient interface; a gas channel extending between the flow generator and the patient interface; and a nebulizer adapted to deliver a substance to at least a first portion of the gas channel, wherein at least a section of the gas channel at and / or downstream of the first portion comprises a smoothbore conduit.

[0018] A gas humidifier can be present at a point along the gas channel.

[0019] The first portion can be downstream of the gas humidifier.

[0020] The smoothbore conduit can comprise a conduit heater.

[0021] The conduit heater can be substantially outside a flow path of gas passing through the smoothbore conduit.

[0022] According to another aspect of the disclosure, there is provided a mount configured to couple a chamber to a gas generating respiratory device, the mount comprising a conduit configured to connect to one of an inlet port or an outlet port of the chamber, the conduit further comprising an auxiliary port such that the conduit comprises a tee port, the conduit having a flow inlet end and a flow outlet end, the auxiliary port positioned between the inlet end and the outlet end.

[0023] The conduit can be configured to connect to the outlet port of the chamber.

[0024] The conduit can comprise an elbow.

[0025] The mount can further comprise a second conduit configured to connect to the inlet port of the chamber.

[0026] The auxiliary port can receive a cap, which can form a removable sealed closure for the port.

[0027] The auxiliary port can be sized and configured to receive at least one of a nebulizer, a sensor, and a tracer gas source.

[0028] According to another aspect of the disclosure, there is provided a nebulizer mount configured to couple a chamber to a respiratory device, the nebulizer mount comprising an outflow conduit configured to connect a chamber rear port, a chamber outlet port, and a nebulizer port of the respiratory device.

[0029] The nebulizer mount can comprise a cap connected to the mount and configured to close the nebulizer port.

[0030] The nebulizer mount can further comprise an inflow conduit, which can be configured to connect a chamber front port and a chamber inlet port of the respiratory device.

[0031] A first end of the inflow conduit and a first end of the outflow conduit can be separated by a first distance between flow channel centers, and a second end of the inflow conduit and a second end of the outflow conduit can be separated by a second distance between flow channel centers, the second distance being greater than the first distance.

[0032] The outflow conduit and the inflow conduit can be integrated into a single structure.

[0033] A bridge can incorporate the outflow conduit and the inflow conduit.

[0034] The nebulizer mounting may also include an outflow collar defining at least a portion of a fitting configured to connect the outflow tubing to the rear port of the chamber, and a medical cone may be formed on the inner surface of the outflow collar.

[0035] The outflow collar may include a first axis, and the portion configured to connect to the chamber outlet port may include a second axis, the first axis and the second axis being substantially perpendicular to each other.

[0036] The outflow pipe may include a first part and a second part, the first part being connected to the second part via a bend.

[0037] The atomizer port can be aligned with the first part.

[0038] The atomizer port can be aligned with the second part.

[0039] The first part can extend vertically.

[0040] The second part can extend horizontally.

[0041] The second part may include a first collar positioned adjacent to a portion of the mounting that can be configured for connection to the rear port of the chamber, wherein the atomizer port may be surrounded by a second collar.

[0042] The first and second rings can be arranged at opposite ends of the second part of the outflow pipe. Attached Figure Description

[0043] Referring to the following figures, specific embodiments and modifications thereof will become apparent to those skilled in the art from the detailed description, in which:

[0044] Figure 1 A schematic diagram of a respiratory therapy system is shown.

[0045] Figure 2 This is a perspective view of a respiratory therapy system arranged and configured according to certain features, aspects, and advantages of this embodiment.

[0046] Figure 3 yes Figure 2 A magnified view of a part of the system.

[0047] Figure 4 yes Figure 2 A perspective view of the system, with the atomizer removed and the cap in place.

[0048] Figure 5 yes Figure 4 A magnified view of a part of the system.

[0049] Figures 6 to 13 is a view of a mounting arranged and configured in accordance with certain features, aspects, and advantages of the present embodiments, the mounting being in Figures 2 to 5 .

[0050] Figure 14 is a view of another respiratory therapy system having different mountings.

[0051] Figure 15 is another view of the system of Figure 14 , with the nebulizer removed.

[0052] Figure 16 is a cross-sectional view of a smooth-bore conduit.

[0053] Figure 17 is a cross-sectional view of a corrugated conduit. DETAILED DESCRIPTION

[0054] OVERALL SYSTEM

[0055] Referring to Figure 1 , a configuration of a respiratory therapy system 100 is shown. In the illustrated configuration, the respiratory therapy system 100 can include a flow generator 101.

[0056] The illustrated flow generator 101 includes a gas inlet 102 and a gas outlet 104. The flow generator 101 can also include a blower 106. The blower 106 can draw gas in from the gas inlet 102. In some configurations, the flow generator 101 can include a source or container of compressed gas (e.g., air, oxygen, etc.). The container can include a valve that can be adjusted to control the flow of gas out of the container. In some configurations, the flow generator 101 can use such a source of compressed gas and / or other gas sources in place of the blower 106. In some configurations, the blower 106 can be used in conjunction with another gas source. In some configurations, the blower 106 can include a motorized blower or can include a bellows device or some other structure capable of generating a flow of gas. In some configurations, the flow generator 101 draws atmospheric gas through the gas inlet 102. In some configurations, the flow generator 101 is adapted to draw atmospheric gas through the gas inlet 102 and is adapted to receive other gases (e.g., oxygen, nitric oxide, or carbon dioxide, etc.) through the same gas inlet 102 or a different gas inlet. Other configurations are possible.

[0057] The illustrated flow generator 101 includes a user control interface 108. The user control interface 108 can include one or more buttons, knobs, dials, switches, levers, touchscreens, speakers, displays, and / or other input or output modules that a user can use to input commands into the flow generator 101, to view data, and / or to control the operation of the flow generator 101 and / or other aspects of the respiratory therapy system 100.

[0058] The flow generator 101 can direct the gas through the gas outlet 104 to a first conduit 110. In the illustrated configuration, the first conduit 110 conducts the gas to a gas humidifier 112.

[0059] The gas humidifier 112 is used to entrain moisture in the gas in order to provide a flow of humidified gas. The illustrated gas humidifier 112 includes a humidifier inlet 116 and a humidifier outlet 118. The gas humidifier 112 can include, can be configured to hold, or can hold water or other humidification or hydration agents (hereinafter referred to as water).

[0060] In some configurations, the gas humidifier 112 includes a heating element (not shown). The heating element can be used to heat the water in the gas humidifier 112, to promote evaporation of the water and / or to entrain the water in the gas flow and / or to increase the temperature of the gas passing through the gas humidifier 112. The heating element may, for example, include a resistive metal heating plate. However, other heating elements are contemplated. For example, the heating element can include a plastic conductive heating plate or a chemical heating system with a controllable heat output.

[0061] In the illustrated configuration, the gas humidifier 112 includes a user control interface 120. The user control interface 120 includes one or more buttons, knobs, dials, switches, levers, touchscreens, speakers, displays, and / or other input or output modules that a user can use to input commands into the gas humidifier 112, to view data, and / or to control the operation of the gas humidifier 112 and / or other aspects of the respiratory therapy system 100.

[0062] In some configurations, the flow generator 101 and the gas humidifier 112 can share a housing 126. In some configurations, the gas humidifier 112 can share only a portion of the housing 126 with the flow generator 101. Other configurations are possible.

[0063] In the illustrated configuration, the gas travels from the humidifier outlet 118 to a second conduit 122. The second conduit 122 can include a conduit heater (see, e.g., FIG. 2) to heat the gas. The second conduit 122 can conduct the gas to a patient interface 124. Figure 16A conduit heater can be used to increase heat to the gas passing through the second conduit 122. The heat can reduce or eliminate the likelihood of water entrained in the gas stream condensing along the walls of the second conduit 122. The conduit heater can include one or more resistive wires located in, on, or around the walls of the second conduit 122. In one or more configurations, such one or more resistive wires can be located outside of any gas passageway. In one or more configurations, such one or more resistive wires are not in direct contact with the gas passing through the second conduit 122. In one or more configurations, the walls or surfaces of the second conduit 122 are between the one or more resistive wires and the gas passing through the second conduit 122.

[0064] The gas passing through the second conduit 122 can be delivered to a patient treatment interface 124. The patient treatment interface 124 can link the pneumatic circuit of the respiratory therapy system 100 to the airway of a patient. In some configurations, the respiratory therapy system 100 utilizes a two-limb system that includes separate inspiratory and expiratory gas passageways that interface with one or more airways of a patient.

[0065] The patient interface 124 can include a sealed or non-sealed interface and can include a nasal mask, oral mask, oral-nasal mask, full face mask, nasal pillows, endotracheal tube, combination thereof, or some other gas delivery system. In some configurations, a short length of tubing connects the interface to the second conduit 122. In some configurations, the short length of tubing can have a smooth bore, as described elsewhere herein. For example, a short length of flexible tubing can connect a nasal cannula or the like to the second conduit 122. The short length of tubing connecting the interface to the second conduit 122 can be air permeable, thus it allows vapor to be transported through the tube walls. In some configurations, the short length of tubing can incorporate one or more heating wires, as described elsewhere herein. The smooth bore, with or without heating, can improve efficiency in delivering aerosolized substances, as described elsewhere herein. Any other appropriate patient treatment interface 124 can be used.

[0066] With continued reference to Figure 1In some configurations, a nebulizer 128 can be used with the respiratory therapy system 100. In some configurations, if the nebulizer 128 is used, the flow generator 101, the gas humidifier 112, and the nebulizer 128 can share the housing 126. In some configurations, the nebulizer 128 is separate from the housing 126. The nebulizer 128 can be linked to a portion of the gas passageway that extends between the flow generator 101 (which can include the gas inlet 102) and the patient interface 124, although other arrangements can be utilized for the nebulizer 128 or another nebulizer. In some configurations, the nebulizer 128 is not positioned in-line at any location between the humidifier outlet 118 and the patient interface 124. Rather, the nebulizer 128 is positioned upstream of the humidifier outlet 118 or upstream of the inlet to the second conduit 122. In some configurations, the nebulizer 128 can be positioned upstream of the inlet to the humidifier. In some configurations, the nebulizer 128 can be positioned between the gas flow source and the chamber.

[0067] The nebulizer 128 can include a substance (e.g., a medical substance, a tracer gas, etc.) that can be introduced into the gas flow. The substance can be entrained in the gas flow and can be delivered to the patient's airway along with the breathing gas. The nebulizer 128 can be linked to a portion of the gas passageway by a conveyance 130, which can include a conduit or an adapter. Alternatively, the nebulizer 128 can interface directly with the gas passageway, which can render the conveyance 130 unnecessary. For convenience, the term "nebulizer" has been used to indicate a component or assembly that is capable of introducing any desired substance into the gas flow. In some configurations, a sensor, a probe, or the like can also be introduced into the gas flow. As used herein, the term "introduced element" encompasses both substances (e.g., a medication, a medicament, a tracer gas, etc.) and components (e.g., a sensor, a probe, etc.).

[0068] In the illustrated configuration, and as implied above, the respiratory therapy system 100 can operate as follows. Gas can be drawn into the flow generator 101 through the gas inlet 102 due to rotation of the impeller of the motor of the blower 106. The gas is pushed out of the gas outlet 104 and is pushed through the first conduit 110. The gas can pass through the humidifier inlet 116 into the gas humidifier 112. Once in the gas humidifier 112, the gas entrains moisture as it passes through or near the water in the gas humidifier 112. The water is heated by a heating element that helps to humidify and / or heat the gas passing through the gas humidifier 112. The gas exits the gas humidifier 112 through the humidifier outlet 118 and enters the second conduit 122. Prior to entering the second conduit 122, the gas receives one or more substances from the nebulizer. The gas passes from the second conduit 122 to the patient interface 124, where the gas enters the patient's airway to help treat the respiratory ailment.

[0069] Respiratory therapy system with first adapter configuration

[0070] Figure 2 Showing with Figure 1 The respiratory therapy system 200 is similar to the one described in the text.

[0071] exist Figure 2 In the configuration shown, the respiratory therapy system 200 incorporates a humidifier with an integrated flow generator. In other words, in the illustrated configuration, the housing 202 contains at least a portion of a flow generator (not shown) and a gas humidifier 204. In the illustrated configuration, the flow generator and the gas humidifier 204 together form an integrated unit 206. In some configurations, the humidifier with the integrated flow generator may be manufactured by Fisher & Paykel Healthcare using AIRVO... TM 2. Devices sold under the name of [unspecified entity]. Such devices are shown and described, for example, in U.S. Patent No. 7,111,624, the entire contents of which are incorporated herein by reference. Any other suitable configuration may be used, and Figure 2 The configuration can be set up with any of the components or configurations described above. Specifically, the flow generator and humidifier need not be integrated units; however, for the sake of simplicity, the following discussion will simply refer to integrated unit 206.

[0072] The gas humidifier 204 in the illustrated integrated unit 206 employs a chamber 210. The chamber 210 can have any suitable configuration, including any configuration shown and / or described in U.S. Patent Nos. 7,146,979 and / or 6,349,722, each of which is incorporated herein by reference in its entirety. The chamber 210 may contain or retain a volume of liquid (e.g., water) for humidifying the gas as it passes through the chamber. In some configurations, the chamber 210 simply defines the location in the system where liquid (e.g., water) is transferred into the flow of gas or air.

[0073] As discussed above, gas that has been processed within the integration unit 206 (e.g., heated and / or humidified) can be delivered to the patient or other user. In some configurations, a tube or conduit (not shown) is used to deliver the gas to the patient or other user. Some examples of tubes or conduits that can be used with the integration unit 206 include, but are not limited to, those shown and described in U.S. Patent Publication Nos. 2014 / 0202462 A1 (also disclosed as WO 2012 / 164407 A1) and WO 2014 / 088430, each of which is incorporated herein by reference in its entirety. Any other suitable tubes or conduits may also be used.

[0074] Continue to refer toFigure 2 The nebulizer 212 can be attached to the integrated unit 206. In some configurations, the nebulizer 212 can be positioned upstream of the humidifier chamber 210. In some configurations, the nebulizer 212 can be positioned downstream of the humidifier chamber 210. In some configurations, when the nebulizer is not attached to the integrated unit 206, a cap (shown in Figure 4 FIG. 6) can be used to close the location where the nebulizer 212 can be attached. The cap can have any suitable configuration. In some configurations, the cap covers the nebulizer port. In some configurations, the cap plugs into the nebulizer port. The cap can be tethered to the mount 230. By attaching the cap at or near the nebulizer port, it is less likely that the cap will be misplaced when the nebulizer 212 is inserted into the nebulizer port (and the cap is removed). In some configurations, the cap is a silicone component. In some configurations, the cap incorporates one or more sealing elements. In some configurations, the cap incorporates one or more silicone sealing elements.

[0075] The nebulizer 212 produces a fine liquid mist. The liquid mist is introduced into the flow of treated gas or pre-treated gas. Any suitable nebulizer 212 can be used. In some configurations, the nebulizer 212 is an Aerogen® nebulizer. In some configurations, the nebulizer 212 is a Pari® nebulizer. In some configurations, the nebulizer 212 is a DeVilbiss® nebulizer. In some configurations, the nebulizer 212 is a Medtor® nebulizer. In some configurations, the nebulizer 212 is a Single atomizer. In the illustrated configuration, the outlet of the atomizer 212 is positioned between the chamber 210 and the conduit or tube 122. In some configurations, the atomizer 212 is configured and positioned to inject a fine liquid mist into the flow of treated gas downstream of the chamber 210 and upstream of the conduit 122 that connects the patient interface to the integrated unit 206. In some configurations, the atomizer 212 is configured and positioned to inject a fine liquid mist into the flow of treated gas downstream of the chamber 210 and upstream of the location of the removable conduit 122 connection to the integrated unit 206. In some configurations, the atomizer 212 is configured and positioned to inject a fine liquid mist into the flow of gas before the flow of gas enters the chamber 210. In some configurations, the atomizer 212 is configured and positioned to inject a fine liquid mist into the flow of gas during the flow of gas into the chamber 210. In some configurations, the atomizer 212 is configured and positioned to inject a fine liquid mist into the flow of gas after the flow of gas enters the chamber 210. In some configurations, the atomizer 212 is configured and positioned to inject a fine liquid mist into the flow of gas before the flow of gas exits the chamber 210. In some configurations, the atomizer 212 is configured and positioned to inject a fine liquid mist into the flow of gas during the flow of gas exiting the chamber 210. In some configurations, the atomizer 212 is configured and positioned to inject a fine liquid mist into the flow of gas after the flow of gas exits the chamber 210. In some of these configurations, rather than injecting a fine liquid mist or having an atomizer, other substances can be injected into the indicated locations, or other components (e.g., sensors, etc.) can be inserted into the indicated locations.

[0076] In the illustrated configuration, the integrated unit 206 includes a chamber front port 214 and a chamber rear port 216. As shown in Figure 3 , the chamber front port 214 receives flow from the flow generator and delivers the flow into the chamber 210 through a chamber inlet port 220. The flow is delivered from a chamber outlet port 222 to the chamber rear port 216. Referring again to Figure 2 , the chamber rear port 216 is fluidly connected to a unit outlet port 224. In some configurations, the chamber rear port 216 and the unit outlet port 224 are opposite ends of a single conduit or tube. Other configurations are possible. The unit outlet port 224 can be connected with a hose or conduit 122 so that gas can be delivered from the integrated unit 226 to the patient interface 124. This hose or conduit can be removably attached to the unit outlet port 224.

[0077] Referring to Figure 2The chamber 210, the integrated unit 206, and the nebulizer 212 or other appropriate components are brought together using a mount 230. As will be described, the mount 230 helps to introduce the fine mist from the nebulizer 212 into the gases traveling from the chamber 210 to the unit outlet port 224, which ultimately travel to a conduit or tube that delivers the gases from the integrated unit 226 to a patient interface. In uses of other components, the mount can help to introduce other substances (e.g., medicaments, tracer gases, nitric oxide, etc.) or components (e.g., sensors, etc.).

[0078] Referring now to Figure 4 The illustrated mount 230 is arranged and configured to connect at least the chamber outlet port 222 and the chamber rear port 216, while also connecting to the nebulizer 212 through the nebulizer port 234. In some configurations, the mount 230 is arranged and configured to connect at least the chamber inlet port 220 and the chamber front port 214, while also connecting to the nebulizer through the nebulizer port 234. In some configurations, the nebulizer 212 is supported by the nebulizer port 234. The outflow conduit 232 connects at least the chamber outlet port 222 and the chamber rear port 216. In the illustrated configuration, the outflow conduit 232 also connects the nebulizer port 234 and the chamber rear port 216. Thus, in the illustrated configuration, the outflow conduit 232 connects the chamber rear port 216 of the integrated unit 206, the chamber outlet port 222 of the chamber 210, and the nebulizer port 234. In general, the mount 230 is adapted to connect the nebulizer 212, the chamber 210, and the integrated unit 206.

[0079] In the illustrated configuration, the mount 230 is also arranged and configured to connect the chamber inlet port 220 and the chamber front port 214. Specifically, the inflow conduit 236 connects the chamber front port 214 and the chamber inlet port 220. Other configurations are possible.

[0080] In the illustrated configuration, as shown in Figures 6 to 13 The mount 230 also includes the outflow conduit 232 and the inflow conduit 236 as a single structure. While the outflow conduit 232 and the inflow conduit 236 can be provided as separate components, integrating or physically connecting the two conduits 232, 236 simplifies assembly and reduces the likelihood of misplacement of one of the two conduits 232, 236. Further, integrating or physically connecting the two conduits 232, 236 provides visual guidance related to a proper mounting orientation. In the illustrated configuration, the bridge 240 spans a distance between a portion of the outflow conduit 232 and a portion of the inflow conduit 236. The bridge 240 incorporates the two conduits 232, 236.

[0081] In the illustrated configuration, collar 242 defines at least a portion of a fitting for joining outflow tubing 232 to chamber rear port 216. Similarly, another collar 244 defines at least a portion of a fitting for joining inflow tubing 236 to a chamber front port. Each of collars 242, 244 can include a medical taper on an inner surface. The medical taper can be used to couple and seal tubing 232, 236 to ports 214, 216 of integration unit 206. Other fastening means (e.g., tapers, threads, friction fit, luer lock, interlocking mechanical parts, etc.) can also be used.

[0082] In the illustrated configuration, bridge 240 joins collars 242, 244 of tubing 232, 236. By positioning bridge 240 on collars 242, 244, bridge 240 can be positioned in an area of integration unit 206 that is offset from other components of system 200. As shown in Figure 13 Bridge 240, as illustrated, can have, for example, but not by way of limitation, an inverted U-shape with a hollow center.

[0083] In the illustrated configuration, bridge 240 also includes a mount 246. Mount 246 can include two fingers, ears, tabs, or the like. Mount 246 is sized and configured to receive tubing of a delivery set. A delivery set is a component that can be attached to a source of liquid (e.g., an IV bag) and can define a passageway for inflow chamber for fluid. Mount 246, as illustrated, faces outward or away from ports 214, 216 of integration unit 206. This positioning allows for securing a delivery set with mount 246 while at the same time splicing chamber 210 into integration unit 206.

[0084] With continued reference to Figures 6 to 13The mounting 230 is arranged and configured to connect the ports 214, 216 of the integration unit 206 with the ports 220, 222 of the chamber 210. The ports 214, 216 extend horizontally, while the ports 220, 222 extend vertically. In some configurations, the portion of the mounting 230 that is arranged and configured to connect with the ports 214, 216 of the integration unit comprises a first axis, and the portion of the mounting 230 that is arranged and configured to connect with the ports 220, 222 of the chamber comprises a second axis that is substantially perpendicular to the first axis. Further, in the illustrated configuration, the ports 214, 216 have a smaller centerline distance relative to the ports 220, 222. In other words, a first end of the inflow conduit is separated from a first end of the outflow conduit by a first distance between the flow passage centers, and a second end of the inflow conduit is separated from a second end of the outflow conduit by a second distance between the flow passage centers that is greater than the first distance. Accordingly, the mounting 230 is arranged and configured to change the flow direction from one end of the conduits 232, 236 to the other end of the conduits 232, 236, while also adjusting the centerline distance from one end of the conduits 232, 236 to the other end of the conduits 232, 236, or the gap between the conduits.

[0085] As illustrated in Figure 6 The outflow conduit 232 includes a first portion 250 and a second portion 252 connected at an elbow or bend 254. In the illustrated configuration, the first portion 250 extends vertically. In the illustrated configuration, the second portion 252 extends horizontally. Other configurations are possible. The first portion 250 can include an internal taper, among other things. The first portion seals or mates with an outer surface of the chamber outlet port 222. The second portion can include the collar 242. As described above, the collar 242 seals or mates with the chamber rear port 216.

[0086] In the illustrated configuration, the second portion 252 includes a second collar 256. The second collar 256 can be at an opposite end of the second portion 252 relative to the collar 242. In the illustrated configuration, the elbow 254 is disposed between the two collars 242, 256. The second collar 256 can be sized and configured to mate or seal with the atomizer 212. The second collar 256 defines a port. In some configurations, the port can be an auxiliary port configured to receive one or more auxiliary components. For example, the auxiliary components can include the atomizer 212. In the illustrated configuration, the atomizer 212 is received within the second collar 256. More specifically, in the illustrated configuration, an inner surface of the second collar 256 includes a tapered surface that mates or seals with an outer surface of the atomizer 212. Other configurations are possible.

[0087] As illustrated in Figure 8As shown, the first ring 242 and the second ring 256 are arranged at opposite ends of the second portion 252 of the outflow conduit 232. The second portion 252 of the outflow conduit 232 shown is a straight section of a pipe or the like. In other words, in the shown configuration, the first ring 242 and the second ring 256 are aligned along a single axis extending through the second portion 252 of the outflow conduit 232. In some configurations, a single plane extending along the central axis of the second portion 252 of the outflow conduit 232 bisects the first ring 242 and the second ring 256, as shown in Figure 9 As shown in [the image]. For example, in [the image]... Figure 9 As shown, although a lumen is defined within the first portion 250 of the outflow conduit 232, if this single plane extends vertically along the central axis of the second portion 252 of the outflow conduit 232, then this single plane does not intersect the lumen defined within the first portion 250. Instead, such a plane intersects the wall of the lumen defining the first portion 250. Other configurations are possible.

[0088] Reference Figure 11 As shown, the curved wall 260 is positioned at or near the intersection of the first portion 250 and the second portion 252 of the outflow conduit 232. The curved wall 260 induces flow at the transition between the first portion 250 and the second portion 252, thereby helping to maintain the fine mist from the atomizer 212 suspended within the treated gas stream. Other configurations are possible.

[0089] Reference Figure 7 The inflow pipe 236 comprises a first portion 264 and a second portion 266. Similar to the outflow pipe 232, the first portion 264 and the second portion 266 are not axially aligned. The first portion 264 is vertical. The second portion 266 is horizontal. The two portions 264 and 266 are joined at an elbow or bend 268. The first portion 264 mates with or seals the chamber inlet port 220. The collar 242 of the second portion 266 mates with or seals the chamber front port 216.

[0090] With mounting 230 in place, gas is delivered from the flow generator to the chamber front port 220. From the chamber front port 220, the gas flows through inlet conduit 236 to the chamber inlet port 220. From the chamber inlet port 220, the gas flows through the chamber 210 and is heated and / or humidified before exiting the chamber outlet port 222. From the chamber outlet port 222, the gas flows through outlet conduit 232 and then to the chamber rear port 216. From the chamber rear port 216, the gas flows to the unit outlet port 224. (As in...) Figure 4 As shown, catheter 270 can be connected to unit outlet port 224, and gas can travel through catheter 270 to the patient or other user.

[0091] Respiratory therapy system with second adapter configuration

[0092] Referring now to Figure 14 and Figure 15 , a second configuration of the mounting 230' is shown. The second configuration of the mounting 230' is identical to the first configuration of the mounting 230 except for the outflow conduit 232'.

[0093] In the second configuration of the mounting 230', the outflow conduit 232' includes a first portion 250' and a second portion 252' connected at an elbow or bend 254'. In the configuration shown, the first portion 250' extends vertically. The second portion 252' extends horizontally in the configuration shown. The second portion 252' intersects the first portion 250' at a location intermediate along the length of the first portion 250'. Other configurations are possible.

[0094] In the configuration shown, the first portion 250' can include an internal taper or the like. The first portion 250' seals or mates with the outer surface of the chamber outlet port 222'. The second portion can include the collar 242'. As described above, the collar 242' seals or mates with the chamber rear port 216'.

[0095] In the configuration shown, the first portion 250' includes a second collar 256'. The second collar 256' is at the opposite end of the first portion 250' from the portion connected to the chamber outlet port 222'. The second collar 256' can be sized and configured to mate or seal with the nebulizer 212'. In the configuration shown, the nebulizer 212' is received within the second collar 256'. More particularly, in the configuration shown, the inner surface of the second collar 256' includes a tapered surface that mates or seals with the outer surface of the nebulizer 212'. Other configurations are possible.

[0096] As shown in Figure 14 , the end of the first portion 250' proximate the chamber 210' and the second collar 256' are disposed at opposite ends of the first portion 250' of the outflow conduit 232'. The first portion 250' of the outflow conduit 232' can be a straight section of tubing or the like. In other words, in the configuration shown, the first end and the second collar 256' are aligned along a single axis that extends through the first portion 250' of the outflow conduit 232'. In some configurations, a single plane that extends along the central axis of the first portion 250' of the outflow conduit 232' bisects the first end and the second collar 256'. Other configurations are possible.

[0097] High flow therapy with nebulizer and smooth bore tubing

[0098] Referring to Figure 16 and Figure 17Two different types of tubes or conduits are presented in cross-section. In Figure 16 , a tube or conduit 300 featuring a smooth bore 302 or non-corrugated bore is shown. This type of tube is best described and shown in, for example, U.S. Patent Publication No. 2014 / 0202462 Al (also published as WO 2012 / 164407 Al) and WO 2014 / 088430, each of which is incorporated herein by reference in its entirety. As described therein, the tube is formed from a bead 304 and a small tube or bubble 306. Generally, the peak-to-valley surface roughness of this tube is on the order of 0.15 mm to 0.25 mm. In one configuration, the conduit or tube has an internal bore diameter of 13 mm to 14 mm. These two components 304, 306 combine to define a conduit or tube having a lumen with minimal surface area deviation. In some configurations, the bead 304 contains a plurality of wires 308. One or more of these wires can be positioned within the flow conveyed by the conduit or tube 300 for heating the wall of the conduit without. In the configuration shown, the bead 304 contains four wires 308. In some configurations, the bead 304 can contain two wires 308. Other numbers of wires can also be used.

[0099] Referring to Figure 17 , the conduit or tube 320 shown is a corrugated tube. In one configuration, the conduit or tube 320 has an internal bore diameter of 20 mm to 21 mm. The corrugated tube 320 includes deep grooves 322 along the wall 324 of the tube 320. In many cases, the grooves 322 result in one or more helical impediments extending along the length of the lumen defined by the wall 324. As such, the inner surface of the conduit or tube is significantly more rough than the smooth bore tube 300 shown in Figure 17 . Generally, the corrugated conduit or tube has a peak-to-valley surface roughness on the order of 1.5 mm to 2.5 mm. In the configuration shown in Figure 17 , one or more heating wires 326 can also be wrapped and positioned in direct contact with the gas flowing through the lumen. When these wires are positioned within the gas flow path, the heating wires add an additional "surface roughness" of 2 mm to 3 mm, although this is only an estimate of the effect of the heater wires positioned within the gas flow path.

[0100] Surprisingly, the use of a more conventional heated breathing tube 320, such as shown in Figure 17 , results in a significantly higher pressure drop than the use of a tube or conduit 300, such as shown in Figure 16The use of the smooth-bore heating tube 300 shown in the middle to transport the drug product from the atomizer 212 / 212' described above results in a significant increase in the efficiency of drug product transport. The efficiency improvement is believed to be due to a substantial reduction in the amount of atomized drug product that is captured within the grooves 322 and exposed heating wires 326 of more conventional heating breathing tubes 320. For example, it has been estimated that the atomized drug product captured by these surfaces is 300% more than the atomized drug product within the smooth-bore heating breathing tube 300 shown in the middle, for example, but not by way of limitation. It is believed that the deposition process (e.g., impingement) is reduced due to less vortex flow and fewer obstacles representing effective roughness. Figure 16

[0101] Testing was performed using the above configuration to spray the atomizer solution into a gas stream. The sprayer solution was a mixture of sodium chloride and green food coloring. The sodium chloride was at a concentration of 7% in a volume of 90 ml (commercially available from Biomed Limited, Auckland, New Zealand). The weight of NaCl in each 90 ml bottle was 6.3 grams, which resulted in a NaCl weight of 0.07 grams / ml. The dose used was 3 ml, which resulted in a dose of NaCl of 0.21 grams. The green food coloring had a concentration of 2.10% in a volume of 50 ml. The weight of coloring in each 50 ml bottle was 1.05 grams. The weight of coloring per ml was 0.021 grams. The mixture was 90 ml of 7% NaCl with 9 ml of added food coloring. As such, the fraction of the NaCl solution was 0.8889 and the fraction of the food coloring was 0.1111. The total drug product volume was 3 ml, which resulted in a volume of NaCl solution of 2.666667 ml and a volume of food coloring of 0.333333 ml. The atomizer solution volume of 2.666667 ml plus the food coloring of 0.333333 ml (10%) resulted in a weight of coloring of 0.007 grams and a weight of NaCl of 0.186667 grams. Thus, the total dry weight of the drug product was 0.193667 grams. The results obtained are presented below.

[0102]

[0103]

[0104] As shown above, during testing at a flow rate of 10 liters per minute, about 20% of the drug product was captured in the corrugated heating breathing tube, while the heated smooth-bore breathing tube retained only about 5% of the drug product.

[0105] ​In some configurations, it is believed that heating the walls of the smooth bore respiratory tube 300 also functions to reduce retained medication. For example, assume that heating the walls reduces condensation of water vapor on the walls or within the tube, which reduces the humidity of the walls. More humid walls can encourage or allow more medication to settle (e.g., water droplets can create more surface area or more flow turbulence, or reduce energy such that medication condenses or settles).

[0106] The respiratory therapy system can include a control system that receives inputs related to the auxiliary components. These inputs can be used to control the operation of the respiratory therapy system. In some configurations, the respiratory therapy system coordinates the operation of the auxiliary components. For example, in some configurations, an oxygen supply is provided. In some configurations, a nebulizer is provided. In such configurations, the respiratory therapy system can be controlled in accordance with the operation of the auxiliary components. In such configurations, the respiratory therapy system can coordinate the operation of the auxiliary components with the basic operation of the respiratory therapy system (e.g., heater plate temperature, flow rate, temperature of heated respiratory tube). In some configurations, the concentration of oxygen and the nebulizer activation (e.g., on / off state, frequency, output) can be controlled by a controller linked to the flow generator / nebulizer.

[0107] In some configurations, it is found that transport efficiency decreases when the flow rate exceeds an optimal flow rate. In other words, at certain high flow rates above 30 lpm, the flow rate is somewhat inversely related to nebulization efficiency (i.e., high flow rates result in more medication being trapped in the circuit rather than being delivered to the patient). Accordingly, the flow generator can be controlled based on the operation of the nebulizer. For example, the flow rate can be reduced when a nebulizer is installed. In some configurations, the flow rate can be reduced when a nebulizer is installed and the nebulizer is operating (i.e., releasing medication). In some configurations, the flow rate can be reduced by a predetermined amount (e.g., 15% or 20%) when it is determined that the nebulizer is to dispense a substance. In some configurations, the flow rate can be reduced just prior to the release of a substance by the nebulizer. In some configurations, the flow rate can be reduced just prior to the release of a substance by the nebulizer and the flow rate can be maintained at the reduced rate for a predetermined period of time. In some configurations, the flow rate can be reduced just prior to the release of a substance by the nebulizer and the flow rate can be maintained at the reduced rate for a predetermined period of time that takes into account the expected time for the nebulized substance to reach the user or patient (i.e., the predetermined time can be a function of the flow rate).

[0108] In some configurations, the second conduit includes a heated breathing tube, as discussed above. In some such configurations, the temperature of the heated breathing tube can be reduced upon installation of the nebulizer. In some such configurations, the temperature of the heated breathing tube can be reduced upon installation of the nebulizer and upon dispensing of the substance by the nebulizer. In some such configurations, the temperature or duty cycle of the humidifier heater (e.g., heater plate) and / or the heated breathing tube can be reduced sufficiently prior to the addition of nebulized medication to the flow by the nebulizer. In some such configurations, the temperature or duty cycle of the humidifier heater and / or the heated breathing tube can remain low for a predetermined period of time (or, for example, as a function of flow rate). Such configurations can better account for thermal lag in the system, while protecting the nebulized substance from excess heat and / or possible thermal damage.

[0109] Methods of use

[0110] In some configurations, the respiratory therapy system 100 can be assembled as follows. These steps can be performed in any appropriate order, and thus the following is merely one example of an order that can be used.

[0111] The integrated unit 103, 206, 206' can be positioned as desired.

[0112] A conduit can be connected to the unit 103, 206, 206'. The conduit can be a non-corrugated type of conduit. In some configurations, the conduit can be a smooth-bore type of conduit. In some configurations, the conduit is a smooth-bore type of conduit with an insulated wall that is heated.

[0113] The mount 230, 230' is positioned on the chamber 210, 210'. The combined mount 230, 230' and chamber 210, 210' are then connected to the integrated unit 103, 206, 206'. The nebulizer 212 is connected to the mount 230, 230'.

[0114] Once assembled, the unit can be used with the nebulizer and conduit to provide any desired therapy that can be performed by the combination of components. In some configurations, a nasal cannula is connected to the conduit, and a nasal high flow therapy is performed while providing a medication via the nebulizer. Other configurations and methods are possible.

[0115] Additional configurations and components of the system

[0116] In some configurations, the respiratory therapy system 100 can include a single user interface located on the flow generator 101, the gas humidifier 112, the first conduit 110, the second conduit 122, the patient interface 124, or other components of the respiratory therapy system 100. In some configurations, a user interface located on a remote computing device, which can be a tablet, a mobile phone, a personal digital assistant, or other computing device, can be used to wirelessly actuate operation of components of the respiratory therapy system 100. In some configurations, operation of the flow generator 101, the gas humidifier 112, or other components or aspects of the respiratory therapy system 100 can be controlled by a controller. The controller can include a microprocessor. The controller can be located in or on the flow generator 101, the gas humidifier 112, or other components of the respiratory therapy system 100, or on a remote computing device. In some configurations, multiple controllers can be used.

[0117] In some configurations, the respiratory therapy system 100 can include one or more sensors for detecting a variety of different characteristics of the gases in the respiratory therapy system 100, including pressure, flow rate, temperature, absolute humidity, relative humidity, heat content, gas composition, oxygen concentration, and / or carbon dioxide concentration, one or more sensors for detecting a variety of different characteristics of the patient or the patient's health, including heart rate, respiration rate, EEG signals, EKG / ECG signals, blood oxygen concentration, blood CO2 concentration, and blood sugar, and / or one or more sensors for detecting a variety of different characteristics of gases or other objects outside of the respiratory therapy system 100, including ambient temperature and / or ambient humidity. One or more of these sensors can be used to help control components of the respiratory therapy system 100, including the gas humidifier 112, using a closed loop or open loop control system, which can occur using the controller described above. In some configurations, there can be no user interface or minimal user interface for components of the respiratory therapy system 100. In some such configurations, the respiratory therapy system 100 can utilize sensors to determine whether a patient is attempting to use the respiratory therapy system 100 and automatically operate according to one or more predetermined parameters if the data obtained from the sensors indicates that the patient is attempting to use the respiratory therapy system 100 (e.g., the flow generator 101 can generate a flow of gases, the gas humidifier 112 can humidify the gases, the nebulizer 128 can nebulize a substance, etc.).

[0118] It should also be appreciated that many of the configurations of the respiratory therapy system 100 can also be used for other applications that do not involve providing gases to a patient's airway. For example, the respiratory therapy system 100 can instead be used to provide insufflation gases for laparoscopic surgery. This can occur by replacing the patient interface 124 with a surgical cannula that can be inserted into the abdominal cavity that has been punctured with a trocar. If the nebulizer 128 is used, the nebulizer 128 can instead be configured to deliver a substance along with the insufflation gases to the abdominal cavity.

[0119] Unless the context clearly requires otherwise, throughout the description and the claims, the words "comprise," "comprising," and the like are to be construed in an inclusive sense as opposed to an exclusive or exhaustive sense; that is to say, in the sense of "including, but not limited to."

[0120] Where, in the foregoing description, reference has been made to integers or components having known equivalents thereof, those integers have been presented as if their disclosure was intended to be incorporated by reference in the description, for the sake of brevity.

[0121] The disclosed methods, apparatuses, and systems can also be said broadly to include the parts, elements and features referred to or indicated in the summary or detailed description, individually or collectively, and any or all combinations of any two or more of said parts, elements or features.

[0122] The reference in this specification to any prior publication (or information derived from it), or reference to any matter which is known, is not, and should not be taken as an acknowledgment or admission that the prior publication (or information derived from it) or known matter forms part of the common general knowledge in the field of endeavour concerned by virtue of its publication (or information derived from it) prior to the priority date of this specification.

[0123] The recitation of a range of values herein is merely intended to serve as a shorthand method of referring individually to each separate value falling within the range, unless otherwise indicated herein, and each separate value is incorporated into the specification as if it were individually recited herein. Furthermore, the incorporation should not be deemed exclusive of any combining of values wherein the contexts allows.

[0124] While the disclosure has been described with respect to specific embodiments thereof, other embodiments will be apparent to those skilled in the art. For example, various components can be repositioned without departing from the spirit and scope of the disclosure. Also, not all of the features, aspects and advantages can be necessary to practice the disclosure. Accordingly, you are to consider the scope of the disclosure as indicated by the following claims, rather than the specific embodiments described above.

Claims

1. A respiratory therapy system for nasal high flow therapy when delivering a substance via a nebulizer, the respiratory therapy system comprising: a housing comprising: a flow generator adapted to deliver a gas to a patient; and a gas humidifier configured to carry humidity in the gas delivered to the patient; a gas passage extending between the flow generator and a patient interface, wherein the gas humidifier is present at a point along the gas passage; and a nebulizer adapted to deliver the substance to at least a first portion of the gas passage, the first portion being downstream of the gas humidifier, wherein, at least a section of the gas passage at and / or downstream of the first portion comprises a smoothbore conduit, the smoothbore conduit comprising a conduit heater; the respiratory therapy system is configured to control the flow generator to reduce the flow rate of the gas delivered to the patient prior to the nebulizer releasing the substance, to reduce the flow rate by a predetermined amount to a reduced flow rate, and to maintain the reduced flow rate over a predetermined period of time; the temperature or duty cycle of the conduit heater is reduced prior to the nebulizer delivering the substance.

2. The respiratory therapy system of claim 1, wherein, the conduit heater comprises one or more resistive wires located in, on or around a wall of the conduit.

3. The respiratory therapy system of claim 1, wherein, the conduit heater comprises one or more resistive wires.

4. The respiratory therapy system of claim 1, wherein, the conduit heater is configured to heat a wall of the smoothbore conduit.

5. The respiratory therapy system of claim 1, wherein, the smoothbore conduit is comprised of a bead and a small tube or bubble, which in combination define the smoothbore conduit.

6. The respiratory therapy system of claim 5, wherein, the bead comprises one or more resistive wires.

7. The respiratory therapy system of claim 1, wherein, the smoothbore conduit has an internal bore diameter of 13 mm to 14 mm.

8. The respiratory therapy system of claim 1, wherein, the internal bore of the smoothbore conduit has a surface roughness of 0.15 mm to 0.25 mm.

9. The respiratory therapy system of claim 1, wherein, the respiratory therapy system comprises a nasal cannula.

10. The respiratory therapy system of claim 9, wherein, a short length, breathable conduit connects the nasal cannula to the smoothbore conduit, such that the short length, breathable conduit allows water vapour to be transported through the wall of the conduit.

11. The respiratory therapy system of claim 1, wherein, the temperature or duty cycle of the heater of the gas humidifier is reduced prior to the nebulizer delivering the substance.

12. The respiratory therapy system of claim 1, wherein, the respiratory therapy system comprises one or more sensors for detecting a plurality of different characteristics of the gas in the respiratory therapy system, and / or one or more sensors for detecting a plurality of different characteristics of the patient or the patient's health, and / or one or more sensors for detecting a plurality of different characteristics of the gas or other objects outside of the respiratory therapy system.

13. The respiratory therapy system of claim 1, wherein, the respiratory therapy system comprises one or more sensors for detecting a plurality of different characteristics of the gas in the respiratory therapy system, at least one sensor being configured to detect a characteristic of the gas downstream of the gas humidifier.

14. The respiratory therapy system of claim 1, wherein, the respiratory therapy system comprises a mount configured to assist in the introduction of the substance from the nebulizer into the gas passage.

15. The respiratory therapy system of claim 14, wherein, the mount comprises a first duct, at least a portion of the first duct extending vertically and at least a portion of the first duct extending horizontally.

16. The respiratory therapy system of claim 14, wherein, the mount comprises an inlet port configured to receive the nebulizer.

17. The respiratory therapy system of claim 14, wherein, the mount is configured to be connected to the gas humidifier.

18. The respiratory therapy system of claim 15, wherein, the mount comprises a second duct.

19. The respiratory therapy system of claim 18, wherein, first ends of the first and second ducts are separated from each other by a first distance, and second ends of the first and second ducts are separated from each other by a second distance.

20. The respiratory therapy system of claim 19, wherein, the mount comprises a bridge joining the first and second ducts.

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