Active pressure-reduction device and method

Abstract

A system for performing active compression decompression (ACD) treatment on a patient includes: a platform placed under the patient; a chest compression actuator that may include a strap configured to extend over the chest chamber of the patient; an upward force actuator; a coupling mechanism for coupling the upward force actuator to the thoracic chamber of the patient to transfer a reduced pressure from the upward force actuator to the thoracic chamber of the patient; and a motor coupled to the strap, the motor configured to: tension the strap around the chest chamber of the patient and apply a pressing force to the chest chamber of the patient; and relaxing the strap around the chest chamber of the patient and allowing the upward force actuator to decompress the patient.

Description

[0001] This application is a divisional application of an application with a filing date of October 22, 2019, a national application number of 201980085277.X (international application number of PCT / US2019 / 057371), and an invention name of “Active Compression-Decompression Device and Method”.

[0002] Priority claim

[0003] This application claims priority under 35 U.S.C. §119(e) to U.S. Patent Application No. 62 / 749,035, filed on October 22, 2018, the entire contents of which are incorporated herein by reference. Technical Field

[0004] The present disclosure relates to chest compression devices for cardiopulmonary resuscitation (CPR) treatment, and more particularly to active compression-relief devices and methods. Background Art

[0005] Cardiopulmonary resuscitation (CPR) is a well-known and valuable first aid method for resuscitating people who suffer from cardiac arrest. CPR requires repeated chest compressions to squeeze the heart and chest cavity to pump blood through the human body. In order to provide better blood flow and improve the effectiveness of bystander resuscitation efforts, various mechanical devices have been proposed to perform CPR. In a mechanical chest compression device, a belt is placed around the patient's chest and chest compressions are performed using the belt. These devices have been proven to be valuable alternatives to manual chest compressions. These devices provide chest compressions with resuscitation speed and depth. The resuscitation speed can be any compression speed that is considered to effectively induce blood flow in patients with cardiac arrest, typically 60 to 120 compressions per minute (the 2015 CPR guidelines recommend that adult patients be 100 to 120 compressions per minute), and the resuscitation depth can be any depth that is considered to effectively induce blood flow, typically 1.5 to 2.5 inches (the 2015 CPR guidelines recommend that adults press 2 to 2.4 inches each time). Summary of the invention

[0006] Various systems and methods for performing active compression and / or decompression (ACD) therapy on a patient are described herein. In some embodiments, a system may include a platform for placement under a patient; a chest compression actuator including a belt configured to extend over the patient's chest, the belt configured to extend from the platform on a first side of the patient to a second side of the patient opposite the first side; an upward force actuator; a coupling mechanism for coupling the upward force actuator to the patient's chest to transfer a decompression force from the upward force actuator to the patient's chest; a controller; and a motor coupled to the belt and configured to receive one or more signals from the controller, the motor configured to respond to one or more signals from the controller to: tighten the belt around the patient's chest and apply a compression force to the patient's chest; and loosen the belt around the patient's chest and allow the upward force actuator to cause decompression of the patient.

[0007] In some embodiments, the upward force actuator can be configured to be attached to the patient's chest via the coupling mechanism. In some embodiments, the upward force actuator can be configured to be coupled to the belt, and the belt is configured to be attached to the patient via the coupling mechanism.

[0008] In some embodiments, the coupling mechanism may include one or more of a suction cup, a gel, and an adhesive.

[0009] In some embodiments, the upward force actuator includes one or more of a rigid arm, a leaf spring, and an elastic material.

[0010] In some embodiments, the amount of decompression of the patient's chest can be adjusted based on the adjustment of the magnitude of the decompression force applied by the upward force actuator to the patient's chest. In some embodiments, the magnitude of the decompression force applied by the upward force actuator to the patient's chest can be adjusted by adjusting the tension in the upward force actuator.

[0011] In some embodiments, the amount of decompression of the patient's chest can be adjusted based on the adjustment of the range of motion of the upward force actuator relative to the platform. In some embodiments, the upward force actuator can be formed by the motor and the belt. The coupling mechanism can include an adhesive configured to attach the belt to the patient's chest. The motor can be configured to respond to one or more signals from the controller to relax the belt around the patient's chest and enable the belt to apply a decompression force to the patient's chest.

[0012] In some embodiments, the strap may include a rigid material. The strap may extend from a first actuator located on a first side of the patient to a second actuator located on a second side of the patient. One of the first actuator or the second actuator may include a motor.

[0013] In some embodiments, at least one of the first actuator and the second actuator can include a rack and pinion configuration to couple the belt to the motor.At least one of the first actuator and the second actuator can be configured to attach to an end of the belt and retract into the platform.

[0014] In some embodiments, the range of the decompression force may include a magnitude between approximately 1-25 pounds.

[0015] In some embodiments, tightening the belt around the patient's chest and applying a compressive force to the patient's chest may include compressing the chest from an initial state of zero compression through a neutral compression state to a fully compressed state. The upward force actuator may decompress the chest from the fully compressed state through the neutral compression state to the initial state of zero compression.

[0016] In some embodiments, the upward force actuator decompresses the chest from a fully compressed state through a neutral compression state and through an initial state of zero compression to a positive decompression state.

[0017] In some embodiments, the upward force actuator can include a collapsible arm coupled to the platform on a first side of the patient, a second side of the patient, or both of the first and second sides of the patient. The collapsible arm can be coupled to the belt or the patient's chest. The collapsible arm can be configured to deform when the motor tightens the belt around the patient's chest. The collapsible arm can be configured to re-straighten when the motor relaxes the belt around the patient's chest, thereby applying a decompression force to the patient's chest.

[0018] In some embodiments, the upward force actuator may include at least one rigid arm configured to be coupled to the belt or to the patient's chest. The rigid arm may be coupled to the platform via a hinge. The rigid arm may be configured to rotate about the hinge from a position below the platform to a position above the platform. In some embodiments, the rigid arm may include an adjustable pivot point for the hinge.

[0019] In some embodiments, the upward force actuator may include a leaf spring, a rigid arm, or a retractable arm configured to be coupled to the belt. When the motor tensions the belt around the patient's chest, the leaf spring, the rigid arm, or the retractable arm may be in a tensioned state. The leaf spring, the rigid arm, or the retractable arm may be configured to cause the belt to apply a decompressive force to the patient's chest when the motor relaxes the belt around the patient's chest.

[0020] In some embodiments, the upward force actuator includes an elastic material that is configured to be in a tensioned state when the motor tightens the band around the patient's chest, and the elastic material is configured to apply a decompressive force to the patient's chest when the motor relaxes the band around the patient's chest.

[0021] In some embodiments, the leaf spring can be a first leaf spring and the system can include a second leaf spring coupleable to the belt, the first leaf spring attached to the platform on a first side of the patient, and the second leaf spring attached to the platform on a second side of the patient.

[0022] In some embodiments, the upward force actuator can include a leaf spring, a rigid arm, or a retractable arm configured to be coupled to the patient's chest, wherein the leaf spring, the rigid arm, or the retractable arm is in tension when the motor tightens the band around the patient's chest, and the leaf spring, the rigid arm, or the retractable arm can be configured to decompress the patient when the motor loosens the band around the patient's chest.

[0023] In some embodiments, the system may include an arm extending from the platform above the patient from a first side of the patient to a second side of the patient, the arm being coupled to the belt and being rigid or semi-rigid. In some embodiments, the system may include an arm extending from the platform above the patient, the arm being coupled to the belt or the patient's chest via the upward force actuator. In some embodiments, the height or position of the arm may be adjustable to adjust the amount of decompression force exerted by the upward force actuator on the patient. In some embodiments, the arm may include a first arm and a second arm, the first arm extending from the platform substantially perpendicular to the platform, the second arm extending from the first arm substantially parallel to the platform, and partially above the patient. In some embodiments, the second arm may be adjustable relative to the first arm.

[0024] In some embodiments, the upward force actuator can include an elastic material that is configured to be in tension when the motor tightens the band around the patient's chest, and the elastic material is configured to apply a decompression force to the patient's chest when the motor relaxes the band around the patient's chest. The elastic material can include a rope or strap. The tension or length of the elastic material can be adjustable. In some embodiments, the arm or the upward force actuator can include a sensor for measuring the decompression force of the elastic material.

[0025] In some embodiments, the upward force actuator can include a spring configured to be in a tensioned state when the motor tightens the belt around the patient's chest, and configured to apply a decompression force to the patient's chest when the motor relaxes the belt around the patient's chest. The tension of the spring can be adjustable. The arm or the upward force actuator can include a sensor for measuring the decompression force of the spring. The controller can be configured to control the motor in response to a signal from the sensor. In some embodiments, the measurement of the decompression force can be displayed on a display or remote display of the system. The sensor can include a strain gauge.

[0026] In some embodiments, the system can include a force sensor configured to measure tension in the arm or the upward force actuator.

[0027] In some embodiments, the arm can be a first arm, and the system can include a second arm coupled to the belt and configured to intersect the first arm above the patient's chest. The first arm or the second arm can be adjustable relative to the other of the first arm and the second arm. The first arm or the second arm can include a telescoping rod to allow adjustment of the position or height of the first arm or the second arm relative to the platform or the patient's chest.

[0028] In some embodiments, the arm can include a series of segmented portions to allow the arm to be retracted into a roll and enable the arm to form a rigid arch. In some embodiments, the arm can include a series of segmented portions to allow the arm to be retracted into a roll and enable the arm to form a rigid arch.

[0029] In some embodiments, the upward force actuator can include a plurality of rods attached to the belt, and each rod of the plurality of rods can be configured for insertion into a corresponding receiver on the platform to couple the rod to the platform.

[0030] In some embodiments, the upward force actuator can include a plurality of rods attached to the platform, each rod of the plurality of rods being configurable for insertion into a corresponding receiver on the belt to couple the rod to the belt.

[0031] In some embodiments, the system may include a first arm extending from the platform at the first side and a second arm extending from the platform at the second side. The first arm and the second arm may each be configured to be coupled to the upward force actuator. The upward force actuator may include a strap extending from the first arm to the second arm, the strap being attached to the strap. In some embodiments, the length of the strap between the first arm and the second arm may be adjustable.

[0032] In some embodiments, the belt can be configured to be coupled to a structure separate from the platform, the belt being configured to be coupled to the structure via an upward force actuator, the upward force actuator being configured to apply a decompression force to the patient's chest when the motor relaxes the belt around the patient's chest. In some embodiments, the upward force actuator can include an elastic material. In some embodiments, the elastic material can include a spring, a strap, or a rope. In some embodiments, the system can include a lever arm having a first end attached to the belt and a second end that can be attached to the upward force actuator opposite the first end.

[0033] In some embodiments, the system can include a strain gauge in communication with the upward force actuator, and the controller can be configured to control the motor in response to a signal from the strain gauge indicative of a decompression force applied by the upward force actuator.

[0034] In some embodiments, the belt can include a force distribution mechanism configured to distribute the compressive force over an area of ​​the chest. In some embodiments, the force distribution mechanism can include a bladder that can include one or more foams and a plurality of tension cords. In some embodiments, the leaf spring, the rigid arm, or the elastic material can be coupled to the platform via an actuator.

[0035] In some embodiments, a portion of the platform is pivotally adjustable to support at least a portion of a patient at an angle relative to a floor surface, and the platform can include a center of gravity that can be below the interface of the patient to stabilize the platform when a portion of the platform is angled.

[0036] In some embodiments, the system may include a force sensor configured to measure the decompression force of the upward force actuator. In some embodiments, the controller may be configured to control the motor in response to a signal from a sensor or force sensor.

[0037] In some embodiments, the amount of decompression of the patient's chest can be adjusted based on the adjustment of the amount of decompression force applied by the upward force actuator to the patient's chest. In some embodiments, the amount of decompression of the chest is a chest displacement selected from a chest displacement to a neutral point, a zero point, or a chest displacement passing through a zero point.

[0038] In some embodiments, a belt for integration with an active compression decompression, i.e., ACD therapy system, may include: a first portion, which is configured to connect to a patient's chest and provide compression force to the patient; a second portion, which is configured to connect to a chest compression actuator; a third portion, which is configured to connect to an upward force actuator that provides a decompression force to the belt; and a fourth portion, which includes a coupling mechanism configured to be attached to the patient, and the belt may be configured to transfer the decompression force from the upward force actuator to the patient.

[0039] In some embodiments, the first portion can include a force distribution mechanism. The third portion can include a top surface configured to be coupled to the upward force actuator. The fourth portion can include a bottom surface of the belt opposite the top surface. The top surface can be connected to the bottom surface by one or more tensile elements, and the one or more tensile elements are configured to transfer the decompression force from the top surface of the belt to the bottom surface of the belt.

[0040] In some embodiments, the upward force actuator can include a retractable rod integrated into the strap along the length of the strap, the retractable rod being configured to deform when a compressive force is applied by the chest compression actuator and to re-straighten when the chest compression actuator ceases applying a compressive force.

[0041] In some embodiments, the coupling mechanism of the belt can include one or more of a suction cup, an adhesive, or a gel. In some embodiments, the coupling mechanism of the belt can be configured to provide a force between 1-25 pounds. In some embodiments, the upward force actuator can include a rigid rod integrated into the belt along the length of the belt, and the belt can include a first end configured to be coupled to a first downward actuator and a second end configured to be coupled to a second downward actuator, the first end being opposite to the second end. In some embodiments, the first end and the second end of the belt each include a linear gear rack.

[0042] In some embodiments, the third portion can include a hook configured to be coupled to the upward force actuator, the upward force actuator including an elastic device. The third portion can include a lever, and the hook can be located at the end of the lever. The upward force actuator can include a plurality of semi-rigid rods attached to the third portion of the belt, each of the plurality of semi-rigid rods being configured to be inserted into a corresponding receiver on the platform to couple the belt to the platform. In some embodiments, the belt can include a high tensile strength material, which can include one or more fabrics. In some embodiments, the one or more tensile elements include one or more elastic cords or springs. In some embodiments, the force distribution mechanism can include a bladder, which can include one or more foams and a plurality of tension cords. In some embodiments, the bladder can be filled with air or filled with foam.

[0043] In some embodiments, a system for performing active compression decompression, i.e., ACD therapy, on a patient may include: a platform for placement under a patient; a chest compression actuator configured to extend above the patient's chest, the chest compression actuator configured to extend from the platform; a first arm coupled to the platform on a first side of the patient; a second arm coupled to the platform on a second side of the patient; an upward force actuator coupled to the first arm and the second arm; a coupling mechanism for coupling the upward force actuator to the patient's chest to transfer a decompression force from the upward force actuator to the patient's chest. A motor may be coupled to the chest compression actuator and may be configured to: cause the chest compression actuator to compress the patient's chest and apply a compressive force to the patient's chest; and cause the chest compression actuator to release the compressive force and allow the upward force actuator to decompress the patient.

[0044] In some embodiments, the chest compression actuator can include a belt configured to extend over the patient's chest, the belt configured to extend from the platform on a first side of the patient to a second side of the patient opposite the first side, and the motor causes the belt to tighten around the patient's chest and apply a compressive force to the patient's chest, and causes the belt to relax around the patient's chest and allow the upward force actuator to decompress the patient.

[0045] In some embodiments, the coupling mechanism can include one or more of a suction cup, a gel, and an adhesive. In some embodiments, the chest compression actuator can include a piston. In some embodiments, the upward force actuator can include a strap. In some embodiments, the upward force actuator can be configured to attach to the patient's chest.

[0046] In some embodiments, the upward force actuator can be configured to be coupled to the chest compression actuator, and the chest compression actuator can be configured to be attached to the patient via a coupling mechanism.

[0047] In some embodiments, the upward force actuator can include an elastic material. The elastic material can include one or more of an elastic cord, a spring, or a bungee cord. The upward force actuator can include a cord, and the cord can be coupled to each of the first arm and the second arm via a corresponding pulley.

[0048] In some embodiments, the system can include a sensor for measuring the decompression force of the upward force actuator. In some embodiments, the controller can be configured to control the motor in response to a signal from the sensor.

[0049] In some embodiments, the amount of decompression of the patient's chest can be adjusted based on the adjustment of the amount of decompression force applied by the upward force actuator to the patient's chest. The amount of decompression applied by the upward force actuator to the patient's chest can be adjusted by adjusting the tension in the upward force actuator. The amount of decompression of the patient's chest can be adjusted based on the adjustment of the range of motion of the upward force actuator relative to the platform.

[0050] In some embodiments, a system for performing active compression decompression, i.e., ACD therapy, on a patient includes: a platform for placement under a patient; a chest compression actuator configured to extend above the patient's chest, the chest compression actuator configured to extend from the platform; a structure that extends above the patient and is rigid; an upward force actuator coupled to the structure; and a coupling mechanism for coupling the upward force actuator to the patient's chest to transfer a decompression force from the upward force actuator to the patient's chest. A motor may be coupled to the chest compression actuator and may be configured to: cause the chest compression actuator to apply a compression force to the patient's chest; and cause the chest compression actuator to release the compression force and allow the upward force actuator to decompress the patient.

[0051] In some embodiments, the chest compression actuator can include a belt configured to extend over the patient's chest, the belt configured to extend from the platform on a first side of the patient to a second side of the patient opposite the first side, and the motor tightens the belt around the patient's chest and applies a compressive force to the patient's chest, and relaxes the belt around the patient's chest and allows the upward force actuator to decompress the patient. The coupling mechanism can include one or more of a suction cup, a gel, and an adhesive. The chest compression actuator can include a piston. In some embodiments, the structure can be attached to the platform. The structure can be a rigid arm or rod that extends partially over the patient, the arm or rod being adjustable relative to the platform so that the arm or rod includes a telescoping rod or an adjustable hinge height. The structure can be detachable from the platform. The upward force actuator can be coupled to the structure and directly attached to the patient. The upward force actuator can be coupled to the structure and to the belt, which can be configured to be attached to the patient via a coupling mechanism.

[0052] In some embodiments, the upward force actuator can include an elastic material. The elastic material can include one or more of an elastic cord, a spring, or a bungee cord.

[0053] In some embodiments, the system includes a sensor for measuring the decompression force of the upward force actuator. In some embodiments, the controller can be configured to control the motor in response to a signal from the sensor.

[0054] In some embodiments, the structure can include a first arm and a second arm, the first arm extending from the platform substantially perpendicular to the platform, and the second arm extending from the first arm substantially parallel to the platform and partially above the patient. The second arm can be adjustable relative to the first arm.

[0055] In some embodiments, the upward force actuator can include an elastic material. The elastic material can include one or more of an elastic cord, a spring, or an elastic cord. Based on the adjustment of the magnitude of the decompression force applied by the upward force actuator to the patient's chest, the amount of decompression of the patient's chest can be adjusted.

[0056] In some embodiments, the amount of decompression applied by the upward force actuator to the patient's chest can be adjusted by adjusting the tension in the upward force actuator. In some embodiments, the amount of decompression applied to the patient's chest can be adjusted based on adjusting the range of motion of the upward force actuator relative to the platform.

[0057] In some embodiments, a system for performing active compression decompression, i.e., ACD therapy on a patient, the system comprising: a platform for placement under a patient; a chest compression actuator configured to extend above the patient's chest, the chest compression actuator configured to extend from the platform; a semi-rigid structure coupled to the platform; a coupling mechanism for coupling the upward force actuator to the patient's chest to transfer a decompression force from the upward force actuator to the patient's chest. A motor may be coupled to the chest compression actuator and may be configured to: cause the chest compression actuator to apply a compression force to the patient's chest; and cause the chest compression actuator to release the compression force and allow the semi-rigid structure to decompress the patient.

[0058] In some embodiments, the chest compression actuator includes a belt configured to extend over the patient's chest. The belt can be configured to extend from the platform on a first side of the patient to a second side of the patient opposite the first side. The motor can tighten the belt around the patient's chest and apply a compressive force to the patient's chest, and relax the belt around the patient's chest and allow the upward force actuator to decompress the patient. In some embodiments, the coupling mechanism can include one or more of a suction cup, a gel, and an adhesive. The chest compression actuator can include a piston. The semi-rigid structure can include a leaf spring. The semi-rigid structure can include a retractable rod. The retractable rod can include a telescopic rod. The semi-rigid structure can be directly attached to the patient. The semi-rigid structure can be coupled to the belt, and the belt can be configured to be attached to the patient via a coupling mechanism.

[0059] In some embodiments, the system includes a sensor for measuring the decompression force of the semi-rigid structure. The controller can be configured to control the motor in response to a signal from the sensor. In some embodiments, the amount of decompression on the patient's chest can be adjusted based on the adjustment of the magnitude of the decompression force applied by the upward force actuator to the patient's chest. The magnitude of the decompression force applied by the upward force actuator to the patient's chest can be adjusted by adjusting the tension in the upward force actuator. In some embodiments, the magnitude of the decompression on the patient's chest can be adjusted based on the adjustment of the range of motion of the upward force actuator relative to the platform.

[0060] In some embodiments, a method of providing active compression decompression, i.e., ACD therapy, includes: providing a system for performing active compression decompression, i.e., ACD therapy on a patient. The system includes: a platform for placement under a patient; a chest compression actuator, comprising a belt configured to extend over the patient's chest, the belt configured to extend from the platform to a first side of the patient to a second side of the patient opposite to the first side; an upward force actuator; a coupling mechanism for coupling the upward force actuator to the patient's chest to transfer a decompression force from the upward force actuator to the patient's chest; a controller; and a motor coupled to the belt and configured to receive one or more signals from the controller, the motor configured to respond to one or more signals from the controller to: tighten the belt around the patient's chest and apply a compression force to the patient's chest; and loosen the belt around the patient's chest and allow the upward force actuator to apply a decompression force to the patient's chest. The method may include placing the patient on the platform to align the patient's chest with the belt; coupling the upward force actuator to the patient's chest directly or via the belt; and commencing operation of the system to repeatedly cycle tensioning and relaxing the belt around the patient's chest.

[0061] In some embodiments, the upward force actuator can include a strap. In some embodiments, the upward force actuator can be configured to attach directly to the patient's chest.

[0062] In some embodiments, the upward force actuator can be configured to be coupled to the belt, and the belt can be configured to be attached to the patient through the coupling mechanism. The upward force actuator can include an elastic material. The elastic material can include one or more of an elastic rope, a spring, or a bungee cord. The upward force actuator can include a rope, and the rope can be coupled to each of the first arm and the second arm through a corresponding pulley. The system can include a sensor for measuring the decompression force of the upward force actuator. The controller can be configured to control the motor in response to a signal from the sensor. Based on the adjustment of the magnitude of the decompression force of the upward force actuator on the patient's chest, the amount of decompression of the patient's chest can be adjusted. The magnitude of the decompression force of the upward force actuator on the patient's chest can be adjusted by adjusting the tension in the upward force actuator. Based on the adjustment of the range of motion of the upward force actuator relative to the platform, the magnitude of the decompression of the patient's chest can be adjusted.

[0063] In some embodiments, a system for performing active compression decompression, or ACD, therapy on a patient, the system comprising: a platform for placement beneath a patient; a belt configured to extend over the patient's chest, the belt configured to extend from the platform on a first side of the patient to a second side of the patient opposite the first side, the belt configured to be coupled to the patient's chest, the belt comprising a rigid or semi-rigid material that maintains an approximate shape of the belt when the belt is coupled to the patient's chest; a first actuator attached to the platform on a first side of the patient, the first actuator coupled to the belt at a first end of the belt; a second actuator attached to the platform on a second side of the patient, the second actuator coupled to the belt at a second end of the belt opposite the first end; and a controller configured to control the first actuator and the second actuator to: tighten the belt around the patient's chest and apply a compressive force to the patient's chest; and loosen the belt around the patient's chest and apply a decompressive force to the patient's chest.

[0064] In some embodiments, a system for performing active compression decompression, i.e., ACD therapy, on a patient, the system comprising: a platform for placement beneath a patient; a chest compression actuator comprising a belt constructed to extend over the patient's chest, the belt constructed to extend from the platform on a first side of the patient to a second side of the patient opposite the first side, the belt constructed to be connected to the patient's chest; a connecting mechanism; an adjustable arm extending from one side of the platform and partially over the patient; an elastic material extending from the arm and connected to the belt; a controller; and a motor capable of being connected to the belt and constructed to receive one or more signals from the controller, the motor constructed to respond to one or more signals from the controller to: tighten the belt around the patient's chest and apply a compressive force to the patient's chest while tightening the elastic material; and relax the belt around the patient's chest, allowing the elastic material to lift the belt to apply a decompressive force to the patient's chest.

[0065] In some embodiments, a system for performing active compression decompression, i.e., ACD therapy, on a patient, the system comprising: a platform for being placed beneath a patient; a chest compression actuator configured to extend above the patient's chest; an upward force actuator; a coupling mechanism for coupling the upward force actuator to the patient's chest, allowing the upward force actuator to apply a decompression force to the patient's chest; a controller; and a motor capable of being coupled to the upward force actuator and configured to receive one or more signals from the controller, the motor being configured to respond to the one or more signals from the controller to: cause the chest compression actuator to apply a compression force to the patient's chest; and cause the chest compression actuator to stop applying compression force to the patient and enable the upward force actuator to decompress the patient.

[0066] In one aspect, a method for performing active compression decompression, i.e., ACD therapy on a patient, the method comprising: providing a system comprising: a platform for placement under a patient. The system comprises a chest compression actuator configured to extend above the patient's chest, the chest compression actuator configured to extend from the platform. The system comprises a structure that extends above the patient and is rigid; an upward force actuator coupled to the structure; and a coupling mechanism for coupling the upward force actuator to the patient's chest to transfer a decompression force from the upward force actuator to the patient's chest. The system comprises a motor coupled to the chest compression actuator and configured to: cause the chest compression actuator to apply a compressive force to the patient's chest; and cause the chest compression actuator to release the compressive force and allow the upward force actuator to decompress the patient. The method includes placing the patient on the platform so that the patient's chest is aligned with the chest compression actuator; coupling the upward force actuator to the patient's chest directly or via the chest compression actuator; and commencing operation of the system to repeatedly cycle tensioning and relaxing of the belt around the patient's chest.

[0067] Devices and methods for active compression-decompression (ACD) for cardiopulmonary resuscitation (CPR) treatment can provide at least one or more of the following advantages. The ACD device is configured to compress and decompress the patient's chest during CPR treatment. Compared with compression alone, decompressing the patient's chest (e.g., pulling the patient's chest upward) can increase the negative pressure in the chest cavity and can cause more blood to flow through the patient. For some patients, in some embodiments, when the patient is intubated, an impedance threshold device with a check valve can be positioned in the patient's airway. For some patients, the valve allows air to be discharged from the patient's lungs when the patient's chest is compressed, and prevents air from entering the lungs when the patient's chest is decompressed. Preventing air from entering the chest during decompression can allow more blood to be pumped through the patient. The ACD device may include a load distribution device that distributes the force of compression and / or decompression on the patient, thereby further reducing the possibility of harming the patient (e.g., relative to manual compression or decompression using conventional devices).

[0068] The ACD device performs automatic ACD treatment on the patient. The user of the device does not need to manually perform compression and decompression on the patient, but can program the ACD device to perform ACD treatment continuously or as needed. The ACD device can perform compression and decompression of consistent depth to avoid over-compression of the patient's chest and over-decompression of the patient's chest, each of which may cause harm to the patient. The ACD device can be calibrated to a specific compression force, compression / decompression depth and / or frequency to maximize the effectiveness of the ACD treatment for the patient. One or more sensors (e.g., force sensors, accelerometers, etc.) can be used to measure the parameters of compression and decompression (e.g., depth, frequency, force, etc.) and provide feedback to the ACD device. The ACD device may include a mechanism for limiting the maximum decompression and / or compression of the ACD treatment. In some embodiments, the limit can be adjusted based on the patient, and the limit can be applied based on feedback received from one or more sensors. For example, if the force applied in compression or decompression exceeds a threshold measured by one or more sensors, the ACD device will reduce the force applied to the patient. In some embodiments, one or more hardware restrictions are included to prevent the compression force and / or decompression force and / or depth from exceeding a preset threshold.

[0069] The ACD device can be modular so that compression and / or pressure relief elements of the ACD device can be added or removed as needed for treatment. For example, the ACD device can include a pressure relief device (arm, leaf spring, etc.) that can be pivoted or retracted when treatment is not needed (e.g., during defibrillation or other treatment).

[0070] Details of one or more embodiments of the ACD device and method for ACD treatment are set forth in the accompanying drawings and the following description. Other features, objectives and advantages of the ACD device and method will be apparent from the description and the accompanying drawings and from the technical solution. BRIEF DESCRIPTION OF THE DRAWINGS

[0071] Figure 1 A perspective view of an ACD device is shown.

[0072] Figure 2A-2B A perspective view of the ACD device platform is shown.

[0073] Figure 3A An axial view of an ACD device including an exemplary upward force actuator is shown.

[0074] Figure 3B Shown for Figure 3A An exemplary upward force actuator for an ACD device.

[0075] Figure 3C An exemplary arm for supporting an upward force actuator is shown.

[0076] Figure 3D An ACD device including an exemplary upward force actuator is shown.

[0077] Figure 3E A perspective view of an ACD device is shown.

[0078] Figure 4A-4B An ACD device including an exemplary upward force actuator including a retractable arm is shown.

[0079] Figure 5A-5E An ACD device is shown including an exemplary upward force actuator including a rigid strap.

[0080] Figure 6 An exemplary retractable arm for an ACD device is shown.

[0081] Fig. 7A A top view of an exemplary ACD device is shown.

[0082] Figure 7B-Figure 7E Shown for Fig. 7A An exemplary upward force actuator for an ACD device.

[0083] Figure 8A-8C An example of a retractable upward force actuator for an ACD device is shown.

[0084] Figure 9A-9B An example ACD device including an upward force actuator is shown.

[0085] Fig.10 An exemplary compression belt for use with an ACD device is shown.

[0086] Figure 11A-11B An ACD device including an exemplary upward force actuator is shown.

[0087] Figure 12-13 An exemplary upward force actuator configured to be coupled to an external structure for an ACD device is shown.

[0088] Fig.14 An example ACD device including an upward force actuator is shown.

[0089] Fig.15 An example ACD device including an upward force actuator with a feedback sensor is shown.

[0090] Fig.16 Shown for use Figure 1-Figure 15 An ACD device performs an exemplary process of ACD therapy.

[0091] Fig.17 Shows the control Figure 1-Figure 16 and Figure 18A-18B One or more operations of the ACD device and performs Fig.16 An exemplary computing device for the process of.

[0092] Fig.18A A perspective view of an ACD device including a piston is shown.

[0093] Fig.18B An axial view of an ADC device including a piston is shown.

[0094] Fig. 18C A perspective view of an ACD device including a piston is shown.

[0095] Like reference numbers in the various drawings represent like elements. DETAILED DESCRIPTION

[0096] Figure 1 An embodiment of an active compression-reduction (ACD) device 100 configured to automatically perform ACD cardiopulmonary resuscitation (CPR) therapy is shown. The ACD device 100 includes a platform 102 and a chest compression actuator 104. The ACD device 100 includes an upward force actuator 120. Figure 1 An example of an upward force actuator 120 is depicted below. Figure 2A-Figure 16 Several examples of upward force actuators are detailed, which can also replace Figure 1The upward force actuator 120 in the ACD device 100 of the embodiment of the present invention is used in conjunction with or in combination with the upward force actuator 120 in the ACD device 100. The upward force actuator 120 is configured to apply a lifting force on the patient's chest in an upward direction to decompress the patient's chest. For the purpose of illustration, the upward direction is a direction away from the surface on which the platform 102 is positioned, and the downward direction is a direction toward the surface on which the platform is positioned. Therefore, when the patient is positioned on the platform, the downward force from the chest compression actuator 104 acting on the patient's chest compresses the patient (and may alternatively be referred to as a compressive force). Similarly, the upward force from the upward force actuator 120 on the patient's chest decompresses the patient (and may alternatively be referred to as a decompression force).

[0097] The platform 102 is constructed to support the patient. For ACD treatment, the platform 102 supports the patient so that the chest area (e.g., chest) of the patient is placed between the chest compression actuator 104 and the platform 102. The exact position of the patient can vary depending on the size of the patient relative to the platform 102. In some embodiments, the platform includes a rotatable joint so that a portion of the platform 102 can be bent and lift the patient's head and shoulder area (e.g., during ACD treatment). The size of the platform 102 can be set so that the center of gravity of the ACD device 100 is below the patient's chest portion that cannot be lifted. The non-lifting compression portion 114 of the platform supports the patient's chest. This construction keeps the ACD device 100 balanced under the patient's body and allows the patient's head and shoulder area to remain lifted by the ACD device 100 without external support.

[0098] The chest compression actuator 104 includes all elements of the ACD device 100 for compressing the patient's chest during the compression phase of ACD therapy. Thus, the chest compression actuator 104 includes a belt 106, a motor / actuator (not shown), and a force distribution mechanism 112. In some embodiments, the chest compression actuator 104 includes a downward force actuator configured to apply a downward force to the patient. In some embodiments, the chest compression actuator includes a compression actuator that can apply a downward force to the patient, but can also apply other forces for compressing the patient's chest, which other forces include some lateral components (e.g., pressing the sides of the patient's chest inward).

[0099] In some embodiments, the chest compression actuator 104 is configured to apply compression to the patient using a compression belt 106. The belt 106 is connected to the platform 102 at a first side 108 of the platform located on a first side of the patient and at a second side 110 of the platform located on a second side of the patient. The platform 102 provides a drive train for the chest compression actuator 104 and a housing for a control system for the ACD device 100. A control system disposed at any location in the device may include a processor and may be operated to control the tensioning operation of the belt and provide outputs on a user interface disposed on the housing. A user may initiate and adjust the operation of the device through a control panel and / or display operated by the control system to provide feedback to the user regarding the status of the device. The one or more motors that actually cause the belt to be tensioned around the patient to compress the patient's chest are controlled by a controller (described in further detail below). The controller causes the one or more motors to tension and / or relax the belt 106 by sending control signals to the one or more motors. As described with respect to Fig.17 In further detail, the controller controls the phase of the compression cycle and the length, frequency, depth, etc. of the compressions through the chest compression actuator 104. The controller can also control the phase of the decompression cycle and the length, frequency, amount, etc. of the decompression through the upward force actuator depending on the specific configuration of the upward force actuator.

[0100] The chest compression actuator 104 includes a load distribution unit 112. In some embodiments, the load distribution unit is located at the middle of the belt and the left and right ends of the belt. When installed on the patient, the load distribution unit 112 is arranged above the patient's anterior chest wall, and the left and right ends of the belt extend behind the patient's left and right armpits under the patient's arm (for example, under the patient's armpit) to be connected to the respective actuators of the left and right ends of the belt, such as lateral drive reels (for example, to be connected to the platform at the first side 108 and the second side 110). The drive reels at the first side 108 and the second side 110 are arranged laterally on both sides of the housing. Band 106 is fixed to these drive reels. The lateral drive reel is then driven by a motor (not shown) that is also arranged in the housing through the drive shaft and the drive belt. Band 106 can be attached to the lateral drive reel so that when the drive reel rotates, band 106 is pulled into the platform and wound around the lateral reel, thereby pulling the band downward to press the patient's chest. After the patient's chest has been compressed, a chest compression actuator 104, which is driven by a motor and controlled by a controller, relaxes the belt 106 around the patient. When the chest compression actuator 104 stops applying compression force and relaxes the belt 106 around the patient, decompression of the patient's chest is allowed. The cycle of controlling the chest compression actuator 104 to tighten the belt, thereby compressing the patient's chest, and then controlling the chest compression actuator 104 to relax the belt and allow decompression of the patient's chest is one compression cycle of ACD CPR therapy. The compressions on the patient during this cycle are referred to as the compression phase, and the decompression of the patient during this cycle is referred to as the decompression phase. The chest compression actuator 104 may include a ZOLL Medical, Inc. of Chelmsford, Massachusetts. One or more embodiments of an apparatus such as described in US Application No. 15 / 942,292 and US Application No. 15 / 942,309, which are incorporated herein by reference in their entirety.

[0101] In some embodiments, the chest compression actuator 104 includes a piston-based compression actuator instead of or in addition to the chest compression belt 106. The piston-based chest compression actuator 106 delivers a compression force to the patient's chest. The piston-based chest compression actuator is used together with the upward force actuator to perform ACD therapy, and the following description of the chest compression belt 106 is provided below. Figures 18A-18C is described in further detail.

[0102] An upward force actuator (e.g., upward force actuator 120) is a device that applies an upward force to the chest (e.g., chest) of a patient. The upward force actuator includes a mechanical device configured to pull the patient's chest upward (directly or via chest compression actuator 104) to decompress the patient's chest. The upward force actuator lifts the chest wall, decompresses the patient's chest cavity, and reduces the patient's intrathoracic pressure.

[0103] The upward force actuator 120 includes an arm 122 having a first end coupled to the platform 102 on one side of the patient and a second end extending beyond and above the patient. A resilient element 124 extends from the second end of the arm and is coupled via a coupling mechanism 126 directly to the patient's chest, or to the belt 106 or load distribution portion 112 or plate that is coupled to the patient's chest.

[0104] The arm 122 can be rigid or semi-rigid and supports the elastic element 124 above the chest of the patient 128. The arm 122 can include a single component or can include two or more components that can be assembled and / or moved relative to each other. The arm 122 can be configured to fold from a storage position (e.g., next to or below the platform 102). The arm 122 can be configured as a telescopic arm, a foldable arm, etc. The arm 122 can be set to be above the platform 102 at different heights to accommodate various chest sizes of the patient. The arm 122 can be adjusted using a sliding mechanism, one or more notches, etc. In some embodiments, the arm can be loosened and fixed in place using a thumb screw, a wing nut, or a similar mechanism. The elastic element 124 is configured to be connected to the arm 122. In some embodiments, the elastic element is detachable from the arm 122. In some embodiments, the elastic element 124 is attached to the arm 122. The arm can be arc-shaped, form a right angle, etc. above the patient. The position of the arm 122 above the patient can be adjustable (e.g., laterally adjustable) so that the elastic element 124 can be precisely adjusted in place without repositioning the patient on the platform. For example, at least a portion of the arm 122 can be rotated and locked in place as needed.

[0105] In some embodiments, the ACD device 100 is combined with an intubation device (not shown) that includes a check valve that prevents air from entering the chest cavity during decompression. During ACD CPR treatment, decompressing the chest cavity and reducing intrathoracic pressure both help increase the amount of blood pumped through the patient, thereby improving the effectiveness of compression therapy. The upward force actuator includes a mechanical device connected to the platform 102 and the patient's chest. The upward force actuator 120 is configured to decompress the patient's chest during the decompression phase. When the belt 106 of the chest compression actuator 104 is relaxed, the upward force actuator 120 can lift the chest wall to decompress the patient. Although the upward force actuator 120 can remain connected to the patient's chest throughout the compression cycle, the upward force actuator 120 will not prevent compression of the chest when the belt 106 of the chest compression actuator 104 is tensioned. The upward force actuator 120 may include various embodiments for providing an upward force on the patient's chest. The following is relative to Figure 2A-Figure 16 Various embodiments of upward force actuators are described.

[0106] In some embodiments, the ACD device 100 may not include Figure 1The belt 106 or load distribution portion 112 described above, but may include another device for the chest compression actuator 104. For example, the ACD device may include a piston or other rigid device for compressing the patient's chest. Figures 18A-18C A piston based chest compression actuator is described.

[0107] Figure 2A-2B 1 shows a perspective view of the ACD device 100, the platform 102, and exemplary coupling mechanisms 202, 204. The coupling mechanisms 202, 204 are configured to receive the belt 106 of the chest compression actuator 104. Figure 2A As shown, during the decompression phase, an upward force actuator in the form of spring levers 206, 208 pushes upward on the belt of the chest compression actuator 104. The belt 106, which is attached to the patient's chest by an adhesive, is tightened around the patient during the compression phase. The belt 106 is then relaxed around the patient and the patient's chest is allowed to decompress (e.g., in response to the decompression force of the upward force actuator). Figure 2B As shown, the spring levers 206, 208 are retracted during the compression phase, allowing the belt 106 of the chest compression actuator 104 to compress around the patient.

[0108] Figure 3A An axial view of an ACD device 300 including an exemplary upward force actuator 304 is shown. A patient 312 is positioned on the platform 302 and is positioned below the upward force actuator 304 and a chest compression actuator (e.g., Figure 1 The chest compression actuator 104 is below the belt 306.

[0109] The upward force actuator 304 includes a rigid or semi-rigid structure 318 (e.g., one or more rods or arms) and a resilient element 320. The structure 318 of the upward force actuator 304 is coupled to the platform 302 at the first side 314 of the platform and at the second side 316 of the platform, respectively, on the first side and the second side of the patient 312. Thus, when the patient is on the platform 302, the structure 318 extends over the chest of the patient 312. In some embodiments, the structure 318 need not extend completely from the first side 314 to the second side 316, but may extend partially (e.g., approximately halfway) from the first side to the second side over the chest of the patient 312. In some embodiments, the structure 318 is coupled to the platform by being inserted into a corresponding slot at the first side 314 of the platform 302 and another corresponding slot at the second side 316 of the platform, and then secured in place by a thumb screw or similar mechanism. The structure 318 can be removed from the platform 302 to allow the patient 312 to lie on the platform 302, and then the structure 318 can be placed over the patient to perform ACD therapy. The structure 318 can be adjustable, for example, the height of the structure 318 relative to the platform 302 can be adjusted by changing the position of the structure in one or more notches or grooves 317. The tension of the elastic element 320 can also be adjusted.

[0110] In some embodiments, at least a portion of structure 318 is coupled to platform 302 via a rotational hinge (e.g., at side 314, at side 316, or both). Structure 318 can rotate above patient 302 from a position substantially coplanar with the platform to a position substantially coplanar with the platform. Figure 3A In some embodiments, structure 318 is coupled via a swivel hinge at side 314 or side 316. Structure 318 can be rotated from a storage position (e.g., below platform 302, beside platform, etc.) to above a patient undergoing ACD therapy and coupled to a latch or other coupling mechanism on the opposite side.

[0111] The elastic element 320 is coupled to the structure 318 and the patient 312. The elastic element 320 includes one or more of a spring (e.g., a coil spring), a bungee cord, an elastic material, etc. The elastic element 320 is configured to be coupled to the chest of the patient 312 via a coupling mechanism. The coupling mechanism of the elastic element 320 may include one or more of a gel, one or more suction cups, an adhesive, or other plates or bases that adhere to the skin of the patient 302. The elastic element 320 of the upward force actuator 304 pulls the chest of the patient 312 upward. During the decompression phase of the ACD compression cycle, when the belt 306 is relaxed around the patient 312, the upward force actuator 304 pulls the chest wall upward and decompresses the chest of the patient 312. During the compression phase of the ACD compression cycle, the elasticity of the elastic element 320 of the upward force actuator 304 allows the chest compression actuator 104 to tighten the belt 106 and compress the chest of the patient 312. The elastic element 320 extends during the compression phase and applies an upward force to the chest wall of the patient.

[0112] In some embodiments, the elastic element 320 is configured to couple with the chest compression actuator 104, such as with the belt 106. The elastic element 320 can be attached using a hook, latch, or hook and loop mechanism (e.g., 312. The belt 306 is coupled to the chest compression actuator 104 by a suction cup, adhesive, or the like. Here, the belt 306 is configured to couple to the patient's chest via a suction cup, adhesive, or the like. When the belt 306 is loose around the patient 312, the elastic element 320 of the upward force actuator 304 pulls the belt 306 (or other portion of the chest compression actuator 104) attached to the patient's chest upward, thereby pulling the chest wall upward during the decompression phase of the ACD compression cycle. The elastic element 320 allows the chest compression actuator 104 to tension the belt 106 and compress the chest of the patient 312 during the compression phase of the ACD compression cycle.

[0113] The amount of decompression applied to the patient's chest can be adjusted by adjusting the amount of decompression applied to the patient's chest to achieve the desired level of decompression. The zero position of the chest refers to the resting position of the chest before compressions begin. After compressions begin, the shape of the chest cavity will change due to rupture of the sternal costal cartilage, fractures of the sternum and ribs, and changes in the biomechanical properties of other anatomical features. The neutral position of the chest refers to the static resting position to which the chest returns after compressions begin when compressions are paused.

[0114] The structure 318 and / or the elastic element 320 of the upward force actuator 304 can be adjusted to provide a specific force or force curve for the patient's desired decompression amount. For example, the structure 318 and / or the elastic element 320 of the upward force actuator 304 can be configured to provide a predetermined decompression force between 1-25 pounds. In some embodiments, the structure 318 and the elastic element 320 are configured to provide the maximum upward force (e.g., 3, 5, 10, 15, 20 pounds) at the deepest compression point, and the force decreases as the depth approaches zero or a neutral point during the decompression stage. In other words, at the beginning of the decompression stage, the force is greater than the force at the end of the decompression stage, for example, the force at the end of the decompression stage is, for example, 80%, 50%, 20%, 10%, 5% or 1% of the force at the beginning of the decompression stage.

[0115] In some embodiments, the upward force actuator 304 can be configured to transmit sufficient force at the maximum decompression upward travel point below or above the neutral point or zero point to reach a specific depth. In some embodiments, the upward displacement of the chest obtained can be the zero position or neutral position of the chest. In another example, the structure 318 and / or the elastic element 320 of the upward force actuator 304 can be configured to provide a decompression force sufficient to achieve an upward displacement of the chest of approximately 0.25 to 4 inches relative to the neutral position or zero position of the chest. For a typical patient, an upward force of approximately 5-20 pounds is required to achieve an upward displacement of 2 inches relative to the neutral position or zero position.

[0116] Figure 3B Shown for Figure 3A 330 and 332 are connected to the platform 302 at the sides 314 and 316, respectively, independently of each other. The arm 330 can be connected to the platform 302 by a connection mechanism 336, and the arm 332 can be connected to the platform by a connection mechanism 338. The connection mechanisms 336 and 338 can both include a rotatable hinge, a ball socket or other such connection mechanisms. When not used in ACD treatment, the arms 330 and 332 can be moved and stowed independently. When the patient 312 is positioned for ACD treatment, one or both of the arms 330 and 332 can be moved and locked in place and / or locked to each other by the connection mechanism 334. The connection mechanism 334 can include a socket and a plug, a latch or other connection mechanism. In some embodiments, when a single arm 330 or 332 is used, the arm can be locked in place (e.g., by a thumbscrew on a ball and socket mechanism at 336 or 338, a spring latch, etc.). The resilient element 320 can be suspended from the arms 330, 332 and can be locked as described above with respect to Figure 3A The ground provides a decompression force.

[0117] Figure 3C A device for supporting an upward force actuator such as Figure 3B The arm 340 is configured to be fixed in position at one of several angles relative to a platform (not shown) to size the ACD device for patients of different sizes. In some embodiments, the arm 340 may include Figure 3B The arm 330 or arm 332 is provided. The arm 340 is connected to the platform by a connection mechanism 342 such as a hinge, a ball joint, etc. The arm 340 includes a plurality of notches or extensions 346 that provide a fulcrum (purchase) for a corresponding rod 344. By sliding one or more extensions 346 over the rod 344, the arm 340 can be ratcheted up or down and fixed in place at different angles relative to the platform. For example, for a small patient (e.g., a child), the arm 340 can be fixed at a smaller angle relative to the platform, and the rod can be set into a higher notch (e.g., notch 348). For example, for a large patient, the arm 340 can be fixed at a larger angle relative to the platform, and the rod can be set into a lower notch (e.g., notch 350). The angle of the arm 340 can be used to adjust the decompression force of the upward force actuator of the ACD device 300. The adjustment features described above (e.g., one or more arms with notches or extensions and corresponding rods for adjusting the angle and / or height of the upward force actuator) can be applied not only to Figure 3B The invention can be applied to an upward force actuator of the ACD device described herein, and can be applied to any other upward force actuator of the ACD device described herein.

[0118] Figure 3D An ACD device including an exemplary upward force actuator 360 is shown. The upward force actuator 360 includes a system with a belt 366. The belt 366 is coupled to two pulleys 362, 364, which can be coupled to the chest compression actuator 104. The chest compression actuator 104 is pulled upward by the belt 366 actuated by one or more actuators from either side of the platform or below the platform 302. The belt 366 is configured to be tensioned and pull the patient's chest upward (or pull the chest compression actuator 104 adhered to the chest upward) to apply a decompression force to the patient's chest. In the compression phase, the chest compression actuator 104 compresses the patient's chest (and pulls the belt 366).

[0119] In some embodiments, the upward force actuator 360 works with the chest compression actuator 104 as a system consisting of two belts with two motors, or a connected belt and a motor that rotates clockwise or counterclockwise. The chest compression actuator 104 includes a belt 106 that is tensioned for compression using a motor (not shown) that runs in a first direction (e.g., counterclockwise). The motor rotates in a second direction (e.g., clockwise) to tension the belt 366 and lift the belt 104 to decompress the patient's chest. The coupling device 112 is attached to the patient's chest (e.g., by a suction cup or other method) for decompression. In some embodiments, one or more arms 368 can provide a portion of the decompression force. The belts 106, 366 actively (e.g., rather than passively using elastic elements) perform compression / decompression. In some embodiments, belts 106 and 366 are a single continuous belt that is looped through one or more arms 368 around pulleys 362, 364, secured to the arms at 370, 372, and attached to the patient at 112. Alternatively, belts 106, 366 may be multiple separate belts. In some embodiments, upward force actuator 360 may be a separate unit that may be retrofitted to an existing chest compression device, or may be integral to a chest compression device.

[0120] Figure 3E A perspective view of an ACD device is shown including an upward force actuator 304 including a structure 318 and a resilient element 320. The strap 306 may be coupled to the resilient element 120 (as shown) or directly to the patient 312.

[0121] Figure 4A-4BAn ACD device is shown including an exemplary upward force actuator 400, which includes support arms 402, 404, which may be retractable or non-retractable. The upward force actuator 400 includes a first arm 402, which is coupled to the platform 102 via a coupling mechanism 412. The upward force actuator 400 may include one or more additional arms 404, which are coupled to the platform 102 via a coupling mechanism 414. In some embodiments, the coupling mechanism may also include an elastic element 410 for providing an upward force. In some embodiments, the arms 402, 404 may include a semi-rigid material so that the arms may bend in response to a force and then reform (e.g., re-straighten or partially re-straighten) to the original form for providing an upward spring force when the force is removed, or alternatively, the arms 402, 404 may be rigid and have a spring in a hinge where the arms 402, 404 are attached to the base. In some embodiments, both the elastic element 410 and the arms 402, 404 can be semi-rigid or have springs at the hinges. The arms 402, 404 are configured to be tensioned during the compression phase and to spring back to their original form during the decompression phase. The arms 402, 404 are attached to the chest of the patient 408, either directly or to the chest compression actuator 104, which in turn is attached to the patient's chest. When the chest compression actuator 104 tensions the belt 106 around the patient to compress the patient's chest, the arms 402, 404 flex or bend, as shown in FIG. Figure 4B The arms 402, 404 apply an upward force to the patient (and / or belt 106).

[0122] In some embodiments incorporating semi-rigid arms, when the strap 106 relaxes during the decompression phase, both arms 402, 404 spring back to Figure 4A The original form shown. Because the arms 402, 404 are attached to the patient 408 (and / or the belt 106), the re-straightening of the arms pulls the patient's chest wall upward and applies a decompression force to the patient. The size of the decompression force applied can be adjusted by changing the material of the arms 402, 404, the length of the arms 402, 404, or the height of each of the arms 402, 404 above the patient 408. The arms 402, 404 can include aluminum, carbon fiber, glass-filled polycarbonate, metal or plastic. For semi-rigid arms, the arms 402, 404 can include metal, plastic, carbon fiber, polyurethane overmolded beryllium copper leaf springs. The arm can be between 5-24 inches above the platform to accommodate patients of different sizes (e.g., to accommodate chest sizes between 10-36 inches in diameter) and apply decompression forces of different sizes. In a specific example, the arms 402, 404 and / or the elastic element 410 can be configured to apply a force between 1-25 pounds to the patient.

[0123] In some embodiments, an ACD device described herein as utilizing a belt as a chest compression actuator for compressing a patient's chest may not include a belt, but may instead include another device for chest compression actuator 104. For example, the ACD device may include a piston or other rigid device to compress the patient's chest. Portions of the upward force actuator such as arms 402, 404 and / or a spring or elastic element may be coupled to the piston device and apply an upward decompression force to the piston, which is attached to the patient's chest and pulls the patient's chest upward. Alternatively, the arm, spring, or elastic element may be coupled directly to the patient's chest and pulls the patient's chest upward. The following description of the ACD device and the chest compression actuator 104 may be used to compress the patient's chest. Figure 18A-18B The upward force actuator including the piston is described in further detail.

[0124] The arms 402, 404 are coupled to the platform 102 by coupling mechanisms 412, 414, respectively. As described above, the coupling mechanisms can include one or more swivel joints, ball joints, etc. The arms 402, 404 can be stowed to the sides of the platform until the patient 408 is positioned for ACD therapy, whereupon the arms 402, 404 can be moved into position and attached to the patient and / or the belt 106.

[0125] Arms 402, 404 can be adjusted to provide a specific force or force curve for the patient's desired decompression amount. For example, arms 402, 404 can be configured to provide a predetermined decompression force between 1-25 pounds. In some embodiments, arms 402, 404 are configured to provide a maximum upward force (e.g., 3, 5, 10, 15, 20 pounds) at the deepest compression point, and during the decompression stage, the force decreases as the depth approaches zero or a neutral point. In other words, at the beginning of the decompression stage, the force is greater than the force at the end of the decompression stage, for example, the force at the end of the decompression stage is, for example, 80%, 50%, 20%, 10%, 5% or 1% of the force at the beginning of the decompression stage.

[0126] In some embodiments, the upward force actuator 400 can be configured to deliver sufficient force to reach a specific depth at a maximum decompression upward travel point below or above the zero point or neutral point. In some embodiments, the upward displacement of the chest obtained can be the zero position or neutral position of the chest. In another example, the arms 402, 404 of the upward force actuator 400 can be configured to provide a decompression force sufficient to achieve an upward displacement of the chest of approximately 0.25 to 4 inches relative to the neutral position or zero position of the chest. For a typical patient, an upward force of approximately 5-20 pounds is required to achieve an upward displacement of 2 inches relative to the neutral position or zero position.

[0127] Figure 5A-5EAn ACD device including an exemplary upward force actuator comprising a rigid band is shown. The upward force actuator comprising a rigid material also forms a chest compression actuator and is configured to be adhered to a patient to apply both compression and decompression forces to the patient's chest.

[0128] Go to Figure 5A and Figure 5E , upward force actuator 500 includes a rigid material 502. In some embodiments, rigid material 502 also forms the above-mentioned belt 106 and is part of chest compression actuator 104. Rigid material 502 includes a coupling mechanism 504 for coupling to the patient's chest. In some embodiments, the coupling mechanism may include one or more suction cups, skin adhesives, gels, etc., for coupling to the patient's chest wall or to a separate chest compression actuator. In some embodiments, the adhesive may include at least one material described in Table 1 below.

[0129] Table 1: Typical properties of common types of medical adhesives

[0130]

[0131] Actuators 506, 508 located on each side of the patient actuate the rigid material 502 up and down relative to the platform 102 to compress and decompress the patient's chest. In some embodiments, the rigid material 502 is inserted into the actuators 506, 508 in the platform 102 after the patient is positioned on the platform for ACD treatment.

[0132] Actuators 506, 508 each include a coupling mechanism to enable the motor of the actuator to drive each end of the rigid material up and down (e.g., as shown by arrow 514) to apply a decompression force and a compression force, respectively. Figure 5B As shown, the rigid material 502 may include a rack 512, and the motor may include a pinion element 510 to drive the rack 512 up and down relative to the platform 520. Each pinion 510 rotates in response to a signal received by the controller, which can control the amount of movement of the rigid material 502 and thus control the amount of compression or decompression force on the patient. In addition, the controller is configured to control the frequency of compression, as described below with respect to Fig.17 Further detailed description.

[0133] Actuators 506, 508 can be adjusted to provide a specific force or force curve for the patient's desired decompression amount. For example, actuators 506, 508 can be configured to provide a predetermined decompression force between 1-25 pounds. In some embodiments, actuators 506, 508 are configured to provide a maximum upward force (e.g., 3, 5, 10, 15, 20 pounds) at the deepest compression point, and during the decompression phase, the force decreases as the depth approaches zero or a neutral point. In other words, at the beginning of the decompression phase, the force is greater than the force at the end of the decompression phase, for example, the force at the end of the decompression phase is, for example, 80%, 50%, 20%, 10%, 5% or 1% of the force at the beginning of the decompression phase.

[0134] In some embodiments, the upward force actuator 500 can be configured to deliver sufficient force to achieve a specific depth at a maximum decompression upward travel point below or above the zero or neutral point. In some embodiments, the upward displacement of the chest obtained can be the zero position or neutral position of the chest. In another example, the actuators 506, 508 of the upward force actuator 500 can be configured to provide a decompression force sufficient to achieve an upward displacement of the chest of approximately 0.25 to 4 inches relative to the neutral position or zero position of the chest. For a typical patient, an upward force of approximately 5-20 pounds is required to achieve an upward displacement of 2 inches relative to the neutral position or zero position.

[0135] When performing ACD therapy, the rigid material 502 of the upward force actuator 500 extends from the actuator 506 to the actuator 508. The rigid material 502 may include one or more of plastic, fiberglass, aluminum, carbon fiber, glass-filled polycarbonate, carbon fiber, polyurethane, and overmolded beryllium copper leaf springs. The rigid material 502 of the upward force actuator 500 may be configured to be attached to the patient's chest. As described above, the rigid material is attached to the patient. When the actuator drives the rigid material 502 upward relative to the platform during the decompression phase of the compression cycle, the rigid material pulls the chest wall upward, decompressing the chest. When the actuator drives the rigid material 502 downward relative to the platform during the compression phase of the compression cycle, the rigid material pulls the chest wall downward, compressing the chest. The rigid material 502 moves directly upward and downward to pull the chest wall upward / downward, thereby minimizing or avoiding squeezing the sides of the patient.

[0136] Figure 5C-5D Examples of actuators 504, 506 for use with the ACD device 500 are shown. Figure 5C A platform 520 for supporting a patient is shown. The platform 520 includes a first actuator 522 and a second actuator 524. The actuators are secured to the rigid material 502. For example, the actuators 522, 524 can be secured to the rigid material 502 by clips. In some embodiments, the rigid material 502 is looped through a slot (e.g., slot 528) and fastened back to itself using a snap fastener or the like. Figure 5D Shows Figure 5C 528. An actuator 522 is shown from a side with a slot 528. The actuator 522 moves in and out of the platform 520 to move the rigid material 502 up and down relative to the platform to apply a compressive force and a decompressive force, respectively. In some embodiments, the actuator can pivot to rotate the rigid material 502 out of the way of the patient. For example, if the patient is interrupting ACD therapy, the actuator shown by the exemplary actuator 530 can pivot the rigid material 502 upward over the patient's head so that the rigid material is approximately coplanar with the platform 502 and out of the way of the patient without removing or disassembling the rigid material from the rest of the ACD device 500. As described above, the actuator 522 can be adjusted to provide a specific force or force curve for the patient's desired amount of decompression.

[0137] Go to Figure 6 Based on the ACD device described herein, an exemplary retractable arm 600 for various arms, rods, levers or plates is configured to rotate under the platform 102. For example, the arm 600 may include the above reference Figure 1 and Figure 3A-Figure 4B The rigid arm or retractable arm described above. Joint 602 may include a ball joint. The ball joint allows arm 600 to pivot and rotate to adjust the amount of compression and decompression force applied by the upward force actuator and chest compression actuator of the ACD device. In some embodiments, joint 602 includes a hinge to allow the arm to rotate under the platform. In some embodiments, such as with respect to Figure 3C As described, arm 600 may include notch or extension 604. The arm may be set against rod 606 to set the angle θ of the arm relative to platform 102. The angle of arm 600 may be varied to accommodate patients of different sizes and to adjust the amount of decompression force of the upward force actuator.

[0138] The angle of arm 600 can be adjusted to provide a specific force or force curve for the patient's desired decompression amount. For example, arm 600 can be configured to provide a predetermined decompression force between 1-25 pounds. In some embodiments, arm 600 is configured to provide a maximum upward force (e.g., 3, 5, 10, 15, 20 pounds) at the deepest compression point, and the force decreases as the depth approaches zero or a neutral point during the decompression phase. In other words, at the beginning of the decompression phase, the force is greater than the force at the end of the decompression phase, for example, the force at the end of the decompression phase is, for example, 80%, 50%, 20%, 10%, 5% or 1% of the force at the beginning of the decompression phase.

[0139] In some embodiments, the arm 600 can be configured to deliver sufficient force at a maximum decompression upward travel point below or above the zero or neutral point to achieve a specific depth. In some embodiments, the upward displacement of the chest obtained can be the zero position or neutral position of the chest. In another example, the arm 600 can be configured to provide a decompression force sufficient to achieve an upward displacement of the chest of approximately 0.25 to 4 inches relative to the zero or neutral position of the chest. For a typical patient, approximately 5-20 pounds of upward force is required to achieve an upward displacement of 2 inches relative to the neutral or zero position.

[0140] Fig. 7A A top view of an exemplary ACD device 700 is shown. The ACD device 700 includes an upward force actuator 712, which includes two arms 704, 706, which form an "X" structure above the chest of a patient 708. Arms 704, 706 can be rigid arms or retractable arms (or a combination of both) as described above. Arms 704, 706 cross at the approximate center 710 of the patient's chest and are configured to provide decompression force on the patient's sternum during the decompression phase. Adding a second arm above the patient helps to stabilize the upward force actuator 712 during the compression cycle and reduce the shear force applied by the upward force actuator to the patient 708. As with the upward force actuator described above, arms 704, 706 can be configured to be attached to the chest compression actuator 104 (which in turn will be attached to the patient 708), or arms 704, 706 can be directly attached to the patient by a coupling mechanism (e.g., skin adhesive, suction cup, gel, etc.). Arms 704, 706 are coupled to platform 702 at locations 714a, 714b, 714c, and 714d. When the patient is positioned on the platform, locations 714a-b are above the shoulders of patient 708, and locations 714c-d are below the armpits of patient 708. Locations 714a-d are located away from the patient on the platform to further reduce shear forces on the sides of the arms 704, 706 near where the arms are positioned relative to platform 702.

[0141] Figure 7B-Figure 7E Shown for Fig. 7A An exemplary upward force actuator of an ACD device 700 that uses at least two arms to generate a reduced pressure force on a patient. Figure 7B, which shows a top view of the upward force actuator 720. The upward force actuator 720 is combined with a chest compression actuator (such as the chest compression actuator 104 described above). The force distribution portion 112 is attached to the belt 106. The upward force actuator 720 includes four retractable arms 722a, 722b, 722c and 722d. The arms 722a-d are connected to the force distribution portion 112 of the chest compression actuator 104 through the central portion 724. In some embodiments, the belt 106, the force distribution portion 112, the central portion 724 and the arms 722a-d are modular with respect to the rest of the ACD device 100 and can be removed and added from the platform 102 for ACD treatment as needed. The belt 106, the force distribution portion 112, the central portion 724 and the arms 722a-d can form a disposable removable assembly. In some embodiments, the arms 722a-d and the central portion 724 can be modular with respect to the chest compression actuator 104. The central portion 724 can include a coupling mechanism (e.g., Velcro, adhesive, etc.) such that the arms 722a-d and the central portion can be added / removed from the strap 106 and force distribution portion 112 of the chest compression actuator 104.

[0142] The arms 722a-d may be, for example, Fig. 7A The central portion 724 is inserted into a slot in the platform 702 near the position 714a-d of the chest compression actuator 104. When the central portion 724 is pulled downward by the belt 106 of the chest compression actuator 104 during the compression phase, because the ends of the arms 722a-d are fixed in the slot of the platform, the arms 722a-d bend inwardly toward each other and become tensioned. Therefore, the arms 722a-d are configured to bend and be in tension during the compression phase when the belt 106 is tensioned to compress the patient. The arms 722a-d are configured to at least partially rebound (e.g., re-straighten) to their original shape to provide a lifting force to the patient's sternum and decompress the patient's chest.

[0143] In some embodiments, arms 722a-d are coupled to platform 702 (e.g., via swivel joints, ball joints, etc.). To couple arms 722a-d to central portion 724 or chest compression actuator 104, the arms can be inserted into sleeves or slots in the central portion (similar to a tent). In some embodiments, the two longer arms extend completely across platform 702, such as Fig.7D As shown. The two arms cross each other and are connected by a central portion 724 or other connecting mechanism. In this example, arms 722a and 722d will be replaced by first arms 740, and arms 722b and 722c will be replaced by second arms 742.

[0144] Arms 722a-d each include a material or structure that is configured to bend and provide lifting force to the central portion 724 and / or the chest compression actuator 104. In some embodiments, arms 722a-d each include a bendable or flexible material piece such as metal or plastic. In some embodiments, the arm includes a telescopic rod that can be shortened or elongated to adjust the size of the decompression force applied to the patient by the upward force actuator 720. In some embodiments, with an elastic cord as a shock core, arms 722a-d each include fiberglass. The rod can be decomposed into multiple segments to elongate or shorten the rod. In some embodiments, arms 722a-d can be stored in the platform 702, but can be removed from the platform. In some embodiments, arms 722a-d are configured to fold in one direction but engage in another direction (e.g., a hinge that opens to 180 degrees).

[0145] Go to Figure 7C , shown above patient 708 Figure 7B 720 . When the belt 106 is tensioned over the chest of the patient 708, the arms 722a and 722b are shown in a tensioned state. The end 730a of the arm 722a and the end 730b of the arm 722b (e.g., by the force distribution mechanism 112 attached to the patient's chest) respectively apply an upward force to the central portion of the patient's chest. The arms 722a, 722b are anchored in the grooves 732a, 732b in the platform 702, respectively. When the belt 106 is relaxed around the patient, the arms 722a, 722b can at least partially straighten back to their original form and provide a decompression force near the ends 730a, 730b to decompress the patient's chest. The length of the arms and the type of material used in the arms can be changed to adjust the amount of decompression force acting on the patient. In some embodiments, the arms 722a-d can have various lengths to accommodate various chest sizes of individual patients. In some embodiments, the amount of decompression force provided by the arms 722a-d together is between 1-25 lbs. The arms 722a-d may include plastic, metal, fiberglass, aluminum, carbon fiber, and / or glass-filled polycarbonate. For semi-rigid arms, the arms 1102, 1104 may include plastic, metal, carbon fiber, polyurethane overmolded beryllium copper leaf springs.

[0146] Go to Fig. 7E , which shows a perspective view of the upward force actuator 720. The arms 722a-d are bent and in tension, similar to Figure 7C The arms 722a-d are coupled to the central portion 724. The platform 702 includes slots 750, 752 for receiving the arms 722a, 722d, respectively. Additional slots (not shown) are provided for the arms 722b-c.

[0147] One or more arms 722a-d can be adjusted to provide a specific force or force curve for the patient's desired decompression amount. For example, one or more arms 722a-d can be configured to provide a predetermined decompression force between 1-25 pounds. In some embodiments, one or more arms 722a-d are configured to provide a maximum upward force (e.g., 3, 5, 10, 15, 20 pounds) at the deepest compression point, and the force decreases as the depth approaches zero or a neutral point during the decompression stage. In other words, at the beginning of the decompression stage, the force is greater than the force at the end of the decompression stage, for example, the force at the end of the decompression stage is, for example, 80%, 50%, 20%, 10%, 5% or 1% of the force at the beginning of the decompression stage.

[0148] In some embodiments, the upward force actuator 720 can be configured to deliver sufficient force at a maximum decompression upward travel point below or above the zero or neutral point to achieve a specific depth. In some embodiments, the upward displacement of the chest obtained can be a zero position or neutral position of the chest. In another example, one or more of the arms 722a-d of the upward force actuator 720 can be configured to provide a decompression force sufficient to achieve an upward displacement of the chest of approximately 0.25 to 4 inches relative to the neutral or zero position of the chest. For a typical patient, an upward force of approximately 5-20 pounds is required to achieve an upward displacement of 2 inches relative to the neutral or zero position.

[0149] In some embodiments, the ACD device 700 described herein as utilizing a belt as a chest compression actuator for compressing a patient's chest may not include a belt, but may instead include another device for the chest compression actuator 104. For example, the ACD device 700 may include a piston or other rigid device to compress the patient's chest. The arms 722a-d may be coupled to the piston device and apply an upward decompression force to the piston, which is attached to the patient's chest and pulls the patient's chest upward. Alternatively, the arm may be directly coupled to the patient's chest and pull the patient's chest upward.

[0150] Figure 8A-8C The invention is shown for use herein (e.g., Figure 1-7E ) is an example of a retractable arm of an upward force actuator of an ACD device. Fig. 8A A retractable arm 800 is shown. The arm 800 is configured to retract when a force is applied to the Figure 8B The arm 800 includes a segment 802 and a flexible backing 804. When the arm 800 is as shown in FIG. Figure 8B When the arm 800 is bent as shown by arrow 812 in FIG. Figure 8CWhen the arm 800 is flexed in the opposite direction indicated by arrow 810, the arm can be rolled up or otherwise collapsed. In some embodiments, the arm 800 can be collapsed for storage purposes. For example, the arm 800 can be stored on a platform (e.g., Figure 1 In some embodiments, arm 800 is a unitary material that includes both segment 802 and backing 804 in a single piece of material. In some embodiments, arm 800 includes a series of segments, each of which includes a rigid material attached to a flexible backing material.

[0151] Figure 9A-9B An example ACD device including an upward force actuator is shown. Figure 9A-9B In both, the upward force actuator includes a leaf spring mechanism that actively or passively flexes to apply a decompressive force to the patient 902. Fig. 9A , which shows a side view of an upward force actuator 900, which includes a leaf spring 908 extending from a platform 102. The leaf spring 908 is coupled to the platform via a coupling mechanism 904. The coupling mechanism 904 includes a joint for rotating the leaf spring 908 relative to the platform 102. In some embodiments, the coupling mechanism includes an actuator that can actively rotate the leaf spring 908 as indicated by an arrow near the coupling mechanism 904. By rotating the leaf spring 908 upward and away from the patient, the actuator can control the leaf spring 908 to actively apply a decompression force to the patient 902. The leaf spring 908 is coupled to the patient via a coupling mechanism 906 (e.g., as described above, directly or via a chest compression actuator 104, such as a belt 106 and a load distribution portion 112). When the actuator is as Fig. 9A When rotated clockwise as shown, leaf spring 908 pulls the patient's chest upward. In some embodiments, leaf spring 908 can passively provide decompression force to the patient by the tension occurring in the leaf spring during the compression phase of the ACD compression cycle, for example, when the leaf spring is coupled to a chest compression actuator or positioned between the patient's chest and the chest compression actuator so that compression by the chest compression actuator causes the leaf spring to flex or bend under tension. When belt 106 is relaxed around the patient, leaf spring 908 releases tension and pulls the patient's chest upward. Here, leaf spring 908 extends above the head of patient 902, providing access to both sides of the patient for the rescuer if necessary. Alternatively, the leaf spring can extend from the side of the platform to the top of the patient, or can be moved back and forth or extend from either side or end of the platform to provide maximum flexibility regarding patient access.

[0152] Go to Fig. 9B , which shows an axial view of an upward force actuator 910 having at least two leaf springs. Fig. 9B In FIG. 1 , two leaf springs 912 and 914 are shown, and the two leaf springs 912 and 914 are Fig. 9A The leaf spring 908 is coupled to the patient at the device 916 (e.g., directly or through the chest compression actuator 104, such as the belt 106 and the load distribution portion 112) in a similar manner. The two actuators 918 and 920 can be rotated in a similar manner as the actuator 904 to cause the leaf springs 912, 914 to apply a decompression force to the chest of the patient 902. Here, the leaf springs 912, 914 extend from both sides of the platform 902 to the top of the patient 902. Alternatively, the leaf springs can extend from the platform to above the patient's head, or can be moved back and forth or extend from either side or end of the platform to provide maximum flexibility with respect to patient access.

[0153] The leaf springs 908, 912, 914 and (if applicable) their respective actuators 918, 920 can be adjusted to provide a specific force or force curve for the patient's desired decompression amount. For example, one or more of the leaf springs 908, 912, 914 and (if applicable) their respective actuators 918, 920 can be configured to provide a predetermined decompression force between 1-25 pounds. In some embodiments, the leaf springs 908, 912, 914 and (if applicable) their respective actuators 918, 920 are configured to provide the greatest upward force (e.g., 3, 5, 10, 15, 20 pounds) at the deepest compression point, and the force decreases as the depth approaches zero or a neutral point during the decompression phase. In other words, at the beginning of the decompression phase, the force is greater than the force at the end of the decompression phase, for example, the force at the end of the decompression phase is, for example, 80%, 50%, 20%, 10%, 5%, or 1% of the force at the beginning of the decompression phase.

[0154] In some embodiments, the upward force actuator 910 can be configured to transmit sufficient force at the maximum decompression upward stroke point below or above the zero point or neutral point to reach a specific depth. In some embodiments, the upward displacement of the chest obtained can be the zero position or neutral position of the chest. In another example, the leaf springs 908, 912, 914 of the upward force actuator 910 and (if applicable) their respective actuators 918, 920 can be configured to provide a decompression force sufficient to achieve an upward displacement of the chest relative to the neutral position or zero position of the chest of approximately 0.25 to 4 inches. For a typical patient, an upward force of approximately 5-20 pounds is required to achieve an upward displacement of 2 inches relative to the neutral position or zero position.

[0155] In some embodiments, the ACD device described herein as utilizing a belt as a chest compression actuator for compressing a patient's chest may not include a belt, but may instead include another device for the chest compression actuator 104. For example, the ACD device 100 may include a piston or other rigid device to compress the patient's chest. Leaf springs 908, 912, 914 may be coupled to the piston device and apply an upward decompression force to the piston, which is attached to the patient's chest and pulls the patient's chest upward. Alternatively, the leaf spring may be directly coupled to the patient's chest and pulls the patient's chest upward.

[0156] Fig.10 Examples of compression belts are shown, including those attached to the examples described herein. Figure 1-9B An example of a force distribution mechanism 1000 for a belt 106 of a chest compression actuator 104 for an ACD device. In any embodiment described herein where an upward force actuator is coupled to the belt 106 and / or force distribution mechanism of a chest compression actuator 104, the chest compression actuator is capable of transmitting the decompression force of the upward force actuator to a patient. In such an embodiment, the chest compression actuator 104 comprises a high strength material having a high tensile strength (e.g., capable of withstanding up to several hundred pounds). The high tensile strength of the material of the chest compression actuator 104 ensures that the decompression force pulling the chest compression actuator also pulls the patient to which the chest compression actuator 104 is attached.

[0157] The force distribution mechanism 1000 is configured to distribute the compressive force (or, in some embodiments, decompressive force) of the chest compression actuator 104 during a compression cycle. The force distribution mechanism 1000 may include a bladder 1002 or other fluid-filled container attached to the belt 106. When the belt 106 is tightened around the patient 1008, the compressive force is distributed across the patient's chest through the bladder 1002. For example, the pressure applied to the patient by the bladder may be less than 5.7 PSI.

[0158] The pouch 1002 can include a fluid (air or liquid) filled interior 1006. In some embodiments, the interior 1006 can be foam rather than fluid. The interior 1006 can include a plurality of tension cords 1004a-c that transmit a force applied by an upward force actuator at a point 1010 on the top surface of the pouch 1002 (e.g., as indicated by arrow 1012) to a bottom surface 1014 and to the chest of a patient 1008 attached to the bottom surface 1014 of the pouch 1002.

[0159] The plurality of tension cords 1004a-c may include resilient elements such as springs, bungee cords, etc. The plurality of tension cords 1004a-c are distributed throughout the interior 1006 of the bladder 1002 such that the bladder 1002 does not substantially deform when a decompressive force is transmitted from the upward force actuator to the patient.

[0160] In some embodiments, the upward force actuator is attached to the bladder 1002 at a single point 1010 (eg, Fig.10 However, the upward force actuator may be attached or coupled to the bladder at multiple points (e.g., if multiple leaf springs are used, as described above with reference to Fig. 9B In some embodiments, the upward force actuator may use a larger surface (e.g., Figure 7B-Figure 7E The central portion 724 of the chest compression actuator 104 is coupled to the bladder 1002. In some embodiments, the upward force actuator is coupled to a different portion of the chest compression actuator 104 than the force distribution portion 1000 (eg, the belt 106).

[0161] When the upward force actuator is coupled to the chest compression actuator 104, the chest compression actuator 104 is attached to the patient's chest through the coupling mechanism. This is because the upward force actuator is coupled to the patient's chest wall in order to pull the chest wall upward and decompress the patient 1008. The chest compression actuator 104 is attached to the chest of the patient 1008. In some embodiments, the force distribution mechanism 1000 is the portion of the chest compression actuator 104 that is attached to the patient 1008.

[0162] In some embodiments, the force distribution mechanism 1000 is attached to the chest by an adhesive. The adhesive includes a skin adhesive that attaches the pouch 1002 to the patient 1008. The adhesive can be selected to limit the amount of decompression force that can be applied to the patient. For example, an adhesive that withstands 1-25 pounds of force before separation from the patient 1008 can be selected. The adhesive can include one or more skin adhesives. The adhesive can include at least the materials shown above in Table 1.

[0163] In some embodiments, the adhesive conforms to the surface of the patient's chest and is hydrophilic and resistant to contaminants (e.g., hair, sweat, etc.) between the bottom surface 1014 of the bladder 1002 and the patient 1008. In some embodiments, when compression is performed (e.g., up to 120 pounds of force), the adhesive reseals to the patient with each cycle (e.g., if the adhesive begins to peel during the decompression phase).

[0164] In some embodiments, the force distribution mechanism 1000 is adhered to the patient 1008 via a suction cup. Similar to an adhesive, the suction force of the suction cup can be reset during the compression phase of the compression / decompression cycle. The suction cup can include a natural leakage system so that the suction cup automatically vents during use. In some embodiments, the suction cup can be large (e.g., on the order of several centimeters in diameter). In some embodiments, the suction cup can be a micro-cup (e.g., on the order of several microns in diameter). The number of suction cups can range from a single suction cup to thousands of suction cups.

[0165] In some embodiments, the upward force actuator is not coupled to the top of the chest compression actuator 104 (e.g., not coupled to the top surface of the force distribution mechanism 1000). Instead, the upward force actuator is configured to be coupled directly to the patient below the chest compression actuator 104, thereby eliminating the need for a tension cord.

[0166] Figure 11A-11B An ACD device including an exemplary upward force actuator 1100 is shown. Arms 1102, 1104 extend from a platform 102 on either side of a patient 1108. The arms can be rotatably coupled to the platform 102 to rotate from a storage position (e.g., along the length of the platform 102 and generally parallel to the platform 102) to a position for use in ACD treatment (e.g., along the length of the platform 102 and generally parallel to the platform 102). Figure 11A-11B ) upright position shown in . Arms 1102, 1104 can be formed of rigid materials such as fiberglass, plastic, metal, aluminum, carbon fiber, glass-filled polycarbonate. For semi-rigid arms, arms 1102, 1104 can include carbon fiber, polyurethane overmolded beryllium copper leaf springs, etc. The arms can be formed from metals, polymers, or natural products alone or in combination to create hard and flexible areas for desired functions. The arms can include multiple segments with springs incorporated at the joints to generate force. Alternatively, the arms can include rigid members with elastic straps to act as force actuators.

[0167] In some embodiments, the arms may include separate or composite metals, polymers, or natural products to create hard and flexible regions for providing upward force via straps. In some embodiments, the arms 1102, 1104 may include multiple segments incorporating springs at joints to generate force. In some embodiments, the arms 1102, 1104 include a rigid member with an elastic strap 1106 to act as a force actuator.

[0168] The strap 1106 is attached to each arm 1102, 1104 on either side of the patient. The strap 1106 is also attached to the chest compression actuator 104 (e.g., as described above with respect to the embodiment of the present invention) directly or through the end or center of the sternum or chest compression actuator. Fig.10 In some embodiments, the strap 1106 is configured to be attached to the patient 1108 indirectly. In some embodiments, the strap 1106 is configured to be attached to the patient via a coupling mechanism such as a skin adhesive, a suction cup, etc. In some embodiments, the strap 1106 is configured to be attached to the patient via a coupling mechanism such as a skin adhesive, a suction cup, etc. etc. are connected to the chest compression actuator 104, Press the ring in the actuator through your chest.

[0169] In some embodiments, the strap 1106 comprises a single member with each end of the member attached to the arms 1102, 1104 and loosely threaded through the anchors or rigidly attached to the patient via the coupling mechanism. In some embodiments, the strap 1106 comprises one or more discrete attachment points to the patient coupling mechanism to help the coupling mechanism resist peeling from the patient. In some embodiments, the strap 1106 connected to the arms 1102, 1104 is variable to adjust the force applied to the patient (e.g., based on the size of the patient).

[0170] Go to Fig.11A , when the patient is in an uncompressed state, strap 1106 is clamped to arms 1102, 1104 and attached to the patient. Strap 1106 may be clamped to the arms at couplings 1110, 1112. Couplings 1110, 1112 may include clips, loops, buckles, etc. Arms 1102, 1104 extend generally vertically and may be slightly bent over the patient. Go to Fig. 11B , when the chest compression actuator 104 compresses the patient's chest, the strap pulls on each arm 1102, 1104, causing tension in each arm. The arms bend over the patient and pull the strap 1106 upward. When the chest compression actuator 104 allows the strap 106 to relax around the patient, both arms 1102, 1104 rebound to straighten again and pull the strap 1106 attached to the patient's chest upward, decompressing the patient's chest.

[0171] Arms 1102, 1104 can be adjusted to provide a specific force or force curve for the patient's desired decompression amount. For example, one or more of arms 1102, 1104 can be configured to provide a predetermined decompression force between 1-25 pounds. In some embodiments, arms 1102, 1104 are configured to provide a maximum upward force (e.g., 3, 5, 10, 15, 20 pounds) at the deepest compression point, and the force decreases as the depth approaches zero or a neutral point during the decompression stage. In other words, at the beginning of the decompression stage, the force is greater than the force at the end of the decompression stage, for example, the force at the end of the decompression stage is, for example, 80%, 50%, 20%, 10%, 5% or 1% of the force at the beginning of the decompression stage.

[0172] In some embodiments, the upward force actuator 1100 can be configured to deliver sufficient force at a maximum decompression upward travel point below or above the zero or neutral point to achieve a specific depth. In some embodiments, the upward displacement of the chest obtained can be the zero position or neutral position of the chest. In another example, the arms 1102, 1104 of the upward force actuator 1100 can be configured to provide a decompression force sufficient to achieve an upward displacement of the chest of approximately 0.25 to 4 inches relative to the neutral position or zero position of the chest. For a typical patient, an upward force of approximately 5-20 pounds is required to achieve an upward displacement of 2 inches relative to the neutral position or zero position.

[0173] Figure 12-13 An exemplary upward force actuator is shown that is configured to be coupled to an external structure 1200 for an ACD device. Fig.12 , as shown in the axial view, the external structure 1200 is positioned adjacent to the ACD device 100. The elastic device 1202 is coupled to the patient 1204, either directly attached to the patient or coupled to the patient through the chest compression actuator 104. For example, the elastic device 1202 is coupled to the force distribution mechanism 112 of the chest compression actuator 104. When the chest compression actuator 104 compresses the chest of the patient 1204 by tightening the belt 106, the elastic device 1202 extends and applies a lifting force to the force distribution mechanism 112. When the chest compression actuator 104 relaxes the belt 106, the elastic device 1202 pulls upward on the force distribution mechanism 112 attached to the patient and applies a decompressing force to the patient 1204. The elastic device 1202 is secured to the patient 1204 by a hook or latch or hook and loop system, In some embodiments, the resilient device 1202 is attached to a coupling surface that is not part of the chest compression actuator 104 but is directly coupled to the patient. For example, a coupling surface of a plate can be positioned below the chest compression actuator 104 or on another part of the patient 1204.

[0174] The elastic device 1202 may include one or more of a spring, an elastic material, a bungee cord, etc. The elastic device 1202 is configured to be coupled to a portion of the external structure 1200. For example, the external structure 1200 may include a hook, a latch, or a loop, and the elastic device 1202 may include a corresponding hook, latch, or loop to couple to an external surface. In some embodiments, the elastic device 1202 may include an adhesive, a suction cup, etc., so that the elastic device can be coupled to various external surfaces.

[0175] In some embodiments, the elastic device 1202 is attached to the patient and allows the patient's chest to be decompressed when the chest compression actuator 104 relaxes the belt 106. In this example, the elastic device 1202 can be attached to the patient by a coupling mechanism such as a skin adhesive, one or more suction cups, etc.

[0176] As mentioned above, elastic device 1202 comprises a first end configured to be connected to an external structure and a second end configured to be connected to a patient. For one or both ends of elastic device 1202, the strength of the coupling mechanism can be configured to keep coupling until the maximum force applied on the patient. For example, elastic element 1202 can include an adhesive configured to withstand 1-25 pounds of force before separating (for example, disengaging from the patient) from the patient. Adhesive can include one or more skin adhesives. Adhesive can include at least the material, suction cup or other materials shown in Table 1 above. In some embodiments, coupling mechanism can be designed to disengage when force exceeds maximum decompression force. For example, detachable hinges, hooks, loops, etc. can be built into elastic device 1202 and / or structure 1204 to limit maximum decompression force.

[0177] External structure 1204 may be provided with ACD device 100 or may be a separate structure. Structure 1204 may be any rigid structure supported by a mechanism other than platform 102. Fig.13 , which shows a perspective view of an external structure 1200. The external structure 1200 may be a ceiling of an ambulance, a patient room, etc. The external structure 1200 may be a rigid structure that is movable, retractable, and / or provided with an ACD device 100 for transportation. The external structure 1200 may include a resilient device 1202 and a coupling mechanism 1306 that is configured to couple with the chest compression actuator 104 and / or directly to the patient.

[0178] Fig.14 A side view of an ACD device 1400 is shown, which is configured to be coupled to an external structure 1402 (or alternatively to an arm, pole, or structure coupled to a platform as described in the above embodiments). The ACD device 1400 includes a lever arm 1404 attached to a chest compression actuator 1406 of the ACD device 1400. In some embodiments, the lever arm 1404 and the chest compression actuator 1406 are a single device. In some embodiments, the lever arm 1404 and the chest compression actuator 1406 are separate modular devices. Similar to Figure 12-13 The ACD device 1400 may include an elastic device 1408 connecting the lever arm 1404 to the external structure 1410.

[0179] The lever arm 1404 includes a rigid material that transfers force from the resilient device 1408 to the patient (e.g., via the chest compression actuator 1406 and / or directly to the patient 1412). The length of the lever arm 1404 is sized to adjust the amount of decompression force on the patient 1412. Adjusting the length of the lever arm 1404 can allow the characteristics of the resilient device 1408 to have a larger tolerance, so that the amount of decompression force can be fine-tuned without a special resilient device. For example, the lever arm 1404 can be a telescopic structure that can extend and retract. The length of the lever arm 1404 can be adjusted based on the size of the patient and / or the desired amount of decompression force. The length of the lever arm 1404 can also be adjusted based on the relative position of the external structure 1410 or other rods or arms (e.g., based on the distance of the external structure from the patient's chest).

[0180] The lever arm 1404 forms an anatomical hinge with the center of the patient's thorax, thereby providing greater decompression force to the patient's chest wall. The lever arm 1404 acts as a Class I lever, pulling the patient's chest upward with a relatively large force while requiring relatively small force from the elastic device 1408. For example, the tension of the elastic device 1408 can be applied to obtain a decompression force on the patient's chest in the range of 1-25 pounds.

[0181] Go to Fig.15 , which shows an ACD device including an exemplary upward force actuator 1500, which includes an independent pressure relief device 1502, which can be used, for example Figure 12-14 The stand-alone pressure relief device 1502 includes a feedback sensor 1504 that measures the amount of force applied to the patient to reduce pressure and / or compress the patient. In some embodiments, the feedback sensor 1504 includes a force sensor such as a strain sensor, a dynamometer, etc. to directly measure the force applied to the patient. In some embodiments, the feedback sensor includes an axis encoder to measure how much the rope or other mechanism has been extended to indirectly measure the force applied to the patient. Similar to Figure 12-14 In an ACD device of the present invention, the external structure 1506 (or other structure extending from the platform) can be connected to the ACD device by a coupling mechanism 1508. In some embodiments, the coupling mechanism does not need to be elastic. Instead, the coupling mechanism can include a rigid material that is driven up and down to apply a compressive force and a decompressive force to the patient (e.g., similar to or including a piston). The motor 1510 can drive the coupling mechanism to provide a compressive force and a decompressive force to the patient. In some embodiments, the coupling mechanism is an elastic element connected to the chest compression actuator 104 (such as connected to a force distribution mechanism and / or a belt 106).

[0182] The independent decompression device 1500 can be adjusted to provide a specific force or force curve for the patient's desired decompression amount. For example, the independent decompression device 1500 can be configured to provide a predetermined decompression force between 1-25 pounds. In some embodiments, the decompression device 1500 is configured to provide a maximum upward force (e.g., 3, 5, 10, 15, 20 pounds) at the deepest compression point, and during the decompression phase, the force decreases as the depth approaches zero or a neutral point. In other words, at the beginning of the decompression phase, the force is greater than the force at the end of the decompression phase, for example, the force at the end of the decompression phase is, for example, 80%, 50%, 20%, 10%, 5% or 1% of the force at the beginning of the decompression phase.

[0183] In some embodiments, the pressure relief device 1502 can be configured to deliver sufficient force at a maximum pressure relief upward travel point below or above a zero or neutral point to achieve a specific depth. In some embodiments, the upward displacement of the chest achieved can be a zero or neutral position of the chest. In another example, the pressure relief device 1502 can be configured to provide a pressure relief force sufficient to achieve an upward displacement of the chest of approximately 0.25 to 4 inches relative to a neutral or zero position of the chest. For a typical patient, approximately 5-20 pounds of upward force is required to achieve an upward displacement of 2 inches relative to a neutral or zero position.

[0184] In some embodiments, the self-contained pressure relief device 1500 can be attached to the patient under the compression belt 106. The belt 106 is tightened to pull the upward force actuator downward. When the chest compression actuator relaxes the belt, the upward force actuator pulls the patient's chest upward and relieves pressure on the patient's chest.

[0185] Fig.16 Shown for use Figure 1-Figure 15 An exemplary process 1600 of performing ACD therapy with an ACD device of the present invention. An ACD system is provided for performing active compression decompression therapy on a patient (1602). The patient is positioned on a platform in such a manner that the platform is located below the patient. The patient is positioned on the platform to align the patient's chest with the belt (1604). A chest compression actuator (e.g., including a belt) extends over the patient's chest (1606). The belt extends from the platform on a first side of the patient to a second side of the patient opposite to the first side. An upward force actuator is attached to the patient's chest by a coupling mechanism to transfer a decompression force from the upward force actuator to the patient's chest (1608). The upward force actuator is directly coupled to the patient's chest by a skin adhesive, or indirectly coupled to the patient's chest by coupling to the belt. The motor coupled to the belt is configured to tighten the belt around the patient's chest and apply a compressive force to the patient's chest, and to relax the belt around the patient's chest and allow the upward force actuator to apply a decompression force to the patient's chest. Operation of the system begins to repeatedly cycle tensioning and relaxing of the belt around the patient's chest (1610).

[0186] In some embodiments, the chest compression actuator includes a piston. The piston mechanism is positioned above the patient's chest and is configured to apply a compressive force to the patient's chest. A motor coupled to the piston mechanism is configured to cause the piston to compress the patient's chest by moving downward against the patient's chest. The motor is configured to move the piston upward away from the patient's chest and allow the upward force actuator to apply a decompressive force to the patient's chest.

[0187] Fig.17 Shows the control Figure 1-Figure 16 and Figures 18A-18C One or more operations of the ACD device and performs Fig.16 1700 for an exemplary computing device for the process of. Embodiments may be implemented in digital electronic circuitry, computer hardware, firmware, software, or a combination thereof. The apparatus of the present invention may be implemented in a computer program product tangibly embodied or stored in a machine-readable storage device for execution by a programmable processor 1710; and the method actions may be performed by the programmable processor 1710, which executes a program of instructions to perform the functions of the present invention by operating on input data and generating output. Embodiments may be advantageously implemented in one or more computer programs executed on a programmable system including at least one programmable processor 1710, which is coupled to a data storage system 1730, at least one input device 1740, and at least one output device to receive data and instructions and to transmit data and instructions. Each computer program may be implemented in a high-level procedural or object-oriented programming language, or, if desired, in assembly language or machine language; and in any case, the language may be a compiled language or an interpreted language.

[0188] For example, processors suitable for executing computer programs include general and special purpose microprocessors and any one or more processors of any kind of digital computer. Typically, the processor will receive instructions and data from a read-only memory or a random access memory or both. The basic elements of a computer are a processor for executing instructions and one or more storage devices 1720 for storing instructions and data. Typically, the computer will also include one or more large-capacity storage devices 1730 for storing data or be operably connected to one or more large-capacity storage devices 1730 for storing data, to receive data from the large-capacity storage device 1730 or to transfer data to the large-capacity storage device 1730, or both to receive and transmit data, the large-capacity storage device 1730 is, for example, a magnetic disk, a magneto-optical disk, or an optical disk. Data can be transmitted via one or more communication protocols, including Bluetooth, TCP / IP, RFID (or other near field communication), WIFI, etc. Computer readable media for containing computer program instructions and data include: all forms of non-volatile memory, including, by way of example, semiconductor memory devices such as EPROM, EEPROM, and flash memory devices; magnetic disks, such as internal hard disks or removable disks; magneto-optical disks; and CD ROM and DVD-ROM disks. The processor and memory may be supplemented by, or integrated into, special purpose logic circuitry. Any of the foregoing may be supplemented by, or integrated into, an ASIC (application specific integrated circuit).

[0189] To provide interaction with a user, embodiments may be implemented on a computer having a display device (e.g., an LCD (liquid crystal display) monitor) for displaying information to the user, and a keyboard and pointing device (e.g., a mouse or trackball) for the user to provide input to the computer. Other types of devices may also be used to provide interaction with the user; for example, the feedback provided to the user may be any form of sensory feedback, such as visual feedback, auditory feedback, or tactile feedback; and input from the user may be received in any form, including sound, voice, or tactile input. The display device may be used for input Figure 1-Figure 15 instructions for use with the device (e.g., decompression and / or compression amplitude settings).

[0190] The computing device 1700 may form a controller for controlling the ACD therapy of the ACD device. The computing device 1700 may control the frequency of the compression cycles of the ACD therapy as well as the depth, force, period, and number of cycles of the ACD therapy.

[0191] Figures 18A-18CAn example of an ACD device 1800 is shown. The ACD device 1800 includes a chest compression actuator 1802 that provides compression force to the patient 128 through a piston mechanism 1804. The piston mechanism 1804 includes a suction cup 1806 (or other such coupling mechanism, such as the coupling mechanism described above) and a piston element 1842 coupled to the suction cup and an actuator (e.g., a motor) that drives the piston to the patient's chest. The suction cup 1806 is configured to be attached to the patient 128. The piston mechanism 1804 is connected to one of the upward force actuators described above.

[0192] For example, Fig.18A A piston mechanism 1804 is shown connected to an arm 122 that forms part of an upward force actuator 1820. The upward force actuator 1820 includes an arm 122 extending above a patient 128 and a resilient element 124 (e.g., similar to the upward force actuator 120). The resilient element 124 is coupled to a suction cup 1806 using a coupling 126. The resilient element 124 is configured to pull the suction cup of the piston mechanism 1804 upward to provide a decompression force to the patient. The upward force actuator 1820 and the chest compression actuator 1802 work together to apply compression and decompression to the patient 128 for ACD therapy. Fig.18A The configuration shown in the embodiment includes an upward force actuator 1820 and a chest compression actuator 1802 that are substantially parallel to each other. However, other configurations of the upward force actuator 1820 and the chest compression actuator 1802 are possible as long as they can provide decompression force and compression force to the patient 128, respectively. In this way, an ACD device without a compression belt provides ACD therapy.

[0193] The upward force actuator 1820 is shown similar to Figure 1 1804, but any of the above upward force actuators can be combined with the piston mechanism 1804 to provide ACD therapy. In some embodiments, the upward force actuator 1820 is configured to be directly coupled to the patient's chest to provide decompression. In some embodiments, the upward force actuator 1820 is coupled to the piston mechanism 1804 or the suction cup 1806 to provide decompression with the aid of the chest compression actuator 1802.

[0194] The piston mechanism 1804 may include one or more sensors for measuring the position of the piston and the force applied by the piston. For example, the piston may include an encoder that is connected to an actuator (e.g., a motor) that drives the piston to the patient's chest. A force sensor may be positioned at the end of the piston element 1842 to measure the pressing force applied by the piston to the patient 128. When the piston is driven downward, the upward force actuator 1820 is constructed to apply a decompression force to the patient 128. When the downward force actuator 1802 releases the piston mechanism 1804, the upward force actuator 1820 pulls the piston back upward and decompresses the patient's chest. The sensor can communicate the position of the piston to the controller of the ACD device to control the upward force actuator so that enough force is applied to the upward force actuator to achieve enough decompression.

[0195] The chest compression actuator 1802 and the upward force actuator 1820 can be adjusted to provide a specific force or force curve for the patient's desired compression amount and / or decompression amount. For example, the upward force actuator 1820 can be configured to provide a predetermined decompression force between 1-25 pounds. In some embodiments, the upward force actuator 1820 is configured to provide a maximum upward force (e.g., 3, 5, 10, 15, 20 pounds) at the deepest compression point, and the force decreases as the depth approaches zero or a neutral point during the decompression stage. In other words, at the beginning of the decompression stage, the force is greater than the force at the end of the decompression stage, for example, the force at the end of the decompression stage is, for example, 80%, 50%, 20%, 10%, 5% or 1% of the force at the beginning of the decompression stage.

[0196] In some embodiments, the upward force actuator 1820 can be configured to deliver sufficient force to achieve a specific depth at a maximum decompression upward travel point below or above the zero or neutral point. In some embodiments, the upward displacement of the chest obtained can be the zero position or neutral position of the chest. In another example, the upward force actuator 1820 can be configured to provide a decompression force sufficient to achieve an upward displacement of the chest of approximately 0.25 to 4 inches relative to the neutral or zero position of the chest. For a typical patient, an upward force of approximately 5-20 pounds is required to achieve an upward displacement of 2 inches relative to the neutral or zero position.

[0197] Fig.18B An axial view of a piston-based ACD device 1830 is shown, which includes an alternative Fig.18A The upward force actuator 1820 shown in FIG. 1 is an upward force actuator. The arm 1832 extends above the piston mechanism 1804. The arm can be similar to Figure 3E1806 and / or arm 1832. Resilient element 124 is coupled to suction cup 1806 and / or arm 1832 to pull the suction cup upward in response to the piston being driven downward to the patient's chest to compress the patient's chest, thereby pulling the patient's chest upward. A motor (not shown) or other actuator may be used to provide a downward force to the patient in piston mechanism 1804. For ACD therapy, piston mechanism 1804 compresses the patient's chest by driving the suction cup to the patient's chest. Resilient element 124 supported by arm 1832 pulls the suction cup upward and provides approximately 1-25 pounds of decompression force to the patient's chest. Arm 1832 is adjustable so that the amount of compression and decompression force can be adjusted.

[0198] Go to Fig. 18C , which shows that Fig.18A An alternative upward force actuator 1840 is combined with the piston-based ACD device 1800. Fig. 18C The elastic element 124 in the embodiment is configured to be included inside the piston mechanism 1804 and coupled to the arm 122 and / or the suction cup 1806. For example, the elastic element 124 may include a spring that is wound around the piston element 1842 inside the piston mechanism 1804.

[0199] In various embodiments described herein, the upward force actuator can be configured to provide a decompression force of 1-35 pounds.

[0200] A number of embodiments of an ACD device have been described. However, it will be appreciated that various modifications may be made without departing from the spirit and scope of the ACD device. Accordingly, other embodiments are within the scope of the following claims.

Claims

1. A belt for integration with an active compression decompression, i.e., ACD, therapy system, the belt comprising: a first portion configured to couple to a patient's chest and provide a compressive force to the patient; a second portion configured to be coupled to a chest compression actuator; a third portion configured to be coupled to an upward force actuator that provides a pressure relief force to the belt; and A fourth portion includes a coupling mechanism configured to be attached to the patient, the strap being configured to transmit the decompression force from the upward force actuator to the patient.

2. The belt according to claim 1, characterized in that The first portion includes a force distribution mechanism, the third portion includes a top surface configured to be connected to the upward force actuator, the fourth portion includes a bottom surface of the belt opposite to the top surface, and the top surface is connected to the bottom surface by one or more tensile elements, and the one or more tensile elements are configured to transfer the decompression force from the top surface of the belt to the bottom surface of the belt.

3. The belt according to claim 1, characterized in that The upward force actuator includes a retractable rod integrated into the strap along its length, the retractable rod being configured to deform when a compressive force is applied by the chest compression actuator and to re-straighten when the chest compression actuator ceases applying a compressive force.

4. The belt according to claim 1, characterized in that The attachment mechanism of the strap includes one or more of a suction cup, an adhesive, or a gel.

5. The belt according to claim 1, characterized in that The coupling mechanism of the strap is configured to provide between 1-25 pounds of force.

6. The belt according to claim 1, characterized in that The upward force actuator includes a rigid rod integrated into the strap along its length, and the strap includes a first end configured to couple to a first downward actuator and a second end configured to couple to a second downward actuator, the first end being opposite the second end.

7. The belt according to claim 2, characterized in that The first end and the second end each include a linear gear rack.

8. The belt according to claim 1, characterized in that The third portion includes a hook configured to be coupled to the upward force actuator, the upward force actuator including a resilient device.

9. The belt according to claim 8, characterized in that The third part includes a lever, and the hook is located at an end of the lever.

10. The belt according to claim 1, characterized in that The upward force actuator includes a plurality of semi-rigid rods attached to a third portion of the strap, each of the plurality of semi-rigid rods being configured to be inserted into a corresponding receiver on a platform to couple the strap to the platform.

11. The belt according to claim 1, characterized in that The belt comprises a high tensile strength material comprising one or more fabrics.

12. The belt according to claim 2, characterized in that The one or more tension elements may include one or more elastic cords or springs.

13. The belt according to claim 2, characterized in that The force distribution mechanism includes a bladder including one or more bubbles and a plurality of tension cords.

14. The belt according to claim 2, characterized in that The bladder is filled with air or with foam.

15. A system for performing active compression decompression, i.e., ACD, therapy on a patient, the system comprising: a platform for placement beneath the patient; a chest compression actuator configured to extend over the patient's chest, the chest compression actuator configured to extend from the platform; a first arm coupled to the platform on a first side of the patient; a second arm coupled to the platform on a second side of the patient; an upward force actuator coupled to the first arm and the second arm; a coupling mechanism for coupling the upward force actuator to the patient's chest to transmit a decompression force from the upward force actuator to the patient's chest; as well as a motor coupled to the chest compression actuator and configured to: causing the chest compression actuator to compress the patient's chest and apply a compressive force to the patient's chest; and The chest compression actuator is caused to release the compression force and the upward force actuator is allowed to decompress the patient.

16. The system according to claim 15, characterized in that The chest compression actuator includes a belt configured to extend over the patient's chest, the belt configured to extend from the platform on a first side of the patient to a second side of the patient opposite the first side, and the motor causes the belt to tighten around the patient's chest and apply a compressive force to the patient's chest, and causes the belt to relax around the patient's chest and allow the upward force actuator to decompress the patient.

17. The system according to claim 15, characterized in that The coupling mechanism includes one or more of a suction cup, a gel, and an adhesive.

18. The system according to claim 15, characterized in that The chest compression actuator includes a piston.

19. The system according to claim 15, characterized in that The upward force actuator includes a strap.

20. The system according to claim 15, characterized in that The upward force actuator is configured to be attached to the patient's chest.

21. The system according to claim 15, characterized in that The upward force actuator is configured to be coupled to the chest compression actuator, and the chest compression actuator is configured to be attached to the patient via a coupling mechanism.

22. The system according to claim 15, characterized in that The upward force actuator includes an elastic material.

23. The system according to claim 22, characterized in that The elastic material includes one or more of an elastic cord, a spring or a bungee cord.

24. The system according to claim 15, characterized in that The upward force actuator includes a rope, and the rope is coupled to each of the first arm and the second arm through a respective pulley.

25. The system according to claim 15, characterized in that The system also includes a sensor for measuring the decompression force of the upward force actuator.

26. The system according to claim 25, characterized in that The controller is configured to control the motor in response to a signal from the sensor.

27. The system according to claim 15, characterized in that Based on the adjustment of the magnitude of the decompression force applied by the upward force actuator to the patient's chest, the amount of decompression of the patient's chest can be adjusted.

28. The system according to claim 27, characterized in that The amount of decompression force applied by the upward force actuator to the patient's chest is adjusted by adjusting the tension in the upward force actuator.

29. The system according to claim 27, characterized in that Based on adjustment of the range of motion of the upward force actuator relative to the platform, the amount of reduced pressure on the patient's chest can be adjusted.

30. A system for performing active compression decompression, or ACD, therapy on a patient, the system comprising: a platform for placement beneath the patient; a chest compression actuator configured to extend over the patient's chest, the chest compression actuator configured to extend from the platform; a structure that extends over said patient and is rigid; an upward force actuator coupled to the structure; a coupling mechanism for coupling the upward force actuator to the patient's chest to transmit a decompression force from the upward force actuator to the patient's chest; as well as a motor coupled to the chest compression actuator and configured to: causing the chest compression actuator to apply a compressive force to the patient's chest; as well as The chest compression actuator is caused to release the compression force and the upward force actuator is allowed to decompress the patient.

31. The system according to claim 30, characterized in that The chest compression actuator includes a belt configured to extend over the patient's chest, the belt configured to extend from the platform on a first side of the patient to a second side of the patient opposite the first side, and the motor causes the belt to tighten around the patient's chest and apply a compressive force to the patient's chest, and causes the belt to relax around the patient's chest and allow the upward force actuator to decompress the patient.

32. The system according to claim 30, characterized in that The coupling mechanism includes one or more of a suction cup, a gel, and an adhesive.

33. The system according to claim 30, characterized in that The chest compression actuator includes a piston.

34. The system according to claim 30, characterized in that The structure is attached to the platform.

35. The system according to claim 34, characterized in that The structure is a rigid arm or pole extending partially above the patient, the arm or pole being adjustable relative to the platform such that the arm or pole includes a telescoping rod or an adjustable hinge height.

36. The system according to claim 30, characterized in that The structure is separate from the platform.

37. The system according to claim 30, characterized in that The upward force actuator is coupled to the structure and is directly attached to the patient.

38. The system according to claim 30, characterized in that The upward force actuator is coupled to the structure and to the strap, which is configured to be attached to the patient via a coupling mechanism.

39. The system according to claim 30, characterized in that The upward force actuator includes an elastic material.

40. The system according to claim 39, characterized in that The elastic material includes one or more of an elastic cord, a spring or a bungee cord.

41. The system according to claim 20, characterized in that The system also includes a sensor for measuring the decompression force of the upward force actuator.

42. The system according to claim 27, characterized in that The controller is configured to control the motor in response to a signal from the sensor.

43. The system according to claim 20, characterized in that The structure includes a first arm extending from the platform substantially perpendicular to the platform and a second arm extending from the first arm substantially parallel to the platform and partially above the patient.

44. The system according to claim 43, characterized in that The second arm is adjustable relative to the first arm.

45. The system of claim 30, wherein: The upward force actuator includes an elastic material.

46. ​​The system according to claim 45, characterized in that The elastic material includes one or more of an elastic cord, a spring or a bungee cord.

47. The system according to claim 30, characterized in that Based on the adjustment of the magnitude of the decompression force applied by the upward force actuator to the patient's chest, the amount of decompression of the patient's chest can be adjusted.

48. The system according to claim 47, characterized in that The amount of decompression force applied by the upward force actuator to the patient's chest is adjusted by adjusting the tension in the upward force actuator.

49. The system according to claim 47, characterized in that Based on adjustment of the range of motion of the upward force actuator relative to the platform, the amount of reduced pressure on the patient's chest can be adjusted.

50. A system for performing active compression decompression, or ACD, therapy on a patient, the system comprising: a platform for placement beneath the patient; a chest compression actuator configured to extend over the patient's chest, the chest compression actuator configured to extend from the platform; a semi-rigid structure coupled to the platform; a coupling mechanism for coupling the upward force actuator to the patient's chest to transmit a decompression force from the upward force actuator to the patient's chest; a motor coupled to the chest compression actuator and configured to: causing the chest compression actuator to apply a compressive force to the patient's chest; and The chest compression actuator is caused to release the compression force and allow the semi-rigid structure to decompress the patient.

51. The system according to claim 50, characterized in that The chest compression actuator includes a belt configured to extend over the patient's chest, the belt configured to extend from the platform on a first side of the patient to a second side of the patient opposite the first side, and the motor causes the belt to tighten around the patient's chest and apply a compressive force to the patient's chest, and causes the belt to relax around the patient's chest and allow the upward force actuator to decompress the patient.

52. The system according to claim 50, characterized in that The coupling mechanism includes one or more of a suction cup, a gel, and an adhesive.

53. The system according to claim 50, characterized in that The chest compression actuator includes a piston.

54. The system according to claim 50, characterized in that The semi-rigid structure includes a leaf spring.

55. The system according to claim 50, characterized in that The semi-rigid structure includes a retractable rod.

56. The system according to claim 55, characterized in that The retractable rod comprises a telescopic rod.

57. The system according to claim 50, characterized in that The semi-rigid structure is attached directly to the patient.

58. The system of claim 50, wherein: The semi-rigid structure is coupled to the strap, and the strap is configured to be attached to the patient via a coupling mechanism.

59. The system according to claim 50, characterized in that The system also includes a sensor for measuring the reduced pressure force of the semi-rigid structure.

60. The system according to claim 59, characterized in that The controller is configured to control the motor in response to a signal from the sensor.

61. The system according to claim 50, characterized in that Based on the adjustment of the magnitude of the decompression force applied by the upward force actuator to the patient's chest, the amount of decompression of the patient's chest can be adjusted.

62. The system according to claim 61, characterized in that The amount of decompression force applied by the upward force actuator to the patient's chest is adjusted by adjusting the tension in the upward force actuator.

63. The system according to claim 61, characterized in that Based on adjustment of the range of motion of the upward force actuator relative to the platform, the amount of reduced pressure on the patient's chest can be adjusted.

64. A system for performing active compression decompression, or ACD, therapy on a patient, the system comprising: a platform for placement beneath the patient; a strap configured to extend over the patient's chest, the strap configured to extend from the platform on a first side of the patient to a second side of the patient opposite the first side, the strap configured to be coupled to the patient's chest, the strap comprising a rigid or semi-rigid material that enables the strap to retain a general shape when coupled to the patient's chest; a first actuator attached to the platform at a first side of the patient, the first actuator coupled to the strap at a first end of the strap; a second actuator attached to the platform at a second side of the patient, the second actuator coupled to the strap at a second end of the strap opposite the first end; as well as a controller configured to control the first actuator and the second actuator to: tensioning the belt around the patient's chest and applying a compressive force to the patient's chest; and The band is allowed to relax around the patient's chest and apply a decompressive force to the patient's chest.

65. A system for performing active compression decompression, or ACD, therapy on a patient, the system comprising: a platform for placement beneath the patient; a chest compression actuator comprising a belt configured to extend over the patient's chest, the belt configured to extend from the platform on a first side of the patient to a second side of the patient opposite the first side, the belt configured to be coupled to the patient's chest; Connecting mechanism; an adjustable arm extending from a side of the platform and partially above the patient; an elastic material extending from the arm and coupled to the band; Controller; and a motor coupled to the belt and configured to receive one or more signals from the controller, the motor configured to respond to the one or more signals from the controller to: tensioning the band around the patient's chest and applying a compressive force to the patient's chest while tensioning the elastic material; and The band is allowed to relax about the patient's chest, allowing the elastic material to lift the band to apply a decompressive force to the patient's chest.

66. A system for performing active compression decompression, or ACD, therapy on a patient, the system comprising: a platform for placement beneath the patient; a chest compression actuator configured to extend over the patient's chest; an upward force actuator; a coupling mechanism for coupling the upward force actuator to the patient's chest, allowing the upward force actuator to apply a decompressive force to the patient's chest; Controller; and a motor coupled to the upward force actuator and configured to receive one or more signals from the controller, the motor configured to respond to the one or more signals from the controller to: causing the chest compression actuator to apply a compressive force to the patient's chest; as well as The chest compression actuator is enabled to stop applying compression force to the patient and the upward force actuator is enabled to decompress the patient.

67. A system for performing active compression decompression, or ACD, therapy on a patient, the system comprising: a platform for placement beneath the patient; a chest compression actuator comprising a belt configured to extend over a chest of the patient, the belt configured to extend from the platform on a first side of the patient to a second side of the patient opposite the first side; an upward force actuator; a coupling mechanism for coupling the upward force actuator to the patient's chest to transmit a decompression force from the upward force actuator to the patient's chest; Controller; and a motor coupled to the belt and configured to receive one or more signals from the controller, the motor configured to respond to the one or more signals from the controller to: tensioning the belt around the patient's chest and applying a compressive force to the patient's chest; and allowing the belt to relax about the patient's chest and allowing the upward force actuator to cause decompression of the patient, The system further includes a force sensor configured to measure a decompression force of the upward force actuator, Wherein, the controller is configured to control the motor in response to a signal from the force sensor.

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