Collateral Ventilation Assessment System

Abstract

An illustrative embodiment includes an occlusion device (110) insertable into a bronchial passageway (184) to selectively seal the bronchial passageway (184) to occlude a lobe of a lung (182). A flow lumen (160) sealingly extends through the occlusion device (110) to a distal end (164) and has a proximal end (166) receiving positive pressure flow. A check valve (144) may be coupled to the flow lumen (160) to allow positive pressure flow to pass to the distal end (164) of the flow lumen (160) and prevent pressure backflow from the flow lumen (160). A flow meter (140) may be coupled to the flow lumen (160) to measure positive pressure flow through the flow lumen (160). Abstract Figure: Figure 1A

Description

Title of the invention: Collateral ventilation assessment system

[0001] Priority claim

[0002] The present application claims priority and benefit from U.S. Provisional Patent Application No. 62 / 849,652 filed May 17, 2019, entitled “COLLATERAL VENTILATION ASSESSMENT SYSTEM”; U.S. Provisional Patent Application Serial No. 62 / 906,542 filed September 26, 2019, entitled “COLLATERAL VENTILATION ASSESSMENT SYSTEM”; and U.S. Provisional Patent Application Serial No. 62 / 906,571 filed September 26, 2019, entitled “COLLATERAL VENTILATION ASSESSMENT DISPLAY SYSTEM”.

[0003] Domain

[0004] The present disclosure relates to apparatus, systems and methods for testing one or more lobes of a patient's lungs for collateral ventilation.

[0005] Background

[0006] The statements in this section only provide background information relating to the present disclosure and do not constitute prior art.

[0007] A number of respiratory conditions, such as emphysema, can lead to a patient being unable to effectively exhale air from one or more lobes of their lungs. The resulting hyperinflation of the lungs can prevent the patient from being able to draw in sufficient oxygen and, thus, can significantly affect the patient's health. Treatments, such as the implantation of a one-way endobronchial valve in a bronchial passage to a malfunctioning lobe, can prevent air from entering that compartment to help prevent hyperinflation of that lobe.

[0008] Such treatments may not be effective when a patient is suffering from collateral ventilation, where air flows between the lobes of the lungs rather than through the appropriate passages in each lobe. To avoid the waste of implanting an endobronchial valve or using another treatment that will not be effective, it is important to be able to detect when collateral ventilation is occurring in a patient's lungs.

[0009] Summary

[0010] The disclosed embodiments include apparatuses, systems, and methods for determining whether collateral ventilation is occurring in a patient's lungs.

[0011] In an illustrative embodiment, an apparatus includes an occlusion device insertable into a bronchial passageway to selectively seal the bronchial passageway to occlude a lobe of a lung to be tested. A flow lumen extends sealingly through the occlusion device to a distal end and has a proximal end receiving positive pressure flow into the flow lumen. A check valve may be pneumatically coupled to the flow lumen to allow the positive pressure flow to pass to the distal end of the flow lumen and to prevent pressure backflow from the distal end of the flow lumen. A flow meter may be pneumatically coupled to the flow lumen to measure positive pressure flow through the flow lumen.The occlusion device can be inserted into the bronchial passageway toward the occluded lobe. Flow meter measurements of positive pressure flow through the flow lumen into the occluded lobe can be monitored to assess the presence of collateral ventilation of the occluded lobe.

[0012] In another illustrative embodiment, a system includes an occlusion device insertable into a bronchial passageway to selectively seal the bronchial passageway to occlude a lobe of a lung to be tested. A flow lumen extends sealingly through the occlusion device to a distal end and has a proximal end receiving a positive pressure flow into the flow lumen. A pressure source may be pneumatically coupled to the proximal end of the flow lumen to provide the positive pressure flow. A check valve may be pneumatically coupled to the flow lumen to allow the positive pressure flow to pass to the distal end of the flow lumen and to prevent pressure backflow from the distal end of the flow lumen.A flow meter may be pneumatically coupled to the flow lumen to measure positive pressure flow through the flow lumen. A measuring device may be communicatively coupled to the flow meter to monitor positive pressure flow through the flow lumen to the occluded lobe over time to assess the presence of collateral ventilation out of the occluded lobe.

[0013] In another illustrative embodiment, a method includes occluding a bronchial passage to occlude a lobe of a lung to be tested. A positive pressure airflow from a continuous positive airway pressure source configured to prevent the positive pressure flow from distending the occluded lobe is introduced into the lobe downstream of the occluded bronchial passage. The positive pressure airflow into the occluded lobe is monitored to detect at least one characteristic selected from the absence of collateral ventilation of the lobe. occluded and the presence of collateral ventilation of the occluded lobe.

[0014] In an illustrative embodiment, a measuring apparatus includes a flow meter input communicably coupleable to an electronic flow meter positionable to monitor positive pressure flow to a selectively occluded lobe of a lung. A processing logic circuit is communicatively coupled to the flow meter input to process measurements of the positive pressure flow and to generate a digital representation of the positive pressure flow in the occluded lobe over time.A display device is configured to receive the digital representation and visually present the positive pressure flow in the occluded lobe over time, wherein a continuous decrease over time in the positive pressure flow in the occluded lobe indicates the absence of collateral ventilation of the lobe and a stabilization over time in the positive pressure flow in the occluded lobe indicates the presence of collateral ventilation of the lobe.

[0015] In another illustrative embodiment, a system includes an occlusion device insertable into a bronchial passageway to selectively seal the bronchial passageway to occlude a lobe of a lung to be tested. A flow lumen extends sealingly through the occlusion device to a distal end and has a proximal end receiving a positive pressure flow into the flow lumen. A pressure source may be pneumatically coupled to the proximal end of the flow lumen to provide the positive pressure flow. A check valve may be pneumatically coupled to the flow lumen to allow the positive pressure flow to pass to the distal end of the flow lumen and to prevent pressure backflow from the distal end of the flow lumen.A flow meter may be pneumatically coupled to the flow lumen to measure positive pressure flow through the flow lumen into the occluded lobe. A measuring apparatus may be communicatively coupled to the flow meter to monitor positive pressure flow to the occluded lobe over time to assess the presence of collateral ventilation out of the lobe. The measuring apparatus includes a processing logic circuit communicatively coupled to the flow meter input to process measurements of the positive pressure flow and to generate a digital representation of the positive pressure flow through the flow lumen into the occluded lobe over time. A display device is configured to receive the digital representation and visually present the digital representation of the positive pressure flow through the flow lumen into the occluded lobe.A continuous decrease over time in positive pressure flow through the outflow lumen in the occluded lobe. indicates the absence of collateral ventilation of the occluded lobe and stabilization over time of positive pressure flow through the outflow lumen in the occluded lobe indicates the presence of collateral ventilation of the lobe.

[0016] In yet another illustrative embodiment, a method includes receiving measurements from an electronic flow meter positioned to monitor positive pressure flow in a lobe of a selectively occluded lung. The measurements of the positive pressure flow over time are processed to generate a digital representation of the positive pressure flow in the occluded lobe over time. A visualizable representation of the measurements of the positive pressure flow in the occluded lobe over time is generated, from which a user can discern changes in the positive pressure flow indicative of the presence of collateral ventilation of the occluded lobe.

[0017] Other features, advantages, and areas of applicability will become apparent from the description herein. It will be understood that the description and specific examples are intended for illustrative purposes only and are not intended to limit the scope of the present disclosure.

[0018] The drawings described herein are for illustrative purposes only and are not intended to limit the scope of the present disclosure in any way. The components in the figures are not necessarily to scale, but rather the emphasis is on illustrating the principles of the disclosed embodiments. In the drawings:

[0019] [fig.lA] is a block diagram of an illustrative system for assessing collateral ventilation;

[0020] [fig.lB] is an enlarged view of a region B of [fig.lA] showing an occlusion device positioned in a bronchial passage;

[0021] [Fig. 2A and 2B] are partial sectional views of an occlusion device of the system of [Fig. 2A and 2B];

[0022] [Fig. 3 to 11] are display screens from an interface in a system for assessing collateral ventilation;

[0023] [fig.12] is a functional diagram of a device for illustrative purposes for the sur positive pressure flow monitoring in an occluded lobe of a lung;

[0024] [fig.13] is a functional diagram of a computer system for illustrative purposes configurable for use in the apparatus of FIGURE 12;

[0025] [fig.14] is a flowchart of a method for illustrating the evaluation of measurements from a flow meter positioned to assess potential ventilation of an occluded lobe of a lung; and

[0026] [fig.15] is a flowchart of a method for illustrating the generation of a re visualizable presentation of positive pressure flow measurements in an occluded lobe of a lung. Detailed description

[0027] The following description is merely illustrative and is not intended to limit the present disclosure, application, or uses. It will be noted that the first digit of the three-digit reference numerals and the first two digits of the four-digit reference numerals correspond, respectively, to the first digit of the one-digit figure numerals and the first two digits of the two-digit figure numerals, in which the element first appears.

[0028] The following description explains, by way of illustration only and not limitation, various embodiments of systems, apparatuses and methods for assessing collateral ventilation between lobes of a lung.

[0029] With reference to FIGURE 1A and FIGURE 1B, and given by way of non-limiting overview, in various embodiments, an illustrative system 100 may assess collateral ventilation by testing a lobe 182 of a lung 180. The system 100 includes an occlusion device 110 insertable into a bronchial passage 184 to the lobe 182 of the lung 180 to be tested. A flow lumen 160 extends sealingly through the occlusion device 110 to a distal end 164 to deliver positive pressure flow to the lobe 182. A pressure source 120 may be coupled to a proximal end 166 of the flow lumen 160 to provide the positive pressure flow to the lobe 182.A check valve 144 may be positioned between the pressure source 120 and the flow lumen 160 to permit positive pressure flow to the lobe 182 and prevent pressure backflow from the lobe 182 through the flow lumen 160. A flow meter 140 may be coupled to the flow lumen 160 to measure the positive pressure flow to the lobe 182. A measuring apparatus 190 may be coupled to the flow meter 140 to monitor changes in the positive pressure flow to the lobe 182 over time to assess the presence of collateral ventilation out of the lobe 182.

[0030] Now that an overview has been given, the details will be explained by means of examples given for illustration purposes only and not by way of limitation.

[0031] Still referring to FIGURES 1A and 1B, the system 100 includes the occluder 110 through which the flow lumen 160 extends into the lobe 182 to be tested. To test the lobe 182, a passage 184 to the lobe 182 is blocked by the occluder 110, thereby preventing the lobe 182 from receiving air through the passage 184. In various embodiments, the occluder 110 is an inflatable device that is selectively inflated or deflated via of an inflation lumen (not shown in FIGURE 1) that extends in conjunction with the flow lumen 160. The configuration of the occlusion device is described in more detail with reference to FIGURES 2A and 2B. The flow lumen 160 extends toward the occlusion device 110 and through it to the distal end 164 which extends into the lobe 182.

[0032] The system 100 further includes the pressure source 120, the flow meter 140, the check valve 144, and an inflation device 150 (for selectively inflating the occlusion device 110). In various embodiments, the flow lumen 160 (which may include an inflation lumen for the occlusion device 110) is coupled downstream of the check valve 144 and the inflation device 150 at a connector 152 (which may include a Luer lock or similar device for connecting the flow lumen 160). Operation of the system 110 and assessment of collateral ventilation is performed by the measurement apparatus 190, the operation of which is further described below with reference to FIGURES 3-11.

[0033] In various embodiments, the system 100 occludes the lobe 182 of the lung 180 to be tested by blocking the bronchial passage 184 to the lobe 182 with the occlusion device 110. With reference to FIGURES 2A and 2B, the bronchial passage 184 may be blocked by inserting the occlusion device 110 into the bronchial passage 184 between walls 202 of the bronchial passage 184. As shown in FIGURE 2A, the occlusion device 110 is in a deflated state. The flow lumen 160 extends sealingly through the occlusion device 110, with the distal end of the lumen 164 extending into the bronchial passage 184 beyond the occlusion device 110. The distal end 164 of the flow lumen 160 and the occlusion device 110 may be a balloon catheter. The flow lumen 160 extends together with an inflation lumen 262 and may be integrally formed therewith.The inflation lumen 262 has a distal end 264 that extends into the occlusion device 110 such that an inflation gas passed through the inflation lumen 262 can inflate the occlusion device.

[0034] With brief reference again to FIGURE 1A, actuation of the inflation device 150 may drive inflation gas through the inflation lumen 262 into the occlusion device 110 to inflate it. Thus, when the inflation device 150 is a syringe, a user may depress a plunger on the syringe to drive inflation gas through the inflation lumen 262 to inflate the occlusion device 110. Referring now to FIGURE 2B, the occlusion device 110 is in an inflated state, thereby blocking the bronchial passage 184 and thereby occluding the lobe 182. The occlusion device 110 presses against the walls opposite 202 of the bronchial passage 184, thereby blocking the flow of air in the bronchial passage 184 except for a flow of gas introduced through the flow lumen 160.

[0035] Referring again to FIGURE 1A, once the occlusion device 110 is in place and the lobe 182 is thus occluded, other components of the system 100 are used to assess potential collateral ventilation of the lobe 182. The pressure source 120 is activated to begin positive pressure flow through the flow lumen 160, thereby introducing positive pressure flow into the occluded lobe 184 downstream of the occluded bronchial passage 184. In various embodiments, the pressure source 120 may be an air pump, such as a continuous positive airway pressure (CPAP) device, as commonly used by patients suffering from sleep apnea. The pressure source 120 is configured to generate a pressure that is tolerable and safe, even for potentially weakened or damaged lungs.In various embodiments, the positive pressure may be set at 15 centimeters of water (cmH20) or in a range of 10 to 15 cmH20 with a volumetric flow of up to 500 milliliters (mL) per minute. This pressure may typically be substantially lower than that generated by ventilators and respirators used for in-hospital care. The pressure source 120 may include a pump motor that drives an impeller or other mechanism in a pump (not shown in FIGURE 1). The pump maintains a stable pressure in a reservoir (not shown in FIGURE 1). A pressure gauge monitors the pressure in the reservoir and, via a feedback path, controls operation of the pump motor to maintain a constant pressure in the reservoir (not shown in FIGURE 1).

[0036] An output from the pressure source 120 passes through the flow meter 140. In various embodiments, the flow meter 140 includes an electronic mass flow meter. The use of an electronic mass flow meter allows for electronic monitoring of the pressure flow by the measuring apparatus 190. Furthermore, the use of an electronic mass flow meter, rather than a mechanical flow meter, allows for a more accurate reading of the flow to discern even small changes in gas flow through the flow lumen 160 into the occluded lobe 182 that may indicate the presence of collateral ventilation out of the occluded lobe 184.

[0037] Downstream of the flow meter, the check valve 144 blocks a return pressure flow from the flow port 160. However, to allow the flow generated by the pressure source 120 at a harmless level to be routed to the lobe 182, in various embodiments, the check valve 144 must have a low opening or tripping pressure. Indeed, the opening or tripping pressure trip pressure must be less than 689.476 Pa or on the order of 68.948 Pa. For example, a Qosina™ Model 91008 “high flow check valve” has a trip pressure of 275.790 Pa which is well suited for use in the system 100. The low trip pressure of the check valve 144 allows the pressure source 120 to be in the form of a CP AP device. It will be appreciated that such a device can cause airflow into the flow lumen 160 at a level that is harmless even to a potentially weakened lobe 182 while still providing a seal against backflow from the flow lumen 160.

[0038] The flow port 160 is connected at the connector 152. When the flow port 160 is integral with the inflation port 262 (FIGURES 2A and 2B), both the inflation device 150 and an outlet of the check valve 144 may be coupled to the flow port 160 at the connector 152.

[0039] With the lobe 182 occluded by the occlusion device 110 and pressure being prepared to be applied across the flow lumen 160, the test can apply the flow lumen 160 to the occluded lobe 184 using the flow meter 140. The measured flow can be monitored with the measuring apparatus 190, as described with reference to FIGURES 3-11. FIGURES 3-8 illustrate an example in which the system 100 determines that there is no collateral ventilation of the occluded lobe 184. FIGURES 9-11 illustrate an example in which the system 100 detects that there is collateral ventilation of the occluded lobe 184.

[0040] Referring to FIGURE 3, at an interface screen 300 in an initial state, a user is provided with a choice between different control options. In various embodiments, the measuring apparatus 190 includes a computer system with a graphical user interface controlled by a mouse, keyboard, or other input devices. In other embodiments, the measuring apparatus 190 includes a touchscreen. In all cases, the interface screen 300 provides user inputs including a power option 310 to turn off the system, a lobe selection button 312 to identify the lobe being tested, and a start button 314 to initiate the test. The interface screen 300 also includes a flow display 320 that includes an independent axis 322 for tracking a time of the test against which a measured flow plotted on a dependent axis 324 is plotted.The interface display 300 also includes an average flow indicator 330 and a total air volume indicator 340. As described below, once the test begins, the flow display 320, the average flow indicator 330, and the total air volume indicator 340 present data for these various measurements. The interface display 300 also includes display controls 350 to allow the user to focus on or enlarge portions of the flow display 320. take a closer look at the measures that are reported.

[0041] Still referring to FIGURE 3, a user may engage the lobe selection button 312 to identify the lobe where the occlusion device is positioned to isolate the lobe for testing for collateral ventilation. The user may engage the lobe selection button 312 by manipulating a slider 316 that is controlled by an input device or, in the case of a touchscreen, by touching the lobe selection button 312.

[0042] Referring to FIGURE 4, upon activating the lobe selection button 312 (FIGURE 3), the user is presented with a lobe selection screen 400. From the lobe selection screen 400, the user can identify the lobe being tested by manipulating the cursor 316 to a lobe button 404 that corresponds to the lobe being tested, and then selecting an enter or OK button 406 to confirm the selection. Alternatively, the user can identify the lobe being tested by manipulating the cursor 316 to select the lobe to be tested from a lobe map 408.

[0043] Referring to FIGURE 5, after identifying that the "Left Lower Lobe" is to be tested (FIGURE 4), the user is returned to the interface screen 300 to initiate the test. To initiate the test, the user can direct the cursor 316 to select the start button 314. Since the test has not yet begun, it will be understood that neither the flow display 320, nor the average flow indicator 330, nor the total air volume indicator 340 presents any flow values.

[0044] Referring to FIGURE 6, the test has begun. The flow display 320 displays a first curve 660 that represents an initial flow measurement corresponding to a patient's breathing. In various embodiments, a dependent axis scale 324 that shows the flow is adjusted to correspond to the first curve. It will be understood that at the beginning of the test and with flow from the pressure source 120 (FIGURE 1), the flow can be expected to be at its highest level as the occluded lobe begins to be filled from the flow lumen 160 (FIGURE 1) with the least pressure to oppose flow in the isolated lobe past the occlusion device (FIGURE 1). The average flow indicator 330 and the total air volume indicators 340 have new values ​​to reflect the resulting measured flow since the beginning of the test.With the start of the test, the start button 314 (FIGURE 3) toggled to present a stop button 614 to terminate the test.

[0045] Referring to FIGURE 7, after approximately one minute of testing, the display flow indicator 320 has a first set of additional curves 762 that plot the flow as a function of time. From the first curve 660 to the first set of additional curves 762, the flow measured over time is seen to decrease steadily. Although the total air volume indicator 340 understandably reports an increasing total volume because flow continued during the test, the average flow indicator 330 shows that the average flow is decreasing, thus indicating that the occluded lobe is resisting airflow from the pressure source 120 (FIGURE 1). Referring to FIGURE 8, after almost another minute of testing, the flow display 320 shows a second set of additional curves 864 that shows a further decrease in flow over time. The trend shows that the occluded lobe is resisting continued airflow, thus indicating that there is no pressure leakage from the occluded lobe.Although the total air volume indicator 340 has further increased to report the total volume during the test, the average flow indicator 330 indicates that the average flow has further decreased, thereby confirming that the occluded lobe is still resisting additional airflow from the pressure source 120 (FIGURE 1). Thus, it can be determined that there is no collateral ventilation of the occluded lobe being tested. Upon completion of the test, the user can engage the test stop button 614 to terminate the test.

[0046] Referring to FIGURE 9, to test another lobe, a user proceeds again to the lobe selection screen 400 (having again selected the lobe selection button 312 as described with reference to FIGURE 3). From the lobe selection screen 400, the user identifies the lobe to be tested by selecting a corresponding lobe button 917 and then selecting the enter or OK button 406 to confirm the selection.

[0047] Referring to FIGURE 10, after a little over one minute of testing, the flow display 320 shows additional curves 1066 and 1068 that plot the flow as a function of time. In the first set of curves 1066, the measured flow over time steadily decreases. However, in the second set of curves 1068, the measured flow over time no longer decreases. The average flow indicator 330 also stabilizes to indicate a steady, continuous flow. The steady flow indicates positive collateral ventilation out of the lobe being tested. Referring to FIGURE 11, to more closely examine the selected curves 1170 on the flow display, a user can engage the display controls 350 to show an enlarged portion of the flow display 1120 to verify that the flow is not decreasing.

[0048] Referring to FIGURE 12, an illustrative embodiment of the measuring apparatus 190 may be coupled to the flow meter 140 (not shown in FIGURE 12) to monitor positive pressure flow through the flow lumen 160 (not shown in FIGURE 12) to determine if collateral ventilation is occurring from the occluded lobe 182 (not shown in FIGURE 12). FIGURE 12). The measuring apparatus 190 includes a flow meter input 1210, processing logic 1220, and a display 1230. The flow meter input 1210 receives an output from the flow meter 140. As previously described with reference to FIGURE 1A, in various embodiments, the flow meter 140 includes an electronic mass flow meter with an electronic output to enable electronic monitoring of pressure flow by the measuring apparatus 190. The flow meter input 1210 may include analog or digital signal lines configured to receive the output from the flow meter 140. The flow meter 140 may include a coupling to receive the output from the flow meter 140, or the input of the flow meter 1210 may be wired to the output of the flow meter 140.

[0049] The processing logic 1220 includes an electronic circuit or comparable system that is operatively coupled to the flow meter input 1210 to receive data from the flow meter 140 and to the display 1230 to display data to the user indicating whether collateral ventilation exists in the lobe being tested. The processing logic 1220 may include a computer system as described in detail with reference to FIGURE 13. The processing logic 1220 is operatively coupled to the flow meter input 1210 and the display 1230. The processing logic 1220 includes circuitry configured to monitor data received from the flow meter 140 via the flow meter input 1210, process the data, and generate a signal suitable for display on the display 1230.In various embodiments, the display 1230 includes a device that receives an electronic signal and converts that signal into a graphical representation viewable by a user. Using the display 1230, a user can monitor whether the positive pressure flow in the occluded lobe of the lung being tested indicates the presence of collateral ventilation, as described with reference to FIGURES 3-11.

[0050] Referring to FIGURE 13, the processing logic 1220 (FIGURE 12) may include a computer system 1300. The computer system 1300 may include any of a number of forms of fixed or mobile computing devices. The computer system 1300 typically includes at least one processing unit 1320 and system memory 1330. Depending on the exact configuration and type of computing device, the system memory 1330 may be volatile (such as RAM), non-volatile (such as ROM, flash memory, and the like), or any combination of the two. The system memory 1330 typically maintains an operating system 1332, one or more applications 1334, and program data 1336. The operating system 1332 may include any number of operating systems executable on desktop or portable devices including, but not limited to, Linux, Microsoft Windows, Apple OS, or Android. or applications 1334 include instructions for receiving and processing flow meter data and generating displayable information, as previously described with reference to FIGURES 3-11.

[0051] The computer system 1300 may also have additional features or functionality. For example, the computer system 1300 may also include additional data storage devices (removable and / or non-removable) such as, for example, magnetic disks, optical disks, tape, or flash memory. Such additional storage is illustrated in FIG. 13 by removable storage 1340 and non-removable storage 1350. The computer storage media may include volatile and non-volatile, removable and non-removable media implemented in any method or technology for storing information, such as computer-readable instructions, data structures, program modules, or other data. The system memory 1330, removable storage 1340, and non-removable storage 1350 are all examples of computer storage media.Available types of computer storage media include, but are not limited to, RAM, ROM, EEPROM, flash memory (in both removable and non-removable forms) or other memory technology, CD-ROM, digital versatile discs (DVDs) or other optical storage, magnetic cassettes, magnetic tape, magnetic disk storage or other magnetic storage devices, or any other media that can be used to store the desired information and that can be accessed by the computer system 1330. Any such computer storage media may be part of the computer system 1330.

[0052] In various embodiments, the computer system 1330 may also have input device(s) 1360 such as a keyboard, mouse, pen, voice input device, touchscreen input device, etc. Output device(s) 1370 such as a display, speakers, printer, short-range transceivers such as a Bluetooth transceiver, etc., may also be included. In various embodiments, the computer system 1330 may include a touch-sensitive display that integrates attributes of an output device 1370 and an input device 1360, allowing a user to interact with user-selectable information and commands presented via the display.Thus, the display 1230 of the measuring device 190 may include a touch-sensitive display allowing a user to control operations of the measuring device 190 and to review information presented by the measuring device 190.

[0053] The computer system 1300 may also include one or more communication connections 1380 that allow the computer system 1300 to communicate communicate with other 1390 computer systems, such as over a wired or wireless network or via Bluetooth (a Bluetooth transceiver can be considered an input / output device and a communications connection). The 1380 communications connection(s) are an example of a communications media. Available forms of communications media typically carry computer-readable instructions, data structures, program modules, or other data in a modulated data signal such as a carrier wave or other transport mechanism and include any information delivery medium. The term "modulated data signal" may include a signal that has one or more of its characteristics fixed or modified so as to encode information in the signal.By way of example, and without limitation, communication media may include wired media such as a wired network or a direct wired link, and wireless media such as acoustic, RF, infrared, and other media. The term computer-readable media as used herein includes both storage media and communication media.

[0054] With reference to FIGURE 14, in various embodiments, a method 1400 is provided as an illustration of testing for collateral ventilation. The method 1400 starts at a block 1405. At a block 1410, a bronchial passage is occluded to occlude a lobe of a lung as previously described with reference to FIGURES 1A-2. At a block 1420, a positive pressure airflow from a continuous positive airway pressure source configured to prevent the positive pressure flow from distended the occluded lobe is introduced into the occluded lobe downstream of the occluded bronchial passage, as previously described with reference to FIGURES 1A and 1B.At a block 1430, the positive pressure airflow is monitored to detect at least one characteristic selected from the absence of collateral ventilation of the occluded lobe and the presence of collateral ventilation of the isolated lobe, as previously described with reference to FIGURES 3-11. The method 1400 terminates at a block 1435.

[0055] With reference to FIGURE 15, in various embodiments, there is provided an illustrative method 1500 for generating a visualizable representation of positive pressure flow in a lobe of a lung to assess possible collateral ventilation. The method 1500 starts at a block 1505. At a block 1510, measurements are received from an electronic flowmeter positioned to monitor positive pressure flow in a lobe of a selectively occluded lung, as previously described with reference to FIGURES 1A and 1B. At a block 1520, the measurements of positive pressure flow over time are processed to generate a visualizable representation of positive pressure flow in a lobe of a lung to assess possible collateral ventilation. of the positive pressure flow over time, as previously described with reference to FIGURES 3-13. At a block 1530, a visualizable representation of the positive pressure flow measurements over time is generated, from which a user can discern changes in the positive pressure flow indicative of the presence of lobe collateral ventilation, as previously described with reference to FIGURES 3-13. As previously described, detection of measurable flow that continues to decrease over time indicates the absence of lobe collateral ventilation, while detection of measurable flow that stabilizes over time may indicate the presence of collateral ventilation. The method 1500 terminates at a block 1535.

[0056] It will be understood that the detailed description set forth above is merely illustrative in nature and that variations which do not depart from the essence and / or spirit of the claimed subject matter are intended to fall within the scope of the claims. Such variations should not be considered as a deviation from the spirit and scope of the claimed subject matter.

Claims

Claims

1. An apparatus comprising: an occlusion device (110) insertable into a bronchial passageway (184) to selectively seal the bronchial passageway (184) to occlude a lobe (182) of a lung (180) to be tested; a flow lumen (160) extending sealingly through the occlusion device (110) to a distal end (164) and having a proximal end (166) receiving positive pressure flow into the flow lumen (160); a check valve (144) pneumatically coupleable to the flow lumen (160) to allow the positive pressure flow to pass to the distal end (164) of the flow lumen (160) and to prevent pressure backflow from the distal end (164) of the flow lumen (160);and a flow meter (140) pneumatically coupleable to the flow lumen (160) for measuring positive pressure flow through the flow lumen (160), said occlusion device (110) and the flow meter's (140) measurements of positive pressure flow through the flow lumen (160) into the occluded lobe (182) may be monitored to assess the presence of collateral ventilation of the occluded lobe (182).;

2. The apparatus of claim 1, wherein the occlusion device (110) includes a selectively inflatable occlusion device for selectively sealing the bronchial passage (184).

3. The apparatus of claim 2, further comprising an inflation lumen (262) pneumatically coupleable to the selectively inflatable occlusion device to receive a flow of gas to selectively inflate and expand the occlusion device (110) to sealably occlude the bronchial passageway (184).

4. The apparatus of claim 2, wherein the selectively inflatable occlusion device includes a balloon catheter through which the flow lumen (160) can extend.

5. The apparatus of claim 1, wherein the positive pressure flow includes a pressure flow in a range of 10 cmH20 to 15 cmH20.

6. The apparatus of claim 5, wherein the positive pressure flow includes a pressure flow at substantially 15 cmH20.

7. The apparatus of claim 1, wherein the positive pressure flow includes a volumetric flow of up to 500 ml per minute.

8. The apparatus of claim 1, wherein the flow meter (140) includes an electronic mass flow meter.

9. Apparatus according to claim 1, wherein the check valve (144) has a trigger pressure of less than 689.476 Pa.

10. Apparatus according to claim 9, wherein the check valve (144) has a trigger pressure of 275.790 Pa.

11. A system comprising: an occlusion device (110) insertable into a bronchial passageway (184) to selectively seal the bronchial passageway (184) to occlude a lobe (182) of a lung (180) to be tested; a flow lumen (160) extending sealingly through the occlusion device (110) to a distal end (164) and having a proximal end (166) receiving a positive pressure flow into the flow lumen (160); a pressure source (120) pneumatically coupleable to the proximal end (166) of the flow lumen (160) to provide the positive pressure flow;a check valve (144) pneumatically couplable to the flow lumen (160) to allow positive pressure flow to pass to the distal end (164) of the flow lumen (160) and to prevent pressure backflow from the distal end (164) of the flow lumen (160); a flow meter (140) pneumatically couplable to the flow lumen (160) to measure positive pressure flow through the flow lumen (160); and a measuring apparatus (190) communicatively couplable to the flow meter (140) to monitor positive pressure flow to the occluded lobe (182) over time to assess the presence of collateral ventilation out of the occluded lobe (182).;

12. The system of claim 11, wherein the occlusion device (110) includes a selectively inflatable occlusion device for selectively sealing the bronchial passage (184) and a

13.

14.

15.

16.

17.

18. inflation lumen (262) pneumatically coupleable to the selectively inflatable occlusion device to receive a flow of gas to selectively inflate and expand the occlusion device (110) to sealingly occlude the bronchial passageway (184). The system of claim 12, wherein the occlusion device (110) includes a balloon catheter through which the flow lumen (160) can extend. The system of claim 11, wherein the pressure source (120) includes a continuous positive airway pressure pump. The system of claim 11, wherein the pressure source (120) is configured to provide the positive pressure flow in a range of 10 cmH20 to 15 cmH20 and a volumetric flow of up to 500 ml per minute. The system of claim 11, wherein the flow meter (140) includes an electronic mass flow meter. The system of claim 11, wherein the check valve (144) has a trigger pressure of less than 689.476 Pa. The system of claim 18, wherein the check valve (144) has a trigger pressure of 275.790 Pa.

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