Vent system and patient interface system

Abstract

To provide a fluid connector for respiratory gas delivery from a respiratory pressure treatment device to a patient.SOLUTION: Provided is a fluid connector for respiratory gas delivery from a respiratory pressure therapy device to a patient, the fluid connector including: a first end including a first opening for fluid flow; a second end including a sealing portion extending around a perimeter of the first opening, a latching portion, and a second opening for fluid flow; a sealing surface extending azimuthally around the second opening and configured to engage the sealing portion to form a face seal; and a complementary latching portion configured to engage the latching portion; wherein the face seal allows the respiratory gas to travel between the first opening and the second opening, and engagement between the latching portion and the complementary latching portion secures the first end with the second end.SELECTED DRAWING: Figure 6B

Description

[Technical field]

[0001] 1 CROSS-REFERENCE TO RELATED APPLICATIONS This application claims priority to U.S. Provisional Application No. 62 / 222,604, filed Sep. 23, 2015, which is incorporated herein by reference in its entirety. [Background technology]

[0002] 2. Technology Background 2.1 Technology field The present technology relates to one or more of the detection, diagnosis, treatment, prevention and amelioration of respiratory related disorders. The present technology also relates to medical devices or apparatus and uses thereof.

[0003] 2.2 Description of Related Art 2.2.1 The human respiratory system and its diseases The body's respiratory system facilitates gas exchange. The nose and oral cavity form the entrance to a patient's airways.

[0004] These airways contain a series of branching tubes that become narrower, shorter and more numerous the deeper they go into the lungs. The primary function of the lungs is gas exchange, allowing oxygen to enter the venous blood from the air and carbon dioxide to leave. The trachea divides into the right and left main bronchi, which further divide into the terminal bronchioles. The bronchi constitute the conducting airways and do not participate in gas exchange. The airways further divide into the respiratory bronchioles and finally into the alveoli. Gas exchange occurs in the alveolar region of the lungs, which is called the respiratory zone. See: "Respiratory Physiology", by John B. West, Lippincott Williams & Wilkins, 9th edition published 2011.

[0005] There is a range of respiratory diseases. Particular diseases can be characterized by particular manifestations such as apnea, hypopnea and hyperpnea.

[0006] Obstructive sleep apnea (OSA) is a form of sleep-disordered breathing (SDB) characterized by episodes such as closure or obstruction of the upper airway during sleep. It results from a combination of an abnormally small upper airway and normal loss of muscle tone in the tongue region, soft palate, and posterior oropharyngeal wall during sleep. The condition causes affected patients to pause in breathing, typically for 30-120 seconds, sometimes as many as 200-300 times per night. The result is excessive daytime sleepiness, which can lead to cardiovascular disease and brain damage. The condition is common, especially in middle-aged, overweight men, but patients are asymptomatic. See U.S. Pat. No. 4,944,310 (Sullivan).

[0007] Cheyne-Stokes respiration (CSR) is another form of sleep-disordered breathing. CSR is a disease of the patient's respiratory regulator, followed by alternating periods of waxing and waning of ventilation, known as the CSR cycle. CSR is characterized by repeated deoxygenation and reaeration of arterial blood. Because of the repeated hypoxia, CSR can be harmful. In some patients, CCR is accompanied by recurrent sleep arousals that cause severe insomnia, increased sympathetic activity, and increased afterload. See U.S. Patent No. 6,532,959 (Berthon-Jones).

[0008] Respiratory failure is a general term for respiratory disorders in which patients are unable to ventilate adequately to balance CO2 in their blood when metabolic activity significantly exceeds resting levels. Respiratory failure may include some or all of the following disorders:

[0009] Obesity hyperventilation syndrome (OHS) is defined as the combination of severe obesity and awake chronic hypercapnia in the absence of any other clear cause for hypoventilation. Symptoms include dyspnea, morning headache, and excessive daytime sleepiness.

[0010] Chronic obstructive pulmonary disease (COPD) encompasses any of a group of lower airway diseases that share certain common characteristics. These include increased resistance to air movement, prolongation of the expiratory phase of breathing, and a decrease in the normal elasticity of the lungs. Examples of COPD include emphysema and chronic bronchitis. Causes of COPD include chronic smoking (the primary risk factor), occupational exposure, air pollution, and genetic factors. Symptoms include dyspnea on exertion, chronic cough, and sputum production.

[0011] Neuromuscular diseases (NMD) is a broad term that encompasses numerous diseases and illnesses that impair muscle function directly through intrinsic muscle pathology or indirectly through neuropathology. Some NMD patients are characterized by progressive muscle damage, resulting in inability to walk, wheelchair confinement, difficulty swallowing, respiratory muscle weakness, and ultimately death due to respiratory failure. Neuromuscular disorders can be classified as rapidly and slowly progressive: (i) rapidly progressive disorders, characterized by muscle damage that worsens over months and leads to death within a few years (e.g., amyotrophic lateral sclerosis (ALS) and Duchenne muscular dystrophy (DMD) in teenagers); (ii) variable or slowly progressive disorders, characterized by muscle damage that worsens over years and only slightly reduces life expectancy (e.g., limb-girdle, facioscapulohumeral, and myotonic muscular dystrophies). Symptoms of respiratory failure in NMD include: increasing generalized weakness, difficulty swallowing, dyspnea on exertion and at rest, fatigue, drowsiness, morning headache, and difficulty concentrating and mood changes.

[0012] Chest wall disorders are a group of thoracic deformities that result in ineffective connections between the respiratory muscles and the rib cage. These disorders are primarily characterized by restrictive defects and share the potential for long-term hypercapnic respiratory failure. Scoliosis and / or kyphoscoliosis can lead to severe respiratory failure. Symptoms of respiratory failure include: dyspnea on exertion, peripheral edema, orthopnea, recurrent chest infections, morning headache, fatigue, poor quality of sleep, and loss of appetite.

[0013] A range of treatments are available to treat or ameliorate such conditions, and otherwise healthy individuals may also benefit from preventative treatments for respiratory disease, but these suffer from a number of deficiencies.

[0014] 2.2.2 Treatment Continuous positive airway pressure (CPAP) therapy has been used in the treatment of obstructive sleep apnea (OSA). Its mechanism of action is that CPAP acts as a pneumatic splint, for example by pushing the soft palate and tongue forward or backward against the posterior oropharyngeal wall, which may prevent the upper airway from closing. Because treatment of OSA with CPAP therapy can be voluntary, patients may choose not to adhere to treatment if they perceive one or more of the following about the device used to deliver the treatment: uncomfortable, difficult to use, expensive, or aesthetically unappealing.

[0015] Non-invasive ventilation (NIV) provides ventilatory support to a patient through the upper airway to assist in breathing by performing some or all of the respiratory functions and / or to maintain adequate oxygen levels in the body. Ventilatory support is provided through a non-invasive patient interface. NIV is used to treat CSR and respiratory failure in forms such as OHS, COPD, MD, and chest wall disorders. In some forms, it can improve the comfort and effectiveness of these treatments.

[0016] Invasive ventilation (IV) provides ventilatory support to patients who can no longer breathe effectively on their own and may be provided using a tracheotomy tube. In some forms, the comfort and effectiveness of these treatments may be improved.

[0017] 2.2.3 Treatment system These therapies may be provided by a therapeutic system or device. Such systems and devices may also be used to diagnose conditions without treating them.

[0018] The treatment system may include a respiratory pressure therapy device (RPT device), an air circuit, a humidifier, a patient interface, and data management.

[0019] Another form of treatment system is a mandibular repositioning device.

[0020] 2.2.3.1 Patient Interface The patient interface may be used to provide the wearer with an interface to the respiratory appliance, for example by providing airflow to the airway entrance. Airflow may be provided via a mask to the nose and / or mouth, a tube to the mouth, or a tracheotomy tube to the patient's trachea. Depending on the therapy being applied, the patient interface may form a seal, for example with an area of ​​the patient's face, to facilitate gas delivery at a pressure of sufficient dispersion with ambient pressure for therapy to be performed (e.g., at a positive pressure of about 10 cmH2O relative to ambient pressure). In other forms of therapy, such as oxygen delivery, the patient interface may not include a seal sufficient to facilitate delivery of a gas supply to the airway at a positive pressure of about 10 cmH2O.

[0021] Certain other mask systems may be functionally inadequate in the field, for example masks that are purely decorative may not be able to maintain adequate pressure, mask systems used for underwater swimming or diving may be configured to protect against water intrusion from higher external pressures and not maintain internal air at pressures higher than ambient.

[0022] A particular mask may be clinically unsuitable for this technology (eg, if the mask blocks airflow through the nose and only allows airflow through the mouth).

[0023] In certain masks, where the patient must insert part of the mask structure into their mouth and create and maintain a seal via the lips, this may be uncomfortable or impractical in the art.

[0024] Certain masks may be impractical for use while sleeping (eg, when sleeping on one's side in bed with head on a pillow).

[0025] There are several challenges in designing a patient interface: The face has a complex three-dimensional shape. Nose size and shape vary greatly between individuals. Because the head contains bone, cartilage and soft tissue, different regions of the face respond differently to mechanical forces; i.e., the chin or mandible may move relative to other bones of the skull. The entire head may move throughout the respiratory treatment period.

[0026] These challenges may result in one or more of the following: some masks may be intrusive, aesthetically undesirable, costly, poor fit, difficult to use, and uncomfortable, especially if the wear time is long or the patient is unfamiliar with the system. For example, masks designed specifically for aviators, as part of personal protective equipment (e.g., filter masks), SCUBA masks, or anesthesia administration masks may be tolerable for their intended use, but such masks may be undesirably uncomfortable to wear for extended periods of time (e.g., hours). Such discomfort may reduce patient compliance with treatment. This is especially true if the mask must be worn while sleeping.

[0027] CPAP therapy is highly effective in treating certain respiratory disorders if the patient complies with the therapy. If the mask is uncomfortable or difficult to use, the patient may not comply with the therapy. Because patients are often encouraged to clean their masks regularly, if the mask is difficult to clean (e.g., difficult to assemble or disassemble), the patient may not be able to clean the mask, which may affect patient compliance.

[0028] Masks for other uses (e.g., for aviators) may be unsuitable for use in treating sleep-disordered breathing, and masks designed for use in treating sleep-disordered breathing may be suitable for other uses.

[0029] For these reasons, patient interfaces for CPAP delivery during sleep form a distinct field.

[0030] 2.2.3.1.1 Sealing formations The patient interface may include a seal forming portion. Because the patient interface is in direct contact with the patient's face, the shape and configuration of the seal forming portion may have a direct impact on the effectiveness and comfort of the patient interface.

[0031] The patient interface may be characterized in part according to the design intent of where the seal-forming portion engages the face in use. In one form of the patient interface, the seal-forming portion may include two sub-portions that engage each of the left and right nostrils. In one form of the patient interface, the seal-forming portion may include a single element that encloses both nostrils in use. Such a single element may be designed to rest, for example, on the upper lip region and nasal bridge region of the face. In one form of the patient interface, the seal-forming portion may include an element that encloses the oral cavity region in use, for example by forming a seal on the lower lip region of the face. In one form of the patient interface, the seal-forming portion may include a single element that encloses both nostrils and the oral cavity region in use. These different types of patient interfaces may be known by various names such as nasal masks, full-face masks, nasal pillows, nasal puffs, and oronasal masks by their manufacturers.

[0032] A seal-forming portion that may be effective in one area of ​​a patient's face may be inadequate in another area due, for example, to different shapes, structures, variability, and sensitive areas of the patient's face. For example, a seal on swim goggles that rests on the patient's forehead may be inadequate for use on the patient's nose.

[0033] A particular seal-forming portion may be designed for mass production so that one design will fit, be comfortable, and be effective for a wide range of different face shapes and sizes. To the extent there is a mismatch between the shape of the patient's face and the seal-forming portion of the mass-produced patient interface, one or both may need to be adapted in order to form a seal.

[0034] One type of seal forming portion extends around the periphery of the patient interface and is intended to seal against the patient's face when force is applied to the patient interface with the seal forming portion engaged against the patient's face. This seal forming portion may include an air or fluid filled cushion, or may include a molded or formed surface of a resilient sealing element comprised of an elastomer such as rubber. With this type of seal forming portion, if the fit is improper, a gap will occur between the seal forming portion and the face, and additional force will be required to press the patient interface against the face to achieve a seal.

[0035] Another type of seal-forming part uses a thin flap seal that is placed around the periphery of the mask to provide a self-sealing action against the patient's face when positive pressure is applied within the mask. As with the previous type of seal-forming part, if the fit between the face and the mask is poor, additional force may be required to achieve a seal or the mask may leak. Additionally, if the shape of the seal-forming part does not match the shape of the patient, the seal-forming part may fold or buckle during use, causing leakage.

[0036] Other types of seal-forming parts may include friction-fit elements that are inserted into the nostrils, for example, but some patients find these seal-forming parts uncomfortable.

[0037] Another form of seal-forming portion may use adhesives to achieve the seal. Some patients find it inconvenient to constantly apply and remove adhesives from their face.

[0038] A range of patient interface seal forming techniques are disclosed in the following patent applications (assigned to ResMed Limited: WO1998 / 004, 310; WO2006 / 074, 513; WO2010 / 135, 785).

[0039] One form of nasal pillow is found in the Adam line manufactured by Puritan Bennett. Another nasal pillow or nasal puff is disclosed in U.S. Pat. No. 4,782,832 (Trimbl), assigned to Puritan-Bennett Corporation.

[0040] ResMed Limited manufactures the following products that use nasal pillows: SWIFT® Nasal Pillows Mask, SWIFT® II Nasal Pillows Mask, SWIFT® LT Nasal Pillows Mask, SWIFT® FX Nasal Pillows Mask and MIRAGELIBERTY® Full Face Mask. Embodiments of nasal pillows masks are described in the following patent applications assigned to ResMed Limited: International Patent Application WO 2004 / 073,778 (which describes, among other things, aspects of ResMed Limited's SWIFT® nasal pillows); U.S. Patent Application No. 2009 / 0044808 (which describes, among other things, aspects of ResMed Limited's SWIFT® LT nasal pillows); International Patent Applications WO 2005 / 063,328 and WO 2006 / 130,903 (which describe, among other things, aspects of ResMed Limited's MIRAGE LIBERTY® full-face mask); and International Patent Application WO 2009 / 052,560 (which describes, among other things, aspects of ResMed Limited's SWIFT® FX nasal pillows).

[0041] 2.2.3.1.2 Positioning and stabilization The seal-forming portions of patient interfaces used in positive air therapy experience corresponding forces from the air pressure that disrupt the seal, so a variety of techniques are used to position the seal-forming portions and maintain a seal against the appropriate portion of the face.

[0042] In one technique, adhesives are used, see, for example, US Patent Application Publication US2010 / 0000534, but adhesives can be uncomfortable.

[0043] Another technique involves the use of one or more straps and / or stabilizing harnesses, many of which suffer from one or more of the following problems: poor fit, bulkiness, discomfort and awkwardness.

[0044] 2.2.3.1.3 Ventilation technology Some forms of patient interface systems may include a vent for pushing out exhaled carbon dioxide. The vent may allow flow from an interior space of the patient interface (e.g., a plenum chamber) to an exterior of the patient interface (e.g., ambient). The vent may include an orifice through which gas may flow when the mask is in use. Many such vents are noisy. Others may become blocked when in use, resulting in insufficient pushing. Some vents may disrupt sleep for the patient 1000 and bed companion 1100, for example, due to noise or airflow concentration.

[0045] ResMed Limited has developed several improved mask ventilation technologies, see International Patent Application Publication No. WO1998 / 034,665; International Patent Application Publication No. WO2000 / 078,381; U.S. Patent No. 6,581,594; U.S. Patent Application Publication No. US2009 / 0050156; U.S. Patent Application Publication No. 2009 / 0044808.

[0046] Conventional mask noise table (ISO17510-2:2007, 10cmH2O pressure at 1m) [Table 1] JPEG2025061736000003.jpg142170

[0047] (*Only one sample was measured at 10cmH2O in CPAP mode using the test method specified in ISO3744) Various sound pressure values ​​for various subjects are shown in the list below. [Table 2]

[0048] 2.2.3.2 Respiratory Pressure Therapy (RPT) Devices Air pressure generators are known in a wide range of applications (e.g., industrial-scale ventilation systems). However, air pressure generators for medical applications have specific requirements that cannot be met by more common air pressure generators (e.g., medical equipment reliability, size, and weight requirements). In addition, even devices designed for medical treatment may suffer from deficiencies related to one or more of the following: comfort, noise, ease of use, effectiveness, size, weight, manufacturability, cost, and reliability.

[0049] One example of a special requirement of a particular RPT device is acoustic noise.

[0050] Table of noise output levels of conventional RPT devices (measured on one sample only at 10cmH2O in CPAP mode using the test method specified in ISO3744). [Table 3]

[0051] One known RPT device used to treat sleep-disordered breathing is the S9 Sleep Therapy System (manufactured by ResMed Limited). Another example of an RPT device is a ventilator. Ventilators (e.g., the ResMed Stellar® series of adult and pediatric ventilators) can provide invasive and non-invasive independent breathing support for patients for a range of conditions (including, but not limited to, NMD, OHS, and COPD).

[0052] The ResMed Elisee® 150 ventilator and ResMed VSIII® ventilators can provide invasive and non-invasive dependent respiratory support suitable for adult or pediatric patients for the treatment of multiple conditions. These ventilators provide volumetric and pressure ventilation modes with single or dual limb circuits. RPT devices typically include a pressure generator (e.g., a motorized blower or compressed gas reservoir) and are configured to deliver airflow to the patient's airway. In some cases, the airflow can be delivered at positive pressure to the patient's airway. The outlet of the RPT device is connected via an air circuit to a patient interface as described above.

[0053] A device designer may be presented with a myriad of choices. Often, design criteria conflict, making certain design choices unconventional or unavoidable. Furthermore, the comfort and effectiveness of a particular embodiment may be significantly affected by minor changes in one or more parameters.

[0054] 2.2.3.3 Humidifier Delivery of the airflow without humidification can lead to drying of the airway. When a humidifier is used with an RPT device and patient interface, humidified gas is produced, minimizing drying of the nasal mucosa and increasing comfort of the patient's airway. Additionally, in cooler climates, the application of warm air to the facial area surrounding the patient interface generally provides greater comfort than cool air. A range of artificial humidification devices and systems are known, but do not meet the special requirements of medical humidification.

[0055] Medical humidifiers are typically used when a patient is sleeping or resting (e.g., in a hospital) to increase the humidity and / or temperature of the air stream relative to the ambient air when necessary. Bedside medical humidifiers may be small. Medical humidifiers may be configured to only humidify and / or heat the air stream delivered to the patient, and not the patient's surroundings. For example, room-based systems (e.g., saunas, air conditioners, or evaporative coolers) may also humidify the air breathed into the patient's body, but these systems also humidify and / or heat the entire room, which may be uncomfortable for occupants. Additionally, medical humidifiers may have more stringent safety constraints than industrial humidifiers.

[0056] Although a number of medical humidifiers are known, such medical humidifiers may suffer from one or more deficiencies, i.e., some of such medical humidifiers provide inadequate humidification and others are difficult or inconvenient for the patient to use.

[0057] 2.2.3.4 Data Management For clinical reasons, data may be obtained to determine whether a patient prescribed respiratory treatment is "compliant" (e.g., whether the patient follows a particular "compliance rule" with their RPT device). One example of a compliance rule for CPAP treatment is that a patient must use the RPT device for at least 4 hours per night for at least 21 days out of 30 consecutive days to be considered compliant. To determine patient compliance, a provider of the RPT device (e.g., a healthcare provider) may manually obtain data describing the patient's treatment with the RPT device, calculate a usage rate over a period of time, and compare this to the compliance rule. Once the healthcare provider determines that the patient has used their RPT device in accordance with the compliance rule, the healthcare provider may notify a third party that the patient is compliant.

[0058] There may be other aspects of a patient's care that would benefit from communication of treatment data to third parties or external systems.

[0059] Existing processes for communicating and managing such data can be one or more of: costly, time consuming, and error prone.

[0060] 2.2.3.5 Mandibular repositioning Mandibular repositioning devices (MRDs) or mandibular advancement devices (MADs) are a treatment option for sleep apnea and snoring. They are adjustable oral appliances available from dentists or other suppliers that hold the mandible (lower jaw) in an anterior position during sleep. MRDs are removable devices that are inserted into the oral cavity before the patient sleeps and removed afterwards. As such, MRDs are not designed for full-time wear. MRDs may be custom made or manufactured in standard forms and include bite impression sites designed to fit the patient's teeth. This mechanical protrusion from the mandible expands the space behind the tongue and applies tension on the pharyngeal walls to reduce airway collapse and reduce palate vibration.

[0061] In certain examples, the mandibular advancement device may include an upper splint intended to engage or mate with teeth on the upper jaw or maxilla, and a lower splint intended to engage or mate with teeth on the upper jaw or mandible. The upper and lower splints are laterally connected to each other via a pair of connecting rods that are fixed symmetrically on the upper and lower splints.

[0062] In such a design, the length of the connecting rod is selected so that the mandible is held in an anterior position when the MRD is placed in the patient's mouth. The length of the connecting rod can be adjusted to vary the level of protrusion of the mandible. The dentist can determine the level of protrusion required for the mandible, which in turn determines the length of the connecting rod.

[0063] Some MRDs are configured to push the mandible forward relative to the maxilla, while others, such as the ResMed Narval CC® MRD, are designed to hold the mandible in an anterior position. The device also reduces or minimizes dental and temporomandibular joint (TMJ) side effects. As such, the device is configured to minimize or prevent any movement of one or more of the teeth.

[0064] 2.2.4 Diagnostic and Monitoring Systems A clinical expert may adequately screen, diagnose or monitor a patient based on personal observation. However, there are situations where a clinical expert is not available or cannot be paid. In some situations, different clinical experts may have different opinions about a patient's condition. Some clinical experts may apply different criteria at different times. When clinical practice is busy, clinicians may find it difficult to keep up with evolving patient management guidelines.

[0065] Polysomnography (PSG) is a conventional system for the diagnosis and prognosis of cardiopulmonary diseases, typically involving application and / or interpretation by expert clinical staff. In PSG, typically 15-20 contact sensors are placed on the human body to record a variety of body signals (e.g., electroencephalography (EEG), electrocardiography (ECG), electrooculography (EOG), electromyography (EMG)). However, while these sensors may be suitable for routine use in clinical settings, such systems can be complex and expensive, and / or may be uncomfortable or impractical for patients attempting to sleep at home. Summary of the Invention [Means for solving the problem]

[0066] 3. Brief description of the technology The present technology relates to the provision of medical devices for use in the diagnosis, amelioration, treatment or prevention of respiratory disorders, which medical devices have one or more of improved comfort, cost, effectiveness, ease of use and manufacturability.

[0067] A first aspect of the present technology relates to a device for use in the diagnosis, amelioration, treatment or prevention of respiratory disease.

[0068] Another aspect of the present technology relates to methods for use in the diagnosis, amelioration, treatment or prevention of respiratory disorders.

[0069] One aspect of certain forms of the present technology is to provide methods and / or devices that improve patient compliance with respiratory treatment.

[0070] A first form of the present technology includes a connector set comprising a compliant face seal between a first end and a second end of the connector set and a retention mechanism coupling the first end and the second end together.

[0071] A second form of the present technology includes a fluid connector for respiratory gas delivery from a respiratory pressure therapy device to a patient. The fluid connector includes a first end including a first opening for fluid flow, a sealing portion extending circumferentially around the first opening, and a latching portion, a second end including a second opening for fluid flow, a sealing surface extending oriented around the second opening and configured to engage with the sealing portion to form a face seal, and a complementary latching portion configured to engage with the latching portion. The face seal allows respiratory gas to move between the first opening and the second opening, and engagement between the latching portion and the complementary latching portion secures the first end together with the second end.

[0072] A third form of the present technology includes a system for providing respiratory therapy to a patient, the system including: a respiratory pressure treatment device; an air circuit; a patient interface connected to the air circuit; and a means for preventing the respiratory pressure treatment device from being connected to the air circuit via an industry standard connection.

[0073] A fourth form of the present technology includes a method of providing a fluid connection for delivering respiratory gas from a respiratory pressure treatment device to a patient. The method includes engaging a latch between a first end and a second end of the fluid connection; and engaging a face seal around a first opening in the first end and around a second opening in the second end. One of the first end and the second end corresponds to the respiratory pressure treatment device.

[0074] A fifth form of the present technology includes a first half of a fluid connector system for respiratory gas delivery from a respiratory pressure treatment device to a patient, the first half including a connector portion including a first opening for fluid flow, a sealing portion extending circumferentially around the first opening, and a latching portion, the sealing portion configured to seal a sealing surface extending circumferentially around a second opening to form a face seal with a second half of the fluid connector system, and the latching portion configured to latch with another latching portion of the second half of the fluid connector system.

[0075] A sixth form of the present technology includes a first half of a fluid connector system for respiratory gas delivery from a respiratory pressure treatment device to a patient, the first half including a connector portion including a first opening for fluid flow, a sealing surface circumscribing the first opening, and a latching portion, the sealing surface configured to receive a sealing portion extending circumscribing the second opening to form a face seal with a second half of the fluid connector system, and the latching portion configured to latch with another latching portion of the second half of the fluid connector system.

[0076] A seventh form of the present technology includes a fluid connector for respiratory gas delivery from a respiratory pressure treatment device to a patient. The fluid connector includes a first end including a first interior and a first retainer for fluid flow, and a second end including a second interior for fluid flow and a complementary retainer configured to engage with the retainer. The first interior and the second interior have a first shape perpendicular to the flow direction, and the retainer and the complementary retainer have a second shape perpendicular to the flow direction, and the first shape and the second shape are different.

[0077] An eighth form of the present technology includes a system for providing respiratory therapy to a patient, the system including a respiratory pressure treatment device, an air circuit, a patient interface connected to the air circuit, the patient interface being specially adapted to operate with the respiratory pressure treatment device, and means for ensuring that the patient interface is specially adapted to operate while connected to the respiratory pressure treatment device.

[0078] In at least one embodiment of the first to eighth aspects of the present technology, (a) the first end is connected to a respiratory pressure treatment device including a blower and the second end is connected to a fluid conduit; (b) the respiratory pressure treatment device is configured to provide a therapeutic pressure for a sleep-related respiratory disorder; (c) the sealing surface is flat; (d) the sealing surface is substantially perpendicular to a fluid flow direction from the first end to the second end; (e) the sealing surface is beveled; (d) the sealing surface extends circumferentially around the second opening; and (e) the sealing surface extends radially from a tube defining the second opening. (f) the flange extends substantially perpendicularly from the tube; (g) the tube extends beyond the flange in a direction toward the sealing portion; (h) the tube extends at least partially through the sealing portion when the complementary latching portion engages the latching portion; (i) the sealing portion is compliant in the engagement direction between the first end and the second end; (j) the sealing portion includes a frusto-conical portion; (k) the frusto-conical portion contacts the sealing surface to form a face seal; (l) the sealing portion includes a partial spherical surface; (m) the partial spherical surface contacts the sealing surface to form a face seal. (n) the sealing portion includes a bellows-like or partial bellows-like portion; (o) the bellows-like or partial bellows-like portion contacts the sealing surface to form the face seal; (p) when the first end and the second end are connected, the sealing portion is configured to engage the sealing surface before the latching portion and the complementary latching portion engage; (q) the sealing portion is radially compliant with respect to an axis defined by an engagement direction of the first end and the second end; (r) the sealing portion has a gap between the sealing portion and the sealing surface in an unpressurized state. (s) when the sealing portion and the sealing surface contact, the sealing portion is compressed against the sealing surface against a direction of air flow from the first opening to the second opening; (t) when the sealing portion is compressed, no significant compressive force is generated; (u) the force required to compress the sealing portion is less than the force required to engage the latching portion with the complementary latching portion; (v) the force required to compress the sealing portion is less than one-half the force required to engage the latching portion with the complementary latching portion;(w) the force required to compress the sealing portion is less than 1 / 10 of the force required to engage the latching portion with a complementary latching portion; (x) at least one of the sealing portion and the sealing surface includes a contact area sufficient to form a seal between the sealing portion and the sealing surface when the centers of the sealing portion and the sealing surface are not aligned with one another; (y) the second end includes an inner portion and a lower portion, the inner portion being rotatably coupled to the lower portion; (z) the inner portion includes the sealing surface; (aa) the inner portion is rigidly connected to a fluid conduit; (bb) the lower portion includes a complementary latching portion; (cc) the complementary latching portion includes a cantilever portion with a protrusion configured to engage the latching portion; (dd) the cantilever portion is configured such that when the cantilever portion is depressed, it engages or disengages with the latching portion of the complementary latching portion to allow engagement or disengagement between the first end and the second end; (ee) the first end includes a travel limit for limiting movement of the second end in an engagement direction between the first end and the second end; (ff) the travel limit is a flange around the first opening. (gg) the latching portion limits the second end from moving in a direction opposite to the engagement direction, the travel limit and the latching portion together defining a travel distance of the second end when the first end and second end are engaged; (hh) the sealing portion is configured to seal against the sealing surface throughout the entire travel distance, the travel distance being a non-zero distance; (ii) the sealing portion seals with the sealing surface along with worst case manufacturing tolerances and after a predetermined amount of wear and / or creep in the fluid connector. (jj) the fluid connector is configured to provide a negligible pressure drop when air flows through the fluid connector throughout the patient's respiratory cycle and at a pressure between 4 cmH2O and 40 cmH2O; (kk) the first end is a female connection and the second end is a male connection; (ll) the female connection and the male connection have a non-circular profile; (mm) the first end includes a port in fluid communication with an interior of the seal portion and separated from the first opening and the second opening; (nn) the first opening and the second opening are interior to the tube;(oo) the first end is connected to a respiratory pressure treatment device including a blower and the second end is connected to an adapter for a fluid conduit connector; (pp) the fluid connector further includes an industry standard fluid connection, said industry standard fluid connection in fluid communication with the first opening and provided on the end opposite the sealing portion; (qq) the fluid connector further includes an industry standard fluid connection, said industry standard fluid connection in fluid communication with the first opening and provided on the end opposite the sealing surface; (rr) the first shape is circular and the second shape comprises characteristics of a circle and a square, and / or; (ss) one of the first interior and the second interior comprises a first male portion and the other of the first interior and the second interior comprises a first female portion, the first male portion and the first female portion comprise a first shape, one of the retaining portion and the complementary retaining portion comprises a second male portion, the other of the retaining portion and the complementary retaining portion comprises a second female portion, and the second male portion and the second female portion comprise a second shape;

[0079] One aspect of one form of the present technology is a portable RPT device that includes a fluid connector that can be carried by a person (e.g., around the home).

[0080] Another aspect of the present technology relates to a vent assembly for a respiratory pressure therapy (RPT) system, the vent assembly including: a vent housing defining a central orifice for flowing pressurized gas through the vent assembly from a delivery conduit to a patient interface, the vent housing having an annular surface about the central orifice, the annular surface having a plurality of holes for releasing the pressurized gas to atmosphere; and a membrane disposed adjacent the annular surface, the membrane being movable such that an increase in pressure of the pressurized gas in the vent assembly urges the membrane against the annular surface of the vent housing.

[0081] Another aspect of the present technology relates to an RPT system including: a venting assembly as described in the preceding paragraph; an RPT device configured to generate a pressurized gas flow in the range of 4-20 cmH20; a patient interface configured to deliver the pressurized gas flow to a patient's airway, the patient interface being non-vented; and a delivery conduit configured to deliver the pressurized gas flow from the RPT device to the patient interface.

[0082] In the embodiment of the vent assembly and RPT system described in paragraph 2 above, (a) the plurality of holes may include a first group of holes and a second group of holes, the first group of holes being closer to the central orifice than the second group of holes, (b) the membrane may be shaped and dimensioned such that the membrane does not cover the first group of holes, (c) the membrane may be constructed to cover more of the second group of holes with increasing pressure of the pressurized gas in the vent assembly, and (d) the first group of holes may be configured to be closer to the central orifice than the second group of holes relative to the pressurized gas flow. and positioned upstream of the second group of holes, (e) the vent assembly may further include a retaining structure for retaining the membrane in a position adjacent the annular surface of the vent housing, (f) the membrane may further include a resilient material, (g) the membrane may be ring-shaped, (h) the membrane may not be bonded to the vent housing, (i) the membrane may be shaped and dimensioned such that an outer edge of the membrane is adjacent an inner circumference of the vent housing, and / or (j) each of the plurality of holes may have a shape that converges from the inner surface of the vent housing to the outer surface of the vent housing.

[0083] Another aspect of the present technology relates to a vent adapter for a respiratory pressure therapy (RPT) system. The vent adapter includes a vent assembly including: a vent housing defining a central orifice for flowing pressurized gas through the vent assembly from a delivery conduit to a patient interface, the vent housing having an annular surface about the central orifice, the annular surface having a plurality of holes for releasing the pressurized gas to atmosphere and a membrane disposed adjacent the annular surface; and a diffusing member.

[0084] Another aspect of the present technology relates to an RPT system including: an RPT device configured to generate a pressurized gas flow in the range of 4-20 cmH20 with the ventilated adapter as described in the previous paragraph; a patient interface configured to deliver the pressurized gas flow to a patient's airway, the patient interface being non-ventilated; and a delivery conduit configured to deliver the pressurized gas flow from the RPT device to the patient interface.

[0085] In the embodiment of the vent adapter and RPT system described in paragraph 2 above, (a) the membrane may be movable such that the membrane is urged against the annular surface of the vent housing with increasing pressure of the pressurized gas in the vent assembly; (b) the plurality of holes may include a first group of holes and a second group of holes, the first group of holes being closer to the central orifice than the second group of holes; (c) the membrane may be shaped and dimensioned such that the membrane does not cover the first group of holes; and (d) the membrane may be configured to be movable such that the membrane is urged against the annular surface of the vent housing with increasing pressure of the pressurized gas in the vent assembly; , may be constructed to cover more of the second group of holes with increasing pressure of the pressurized gas in the vent assembly; (e) the first group of holes may be disposed upstream of the second group of holes relative to the pressurized gas flow; (f) the vent adapter may further include a retention structure for holding the membrane adjacent to the annular surface of the vent housing; (g) the membrane may further include a resilient material; (h) the membrane may be ring-shaped; (i) the membrane may not be bonded to the vent housing; (j) the membrane may be configured to be elastically bonded to an outer edge of the membrane; (k) each of the plurality of holes may have a shape that converges from the inner surface of the vent housing to the outer surface of the vent housing; (l) the vent adapter may include a heat and moisture exchanger (HME) that may be disposed downstream of the plurality of holes relative to the pressurized gas flow; (m) the diffusing member may be disposed on an exterior of the vent housing to at least partially cover the plurality of holes; and (n) the vent adapter further includes a blocking member having an air impermeable material. (o) the diffusing member and the blocking member may be configured to direct gas exiting the plurality of holes outwardly from the diffusing member in a different orientation than the plurality of holes; (p) the diffusing member may provide a flow path parallel to a surface of the blocking member in contact with the diffusing member; (q) the diffusing member may be a porous material; (r) the diffusing member may be a cellular foam; and / or (s) the diffusing member may be a fibrous material.

[0086] One aspect of the present technology relates to a ventilation system for use with a patient interface during respiratory treatment of a patient with a therapeutic gas flow pressurized above ambient pressure. The ventilation system provides a ventilation gas flow from a pressurized volume to the patient's exhaled exhaust gases, the ventilation flow being continuous during respiratory treatment. The ventilation system includes a vent housing including: a base having a therapeutic gas flow inlet extending through the base; at least one first orifice extending through the base to allow gas from the pressurized volume to be released to atmosphere; at least one second orifice extending through the base to allow gas from the pressurized volume to be released to atmosphere; and a membrane disposed adjacent the base.

[0087] One aspect of the present technology relates to a ventilation system for use with a patient interface during respiratory therapy of a patient with a therapeutic gas flow pressurized above ambient pressure. The ventilation system provides a ventilation gas flow from a pressurized volume to the patient's exhaled exhaust gas, the ventilation flow being continuous during respiratory therapy. The ventilation system includes a ventilation housing including: a base having at least one first orifice extending therethrough to allow gas from the pressurized volume to be released to atmosphere; at least one second orifice to allow gas from the pressurized volume to be released to atmosphere; and a membrane disposed adjacent to the base, the pressurized volume being in fluid communication with atmosphere through the at least one first orifice and the at least one second orifice throughout a therapeutic pressure range, the membrane being elastically deformable due to pressure within the pressurized volume distributing the ventilation flow between the at least one first orifice and the at least one second orifice throughout the therapeutic pressure range.

[0088] In embodiments, (a) the vent housing may include an outer wall and an inner wall, the inner wall defining an inlet for therapeutic gas flow, and the base may be disposed between the outer wall and the inner wall, (b) the base may include an inner base and an outer base, (c) the outer base may be adjacent to the outer wall, the inner base may be adjacent to the outer base, and the inner base may be adjacent to the inner wall, (d) the at least one first orifice may include a plurality of inner orifices, and the at least one second orifice may include a plurality of outer orifices, and (e) the plurality of outer orifices may pass through the outer base, and the plurality of inner orifices may pass through the outer base. The orifice may pass between the outer base and the inner base; (f) the vent system may include a plurality of base connectors for joining the inner base and the outer base and dividing the plurality of inner orifices; (g) the vent system may include a plurality of membrane spacers extending from the inner base; (h) the membrane may be supported on the outer base and the plurality of inner orifices on the membrane spacers; (i) the vent housing may include a base divider between the inner base and the outer base, and the membrane may be supported on the plurality of inner orifices on the base divider and the membrane spacers; (i) the vent housing may include a base divider between the inner base and the outer base, and the membrane may be supported on the plurality of inner orifices on the base divider and the membrane spacers; (j) the plurality of membrane spacers may define a plurality of membrane spacer gaps between adjacent ones of the plurality of membrane spacers; (k) the membrane may include an atmosphere side adjacent the inner base and the outer base of the vent housing, and an inner surface defining the membrane opening and an inner base membrane passage for the discharge flow may be defined between the atmosphere side of the membrane and the inner base of the vent housing; (l) an inner wall membrane passage for the discharge flow may be defined between the inner surface of the membrane and the inner wall of the vent housing; and (m) the inner base defines a plurality of inner base slots between adjacent ones of the plurality of membrane spacers. (n) the outer base may include a plurality of lateral membrane supports configured to prevent the membrane from covering the plurality of outer orifices; (o) the vent housing may include a plurality of recesses on opposite sides of the outer base, at least one of the plurality of outer orifices may open into a corresponding one of the plurality of recesses; (p) the inner wall may extend above the inner and outer bases; (q) the inner wall may extend below the inner and outer bases; (r) the membrane may include an elastically deformable material; (s) the elastically deformable material may include silicone; (t) the vent housing may include(u) the relatively rigid material may be polycarbonate; (v) the outer wall, the inner wall, the inner base, the outer base, and the membrane may be circular; (w) the outer wall, the inner wall, the inner base, the outer base, and the membrane may be coaxial; and / or (x) the membrane may not be attached to the vent housing such that the membrane is free to move proximally and distally relative to the base.

[0089] Another aspect of the present technology relates to a patient interface including a seal-forming structure, a plenum chamber joined to the seal-forming structure, a positioning and stabilizing structure for securing the patient interface on a patient in use, and a ventilation system of any of the aspects and / or embodiments disclosed in the two immediately preceding paragraphs. The patient interface may include a vent connector tube or decoupling structure for fluidly connecting the ventilation system to the plenum chamber.

[0090] Another aspect of the present technology relates to a ventilation system for use with a patient interface during respiratory therapy of a patient with a therapeutic gas flow pressurized above ambient pressure. The ventilation system provides a ventilation gas flow from a pressurized volume to exhaust gas exhaled by the patient, the ventilation flow being continuous during respiratory therapy. The ventilation system includes a vent housing having at least one first orifice extending through the base to allow gas from the pressurized volume to be released to atmosphere, at least one second orifice to allow gas from the pressurized volume to be released to ambient, and a membrane disposed adjacent the base. The pressurized volume is in fluid communication with the surroundings through the at least one first orifice and the at least one second orifice throughout a therapeutic pressure range, and the membrane is configured such that as pressure in the pressurized volume increases, the membrane restricts a first airflow through the at least one first orifice throughout a therapeutic pressure range, and as the first airflow through the at least one first orifice is restricted, the second airflow through the at least one second orifice increases, thereby maintaining the airflow through the at least one first orifice and the at least one second orifice approximately constant throughout the therapeutic pressure range.

[0091] In embodiments, (a) the vent housing may include an outer wall and an inner wall, the inner wall defining an inlet for the therapeutic gas flow, and the base may be disposed between the outer wall and the inner wall, (b) the outlet flow may be greater than or equal to a sum of the first vent flow and the second vent flow, (c) the membrane may be elastically deformable toward the base in use such that the first vent flow is restricted as the membrane is deflected toward the base, and (d) the membrane is configured to deflect closer to the base when the therapeutic pressure increases above a threshold therapeutic pressure value. (e) the membrane may be configured to reduce the first vent flow such that the second vent flow increases as the membrane deflects closer to the base due to the treatment pressure increasing above a threshold treatment pressure value; (g) the at least one first orifice may include a plurality of inner orifices and the at least one second orifice may include a plurality of outer orifices; (f) the base may include an inner base and an outer base; (h) the vent system may include a plurality of membrane spacers extending from the inner base; (i) the membrane may be supported across the outer base and the plurality of inner orifices on the membrane spacers such that the membrane deflects toward the inner base as the treatment pressure increases above the threshold treatment pressure value; (j) the membrane may be configured such that a membrane-inner base gap defined between the membrane and the inner base decreases as the treatment pressure increases above the threshold treatment pressure value; (k) the membrane may be configured such that the first vent flow decreases and the second vent flow increases with the reduction in the membrane / inner base gap; and (l) the membrane may be elastically deformable. (m) the elastically deformable material may include silicone; (n) the vent housing may be formed from a single homogenous piece of relatively rigid material; (o) the relatively rigid material may be polycarbonate; (p) the outer wall, inner wall, inner base, outer base and membrane may be circular; (q) the outer wall, inner wall, inner base, outer base and membrane may be coaxial; and (r) the membrane may not be attached to the vent housing such that the membrane is freely moveable in the proximal and distal directions relative to the base.

[0092] Another aspect of the present technology relates to a patient interface including a seal-forming structure, a plenum chamber joined to the seal-forming structure, a positioning and stabilizing structure for securing the patient interface on a patient in use, and a ventilation system of any of the aspects and / or embodiments disclosed in the two immediately preceding paragraphs. The patient interface may include a vent connector tube or decoupling structure for fluidly connecting the ventilation system to the plenum chamber.

[0093] Another aspect of the present technology relates to a patient interface that may include: a plenum chamber pressurizable to a therapeutic pressure of at least 6 cmH2O above ambient air pressure, said plenum chamber including a plenum chamber inlet port sized and configured to receive an airflow at said therapeutic pressure for breathing of the patient; a seal-forming structure constructed and arranged to form a seal against an area of ​​the patient's face surrounding an entrance to the patient's airways whereby an airflow at said therapeutic pressure is delivered to at least an entrance to the patient's nares, the seal-forming structure constructed and arranged to maintain said therapeutic pressure within the plenum chamber throughout the patient's respiratory cycle in use; and a seal-forming structure configured to attach the seal-forming structure to a therapeutic pressure on the patient's head. and a ventilation system for use with a patient interface during respiratory treatment of a patient with a therapeutic gas flow pressurized above ambient pressure, the ventilation system providing a ventilation gas flow from a pressurized volume to exhaust gas exhaled by the patient, the ventilation system including: a venting housing having a base having at least one first orifice extending through the base to allow gas from the pressurized volume to be released to atmosphere; at least one second orifice to allow gas from the pressurized volume to be released to atmosphere; and a membrane disposed adjacent the base.wherein the pressurized volume is in fluid communication with the atmosphere through the at least one first orifice and the at least one second orifice throughout a therapeutic pressure range, wherein the membrane is configured such that as pressure in the pressurized volume increases, it causes the membrane to restrict a first airflow through the at least one first orifice throughout a therapeutic pressure range, and as the first airflow through the at least one first orifice is restricted, it increases a second airflow through the at least one second orifice such that the airflow through the at least one first orifice and the at least one second orifice is substantially constant throughout the therapeutic pressure range, and the patient interface is configured to allow the patient to breathe from the environment through his or her oral cavity in the absence of a flow of pressurized air through the plenum chamber inlet port, or alternatively, the patient interface is configured to leave the patient's oral cavity exposed.

[0094] In embodiments, (a) the vent housing may include an outer wall and an inner wall, the inner wall defining an inlet for the therapeutic gas flow, and the base may be disposed between the outer wall and the inner wall; (b) the outlet flow may be greater than or equal to the sum of the first vent flow and the second vent flow; (c) the membrane may be elastically deformable toward the base in use such that the first vent flow is restricted as the membrane is deflected toward the base; (d) the membrane may be configured to deflect closer to the base when the therapeutic pressure increases above a threshold therapeutic pressure value; and (e) the membrane may be configured to deflect closer to the base when the therapeutic pressure increases above a threshold therapeutic pressure value. The first vent flow may be configured to reduce such that the second vent flow increases as the membrane deflects closer to the base due to the treatment pressure increasing above a threshold treatment pressure value; (f) the base may include an inner base and an outer base; (g) the at least one first orifice may include a plurality of inner orifices and the at least one second orifice may include a plurality of outer orifices; (h) the vent system may include a plurality of membrane spacers extending from the inner base; (i) the membrane may be disposed on the outer base and the membrane spacers. (j) the vent housing may include a base divider between the inner base and the outer base, and the membrane may be supported on the inner orifices on the base divider and the membrane spacer; (k) the outer base may include a plurality of lateral membrane supports configured to prevent the membrane from covering the outer orifices; (l) the membrane may include an elastically deformable material; (m) the elastically deformable material may include silicone; (n) the vent housing may be a homogenous single piece of a relatively rigid material. (o) the relatively rigid material may be polycarbonate; (p) the outer wall, inner wall, inner base, outer base and membrane may be circular; (q) the outer wall, inner wall, inner base, outer base and membrane may be coaxial; (r) the membrane may be unattached to the vent housing such that the membrane is free to move proximally and distally relative to the base; and / or (s) the patient interface may include a vent connector tube or decoupling structure for fluidly connecting the vent system to the plenum chamber.

[0095] Another aspect of the present technology relates to a patient interface that may include: a plenum chamber pressurizable to a therapeutic pressure of at least 6 cmH2O above ambient air pressure, said plenum chamber including a plenum chamber inlet port sized and configured to receive an airflow at said therapeutic pressure for breathing of the patient; a seal-forming structure constructed and arranged to form a seal against an area of ​​the patient's face surrounding an entrance to the patient's airways, whereby the airflow at said therapeutic pressure is delivered to at least an entrance to the patient's nares, the seal-forming structure constructed and arranged to maintain said therapeutic pressure within the plenum chamber throughout the patient's respiratory cycle in use. a positioning and stabilizing structure providing a resilient force to hold the seal-forming structure in a therapeutically effective position on the patient's head, the positioning and stabilizing structure including a tether, the tether constructed and arranged such that in use at least a portion of the tether rests against an area of ​​the patient's head above the upper ear base of the patient's head, a portion of the tether being dimensioned and configured to engage a portion of the patient's head in use within an area of ​​the parietal bone, the positioning and stabilizing structure having a non-rigid disconnect; and a ventilation system providing a ventilation gas flow from a pressurized volume to patient exhaled exhaust gases, the ventilation flows being continuous during respiratory therapy, the ventilation flows including a first ventilation flow and a second ventilation flow, the ventilation system including: a ventilation housing including a base having at least one first orifice extending through the base for the first ventilation flow; at least one second orifice for the second ventilation flow; and a membrane disposed adjacent to the base.wherein the pressurized volume is in fluid communication with the atmosphere through at least one first orifice and at least one second orifice throughout a therapeutic pressure range, wherein the membrane is configured to elastically deform with pressure within the pressurized volume such that increasing deformation due to increasing pressure reduces a first airflow through the at least one first orifice and increases a second airflow through the at least one second orifice to maintain a substantially constant airflow throughout the therapeutic pressure range, and wherein the patient interface is configured to allow the patient to breathe from the environment through his or her oral cavity in the absence of a flow of pressurized air through the plenum chamber inlet port, or alternatively the patient interface is configured to leave the patient's oral cavity exposed.

[0096] In embodiments, (a) the vent housing may include an outer wall and an inner wall, the inner wall defining an inlet for the therapeutic gas flow, and the base may be disposed between the outer wall and the inner wall; (b) the outlet flow may be greater than or equal to the sum of the first vent flow and the second vent flow; (c) the membrane may be elastically deformable toward the base in use such that the first vent flow is restricted as the membrane is deflected toward the base; (d) the membrane may be configured to deflect closer to the base when the therapeutic pressure increases above a threshold therapeutic pressure value; and (e) the membrane may be configured to deflect closer to the base when the therapeutic pressure increases above a threshold therapeutic pressure value. The first vent flow may be configured to reduce such that the second vent flow increases as the membrane deflects closer to the base due to the treatment pressure increasing above a threshold treatment pressure value; (f) the base may include an inner base and an outer base; (g) the at least one first orifice may include a plurality of inner orifices and the at least one second orifice may include a plurality of outer orifices; (h) the vent system may include a plurality of membrane spacers extending from the inner base; (i) the membrane may be disposed on the outer base and the membrane spacers. (j) the vent housing may include a base divider between the inner base and the outer base, and the membrane may be supported on the inner orifices on the base divider and the membrane spacer; (k) the outer base may include a plurality of lateral membrane supports configured to prevent the membrane from covering the outer orifices; (l) the membrane may include an elastically deformable material; (m) the elastically deformable material may include silicone; (n) the vent housing may be a homogenous single piece of a relatively rigid material. (o) the relatively rigid material may be polycarbonate; (p) the outer wall, inner wall, inner base, outer base and membrane may be circular; (q) the outer wall, inner wall, inner base, outer base and membrane may be coaxial; (r) the membrane may be unattached to the vent housing such that the membrane is free to move proximally and distally relative to the base; and / or (s) the patient interface may include a vent connector tube or decoupling structure for fluidly connecting the vent system to the plenum chamber.

[0097] Of course, some of the above aspects may form sub-aspects of the present technology, and various one of the sub-aspects and / or aspects may be combined in various ways to form further aspects or sub-aspects of the present technology.

[0098] Other features of the present technology will become apparent in light of the information contained in the following detailed description, abstract, drawings, and claims. [Brief description of the drawings]

[0099] 4. Brief Description of the Drawings The present technology is illustrated by way of one non-limiting example in the accompanying drawings, in which like reference symbols include like elements: 4.1 Treatment system [Figure 1A] Figure 1A shows a system including a patient 1000 wearing a patient interface 3000. The system takes the form of nasal pillows and receives air at positive pressure supplied by an RPT device 4000. The air from the RPT device is humidified by a humidifier 5000 and travels along an air circuit 4170 to the patient 1000. A co-sleeper 1100 is also shown. [Figure 1B] 1B shows a system including a patient 1000 wearing a patient interface 3000. The system takes the form of a nasal mask and receives air at positive pressure supplied by an RPT device 4000. Air from the RPT device is humidified by a humidifier 5000 and travels along an air circuit 4170 to the patient 1000. [Figure 1C] 1C shows a system including a patient 1000 wearing a patient interface 3000. The patient interface 3000 takes the form of a full face mask and receives a supply of air at positive pressure from an RPT device 4000. Air from the RPT device is humidified by a humidifier 5000 and travels along an air circuit 4170 to the patient 1000. 4.2 Respiratory System and Facial Anatomy [Figure 2A]FIG. 2A shows an overview of the human respiratory system, including the nose and oral cavity, larynx, vocal folds, esophagus, trachea, bronchi, lungs, alveolar sacs, heart and diaphragm. [Figure 2B] FIG. 2B is a diagram of the human upper airway including the nasal cavity, nasal bones, lateral nasal cartilages, greater alar cartilage, nostrils, upper lip, lower lip, larynx, hard palate, soft palate, oropharynx, tongue, epiglottis, vocal cords, esophagus, and trachea. [Figure 2C] Figure 2C is a front view of the face including several features of the surface anatomy including the upper lip, upper vermilion lip, lower vermilion lip, lower lip, oral width, endocardium, nasal alar, nasolabial fold and corners of the mouth. The directions of superior, inferior, radially inward and radially outward are also described. [Figure 2D] Figure 2D is a side view of the head including several features of the surface anatomy including the glabella, cerion, nasal tip, subnasal point, upper lip, lower lip, chin, nasal ridge, narrow apex, superior and inferior auricles. The directions of superior and inferior, and anterior and posterior are also described. [Figure 2E] Figure 2E is a further lateral view of the head. The approximate locations of the Frankfort horizontal and nasolabial angle are noted. The frontal plane is also noted. [Figure 2F] FIG. 2F is a bottom view of the nose including several features including the nasolabial fold, lower lip, upper vermilion, nostrils, subnasal point, columella, nasal tip, major axis of the nostril and sagittal plane. [Figure 2G] FIG. 2G is a side view of the surface features of the nose. [Figure 2H] FIG. 2H shows the subcutaneous structures of the nose including the lateral cartilage, septal cartilage, greater alar cartilage, lesser alar cartilage, sesamoid cartilage, nasal bone, epidermis, adipose tissue, frontal process of the maxilla, and fibro-adipose tissue. [Figure 2I] FIG. 2I shows the mid-nasal incision, approximately a few millimeters from the sagittal plane, specifically showing the septal cartilage and the medial crus of the greater alar cartilage. [Figure 2J] FIG. 2J is a bony frontal view of the skull including the frontal, nasal and cheekbones. The nasal turbinates are shown along with the maxilla and mandible. [Figure 2K]FIG. 2K is a side view of the skull along with the outline of the head surface and some of the muscles. The following bones are shown: frontal, sphenoid, nasal, zygomatic, maxilla, mandible, parietal, temporal, and occipital. The mental protuberance is shown. The following muscles are shown: digastric, masseter, sternocleidomastoid, and trapezius. [Figure 2L] Figure 2L shows the anterolateral side of the nose. 4.3 Patient Interface [Figure 3A] FIG. 3A shows a patient interface in the form of a nasal mask in accordance with one form of the present technology. [Figure 3B] 3B is a schematic cross-sectional view of the structure cut at a point, where the outward normal is shown, and the curvature at this point has a positive sign and a relatively large magnitude compared to the magnitude of curvature shown in 3C. [Figure 3C] Figure 3C is a schematic cross-sectional view of the structure cut at a point, where the outward normal is shown, and the curvature at this point has a positive sign and a relatively small magnitude compared to the magnitude of curvature shown in Figure 3B. [Figure 3D] 3D is a schematic cross-sectional view of the structure cut at a point, where the outward normal is shown, and where the curvature value is zero. [Figure 3E] Figure 3E is a schematic cross-sectional view of the structure cut at a point, where the outward normal is shown, and the curvature at this point has a negative sign and a relatively small magnitude compared to the magnitude of curvature shown in Figure 3F. [Figure 3F] Figure 3F is a schematic cross-sectional view of the structure cut at a point, where the outward normal is shown, and the curvature at this point has a negative sign and a relatively large magnitude compared to the magnitude of curvature shown in Figure 3E. [Figure 3G] 3G shows a mask cushion including two pillows. The outer surface of the cushion is shown. The edge of the surface is shown. The dome region and the saddle region are shown. [Figure 3H]FIG. 3H shows a cushion for a mask. The outer surface of the cushion is illustrated. The edge of the surface is illustrated. The path on the surface between points A and B is illustrated. The straight line distance between A and B is illustrated. The two saddle regions and the dome region are illustrated. 4.4 RPT Device [Figure 4A] 4 shows an RPT device 4000 in accordance with one form of the present technology. [Figure 4B] FIG. 4 is a schematic diagram of an air circuit of an RPT device 4000 in accordance with one form of the present technology, with upstream and downstream directions indicated. [Figure 4C] FIG. 40 is a schematic diagram of electrical components of an RPT device 4000 in accordance with one aspect of the present technology. [Figure 4D] FIG. 4D is a schematic diagram of an algorithm executed in an RPT device in accordance with one form of the present technology. [Figure 4E] 9D in accordance with an aspect of the present technology. [Figure 5A] FIG. 5A is an isometric view of a humidifier in accordance with one form of the present technology. [Figure 5B] FIG. 5B is an isometric view of a humidifier in accordance with one form of the present technology, showing the humidifier reservoir 5110 removed from the humidifier reservoir dock 5130. [Figure 5C] FIG. 5C is a schematic diagram of a humidifier in accordance with one form of the present technology. 4.6 Vent Adapter [Figure 6A] FIG. 6A is a side view of a fluid connector with first and second ends mated to one another. [Figure 6B] FIG. 6B is a side cross-sectional view of the fluid connector where the first end and the second end are not interdigitated. [Figure 6C] FIG. 6C is a side cross-sectional view of a fluid connector with the first and second ends interdigitated with each other. [Figure 6D] FIG. 6D is a perspective view of a fluid connector with the first and second ends separated from one another and the interior of the first end is not visible. [Figure 6E] FIG. 6E is a cross-sectional view of a fluid connector with an additional fluid port. [Figure 6F] FIG. 6F shows a fluid connector with a first end and a second end connected together and the first end integrated with an RTP device. [Figure 6G] FIG. 6G shows a fluid connector with a first end and a second end that are not connected and with the first end that is integrated with an RTP device. [Figure 6H] FIG. 6H is a perspective view of the fluid connector with the first and second ends separated from one another and the sealing surface of the second end visible. [Figure 7A] FIG. 7A is a perspective view of a vent adapter according to an embodiment of the present technology. [Figure 7B] FIG. 7B is a side view of a vent adapter according to an embodiment of the present technology. [Figure 7C] FIG. 7C is a top view of a vent adaptor according to an embodiment of the present technology. [Figure 7D] FIG. 7D is a cross-sectional view of a vent adapter taken through line 7D-7D of FIG. 7C in accordance with an embodiment of the present technology. [Figure 7E] FIG. 7E is an exploded view of a vent adapter according to an embodiment of the present technology. [Figure 7F] FIG. 7F is another exploded view of a vent adapter according to an embodiment of the present technology. [Figure 8A] FIG. 8A is a perspective view of a vented housing according to an embodiment of the present technology. [Figure 8B] FIG. 8B is another perspective view of a vent housing according to an embodiment of the present technology. [Figure 8C] FIG. 8C is a side view of a vented housing according to an embodiment of the present technology. [Figure 8D] FIG. 8D is another side view of a vent housing according to an embodiment of the present technology. [Figure 8E] FIG. 8E is a top view of a vented housing according to an embodiment of the present technology. [Figure 8F]FIG. 8F is a cross-sectional view of a vented housing according to an embodiment of the present technology taken through line 8F-8F of FIG. 8E. [Figure 9A] FIG. 9A is a perspective view of a vented housing connector according to an embodiment of the present technology. [Figure 9B] FIG. 9B is another perspective view of a vented housing connector according to an embodiment of the present technology. [Figure 9C] FIG. 9C is a side view of a vented housing connector according to an embodiment of the present technology. [Figure 9D] FIG. 9D is another side view of a vented housing connector according to an embodiment of the present technology. [Figure 9E] FIG. 9E is a top view of a vented housing connector according to an embodiment of the present technology. [Figure 10A] FIG. 10A is a perspective view of a bellows seal according to an embodiment of the present technology. [Figure 10B] FIG. 10B is another perspective view of a bellows seal in accordance with an embodiment of the present technology. [Figure 10C] FIG. 10C is a side view of a bellows seal according to an embodiment of the present technology. [Figure 10D] FIG. 10D is another side view of a bellows seal according to an embodiment of the present technology. [Figure 10E] FIG. 10E is a bottom view of a bellows seal according to an embodiment of the present technology. [Figure 11A] FIG. 11A is a perspective view of a vented adapter connector according to an embodiment of the present technology. [Figure 11B] FIG. 11B is another perspective view of a vented adapter connector according to an embodiment of the present technology. [Figure 11C] FIG. 11C is a side view of a vented adaptor connector according to an embodiment of the present technology. [Figure 11D] FIG. 11D is another side view of a vented adaptor connector according to an embodiment of the present technology. [Figure 11E] FIG. 11E is a bottom view of a vented adapter connector according to an embodiment of the present technology. [Figure 12A]FIG. 12A is a perspective view of a heat and moisture exchanger (HME) clip according to an embodiment of the present technology. [Figure 12B] FIG. 12B is a side view of a heat and moisture exchanger (HME) clip according to an embodiment of the present technology. [Figure 12C] FIG. 12C is another side view of a heat and moisture exchanger (HME) clip according to an embodiment of the present technology. [Figure 12D] FIG. 12D is another side view of a heat and moisture exchanger (HME) clip according to an embodiment of the present technology. [Figure 13A] FIG. 13A is a perspective view of a heat and moisture exchanger (HME) housing according to an embodiment of the present technology. [Figure 13B] FIG. 13B is a side view of a heat and moisture exchanger (HME) housing according to an embodiment of the present technology. [Figure 13C] FIG. 13C is another side view of a heat and moisture exchanger (HME) housing according to an embodiment of the present technology. [Figure 13D] FIG. 13D is a top view of a heat and moisture exchanger (HME) housing according to an embodiment of the present technology. [Figure 14A] FIG. 14A is a perspective view of a conduit connector according to an embodiment of the present technology. [Figure 14B] FIG. 14B is a top view of a conduit connector according to an embodiment of the present technology. [Figure 14C] FIG. 14C is a side view of a conduit connector according to an embodiment of the present technology. [Figure 14D] FIG. 14D is a front view of a conduit connector according to an embodiment of the present technology. [Figure 15A] FIG. 15A is a perspective view of a vent adapter according to an embodiment of the present technology. [Figure 15B] FIG. 15B is another perspective view of a vent adapter according to an embodiment of the present technology. [Figure 15C] FIG. 15C is an exploded view of a vent adapter according to an embodiment of the present technology. [Figure 15D] FIG. 15D is an exploded view of a vent adapter according to an embodiment of the present technology. [Figure 15E]FIG. 15E is a side view of a vent adapter according to an embodiment of the present technology. [Figure 15F] FIG. 15F is a cross-sectional view of a vent adapter according to an embodiment of the present technology taken through line 15F-15F of FIG. 15B. [Figure 16] FIG. 16 is a graph comparing the airflow from a full face mask to the airflow from a constant flow ventilation (CFV) according to the present technology over a range of therapeutic pressures. [Figure 17] FIG. 17 is an illustration of a patient undergoing treatment according to one embodiment of the present technology. [Figure 18] FIG. 18 is a graph comparing the airflow from a full face mask to the airflow from a constant flow ventilation (CFV) according to the present technology over a range of therapeutic pressures. [Figure 19] FIG. 19 is a graph of ventilation flow from constant flow ventilation (CFV) alone, from passive ventilation alone, and a combination of both according to the present technique, over a range of therapeutic pressures. [Figure 20] FIG. 20 shows an example of a constant flow vent (CFV) membrane according to one embodiment of the present technology. [Figure 21A] FIG. 21A is a cross-sectional view of a vent adaptor according to an embodiment of the present technology. [Figure 21B] FIG. 21B is an exploded view of a constant flow vent (CFV) of a vent adapter according to an embodiment of the present technology. [Figure 21C] FIG. 21C is a rear view of a constant flow vent (CFV) vent adapter according to an embodiment of the present technology. [Figure 21D] FIG. 21D is a perspective view of a constant flow vent (CFV) of a vent adapter according to an embodiment of the present technology. [Figure 21E] FIG. 21E is another perspective view of a constant flow vent (CFV) of a vent adapter according to an embodiment of the present technology. [Figure 21F] FIG. 21F is a cross section of a vent adaptor constant flow vent (CFV) according to an embodiment of the present technology. [Figure 22] FIG. 22 is an exploded view of a vent adapter according to an embodiment of the present technology. [Diagram 23] FIG. 23 shows a chart of an exemplary patient interface according to the present technology. [Figure 24A] FIG. 24A is a cross-sectional view of a vent adaptor according to an embodiment of the present technology. [Figure 24B] FIG. 24B is a perspective view of a vent adapter according to an embodiment of the present technology. [Figure 25A] FIG. 25A is a cross-sectional view of an HME 7000 including a single layer 7001 according to one embodiment of the present technology. [Figure 25B] FIG. 25B shows an example of a single corrugation 7030 of an HME 7000 in accordance with one aspect of the present technology. [Figure 25C] FIG. 25C is a schematic diagram showing an HME 7000 that includes multiple layers 7001 stacked along both vertical and horizontal axes. [Figure 25D] FIG. 25D shows the HME under preload to compress the corrugations to a constant volume such that the number of layers 7001 is increased within the constant volume. [Figure 25E] 25E shows a corrugated structure 7002 that includes a plurality of corrugations 7030. The corrugated structure is rolled to form the HME 7000. [Figure 26] FIG. 26 shows the orifice, diffusing member and blocking member that form part of the gas discharge vent. [Figure 27] FIG. 27 shows the orifice, diffusing member and blocking member forming part of the gas discharge vent, with a hole provided in the blocking member. [Figure 28] FIG. 28 is an exploded view of the orifices, diffusing members and blocking members that form part of the gas discharge vent formed in a circle around a central hole. [Figure 29] FIG. 29 is a simplified diagram of the orifices, diffusing members and blocking members that form part of a gas discharge vent formed in a circle around a central hole. [Diagram 30] FIG. 30 is a cross-sectional view taken through line 30-30 of FIG. [Figure 31A]FIG. 31A is a partial view of an elbow with a gas discharge vent with one annular outlet. [Figure 31B] FIG. 31B is an axial view of the orifice during gas discharge venting of FIG. 31B. [Figure 31C] FIG. 31C is a cross-sectional view taken through the plane of the view of FIG. 31 which corresponds to the plane labeled as 31C-31C in FIG. 31B. [Figure 32A] FIG. 32A shows an elbow with a ball and socket joint and gas relief vent. [Figure 32B] FIG. 32B is an exploded view of the elbow of FIG. 32A. [Figure 32C] FIG. 32C is a side view of the elbow. [Fig. 32D] FIG. 32D is a cross-sectional view taken through line 32D-32D of FIG. 32C. [Figure 33A] FIG. 33A is a perspective view of a vent adapter according to an embodiment of the present technology. [Figure 33B] FIG. 33B is another perspective view of a vent adapter according to an embodiment of the present technology. [Figure 33C] FIG. 33C is a top view of a vent adapter according to an embodiment of the present technology. [Figure 33D] FIG. 33D is a bottom view of a vent adapter according to an embodiment of the present technology. [Figure 33E] FIG. 33E is a side view of a vent adapter according to an embodiment of the present technology. [Figure 33F] FIG. 33F is a cross-sectional view of the vent adapter taken through line 33F-33F of FIG. 33C according to an embodiment of the present technology. [Figure 33G] FIG. 33G is an exploded view of a vent adapter according to an embodiment of the present technology. [Figure 34A] FIG. 34A is a perspective view of a vent assembly for a vent adapter according to an embodiment of the present technology. [Figure 34B] FIG. 34B is another perspective view of a vent assembly for a vent adapter according to an embodiment of the present technology. [Figure 34C]FIG. 34C is a rear view of a vent assembly for a vent adapter according to an embodiment of the present technology. [Fig. 34D] FIG. 34D is a front view of a vent assembly for a vent adapter according to an embodiment of the present technology. [Figure 34E] FIG. 34E is a lateral view of a vent assembly for a vent adapter according to an embodiment of the present technology. [Fig. 34F] FIG. 34F is a cross-sectional view of a vent assembly for a vent adapter taken through line 34F-34F of FIG. 34C according to an embodiment of the present technology. [Figure 34G] FIG. 34G is an exploded view for a vent adapter vent assembly according to an embodiment of the present technology. [Diagram 35] FIG. 35 is a perspective view of a vent adaptor with patient interface according to an embodiment of the present technology. [Figure 36A] FIG. 36A is a perspective view of an air circuit according to an embodiment of the present technology. [Figure 36B] FIG 36B is another perspective view of an air circuit according to an embodiment of the present technology. [Figure 36C] FIG. 36C is an exploded view of an air circuit according to an embodiment of the present technology. [Figure 37A] FIG. 37A is a perspective view of a vent adapter according to an embodiment of the present technology. [Figure 37B] FIG. 37B is another perspective view of a vent adapter according to an embodiment of the present technology. [Figure 37C] FIG. 37C is a lateral view of a vent adapter according to an embodiment of the present technology. [Figure 37D] FIG. 37D is a cross-sectional view of the vent adapter taken through line 37D-37D of FIG. 37B according to an embodiment of the present technology. [Figure 37E] FIG. 37E is an exploded view of a vent adapter according to an embodiment of the present technology. [Figure 38A] FIG. 38A is a perspective view of a heat and moisture exchanger (HME) housing according to an embodiment of the present technology. [Figure 38B]FIG. 38B is another perspective view of an HME housing according to an embodiment of the present technology. [Figure 38C] FIG. 38C is an exploded view of an HME housing according to an embodiment of the present technology. [Figure 39A] FIG. 39A is a perspective view of a heat and moisture exchanger (HME) housing according to an embodiment of the present technology. [Figure 39B] FIG. 39B is another perspective view of an HME housing according to an embodiment of the present technology. [Figure 39C] FIG. 39C is an exploded view of an HME housing according to an embodiment of the present technology. [Diagram 40] FIG. 40 is a perspective view of a vent adaptor with patient interface according to an embodiment of the present technology. [Diagram 41] FIG. 41 is a perspective view of a vent adaptor with patient interface according to an embodiment of the present technology. [Figure 42A] FIG. 42A is a top perspective view of a vent housing according to another embodiment of the present technology. [Figure 42B] FIG. 42B is a top view of a vent housing according to another embodiment of the present technology. [Figure 42C] FIG. 42C is a bottom view of a vent housing according to another embodiment of the present technology. [Fig.42D] FIG. 42D is a bottom perspective view of a vent housing according to another embodiment of the present technology. [Figure 42E] FIG. 42E is a side view of a vent housing according to another embodiment of the present technology. [Fig.42F] FIG. 42F is a cross-sectional view of a vented housing according to another embodiment of the present technology taken through line 42F-42F of FIG. 42B. [Fig.42G] FIG. 42G is a cross-sectional view of a vented housing according to another embodiment of the present technology taken through line 42G-42G of FIG. 42B. [Figure 43A] FIG. 43A is a top perspective view of a ventilation system according to another embodiment of the present technology. [Figure 43B]FIG. 43B is a top view of a ventilation system according to another embodiment of the present technology. [Figure 43C] FIG. 43C is a bottom view of a ventilation system according to another embodiment of the present technology. [Fig. 43D] FIG. 43D is a bottom perspective view of a ventilation system according to another embodiment of the present technology. [Figure 43E] FIG. 43E is a side view of a ventilation system according to another embodiment of the present technology. [Figure 43F] FIG. 43F is a cross-sectional view of a ventilation system according to another embodiment of the present technology taken through line 43F-43F of FIG. 43B. [Figure 43G] FIG. 43G is a cross-sectional view of a ventilation system according to an embodiment of the present technology taken through line 43G-43G of FIG. 43B. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0100] 5 Detailed Description of Technical Examples Before describing the present technology in further detail, it should be understood that the present technology is not limited to the specific embodiments described herein, which may vary. It should also be understood that the terminology used in the present disclosure is for the purpose of describing the specific embodiments described herein, and is not intended to be limiting.

[0101] The following description is provided in conjunction with various embodiments that may share one or more common characteristics and / or features. It should be understood that one or more features of any one embodiment may be combined with one or more features of another embodiment or other embodiments. In addition, any single feature or combination of features in any of these embodiments may constitute an additional embodiment.

[0102] 5.1 Treatment In one form, the present technology includes a method of treating a respiratory disorder, the method including the step of applying positive pressure to an entrance to the airways of a patient 1000.

[0103] In a particular embodiment of the present technology, a supply of air at positive pressure is provided to the patient's nasal passages via one or both nostrils.

[0104] In certain embodiments of the present technology, mouth breathing is restricted, limited or prevented. 5.2 Treatment system

[0105] In one form, the present technology includes an apparatus or device for the treatment of respiratory disorders. The apparatus or device may include an RPT device 4000 that supplies compressed air to a patient 1000 via an air circuit 4170 to a patient interface 3000.

[0106] 5.3 Patient Interface A non-invasive patient interface 3000 according to one aspect of the present technology includes the following functionalities: a seal forming structure 3100, a plenum chamber 3200, a positioning and stabilizing structure 3300, a vent 3400, a form of connection port 3600 for connection to an air circuit 4170, and a forehead support 3700. In some forms, the functionalities may be provided by one or more physical components. In some forms, one physical component may provide one or more functionalities. In use, the seal forming structure 3100 is positioned to surround an entrance to the patient's airway to facilitate the supply of air at positive pressure to the airway.

[0107] 5.3.1 Closed formation structure In one form of the present technology, the seal forming structure 3100 provides a seal forming surface and may further provide a cushioning function.

[0108] A seal-forming structure 3100 according to the present technology may be constructed from a material that is soft, flexible and resilient (eg, silicone).

[0109] In one form, the seal forming structure 3100 includes a sealing flange and a support flange. The sealing flange includes a relatively thin member having a thickness of less than about 1 mm (e.g., about 0.25 mm to about 0.45 mm). The member extends around the perimeter of the plenum chamber 3200. The support flange may be relatively thicker than the sealing flange. The support flange is disposed between the sealing flange and the periphery of the plenum chamber 3200 and extends around at least a portion of the perimeter. The support flange is or includes a spring-like element and functions to support the sealing flange against buckling in use. In use, the sealing flange may readily respond to system pressure in the plenum chamber 3200 to act on its underside to form a tight sealing engagement with a surface.

[0110] In one form, the seal forming portion of the non-invasive patient interface 3000 includes a pair of nasal puffs or nasal pillows, each constructed and arranged to form a seal with a respective nostril of the patient's nose.

[0111] A nasal pillow according to one aspect of the present technology includes a frustum of a cone. At least a portion of the frustum forms a seal over the underside of the patient's nose, the stalk, and a flexible region on the underside of the frustum, connecting the frustum to the stalk. Additionally, the structure to which the nasal pillows of the present technology are connected includes a flexible region adjacent the base of the stalk. The flexible region may function to facilitate a universal joint structure. The universal joint structure accommodates both the displacement and angle of the frustum of the cone and the relative movement of the structure to which the nasal pillows are connected. For example, the frustum of the cone may be displaced axially towards the structure to which the stalk is connected.

[0112] In one form, the non-invasive patient interface 3000 includes a seal-forming portion that forms a seal over the upper lip area (ie, upper lip) of the patient's face.

[0113] In one form, the non-invasive patient interface 3000 includes a seal-forming portion that forms a seal on the chin area of ​​the patient's face.

[0114] 5.3.2 Plenum chamber The plenum chamber 3200 has a perimeter with a shape that is complementary to the surface contour of an average human face in the area where a seal is formed in use. In use, the peripheral edge of the plenum chamber 3200 is positioned in close proximity to the adjacent surface of the face. Actual contact with the face is provided by the seal forming structure 3100. The seal forming structure 3100 may extend around the entire perimeter of the plenum chamber 3200 in use.

[0115] 5.3.3 Positioning and stabilizing structures The seal-forming structure 3100 of the patient interface 3000 of the present technology may be held in a sealed position by the positioning and stabilising structure 3300 in use.

[0116] In one form of the present technology, a positioning and stabilizing structure 3300 is provided that is configured to be worn by a patient while sleeping. In one embodiment, the positioning and stabilizing structure 3300 has a low profile or cross-sectional thickness to reduce the perceived or actual bulk of the device. In one embodiment, the positioning and stabilizing structure 3300 includes at least one strap having a rectangular cross-section. In one embodiment, the positioning and stabilizing structure 3300 includes at least one flat strap.

[0117] In one form of the present technology, the positioning and stabilizing structure 3300 includes a strap constructed from a laminate of a fabric patient-contacting layer, a foam material inner layer, and a fabric outer layer. In one form, the foam material is porous to allow moisture (e.g., sweat) to pass through the strap. In one form, the fabric outer layer includes a loop material that engages with a hook material portion.

[0118] In certain forms of the present technology, the positioning and stabilizing structure 3300 includes a stretchable (e.g., stretchable with elasticity) strap. For example, the strap can be configured to be tensioned in use to direct a force that causes the cushion to seal against a portion of the patient's face. In one example, the strap can be configured as a tie.

[0119] In certain forms of the present technology, the positioning and stabilizing structure 3300 includes straps that are bendable, e.g., non-rigid. An advantage of this embodiment is that the straps are more comfortable when the patient lies down to sleep.

[0120] 5.3.4 Ventilation In one form, the patient interface 3000 includes a vent 3400 constructed and arranged to allow for the expulsion of exhaled gases (eg, carbon dioxide).

[0121] The ventilation section 3400 in one embodiment according to the present technology includes a plurality of holes (eg, about 20 to about 80 holes, or about 40 to about 60 holes, or about 45 to about 55 holes).

[0122] The vent 3400 may be disposed within the plenum chamber 3200. Alternatively, the vent 3400 is disposed within a decoupling structure (e.g., a swivel).

[0123] 5.3.5 Decoupling structures(multiple) In one form, it includes at least one decoupling structure (eg, a swivel or ball socket).

[0124] 5.3.6 Connection Ports The connection port 3600 allows connection to the air circuit 4170 .

[0125] 5.3.7 Forehead support In one form, the patient interface 3000 includes a forehead support 3700.

[0126] 5.3.8 Anti-asphyxiation valves In one form, the patient interface 3000 includes an anti-asphyxiation valve.

[0127] 5.3.9 Ports In one form of the present technology, the patient interface 3000 includes one or more ports that allow access to the volume within the plenum chamber 3200. In one form, this allows a clinician to provide supplemental oxygen. In one form, this allows a characteristic of the gas (e.g., pressure) within the plenum chamber 3200 to be directly measured.

[0128] 5.4 Ventilated adapter 5.4.1 Constant flow ventilation FIG. 16 shows a comparison of airflow rates between a rhythmic vent (FFM·Nom flow) and a constant flow vent (CFV). The rhythmic vent is a standard molded vent (e.g., vent 3400 formed on the patient interface 3000 in FIG. 3A). As can be seen from the graph, the airflow rates are compared in a mask pressure range of 4-20 cm of H2O (which is the standard pressure range for respiratory pressure therapy for SDB and OSA). As can be seen, the airflow rate increases logarithmically with increasing pressure. In comparison, the CFV shows a flatter curve, where the airflow rate appears more constant and lower in the same pressure range.

[0129] The ventilation flow should be at least 16 L / min to push enough CO2 through the system to minimize rebreathing of CO2 by the patient. It has been found that a ventilation flow of 20-27 L / min makes breathing easier (patient does not wake up due to increased CO2 rebreathing) and safer (avoids choking due to too much CO2 rebreathing). One aspect of the present technology includes providing a minimum (or minimum range) ventilation flow to ensure sufficient CO2 is pushed out. Any ventilation flow beyond such minimum range may be considered wasteful. For example, looking at the graph shown in FIG. 16, the area between the CFV ventilation flow and the FFM·Nom flow may be considered wasteful flow. For the CFV, achieve 16 L / min as the minimum ventilation flow required within the therapeutic pressure range, and maintain this ventilation flow of 16-27 L / min within the pressure range of 4-20 cm of H20. In comparison, the FFM·Nom flow is 22-55 L / min. Therefore, unnecessary flow losses may increase with FFM·Nom flow aeration.

[0130] To compensate for the unwanted flow losses, the flow generator or RPT device may need to increase its flow to achieve the same pressure compared to a CFV. Therefore, more power is required to compensate for this venting, and a more complex flow generator is required for larger flow swings (e.g., venting flows of 16-55 L / min). However, a CFV may need to adjust the venting flow under pressure changes to reduce the venting flow rate with increasing pressure. Therefore, the use of a CFV increases the power savings of the flow generator and also increases simplicity since complex pressure / flow control is not required.

[0131] A constant flow vent (CFV) according to the present technology can be a vent flow adjusting valve (movable membrane) 9140 that adjusts the airflow in response to mask pressure. An exemplary CFV is shown in Fig. 21A-F. The valve 9140 can be adjusted to provide a relatively constant flow within a given pressure range. That is, as pressure in the mask / system increases, the flap 9140 covers the internal vent hole 9126 more, decreasing the airflow rate (airflow rate increases with increasing pressure). As pressure in the mask / system decreases, the flap 9140 covers the vent hole less, increasing the airflow rate (compensating for the lower airflow rate at lower pressure). Such adjustments can allow for a substantially constant airflow rate within a certain pressure range. The graph in Fig. 18 shows the flow change under pressure changes with and without the CFV. The performance of the exemplary CFV graphed in FIG. 18 shows that as the pressure increases from 0-40 cmH2O, the flow rate increases to 24 L / min.

[0132] According to one embodiment of the present technology, the CFV may include a movable flap or CFV membrane 9140 and may be constructed of an elastic material (e.g., silicone or other TPE (thermoplastic elastomer)). The configuration of the flap 9140 is such that an increase in pressure in the mask biases the flap to cover more of the internal vent hole 9126 and progressively reduce the flow rate. The flap 9140 may be positioned perpendicular to the pressurized gas flow to the patient. The vent passage of the internal vent hole 9126 may also run perpendicular to the flow and away from the patient, exiting to atmosphere. The flap 9140 may be positioned such that a pressure buildup in the mask biases the flap to the internal vent hole 9126.

[0133] FIG. 21F is a cross-sectional view of an exemplary CFV configuration. CFV units may be arranged in a line (within an air delivery conduit circuit). As shown in FIG. 21F, when pressure builds up in the mask, the position of the flap 9140 is such that the flap 9140 may move toward the interior vent hole 9126. When pressurized gas reaches the interior vent hole 9126 that is not blocked by the flap 9140, the gas may then be vented to the atmosphere via the exterior vent hole 9125.

[0134] CFV is a property that may allow for simplification of the RPT system. Maintaining a substantially constant airflow rate within a constant pressure range may reduce the complexity of the flow generator or RPT device since the pressure control required to compensate for pressure loss changes due to airflow is substantially unnecessary. In addition, the use of CFVs may also allow for reduced power consumption since the power required to compensate for flow changes at different pressures is unnecessary. That is, CFVs are passive (pressure-driven) and can adjust pressure due to airflow changes that are typically dynamically compensated by changes in pressure / flow delivery from the RPT device. Such simplification may result in a simpler RPT device for therapy delivery (e.g., the device may have fewer parts, the device may be smaller, motorized humidification may not be required, and / or the overall power for therapy delivery may be reduced) (due to the fact that compensation for airflow changes is not required). CFVs may also allow for passive humidification via a heat and moisture exchanger (HME) as described below.

[0135] A problem with known CFV concepts is that there may be associated ventilation noise when adjusting the ventilation flow. That is, interactions between the flap 9140 and the internal vent 9126 may disrupt the ventilation flow and cause noise. For example, assume that the movable flap 9140 does not completely cover a portion of the internal vent 9126 as it moves under pressure. Such an interaction may cause gas to flow between the flap 9140 and the internal vent 9126, creating turbulence and associated noise.

[0136] One way to reduce turbulence and therefore noise is to reduce the number of holes 9126 that interact with the flap 9140. However, minimizing the ventilation flow required to prevent CO2 rebreathing in the mask and reducing the number of ventilation holes 9126 that interact with the flap 9140 may not provide sufficient ventilation. Therefore, a solution according to the present technology may include regulating some of the ventilation holes 9126 with the radial disk flap 9140 and leaving other ventilation holes 9126 not engaged with the flap 9140 and in a permanently open state. Keeping some ventilation holes 9126 permanently open (i.e., static ventilation) increases the ventilation flow rate with increasing pressure in the system according to Bernoulli's principle.

[0137] To compensate for such increases in vent flow while keeping the overall vent flow substantially constant across the pressure treatment range, the remaining vent flow (i.e., modulated vent) may be reduced with increasing pressure. These vent holes 9126 may be modulated by movable flaps 9140, which progressively cover the vent holes 9126 with increasing pressure, thereby reducing the vent flow. The overall flow rate of the static vent may then be averaged with the modulated vent flow to achieve a generally substantially constant flow rate across a range of treatment pressures. The reduced vent noise level may also be due to molded vent technology (e.g., by molding small vent holes with a converging profile) which produces a low level of noise with increasing pressure and vent flow. This technology, along with vent flow modulation, may allow for a general noise substitution for constant flow vent.

[0138] The vent adapter 9100 or fluid connector may include a constant flow vent (CFV) unit. The CFV unit may include a CFV ring 9150, a flat annular valve 9140, and a vent housing 9120. The CFV ring 9150 may hold the valve 9140 in place relative to the vent hole 9126. The vent housing 9120 may include an annular surface including multiple vent holes 9126. The annular surface may include a central orifice for allowing pressurized gas flow into the mask chamber (inlet flow). The annular surface may include multiple vent holes 9126 to allow vent flow. The valve 9140 may be adjacent the vent hole 9126 and may be freely held (i.e., sandwiched) between the annular surface of the CFV ring 9150 and the vent housing 9120. That is, the flap 9140 is not fixed to the CFV ring 9150 or the vent housing 9120. As the mask pressure increases, the pressure increases towards the vent and the valve 9140 is forced towards the vent holes 9126, covering more of the vent holes 9126. In contrast, as the mask pressure decreases, less pressure is exerted on the valve 9140 and the valve 9140 moves away from the vent holes 9126, covering fewer of the vent holes 9126.

[0139] Reducing vent noise for constant flow vent designs can be achieved by changing the vent flow characteristics through the use of flow regulating valves or membranes 9140. However, using membranes 9140 can increase vent noise compared to traditional molded or static vents (i.e., the vent holes do not change shape or form upon pressure changes). This noise can be due to multiple factors, such as: 1) changes in the velocity of the flow through the regulated vent when the vent holes 9126 are opened or closed by the membrane 9140, and / or 2) main stream disturbances caused by the membrane 9140 can cause noise (i.e., turbulence). For example, changing the vent flow direction can cause turbulence, which can result in noise from multiple factors. This can be due to gas impinging into the surface of the vent (vent wall or CFV membrane) 9140 or air passing over the surface of the vent (vent wall and / or membrane) 9140. Therefore, when the vent holes 9126 are partially closed, more noise can be generated due to factors 1) and / or 2) above.

[0140] As discussed above, aspects of the present technology include a substantially constant flow rate vent within a therapeutic pressure range (i.e., 4-20 cm of H2O or 2-40 cm of H2O). The flow curve of the vent holes 9126 can be dynamically changed over the therapeutic pressure range to meet a desired vent flow curve under pressure changes. This can be accomplished by altering the size, number and / or shape of the vent holes. Changing such characteristics can change the flow characteristics of gas passing through the vent holes, which can result in increased vent noise. Using molded vent technology that includes a converging vent shape (i.e., a shape that converges from the inner vent holes 9126 to the outer vent holes 9125) as the vent exits the atmosphere can be tailored to minimize vent flow noise. However, it should be understood that molded vent holes do not change size, shape or number under pressure changes. As such, the flow through the vent holes 9126 can be altered using a deformable membrane or flap 9140 that moves under pressure to close or open the vent. However, when a deformable membrane or flap 9140 is used, undesirable noise levels may be generated due to the vent hole 9126 being opened or closed by the membrane 9140 and / or due to changes in the flow rate through the regulated vent due to partially closing the vent hole 9126.

[0141] Such noise can be reduced by providing a membrane flap 9140 that gradually closes the vent hole 9126 with increasing pressure. The flaps 9140 are fixed at one end such that the flap 9140 deflects upon pressure changes. The problem with this technique is that the membrane 9140 can only partially close a given vent hole 9126, so that flow can flow at high velocities between the vent hole 9126 and the membrane 9140. As a result, noise is generated when passing along or impinging into the surfaces of the vent hole 9126 and the membrane 9140.

[0142] This problem can be overcome by reducing the number of regulated vents while maintaining a substantially constant overall vent flow within the therapeutic pressure range to reduce vent noise. Molded vents (i.e., static vents) can be used to maintain the desired noise level. However, these vents may not be able to achieve the desired flow curve (i.e., a substantially constant flow rate in the therapeutic pressure range of 4-20 cmH20). This can be achieved by combining some regulated vents with static vents such that the overall vent flow is substantially constant in the therapeutic pressure range. Increasing the number of static vents that are not regulated by a membrane can result in a reduction in the overall vent noise.

[0143] However, the introduction of such molded vents can lead to new problems, such as the difficulty of ensuring a substantially constant vent flow within the therapeutic pressure range using a combination of static and regulated vents. It is known that molded static vents have a logarithmic vent flow characteristic, where the vent flow increases with increasing pressure, as shown in FIG. 16. To compensate for the static vent flow, an inverse flow curve must be obtained from the regulated vent, where the vent flow decreases with increasing pressure. Therefore, the membrane 9140 regulating the vent 9126 can be adjusted to provide such a vent flow.

[0144] There are multiple ways to adjust the membrane 9140 to obtain an inverse vent flow to the logarithmic flow curve of the static shaped vent. For example, the shape / structure of the membrane 9140 can be altered to adjust the flow curve of the regulated vent, and the material of the membrane 9140 can be altered to adjust the flow curve of the regulated vent.

[0145] The annular disk membrane 9140 structure of the CFV membrane may allow the membrane 9140 to be adjusted in multiple ways to change the regulated vent flow, as shown in FIG. 20. The percentage of the vent holes 9126 that are covered / opened at a constant pressure may allow the regulated vent flow to be changed. If the membrane 9140 covers a larger amount of the vent at a constant pressure, the vent flow will be lower than if the membrane 9140 covered less. The annular disk structure 9140 may allow the membrane 9140 to be easily adjusted to cover a variety of vent volumes at a constant pressure. One way to achieve this is by changing the central orifice diameter or by changing the vent engagement surface width.

[0146] The overall size of the membrane 9140 is constrained by the size of the CFV unit housing 9120, but it is desirable to reduce the size of the CFV as much as possible. Therefore, the width of the vent hole engagement surface can be adjusted by adjusting the size of the central orifice. If the size of the central orifice is increased, the width of the vent hole engagement surface must also be reduced. Such a reduction reduces the surface area of ​​the membrane 9140. With reduced surface area, there is less resistance to deformation under a given pressure, and more vent holes are covered at a given pressure compared to a wider (i.e., larger) membrane 9140. This principle applies for a given range of surface areas. That is, if the surface area is too small to provide sufficient surface (i.e., the width of the vent hole engagement surface is too narrow), more force is required to deform (i.e., bottom out) the membrane 9140.

[0147] The thickness of the membrane 9140 can also be varied to make it more easily deform under a given pressure. For example, if the mask pressure is 15 cmH2O, a thinner membrane 9140 will deform more easily compared to a thicker membrane 9140 of the same shape at the same pressure.

[0148] The membrane 9140 may be structured such that under a certain pressure it is free to move to cover the vent hole 9126. For example, in the related art, the membrane 9140 is fixed at one point (e.g., on the vent housing 9120) and hinged relative to the fixed point, causing the membrane 9140 to distort about the fixed point due to pressure changes.

[0149] The design of the CFV membrane 9140 according to one embodiment of the present technology allows for free movement between the retaining structure and the vent surface, and this configuration may allow the membrane 9140 to be more easily adjusted to adjust the airflow compared to a flap design (i.e., a design in which the membrane is fixed on one end and moves relative to the fixed end).

[0150] A more flexible / compliant membrane 9140 can deform more easily under a given pressure / load and therefore will cover more of the vent holes 9126 compared to a stiffer membrane. Therefore, if the material of the membrane 9140 of the same size and structure is changed to a more flexible material, the membrane 9140 will deform more easily under the same pressure and cover more of the vent holes 9126, reducing the airflow. This allows the membrane 9140 to be tuned to achieve the desired airflow curve within the therapeutic pressure range.

[0151] As discussed above, there are multiple methods that can be used to provide a membrane 9140 that responds to pressure within a target therapeutic range for a given ventilation flow curve (i.e., a substantially constant overall ventilation flow rate when the pressure of H2O is between 4 and 30 cm). It may also be desirable to obtain such a constant ventilation flow while minimizing ventilation noise. One solution may be to maximize the number of static non-membrane regulated ventilations and minimize the membrane regulated ventilations that provide a substantially constant overall ventilation flow average. This flow curve is shown in FIG. 19 by the thicker solid line entitled "Active Ventilation Only". In this example, the dashed line represents the static non-membrane regulated ventilation and the thinner solid line entitled "Combined CFV & Passive Ventilation" represents the ventilation flow combination. Note that the static ventilation ventilation flow increases progressively with increasing pressure while the CFV membrane regulated ventilation decreases progressively to a threshold value.

[0152] Another source of noise may be the obstruction of the vent flow caused by the CFV membrane 9140, which may affect the airflow through the static vent. In the related art, the static vent is located near the CFV membrane regulated vent (i.e., the vent hole is located on the same surface as the CFV housing 9120). As a result, noise is generated even in the case of non-regulated static vent because the membrane affects the flow characteristics of the static vent flow. Therefore, it is desirable to locate the static vent away from the CFV membrane regulated vent so that the membrane 9140 does not affect the static vent flow passing therethrough. In one embodiment of the present technology, the static vent hole is located on a distal surface from the CFV regulated vent hole. For example, the static vent hole may be located on a different component than the CFV housing 9120. The placement of the static vent may also be limited in that it cannot push CO2. The ability to push CO2 increases the closer the static vent hole is to the patient. However, the static vent may be located on the opposite side of the HME relative to the patient to prevent moisture loss during exhalation, as described below.

[0153] 5.4.1.1 Vented Housing 42A-42G show an example of a ventilation system 13400 according to one embodiment of the present technology. The ventilation system 13400 includes a ventilation housing 13401 that may include an outer wall 13402. The outer wall 13402 may define an outer periphery of the ventilation housing 13401. The ventilation housing 13401 may also include an inner wall 13410. The inner wall 13410 may define an inlet for gas generated by the RPT device 4000. The gas is directed into the plenum chamber 3200 and to the patient for treatment. As can be seen, the outer wall 13402 and the inner wall 13410 are formed as concentric circles in this embodiment.

[0154] Disposed between the outer wall 13402 and the inner wall 13410 is a base. The base may further include an outer base 13403 and an inner base 13406. The outer base 13403 may extend from an inner periphery of the outer wall 13402 and the inner base 13406 may extend from an outer periphery of the inner wall 13410. As can be appreciated, the outer base 13403 and the inner base 13406 are also formed as coaxial circular shapes in this example.

[0155] The outer base 13403 may include one or more outer orifices 13404 distributed radially around the outer base 13403. These outer orifices 13404 may extend generally through the outer base 13403 to provide a flow path from the interior of the ventilation system 13400 to the atmosphere. The outer orifices 13404 may be provided in a straight line (i.e., perpendicular to the outer base 13403) or the outer orifices 13404 may pass through the outer base 13403 with a curved or angled path. The diameter of the outer orifices 13404 may be constant along its length or may vary in diameter. The outer orifices 13404 may all be the same or some may be different from the others. The edges of the outer orifices 13404 may be chamfered or filleted. The outer base 13403 can at least partially support the membrane 13430 to prevent the inner orifice 13407 from being completely blocked by the membrane 13430. As such, the outer base 13403 can extend higher than the inner base 13406, as can be seen in Figures 42A-42G.

[0156] The vent housing 13401 may also include lateral membrane supports 13405 distributed around the inner circumference of the outer base 13403 and the outer wall 13402. The lateral membrane supports 13405 may abut the membrane 13430 to prevent the membrane 13430 from moving laterally in use, thereby covering the outer orifice 13404. As described below, it may be desirable to not block the outer orifice 13404 so that the vent system 13400 can maintain a substantially constant vent flow rate over most of the typical therapeutic pressure range. To that end, the lateral membrane supports 13405 may project radially inward beyond the edge of the outer orifice 13404. The lateral membrane supports 13405 may be semicircular, as in Figures 42A-42G. In the embodiment depicted in FIGS. 42A-42G, the outer orifices 13404 are evenly distributed among three groups between adjacent lateral membrane supports 13405 around the circumference of the outer base 13403.

[0157] The vent housing 13401 may be circular in shape. However, the vent housing 13401 may be oval in shape, or the vent housing 13401 may be polygonal in shape (e.g., triangular, square, rectangular, pentagonal, hexagonal). In any of these configurations, the membrane 13430 may be shaped to correspond to the shape of the vent housing 13401.

[0158] The inner base 13406 may be disposed radially inward of the outer base 13403, and the inner base 13406 and the outer base 13403 may be joined by base connectors 13408 radially distributed therebetween. One or more inner orifices 13407 are provided between adjacent base connectors 13408 and between the inner base 13406 and the outer base 13403. The inner orifices 13407 in these embodiments are formed as slots with an arcuate cross section. However, it is contemplated that the inner orifices 13407 may be circular, similar to the outer orifices 13404. The inner orifices 13407 extend completely through the vent housing 13401 between the inner base 13406 and the outer base 13403. As described below, it may be desirable to have the inner orifice 3407 at least partially occluded by the membrane 13430 so that the ventilation system 13400 can maintain a substantially constant ventilation flow rate over a large portion of the typical therapeutic pressure range. The edges of the inner orifice 13407 may be chamfered or filleted.

[0159] The inner base 13406 of the vent housing 13401 may also include several membrane spacers 13409. These membrane spacers 13409 may be evenly distributed radially around the inner base 13406. As shown in Figures 42A-42G, the membrane spacers 13409 may be disposed on the edges of the inner base 13406 to blend into the inner wall 13410. The membrane spacers 13409 are provided to at least partially support the membrane 13430, as described in more detail below. The membrane spacers 13409 may extend from the inner base 13406 in a kamaboko or rectangular shape as in Figures 42A-42G. The edges of the membrane spacers 13409 may be chamfered or filleted.

[0160] The vent housing 13401 may also include one or more recesses 13415. The one or more recesses 13415 are spaced apart around opposite sides of the outer base, as seen in Figures 42A-G. The recesses 13415 may be separated by recess dividers 13414. The outer orifices 13404 may extend through the outer base 13403 and open into corresponding recesses 13415, and multiple outer orifices 13404 may open into a single recess 13415.

[0161] In another embodiment, the vent housing 13401 may only include one group of orifices similar to the inner orifices 13407 described above in that the airflow therethrough may be restricted by the position of the membrane 13430. As such, another group of orifices may be provided elsewhere on the patient interface 3000 similar to the outer orifices 13404 described above (in that the airflow therethrough is not restricted by the membrane 13430 regardless of the position of the membrane 13430). The latter group of orifices not restricted by the membrane 13430 may be located on any of the plenum chamber 3200, the seal forming structure 3100, the decoupling structure 3500, the vent connector tube 4180 or other components closer to the patient than the vent housing 13401. The operating principles of the ventilation system 13400 described above apply to such alternative arrangements, however, it is believed that the ability to establish an orifice that is not restricted by the membrane 13430 closer to the patient may improve the release of exhaled CO2.

[0162] The vent housing 13401 may be constructed from a single homogenous piece of material. The material of the vent housing 13401 may be relatively rigid. The material of the vent housing 13401 may be polycarbonate.

[0163] 5.4.1.2 Membrane 43A-G also show an exemplary membrane 13430 comprising the vent system 13400 and disposed adjacent to the vent housing 13401. The exemplary membrane 13430 may be used with any of the various vent housing 13401 configurations disclosed above. The shape of the membrane 13430 may be a flat disk. In other words, the thickness of the membrane 13430 (see FIG. 43F and FIG. 43G) may be small compared to the outer diameter. The thickness of the membrane 13430 may be generally uniform as shown in FIG. 43F and FIG. 43G. Alternatively, the thickness of the membrane 13430 may vary in the radial direction.

[0164] The membrane 13430 includes a membrane opening 13431, which when assembled onto the vent housing 13401 allows air flow through the inlet 13411 to reach the patient through the membrane opening 13431 as well. The membrane 13430 also includes a patient side 13432 that faces the patient in use and an atmosphere side 13433 opposite the patient side 13432 that faces the atmosphere in use. Additionally, the atmosphere side 13433 faces the vent housing 13401 when assembled. The membrane 13430 also includes an inner surface 13434 that defines the membrane opening 13431 and an outer surface 13435 opposite the inner surface 13434.

[0165] The inner radius (i.e., the radius of the inner surface 13434) and the outer radius (i.e., the radius of the outer surface 13435) can be selected such that the membrane 13430 can be positioned over the inner orifice 13407 in use without covering the outer orifice 13404. The inner and outer radii can also be selected such that the membrane 13430 is adjacent to the inner surface 13434 and covers a substantial portion of the inner base 13406 while being supported on a membrane spacer 13409 provided on the outer base 13403.

[0166] The membrane 13430 may be constructed from a single piece of homogenous material. The material may be elastically deformable so that the membrane 13430 may be distorted by pressure from air flow during use. The material may be silicone. The membrane 13430 may be "tuned" to deform in a desired manner by changing one or more of the thickness, length, material, shape, inner radius, and / or outer radius.

[0167] 5.4.1.3 Constant flow ventilation systems 43A-43G are several views of an example vent system 13400 in which the membrane 13430 is assembled with the vent housing 13401. In FIGS. 43A-43G, the inner wall 13410 does not extend above the inner base 13406. In embodiments in which the inner wall 13410 extends upwardly from the inner base 13406, the inner wall 13410 may provide a baffle function to separate the gas flow moving into the vent system 13400 via the inlet 13411 from the vent flow exiting the vent system 13400, such that the amount of gas entering the inlet 13411 and exiting the vent system 13400 directly may be reduced.

[0168] In the embodiment of Figures 43A-43G, it can be seen that a portion of the membrane 13430 adjacent to the outer surface 13435 is supported on an inner portion of the outer base 13403. A portion of the membrane 13430 adjacent to the inner surface 3434 is supported directly above the membrane spacer 13409. However, the membrane 13430 can also be supported on the membrane spacer 13409, even in the absence of any air pressure causing deformation, since the membrane 13430 can deform towards the membrane spacer 13409 due to its own weight.

[0169] 43A-43G also show the position of the membrane 13430 restricted by the lateral membrane supports 13405. As mentioned above, the membrane 13430 may be shaped and dimensioned to cover only the inner orifices 13407 and not the outer orifices 13404. However, the membrane 13430 may be free to move as it may not be directly attached to the vent housing 13401. Thus, a sufficient number of the lateral membrane supports 13405 may prevent the membrane 13430 from moving laterally such that the membrane 13430 cannot cover one or more of the outer orifices 13404 in use.

[0170] The reverse of these embodiments is also contemplated, i.e. the outer orifice 13404 may be covered by the membrane 13430 and the inner orifice 13407 is not blocked by the membrane 13430. Thus, lateral membrane supports 13405 may be provided to prevent the membrane 13430 from being covered by the inner orifice 13407.

[0171] As described above, the example vent system 13400 can include a membrane 13430. The membrane 13430 is positioned over the inner orifice 13407 such that vent flow through the outer orifice 13404 is unrestricted by the membrane 13430 and at least partially restricts gas flow through the inner orifice 13407.

[0172] It should also be understood that the features of the vent system 13400 described in Sections 5.4.1.1-5.4.1.3 may be employed in any of the vent adapters 9100 disclosed in Section 5.4.5.

[0173] 5.4.2 Ventilation diffusers The vent adapter 9100 may also include a portion that houses a diffuser 9146. The diffuser 9146 may be removable for replacement. The diffuser 9146 may have an annular disk shape that complements the shape of the annular surface of the vent housing 9120 on the side facing the atmosphere (i.e., external to the inlet flow). The diffuser 9146 may cover the vent holes 9125 and diffuse the vent flow after it exits the multiple vent holes 9125. That is, the vent flow that flows through the molded vent holes 9125 may reach the atmosphere after passing through the diffuser 9146.

[0174] The diffuser 9146 may act as a sound absorbing material and may reduce some of the noise generated by the regulated CFV membrane 9140 and static vents.

[0175] FIG. 26 is a cross-sectional view through a portion of the orifice 3402. The orifice 3402 is illustrated as a hole through the wall 3404 of the plenum chamber 3200. However, the orifice 3402 may be located at a location other than the wall 3404. For example, the orifice 3402 may be located between the decoupling structure 3500 and the connection port 3600, or may be located within a portion of the air circuit 4170, preferably adjacent the connection port 3600 or in the vent adapter 9100. The holes are illustrated as having a diameter smaller than the axial length of the hole. The length and / or diameter may be selected such that an appropriate flow rate is generated when the plenum chamber 3200 is pressurized to a therapeutic pressure. The flow through the orifice 3402 may become clogged (e.g., at Mach number 1) at therapeutic pressures (e.g., at pressures of 4 cmH2O or greater), or the flow may generate a pressure drop that is less than the pressure drop that causes clogging. When flow is blocked, substantially all of the pressure drop in vent 3400 occurs due to orifice 3402. The arrows conceptually show the flow direction when plenum chamber 3200 is pressurized above ambient pressure.

[0176] The orifices 3402 are formed through the thickness of the material of the wall 3404. The orifices 3402 each define an axis (e.g., along the orifice center). This axis forms an acute angle with a normal to the surface of the wall 3404. This angle can be between 15 and 75 degrees, or between 30 and 60 degrees (e.g., any integer within the range described). For example, the angle can be about 45 degrees.

[0177] The orifice 3402 is covered by the diffusion member 3406 so that the flow exiting the orifice 3402 impinges on and at least partially flows into the diffusion member 3406. The diffusion member 3406 may be formed of a material (e.g., a porous material) that allows gas to pass through the material and diffuses any jets or other flow formations exiting the orifice 3402. Some suitable examples of diffusion materials include non-woven fibrous materials, woven fibrous materials, or open-cell foam materials. The diffusion material may be similar or the same as the filter media. The diffusion member 3406 may reduce the perceptible noise generated by the vent 3400 during use (e.g., upon application of treatment pressure).

[0178] The diffusing member 3406 is shown covered by the blocking member 3408. The blocking member 3408 prevents gas from exiting the orifice 3402 and passing directly through the diffusing member 3406. The blocking member 3408 may be at least partially constructed of an air impermeable material. The air impermeable material may be any suitable flexible or rigid material. For example, the air impermeable material may be a rigid plastic (e.g., molded polycarbonate) or a flexible plastic (e.g., a sheet of commercially available plastic). The blocking member 3408 may be integrally formed with the diffusing member 3406, may be separate from and permanently secured to the diffusing member 3406, may be separate from and in removable contact with the diffusing member 3406, or a combination thereof. The blocking member 3408 is shown disposed on the opposite side of the thickness of the diffusing member 3406 to the exit orifice 3402.

[0179] The blocking member causes the flow to change direction (relative to the direction through the orifice 3402) before exiting the diffusion member 3406. The blocking member 3408 and / or diffusion member 3406 can be configured such that the flow from the orifice 3402 flows at least a predetermined distance through the diffusion member 3406 before flowing to the ambient atmosphere. The blocking member 3408 can also be configured such that the flow exiting the vent 3400 moves in a particular direction and / or orientation to minimize any disturbance to the wearer and / or bed companions due to the flow. For example, the blocking member 3408 can cause the gas to flow through the diffusion member 3406 generally parallel to the surface of the blocking member 3408 closest to the diffusion member 3406.

[0180] In FIG. 26, the orifice 3402 and the diffusion member 3406 are oriented relative to one another such that the central axis of each orifice is not perpendicular to the nearest surface of the diffusion member 3406, although a perpendicular arrangement such as that shown in FIG. 8 is also possible.

[0181] A channel 3410 may be provided on an exterior surface of the wall 3404. The channel 3410 is illustrated as having a V-shaped cross-section, but may be formed with any suitable cross-section (e.g., U-shaped). The channel 3410 may be configured to allow liquid to exit from one or more outlets of the orifice 3402. The orifice 3402 may be formed as a leg of a V or U shape.

[0182] 27 shows another configuration of the blocking member 3408. In FIG. 27, the blocking member 3408 includes holes 3412. The holes 3412 can direct the flow from the diffusion member 3406 in a different direction opposite the orifice 3402. As such, the flow path is not linear through the orifice 3402 and the diffusion member 3406. The arrows associated with the holes 3412 are illustrated as parallel, but this is solely for ease of illustration. The holes 3412 can be configured to redirect the flow in multiple directions.

[0183] Each of the holes 3412 defines an axis that is aligned with or parallel to the axis defined by each of the orifices 3402. Looking at the cross-sectional view of Figure 27, an angle is formed by any one axis defined by the holes 3412 and any one axis defined by the orifices 3402. This angle can be between 15 and 75 degrees, or between 30 and 60 degrees (e.g., any integer within the range described). For example, the angle can be about 45 degrees.

[0184] 28-30 show another configuration of the vent 3400. FIG. 28 shows a partially exploded view, FIG. 29 shows a simplified assembly view, and FIG. 30 shows a cross-sectional view taken along line 30-30 of FIG. 29. In these figures, the orifices 3402 are illustrated as a circular array around a central hole 3414. The circular array is illustrated as including three circular rows of holes, with the two innermost circular rows being closer together than the outermost circular rows, although any number of circular rows may be provided and the spacing between the rows may be uniform. The central hole 3414 allows fluid communication between the plenum chamber 3200 and the connection port 3600 and therefore the air circuit 4170. Also illustrated is a diffusion member 3406 and a blocking member 3408 disposed around the central hole 3414. With this configuration, the blocking member 3408 may be removably attached (e.g., a removable snap fit or threaded engagement) or fixedly attached (e.g., a permanent adhesive or snap fit that must be broken upon disassembly). The diffusing member 3406 may be fixed to the blocking member 3408 or may be unfixed to and retained by the blocking member 3408. A radial opening 3416 is provided to allow gas to escape radially from the diffusing member 3406 through a central hole 3414, as best shown in FIG.

[0185] Figures 31A-31C show another alternative configuration of the vent 3400. Figure 31A is a partial view of a flow passage in the form of an elbow 3418. This flow passage may be disposed between a decoupling structure 3500 and a connection port 3600 and contains the vent 3400. As this configuration largely covers the features of the vent 3400, the remainder of the description refers to Figures 31B and 9C.

[0186] FIG. 31B is an axial view, with the cap 3422 and diffusing member 3406 omitted, allowing the exit orifices 3402 to be clearly illustrated. Three annular rows are shown containing 40 exit orifices 3402 each. The orifices are offset such that the exit orifices 3402 in the inner and outer rows are not radially aligned. This configuration allows for closer radial spacing between the annular rows. Although two rows are shown, any number of rows may be provided, for example one or more than two rows may be used. Although 40 exit orifices 3402 are shown in each annular row, more or fewer may be provided as needed to maintain proper gas discharge levels. For example, the number of exit orifices 3402 per annular row can be 1, 5, 10, 15, 20, 25, 30, 35, 40, 45, 50 or more exit orifices 3402, or any number in between.

[0187] 31C, the annular array of orifices 3402 can be viewed in cross section through wall 3420. Wall 3420 is similar to wall 3404 except that wall 3420 is illustrated as being distal to plenum chamber 3200, although wall 3420 may be part of plenum chamber 3200.

[0188] The diffusion member 3406 is shown as being ring-like with a rectangular cross section. The blocking member 3408 is shown as being a relatively thin sheet-like ring on the side of the diffusion member 3406 opposite the orifice 3402. The blocking member 3408 may be secured to the diffusion member 3406 by any suitable means, such as an adhesive.

[0189] The cap 3422 is shown covering the diffusing member 3406 and the blocking member 3408. The cap 3422 may contact the blocking member 3408 such that the diffusing member 3406 is pressed against the wall 3420. Alternatively, the diffusing member 3406 may not be pressed against the wall 3420. The cap 3422 may function as the blocking member 3408, in which case the ring-shaped blocking member 3408 shown in FIG. 31C may be omitted.

[0190] The cap 3422 may include an angled annular flange 3424. The angled annular flange 3424 may be spaced from the wall 3420 to form an annular gap 3426. The annular flange 3424 may be considered to be skirt-like or frusto-conical. The annular gap 3426 may provide a flow path to the ambient atmosphere such that the gas discharge flow is not unduly restricted. Alternatively, one or more openings (e.g., radial openings 3416) may be provided in the annular flange 3424 to provide a flow path to the ambient atmosphere, thereby allowing the annular gap 3426 to be eliminated in whole or in part.

[0191] The cap 3422 is illustrated as having an annular groove 3428. The annular groove 3428 mates with an annular projection 3430 to hold the cap 3422 in place. The annular projection may be continuous to form a snap fit or may be multiple annularly spaced projections that provide minimal or no interference when twisted to provide axial interference after axial insertion and to hold the cap 3422 in place. In FIG. 31C, the annular projection 3430 is illustrated as three annularly spaced projections. The lips 3432 of the annular groove 3428 may be omitted in three corresponding positions and sizes to reduce or eliminate interference of the cap 3422 during axial insertion. Other mounting configurations are possible. For example, a threaded fastening arrangement may be provided and the cap 3422 may be adhesively or welded in place. A releasable fastening (eg, the configuration shown or a threaded connection) allows the diffusion member 3406 to be deployed, for example, if the diffusion member becomes damaged, clogged, or dirty.

[0192] Although the vent 3400 is shown on one side of the bend in the elbow 3418 (eg, upstream relative to the direction of exhalation), the vent 3400 may be located upstream or downstream of the bend.

[0193] 32A-32C show another alternative configuration of vent 3400. Like reference numerals are the same as those described above and will not be described in detail, except as set forth below. The vent 3400 in these figures is formed around one embodiment of a decoupling structure 3500. The decoupling structure 3500 includes a ball 3434 and a socket 3436 that are part of the elbow 3418. In the illustrated form, the ball 3434 and socket 3436 provide three degrees of rotational freedom. However, fewer degrees of rotational freedom may be provided (e.g., one or two degrees of rotational freedom).

[0194] As best shown in FIG 32D, the cap 3422 is connected with a first half 3440 disposed on the cap 3422 and a second half 3442 on the mating component by a snap-fit ​​connection 3438. Six of the first half 3440 and second half 3442 are provided between the six radial openings 3416. Three of these six radial openings 3416 are illustrated in FIG 32A, however, more or fewer may be provided as needed to provide adequate retention and / or flow rate.

[0195] As best seen in FIG. 32C, 44 orifices 3402 are shown evenly spaced in a single annular row. However, the number and spacing of the orifices 3402 may take other configurations. For example, fewer orifices 3402 may be provided if a lower flow rate is desired, and more orifices 3402 may be provided if a higher flow rate is desired. As noted above, more rows may be provided. Also, the orifices do not have to be in an annular array. For example, if the orifices are located at locations other than those shown, the orifices may be located in a grid based on Cartesian coordinates. Alternatively, the orifices 3402 may not be located in any type of row, but may be located at random or pseudo-random locations.

[0196] 5.4.3 Heat and Humidity Exchanger (HME) The heat and moisture exchanger (HME) may include a material that has moisture-retaining properties. Respiratory pressure therapy (RPT) may result in dry airways, making breathing uncomfortable for the patient. To prevent this, a humidifier may be used in conjunction with the respiratory pressure device to deliver humidified air to the patient. The addition of such a humidifier may increase the size and power requirements of the RPT device.

[0197] It is known that the level of humidified air generated by a patient during exhalation originates from the airway mucosa. HMEs can be used to recycle this exhaled moisture by capturing moisture from the humidified air during exhalation and then redelivering it to the patient. One issue with using HMEs is their effectiveness (i.e., their ability to capture sufficient heat and moisture) and their impact on therapy (i.e., HMEs may be placed in the flow circuit, causing flow impedance).

[0198] An aspect for improving effectiveness is to reduce any loss of heat and moisture captured by the HME. A problem with using an HME in RPT can be the point at which heat and moisture exhaled from the patient reaches the HME after being lost through the vent. To minimize such loss, the HME can be placed near the patient's airway (i.e., the moisture source) and the vent on the opposite side of the HME (i.e., distal to the patient). This configuration can ensure that exhaled moisture-laden gas passes through the HME and exits through the vent after the moisture is captured by the HME. The vent adapter can be configured such that the HME is placed between the patient's airway and the constant flow of vent.

[0199] The vent adapter may also include a removable HME unit, i.e., the vent adapter may or may not be used with an HME. The HME unit may include a housing that holds the HME in place. The housing may be opened when the HME is removed (the housing may include front and rear components).

[0200] The HME may be designed to maximize the surface area per unit volume for heat and moisture exchange. Additionally, the HME may be designed to reduce the effect of the HME on flow impedance. The design may include multiple corrugations that allow flow passage therethrough. The HME may be formed as a coiled layer of HME material that includes the corrugations.

[0201] As mentioned above, the CFV may reduce flow wastage by adjusting the ventilation flow to a level above the minimum level required for ventilation flow rate. Reducing flow wastage may also reduce the level of moisture loss in the treatment system. It is known in the art that exhaling humidified air by a patient may lead to drying of the mucous membranes. This drying may be exacerbated when RPT treatment is applied for SDB. Therefore, reducing the flow required to achieve treatment pressure, combined with reducing the level of humidified air loss from the system, may lead to reduced mucous membrane drying.

[0202] One method to increase the level of humidified air delivered to the patient is to use power-driven humidification. Another method to humidify the air delivered to the patient is to use a heat and moisture exchanger (HME). The heat and moisture exchanger (HME) captures water vapor in the air so that it can be delivered back to the patient. The HME can be used to capture the moisture from the patient's exhaled gas, which can then be redelivered to the patient again. The HME should be located in a position such that it can capture enough moisture from the exhaled gas stream and redelive the moisture through the therapy stream, as shown in FIG. 17. To ensure that the captured moisture from the exhaled gas stream is maximized, the HME should be located between the patient and the vent. If the vent is located between the patient and the HME, the moisture in the exhaled gas stream is vented and then reaches the HME for capture and redelivery. However, in the configuration shown in FIG. 17, the vent passes through the HME through the therapy stream and then directly exits the vent (for later delivery to the patient), which may result in some moisture loss along the way. This flow is labeled "HME Vent Flow" in FIG. 17. HME Vent Flow becomes more of a problem when the therapeutic flow rate is increased. As shown in the graph in FIG. 18, the flow rate can increase with increasing mask pressure. This flow can be increased to compensate for ventilation flow losses. Increasing the flow rate increases the therapeutic flow, which can result in the therapeutic flow penetrating deeper into the HME. However, when some of this penetrating flow is delivered to the patient, some of this flow is also directed to the ventilation (as shown by the HME Vent Flow) before being sent to patient delivery. Thus, the HME Vent Flow can also lead to moisture loss due to drying out of the HME.

[0203] As shown in the graph in FIG. 18, the CFV may reduce the ventilation flow rate at the same pressure range compared to standard FFM·Nom flow ventilation. This reduced flow may result in reduced HME ventilation flow, which reduces moisture loss. In other words, reduced flow occurs at the same pressure in a CFV system compared to a standard ventilation system, resulting in reduced HME ventilation flow. This reduced HME ventilation flow improves the ability of the HME to capture and redeliver moisture from the exhaled gas stream, which synergistically improves the effectiveness of the HME in reducing mucosal drying.

[0204] Another method for reducing the HME vent flow can be to redirect the flow direction so that the flow through the vent is reduced and redirected into the system. Such redirection can be accomplished by structures (e.g., baffles) placed between the flow path and the HME and vent so that less flow is directed from the vent to the atmosphere.

[0205] The present technology can achieve humidification levels approaching power-driven humidification without the use of power-driven humidification. Eliminating the need for power-driven humidification eliminates the need for a water reservoir and heating mechanism to deliver power-driven humidification to the therapy flow, which may further simplify the flow generator. Thus, both the CFV and HME may enable the flow generator associated with the present technology to be effective in providing RPT therapy for OSA and other SDB (without the need for complex pressure / flow control and power-driven humidification), ultimately benefiting the patient by providing a substantially smaller flow generator with less control.

[0206] 25A-25D show an example of an HME according to the present technology. FIG. 25A shows a cross section of an HME 7000. The HME 7000 includes a corrugated structure 7002. The corrugated structure 7002 includes a plurality of corrugations 7030 between a substantially planar substrate-top structure 7010 and a substantially planar substrate-base structure 7020 to form a concertina layer 7001. The layer 7001 includes a plurality of upper channels 7012 formed between an upper surface of the corrugated structure 7002 and the upper structure 7010. Additionally, the layer 7001 includes a plurality of lower channels 7022 between a lower surface of the corrugated structure 7002 and the base structure 7020. The HME 7000 allows a flow of breathable and exhaled gases to travel along the surface of the corrugated structure through the plurality of upper 7012 and lower 7022 channels to exchange heat and moisture. Moisture is absorbed from exhaled gases exhaled from the patient and retained in the material of the corrugated structure 7002. The material of the corrugations 7030, the upper structure 7010, and / or the base structure 7020 may include paper or paper-based materials capable of absorbing water and / or heat. The material of the corrugations 7030, the upper structure 7010, and / or the base structure 7020 may be porous, water permeable, and / or air permeable. The retained moisture may then be redelivered to the patient by humidifying the flow of breathable gas delivered to the patient's airway. In other words, moisture may be absorbed from the HME 7000 as the flow of breathable gas is delivered to the patient's airway. FIG. 25B illustrates various dimensions of the HME according to these embodiments.

[0207] The multiple corrugations 7030 increase the surface area of ​​the corrugated structure 7002, thereby increasing the active surface area for heat and moisture exchange (which occurs between the corrugated structure 7002 and the surrounding volume provided by the multiple upper 7012 and lower 7022 channels). The upper structure 7010 and the base structure 7020 may also be formed from the same heat and moisture exchange material as the corrugated structure 7022. Alternatively, the upper structure 7010 and / or the base structure 7020 may be formed from a rigid or semi-rigid material that does not absorb moisture to support the corrugated structure 7002.

[0208] The humidification performance of the HME7000 depends on the effective surface area of ​​the HME7000 provided within a given volume of space. The effective surface area is the surface area of ​​the HME7000 exposed to the flow of breathable gas along the surface of the HME where heat and moisture exchange occurs. The surface area per unit volume of the HME7000 can be adjusted by providing corrugations 7030 within the heat / moisture exchange portion of the HME7000. Additionally, the surface area per unit volume may also be adjusted by changing at least one of the fin thickness, pitch, or height of the corrugations or flutes, which may affect the surface area per unit volume of the HME7000.

[0209] The HME 7000 may include multiple layers 7001 stacked along the vertical axis of the HME 7000 as shown in FIG. 25C. These layers 7001 may be stacked vertically such that the base structure 7020 is stacked on the corrugated structure 7002 of the adjacent layer 7001 below. There may also be several layers 7001 of HME stacked horizontally. By providing multiple layers 7001 including corrugated structures 7002 stacked along the vertical axis of the HME 7000, the surface area per unit volume of the HME is further increased. This increased surface area within a predefined volume increases the efficiency of the heat and moisture exchange of the HME 7000. Furthermore, when the layers 7001 are compressed under a preload as shown in FIG. 25D, the number of layers can be increased within a fixed volume to increase the surface area per unit volume. The preload is calculated by the following formula:

[0210]

number

[0211] where P is the preload, hstart is the corrugation or flute height before compression, and hfinal is the corrugation height after compression.

[0212] Alternatively, the final three-dimensional shape of the HME 7000 may be formed by combining layers 7001 of different sizes and shapes to create an irregularly shaped HME 7000 adapted to fit within the plenum chamber 3200 of the patient interface 3000. The layers 7001 may be laser cut to the desired shape and size.

[0213] As shown in FIG. 25E showing another embodiment, the HME 7000 may be rolled from a single strip layer 7001 including a corrugated structure 7002 extending from a surface of a base structure 7020 to form a plurality of corrugations 7030. The single strip layer 7001 may be rolled such that the upper folds 7031 of the corrugations 7030 engage the lower surface of the base structure 7020. This configuration ensures that the plurality of channels 7012 are maintained between each roll of the single strip layer 7001.

[0214] As noted above, a CFV may reduce ventilation flow rate in the same pressure range compared to standard FFM·Nom flow ventilation. This reduced flow may result in reduced HME ventilation flow, which reduces moisture loss. In other words, reduced flow occurs at the same pressure in a CFV system compared to a standard ventilation system, resulting in reduced HME ventilation flow. This reduced HME ventilation flow may improve the ability of the HME to capture and redeliver moisture from the exhaled gas stream, which may synergistically improve the effectiveness of the HME in reducing mucosal drying.

[0215] The CFV membrane may allow the ventilation flow to be maintained above the minimum required level within the therapeutic pressure range, and may also allow the ventilation flow to be adjusted below the level that occurs with standard static ventilation, so that CO2 exhalation always remains at a sufficient level. The ventilation flow may be adjusted to obtain the minimum level required for CO2 exhalation, thereby minimizing the ventilation flow and, therefore, the moisture loss from the HME.

[0216] Another method for reducing the HME vent flow is to redirect the flow direction to reduce the flow redirected through the vent to the air delivery circuit. That is, the flow can be redirected to minimize the vent flow, where the flow passes through the HME and then directly out the vent. Such flow redirection can be achieved by structures (e.g., baffles) placed in the flow path between the HME and the vent to reduce the flow redirected from the vent to the atmosphere.

[0217] 38A-38C show an embodiment of an HME housing 9400 according to an embodiment of the present technology. The HME housing 9400 may have a two-part structure including a patient side HME housing portion 9402 and an atmosphere side HME housing portion 9404. The patient side HME housing portion 9402 and the atmosphere side HME housing portion 9404 may be assembled together to hold the HME material therein. The patient side HME housing portion 9402 may include a patient side HME housing portion crossbar 9406 for holding the HME material axially towards the patient in use, and the atmosphere side HME housing portion 9404 may include an atmosphere side HME housing portion crossbar 9408 for holding the HME material axially towards the atmosphere in use. The atmosphere side HME housing portion 9404 may also include one or more openings 9410 for connecting to corresponding tabs 9412 on the patient side HME housing portion 9402 to interconnect the two portions. The connection between the opening 9410 and the tab 9412 may include a snap fit and may be capable of being released to allow the HME housing 9400 to be disassembled so that the HME material can be removed for cleaning or replacement.

[0218] 39A-39C show another example of an HME housing 9400 according to one embodiment of the present technology. The HME housing 9400 may have a two-part structure including a patient side HME housing portion 9402 and an atmosphere side HME housing portion 9404. The patient side HME housing portion 9402 and the atmosphere side HME housing portion 9404 may be assembled together to hold the HME material therein. The patient side HME housing portion 9402 may include a patient side HME housing portion crossbar 9406 for holding the HME material axially towards the patient in use, and the atmosphere side HME housing portion 9404 may include an atmosphere side HME housing portion crossbar 9408 for holding the HME material axially towards the atmosphere in use. The atmosphere side HME housing portion 9404 may also include one or more openings 9410 for connecting to corresponding tabs 9412 on the patient side HME housing portion 9402 to interconnect the two portions. The connection between the opening 9410 and the tab 9412 may include a snap fit and may be releasable to allow the HME housing 9400 to be disassembled so that the HME material can be removed for cleaning or replacement. The atmosphere side HME housing portion 9404 may also include an atmosphere side HME housing portion ring 9414 from which extends an HME inner housing 9416 that may include the HME material. The HME inner housing 9416 may form an HME bypass passage 9418 with the patient side HME housing portion 9402 and the atmosphere side HME housing portion 9404. The HME bypass passage 9418 allows a portion of the flow traveling within the HME housing 9400 to bypass the HME material.

[0219] 5.4.4 Custom Connections 6a is a side view of a fluid connector 9000 with a first end 9002 and a second end 9004 intermeshing. A portion of a fluid conduit 9006 may be part of the air circuit 4170 and is connected to the second end 9004. An adapter or connector to a fluid conduit may be provided in place of the fluid conduit 9006. The outlet of the RPT device 4000 may include the second end 9004 in some forms of the present technology.

[0220] The fluid connector 9000 may be configured to be removable from a sealed connection that allows air flow therethrough (e.g., from the RPT device 4000 to the patient interface 3000). The fluid connector 9000 may include multiple components (e.g., a first end 9002 and a second end 9004) that may be releasably connected to one another to make and / or break the sealed connection.

[0221] The first end 9002 and the second end 9004 may form a pneumatic path therebetween via complementary sealing portions and may be held together by complementary retaining portions, which may be separate portions from the complementary sealing portions, such that the first end 9002 and the second end 9004 may each include separate sealing portions and retaining portions as described in more detail elsewhere in this document.

[0222] When the sealing and retention functions are performed by separate complementary parts, the sealing and / or retention functions may each be more easily optimized to address one or more of competing design requirements. For example, when a pair of complementary parts function to seal and retain two components, high frictional forces may be generated when an airtight seal is formed, which may result in reduced ease of connecting and / or disconnecting the components.

[0223] Furthermore, with increased accessibility to connect / disconnect, the seal may not be as robust, such as when the two components are subjected to forces and / or torques of multiple directions and magnitudes. With a fluid connector as described herein, the fluid connector may be pulled and / or twisted in multiple directions as a patient wearing the patient interface 3000 may move around while sleeping or trying to fall asleep.

[0224] As such, one aspect of the present technology relates to a fluid connector 9000. In the fluid connector 9000, a first end 9002 and a second end 9004 are interconnected by complementary sealing and retaining portions.

[0225] In one form, the first end 9002 and the second end 9004 can include complementary sealing portions that form an air seal when connected. The air seal can be configured to form and maintain a sealed engagement to allow an air flow to pass therethrough. The sealed engagement can be sufficient to allow a pressurized air flow to pass therethrough at a pressure of, for example, 4 cmH2O to 40 cmH2O to provide respiratory therapy.

[0226] In some forms, the first end 9002 and the second end 9004 may include complementary portions for retaining the first end 9002 and the second end 9004. The retaining portion may maintain the first end 9002 and the second end 9004 in sealing engagement with one another, for example, by preventing accidental disengagement. The retaining portion may include a latching mechanism as described further herein.

[0227] FIG. 6b is a cross-sectional view of the fluid connector 9000. Here, the first end 9002 and the second end 9004 are not connected to each other. In this view, the sealing portion 9008 is visible. The sealing portion 9008 may be formed from any material (e.g., silicone) suitable for forming a seal in the air path of a device that provides breathing gas to a patient. The sealing portion 9008 extends around a first opening 9010, shown as the interior of a first tube 9022. The latching portion 9012 may take the form of a recess and is provided in the first end 9002. The latching portion 9012 may be provided on a single side or on the entire circumference of the first end 9002, on opposing sides as shown in FIG. 6b. As shown, the latching portion 9012 is an undercut that is substantially perpendicular to the central axis of the first end 9002. Other angles are possible depending on the desired retention force.

[0228] The second end 9004 includes a sealing surface 9016. The sealing surface 9016 may be formed circumferentially around a second opening 9018, which is illustrated as an interior of the second tube 9020. The sealing surface 9016 is illustrated as a substantially annular surface that extends radially perpendicular (i.e., at 90°) away from the second tube 9020. As a result, the sealing surface 9016 is substantially perpendicular to the direction of fluid flow from the first end 9002 to the second end 9004. However, the sealing surface 9016 may extend outwardly in a direction such that the sealing surface 9016 is beveled, for example. For example, the sealing surface may be provided at a positive or negative angle of 85°, 80°, 75°, 70°, 65°, 60°, 55°, 50°, or 45°, or any value between these values. As can be seen in Fig. 6b, the second tube 9020 can include an overhang portion 9034 that extends beyond the sealing surface 9016 into the seal portion 9008. As a result, the overhang portion 9034 of the second tube 9020 extends through the seal portion 9008 as shown in Fig. 6c. It should be understood that in some embodiments of the present technology, the second tube 9020 may not include an overhang portion.

[0229] The overhang portion may be configured to align with the first end 9002 with the second end 9004 in one or more directions. The overhang portion 9034 may be configured to be inserted as a lead-in into a guide portion 9038 on the first end 9002 to radially (or transversely) align the second end 9004 with the first end 9002. As such, the first end 9002 and the second end 9004 may have a male / female relationship. Additionally, a stop 9030 may be provided to limit the movement of the second tube 9020, for example, by pressing the overhang portion 9034 against the movement limiter. Although the overhang portion 9034 is illustrated as a tube, the overhang portion may not extend continuously around the circumference of the second end 9004 since it is internal to the seal (seal portion 9008 and sealing surface 9016) created by the complementary sealing portions. The overhanging portion may extend only partially through the seal portion 9008, such as a castellated extension, a tab, a rib, or the like.

[0230] 6c, the internal flow path of the fluid connector 9000 defined by the first tube 9022, the second tube 9020 and the stop 9030 is substantially identical to the interior of the fluid conduit 9006 as assessed, for example, by cross-sectional shape and size, and therefore provides very little flow restriction such that the pressure drop across the fluid connector 9000 can be negligible as air flows through the fluid connector 9000 throughout the patient's breathing cycle and treatment pressures (e.g., at pressures of 4 cmH2O to 40 cmH2O).

[0231] The sealing portion 9008 may include a portion that contacts the sealing surface 9016 in any manner suitable for forming a face seal (e.g., with a tangential contact therebetween). As shown, the sealing portion 9008 contacts the sealing surface 9016 in a substantially frustoconical shape that resembles a bellows or partial bellows. Alternatively, a partial spherical or partial toroidal surface may be provided on the sealing portion 9008. With any of these shapes, the sealing portion 9008 contacts the sealing surface 9016 before the latching portion 9012 and the complementary latching portion 9014 are fully or even partially engaged. Alternatively, the sealing portion 9008 and the sealing surface 9016 may be separated by a gap even after the latching portion 9012 and the complementary latching portion 9014 are fully engaged. In this scenario, due to internal pressurization, the sealing portion 9008 moves to contact the sealing surface 9016 and form a seal.

[0232] The seal portion 9008 may include a resilient and compliant material such that it can deform under load and also maintain its original configuration when the load is removed. The seal portion 9008 may be configured to easily deform under load to form and / or maintain a seal 9016 with the sealing surface. In some forms, the seal portion 9008 may include a silicone membrane. The silicone membrane seal portion 9008 may be sufficiently compliant such that pressure due to air flow causes it to deform and move into contact with the sealing surface 9016. Additionally or alternatively, the silicone membrane seal portion 9008 may be sufficiently compliant such that it maintains sealing engagement with the sealing surface 9016 when compressed from a non-deformed configuration.

[0233] The proposed configuration of the sealing portion 9008 may result in a seal that is compliant with respect to the mating direction between the first end 9002 and the second end 9004 (e.g., to the left in FIG. 6b) and / or is radially compliant with respect to an axis defined by the engagement direction between the first end 9002 and the second end 9004 (e.g., up and down in FIG. 6b).

[0234] The force required to compress the sealing portion 9008 (e.g., if compression is required to form and / or maintain a seal) may be small enough to avoid significant compression. For example, the force required to compress the sealing portion 9008 may be less than the force required to engage the latching portion 9012 with the complementary latching portion 9014 (e.g., to overcome any friction in connecting the second end 9004 and the first end 9002). Alternatively, the force required to compress the sealing portion 9008 may be less than half the force required to engage the latching portion 9012 with the complementary latching portion 9014. Alternatively, the force required to compress the sealing portion 9008 may be less than 1 / 10 the force required to engage the latching portion 9012 with the complementary latching portion 9014. As such, in a configuration in which the latching portion 9012 and complementary latching portion 9014 are fully engaged after the sealing portion 9008 contacts the sealing surface 9016, a user does not encounter any significant force that could be mistaken for full engagement. In some forms, any force generated due to compression of the sealing portion 9008 to connect the second end 9004 and the first end 9002 may be sufficiently small that it is substantially imperceptible to a user. That is, the force perceived by a user in a configuration in which the sealing portion 9008 is disengaged from the first end 9002 may be substantially the same as a configuration in which the sealing portion 9008 needs to be compressed to connect.

[0235] The shape of the sealing portion 9008 according to the present technology may result in a seal that is compliant in the direction opposite to the mating direction between the first end 9002 and the second end 9004 (e.g., to the right in FIG. 6b). This may result in the sealing portion 9008 being able to seal against the sealing surface 9016 even if there is a gap between the sealing portion 9008 and the sealing surface 9016 when the fluid connector 9000 is in an unpressurized state. When pressure is provided to the interior of the fluid connector 9000 (e.g., the first tube 9022), the sealing portion 9008 may expand against the sealing surface 9016 to contact and form a seal with the sealing surface 9016. This configuration should prevent a user from encountering any additional force when connecting the first end 9002 to the second end 9004 beyond the force required to engage the latching portion 9012 and the complementary latching portion 9014.

[0236] Although particular configurations of the seal 9008 are described above, other configurations are possible. For example, some forms of the seal 9008 may include an O-ring or gasket material.

[0237] The sealing portion 9008 or the sealing surface 9016, or both, may be configured such that a seal is obtained between the sealing portion 9008 and the sealing surface 9016 even in the event of improper alignment between the sealing portion 9008 and the sealing surface 9016. For example, the sealing portion 9008 and / or the sealing surface 9016 may be configured to tolerate a range of misalignment in the radial (or transverse) direction and / or axial direction while still forming a seal therebetween.

[0238] For example, the sealing surface 9016 can include an annular shape (as shown in FIG. 6H ) configured to form a face seal with a surface of the sealing portion 9008 at multiple radial locations. That is, the sealing portion 9008 and the sealing surface 9016 can form a seal between the axis of the first tube 9022 and the axis of the second tube 9020 even if they are misaligned by, for example, 0.5 mm, 1 mm, 1.5 mm, 2 mm, 3 mm, or 4 mm. In one form, the sealing surface 9016 can include an annular portion that is wide enough that the sealing portion 9008 can form a seal against the annular portion.

[0239] The second end 9004 also includes a complementary latching portion 9014. The complementary latching portion 9014 is illustrated as a cantilever hook including a protrusion that mates or engages with the latching portion 9012. Similar to the latching portion 9012, the complementary latching portion 9014 may be provided on multiple (e.g., opposing) sides or on a single side as shown in FIG. 6b. The complementary latching portion 9014 may take the form of a U-shape or C-shape in cross section as shown in FIG. 6d. When the complementary latching portion 9014 is depressed, it may engage or disengage with the latching portion 9012, allowing engagement or disengagement between the first end 9002 and the second end 9004. Providing more than two complementary latching portions 9014 is possible, but in such a case disengaging the second end 9004 from the first end 9002 may become unnecessarily complicated.

[0240] The stop 9030 and the latching portion 9012 together may define a predetermined distance (travel) that the second end 9004 may move relative to the first end 9002 with the two ends connected. For example, if the first axial distance between the stop 9030 and the latching portion 9012 exceeds the second axial distance between the end of the second tube 9020 and the protrusion on the complementary latching portion 9014, the difference between the first axial distance and the second axial distance defines a predetermined travel distance that is non-zero. If the first axial distance and the second axial distance are equal, no travel is possible. However, there may also be associated benefits if the travel is non-zero, at least due to ease of manufacture, since manufacturing tolerances may allow for reduced costs. Thus, benefits may be obtained from configuring the sealing portion 9008 to form a seal 9016 with the sealing surface with worst case manufacturing tolerances after a predetermined amount of wear and / or creep in the fluid connector 9000. The geometry of the seal 9008 described above may enable the seal 9008 to take such worst case scenarios into account.

[0241] As best shown in FIG. 6b, the second end 9004 can include an inner portion 9024 and a lower portion 9026 rotatably coupled to one another at an interface 9028. The inner portion 9024 can include a sealing portion 9008 and the lower portion 9026 can include a complementary latching portion 9014. As shown, the inner portion 9024 is rigidly or fixedly connected to the fluid conduit 9006 such that the inner portion 9024 and the fluid conduit 9006 can rotate together relative to the lower portion 9026. A rigid connection between the fluid conduit 9006 can be formed by overmolding at least a portion of the fluid conduit 9006 onto the inner portion 9024. In other forms, the fluid conduit 9006 can be friction or interference fit within the inner portion 9024 to form a rigid connection.

[0242] As best shown in FIG. 6d, the profile of the lower portion 9026 may be a profile having four sides and also having some circular features, which may be uniquely distinguished when compared to a typical circular profile. The first end 9002 may include a recess of a complementary shape. Thus, the first end 9002 includes a female portion and the second end 9004 includes a male portion. Providing male and female portions of the above shapes or any other non-standard shape or configuration may provide benefits. A fluid connector 9000 including a first, non-standard shape and / or configuration may not conform to industry standards (e.g., ISO 5356-1) (e.g., the use of a circular spigot (e.g., lead-in taper) into which a cuff (e.g., rubber) is inserted on top). Although not conforming to industry standards may seem counterintuitive, there may be benefits. For example, the fluid connector 9000 may be used to connect an RPT device and a patient interface that are designed to work optimally together. For example, if the RPT device provides a lower flow rate that may only be advantageous with a patient interface designed to operate at the lower flow rate, providing a fluid connector 9000 that does not conform to industry standards can only ensure that the correct RPT device and patient interface are being used together. Secondly, with the illustrated profile in particular, the first and second ends 9004 may only mate with one another in a predetermined number of relative orientations (e.g., four orientations). With this four-sided shape, well-defined edges may also be provided that can be easily identified and easily gripped upon actuation of the complementary latching portion 9014. Thirdly, with non-standard shapes such as those described herein, a user may easily identify which end of the patient conduit 4170 is a complementary connector to another connector (e.g., the outlet of an RPT device).

[0243] 6e shows another embodiment of the present technology, where a port 9032 is provided in the first end 9002. The port 9032 can be used to sense pressure downstream of the blower and outside the blower housing, for example by sensing pressure downstream of an RPT device. The port 9032 can be in fluid communication with the second end 9004 to determine the pressure of the air in the second opening 9018.

[0244] In one form, the port 9032 may be in fluid communication with the interior of the second opening 9018, for example by forming a fluid connection to an opening in the interior of the seal 9008. This may allow the opening in the interior of the seal 9008 to be in fluid communication with a pressure tap 9036 to the second opening 9018. Thus, the first end 9002 and the second end 9004, when connected to each other, may form two fluid connections between them. The port 9032 may provide the advantage of being able to measure pressure closer to the patient (rather than measuring pressure within the RPT device). Due to pressure losses inherent in the internal fluid flow and leakage throughout the air path from the blower to the patient, measuring pressure closer to the patient may allow for a more accurate measurement than pressure measurements made more distal to the patient.

[0245] This arrangement also allows the second end 9004 to be rotated relative to the first end 9002 while maintaining two fluid connections (i.e., one for airflow delivery and the other for pressure measurement). Doing so may be advantageous as it allows the fluid conduit 9006 to be rotated relative to the lower portion 9026, thereby reducing torque applied to the fluid conduit and / or the lower portion 9026. Furthermore, such a configuration also allows a user to connect the first end 9002 and the second end 9004 in one of multiple mutual rotational orientations while maintaining two fluid connections.

[0246] Figure 6f shows the first end 9002 integrated with the RPT device and the second end 9004 disconnected, and Figure 6g shows the first end 9002 integrated with the RPT device and the second end 9004 connected.

[0247] Although the above description primarily describes both halves of the connector system together (e.g., first end 9002 and second end 9004), it should be understood that the description of either halve may be considered individually.

[0248] It may also be advantageous to ensure that the appropriate mask is used with the CFV membrane regulated ventilation. A mask according to one embodiment of the present technology may be a non-vented mask specifically designed to match the CFV membrane venting adjustment described above. The present system may be designed such that the flow generator is also compatible with the vent adapter (i.e., the flow generator is programmed with a mask system having a constant vent flow). That is, since each mask type (nose, pillow, and full face) may connect to the same vent adapter, the vent adapter must allow sufficient CO2 exhalation for each mask type. The lowest CO2 exhalation is primarily seen in full face masks due to the increased volume of the mask dead space. Therefore, the vent adapter must allow sufficient CO2 exhalation in full face masks (i.e., worst case scenario). Since the system of the present technology (e.g., the flow generator, the vent adapter, and each mask type) may be specifically designed to work together, it may be advantageous to prevent an incompatible mask from being connected to the CFV connector.

[0249] Thus, a connection mechanism may be provided such that the seal formed between the two removably connecting components is achieved by the connection mechanism. As described above, the nasal mask and pillow mask may connect to a short tube connector which then connects to the ventilation adapter. In contrast, the full face mask may connect directly to the ventilation adapter 9100. In another embodiment, the HME may include a separate removable housing that is removable from the ventilation adapter. However, to reduce the overall size, the HME may be integrated into the ventilation adapter along with the CFV unit, and the HME slides into the same housing as the CFV. With such a design, there may be unused space in the CFV housing of the ventilation adapter 9100 when the HME is removed.

[0250] In the case of a full face mask according to the present technology, the short tube connector end may be formed as an inlet to the full face mask, i.e., the same bellows engagement surface is designed as part of the mask shell that may form part of the mask plenum chamber.

[0251] The bellows sealing membrane may be constructed such that it can move under pressure so that the membrane moves to a sealing surface on the opposing connector. A pressure supported seal may mean that the seal between the CFV unit and the connector remains robust under high pressure.

[0252] Bellows seals may allow a seal to be formed between the CFV unit and the connector while minimizing friction between the two components, allowing for a swivel connection. For example, seals using interference fits, lip seals, gasket configurations, or other forms of compression seals between components may not easily provide enough movement between the components to allow them to rotate while still maintaining a robust seal.

[0253] 5.4.5 Exemplary Vented Adapters An example of a vent adapter 9100 and its components are shown in Figures 7A-14D. The vent adapter 9100 according to this example of the present technology may include a conduit connector 9110, a vent housing 9120, a vent diffuser cover 9130, a membrane 9140, a CFV ring 9150, a vent housing connector 9160, a heat and moisture exchanger (HME) clip 9170, an HME housing 9180, a bellows seal 9190, and a vent adapter connector 9200.

[0254] The vent housing 9120 may include an end 9121 with a protrusion 9122 for connecting the vent housing 9120 to the conduit connector 9110 at the vent adapter end 9112. The end 9121 may define a central orifice of the vent housing 9120 through which pressurized gas flow is provided to the patient. The vent housing 9120 may include an exterior vent hole 9125 and an interior vent hole 9126 that define passageways for venting pressurized gas from the RPT system. That is, gas may be vented through these passageways into the interior vent hole 9126 and then to the exterior vent hole 9125 and atmosphere. The vent housing 9120 may also include a tab 9123. The tab 9123 is joined to the lip 9124 via a support 9128 for releasably attaching the vent housing 9120 to the vent housing connector 9160 and the vent adapter connector 9200. When the patient actuates the tab 9123 and presses down on the support 9128, the lip 9124 disengages from the vent housing connector 9160 and the vent adapter connector 9200. When attached, the lip 9124 allows the vent housing 9120 to rotate relative to the vent adapter connector 9200 while remaining connected. The vent housing 9120 may have a shoulder 9127 that fits into a corresponding notch 9164 in the vent housing connector 9160. The vent housing 9120 may also include a notch 9129 that receives a corresponding bellows seal connector 9191 that attaches the bellows seal 9190 to the vent housing 9120 during assembly to seal the interior of the vent adapter 9100 to the vent adapter connector 9200.

[0255] The vented housing connector 9160 can include a first bar 9161 and a second bar 9162 that form a receptacle 9163. The receptacle 9163 receives a corresponding lip 9124 of the vented housing 9120 for attaching the vented housing connector 9160 to the vented housing 9120. The notch 9164 also receives the shoulder 9127 of the vented housing 9120 as described above. The vented housing connector 9160 can also include a curved outer surface 9165.

[0256] The bellows seal 9190 may be a bellows seal similar to the features described above in connection with Figures 6A-6H. The bellows seal 9190 may have a shoulder surface 9194 with a bellows seal connector 9191 for attaching the bellows seal 9190 to the notch 9129 of the vent housing 9120. The bellows seal 9190 may also have an inner surface 9193 that is biased outward upon contact with pressurized gas during assembly such that the outer surface 9192 forms a seal against the vent adapter connector 9200.

[0257] The vent adapter connector 9200 may have an orifice 9201 through which pressurized gas travels from the vent adapter 9100 onto the patient during treatment. Also, exhaled gas may be exhausted into the vent adapter 9100 through the orifice 9201. The vent adapter connector 9200 may be connected to a patient interface at the orifice 9201 through another tube (not shown). The vent adapter connector 9200 may also have a rim 9202 that engages lips 9124 of the vent housing 9120 to connect the vent housing 9120 to the vent adapter connector 9200 and rotate relative to the vent adapter connector 9200. It should be understood that in another form of the present technology, the vent adapter connector 9200 may be directly connected to the patient interface or may be integrally formed with the patient interface (e.g., mask shell).

[0258] The vent adapter 9100 may also include an HME clip 9170 and an HME housing 9180 for holding the HME material in position within the vent adapter 9100 between the internal vent hole 9126 and the patient as described above. The HME material (not shown) may be a coiled or cylindrical structure that is inserted into the HME housing 9180 and held therein by the HME clip 9170. The clip 9170 may have a pair of arms 9171 extending from a central shaft 9172. The central shaft 9172 may extend from the center of the HME material and secure the shaft end 9173 into a receiver 9183 suspended on a cross member 9182 of the HME housing 9180 to secure the HME material within the HME housing 9180. The HME housing 9180 may also include a pair of slots 9181 in the outer wall 9184. These slots 9181 correspond to the arms 9171 and receive the arm ends 9174 so that the HME clip 9170 does not rotate relative to the HME housing 9180 when assembled. The HME material is thus secured between the arms 9171 and the cross member 9182. The outer wall 9184 may include a number of notches 9185.

[0259] The conduit connector 9110 may include a vent adapter end 9112 and a conduit end 9111. As described above, the vent adapter end 9112 may connect to a vent housing 9120, and the conduit end may connect to a conduit (not shown) that is connected at the other end to an RPT device to receive the pressurized gas flow. The conduit connector 9110 may also include an anti-asphyxiation valve (AAV) opening 9113.

[0260] Another embodiment of the vent adapter 9100 and its components is shown in Figures 15A-15F. This embodiment may include similar features to the embodiment shown in Figures 7A-14D above. In this embodiment, the vent adapter connector 9200 includes a rim 9203. The rim 9203 connects to a tab 9123 on the vent housing 9120 to connect the vent adapter connector 9200 to the vent housing 9120. This embodiment also shows an anti-asphyxiation valve (AAV) 9135 that may be attached within the conduit connector 9110. The conduit connector 9110 may also have a ring 9115 that connects to a conduit (not shown). Also, in this embodiment, a bellows seal 9190 can be seen attached to the vent housing connector 9160. The vent housing connector 9160 also has a ridge that allows for attachment to the vent housing 9120 using the tab 9123. Additionally, an embodiment of the HME material 9145 and diffuser 9146 are shown.

[0261] Another embodiment of the vent adapter 9100 and its components is illustrated in Figures 21A-21F. This example may include similar features to the embodiments shown in Figures 7A-14D and 15A-15F above. In this embodiment, the HME housing 9180 is not completely contained within the vent adapter 9100. That is, the HME housing 9180 is partially exposed and forms part of the structure that connects the vent housing 9120 to the vent adapter connector 9200.

[0262] Another embodiment of the vent adapter 9100 and its components is shown in Figure 22. This example may include similar features to the embodiments shown in Figures 7A-14D and 15A-15F above. Figure 22 also includes a flap retention structure 9141. The flap retention structure 9141 may be attached to the HME clip 9170 on one side and presses against the flap 9140 on the other side to maintain the flap 9140 in an operable position relative to the vent housing 9120.

[0263] Another embodiment of a vent adapter 9100 and its components is shown in Figures 24A-24B. This example may include similar features to the embodiments shown in Figures 7A-14D and 15A-15F above.

[0264] 23 shows a diagram of how the ventilation adapter 9100 can be attached to different patient interfaces. In the case of the nasal cushion patient interface 3000A or the nasal pillows patient interface 3000B, the ventilation adapter 9100 can be connected to either patient interface via a short tube 9210. One end of the short tube 9210 can be connected to the patient interface 3000A, 3000B and the other end can be connected to the ventilation adapter connector 9200 described above. Alternatively, in the case of the full face patient interface 3000C, the ventilation adapter 9100 does not include the ventilation adapter connector 9200 and the short tube 9210 is not provided as the ventilation adapter 9100 is connected directly to the full face patient interface 3000C.

[0265] 33A-33G show another embodiment of a vent adaptor 9100 according to an embodiment of the present technology. The vent adaptor 9100 can be connected to a patient interface 3000 as shown in FIG. 35, for example, to provide the functionality of that component.

[0266] The vent adapter includes an elbow assembly 9220. The elbow assembly 9220 provides a fluid connection to the patient interface 3000 (e.g., via a connection port 3600 on the plenum chamber 3200). This embodiment of the elbow assembly 9220 includes an elbow frame 9222 and an elbow overmold 9224. The elbow assembly 9220 may provide a releasable connection with the plenum chamber 3200 at the connection port. The elbow frame 9222 may include elastically deformable tabs for the releasable connection, and the elbow overmold 9224 may provide a fluid-tight seal around an opening in the elbow frame 9222 and may provide greater elasticity for the elbow frame 9222. The elbow assembly 9220 may also be rotatable relative to the plenum chamber 3200, which may reduce the effects of tubing pull from the vent adapter 9100 and other components of the air circuit 4170. The elbow assembly 9220 may also be removably connected to the patient interface 3000 and may be able to rotate relative to the patient interface 3000.

[0267] The vent adapter 9100 may also include a short tube assembly 9210. The short tube assembly 9210 may decouple the other components of the vent adapter 9110 (e.g., the vent housing 9320 and the vent core structure 9300) from connection with the plenum chamber 3200 of the elbow assembly 9220. Decoupling the other components of the vent adapter 9110 in this manner may reduce the mass that needs to be carried directly on the patient's head via the patient interface 3000, resulting in a lighter and more comfortable patient experience. The short tube assembly 9210 may include a tube 9212 that may include one or more helical coils. The short tube assembly 9210 may include a tube elbow connector 9216 that provides connection with the elbow assembly 9220. The connection between the tube elbow connector 9216 and the elbow assembly 9220 may include a snap fit. The connection between the tube elbow connector 9216 and the elbow assembly 9220 may be permanent. In other words, the connection may be capable of being separated without damaging the components. The short tube assembly 9210 may include a tube housing connector 9214 that provides a connection with the vent housing connector 9160. The connection between the tube housing connector 9214 and the vent housing connector 9160 may include a snap fit. The connection between the tube housing connector 9214 and the vent housing connector 9160 may be permanent. In other words, the connection may be capable of being separated without damaging the components.

[0268] The vent adapter 9100 may include a vent housing connector 9160 for connecting the short tube assembly 9210 with the vent housing 9320. As described above, the vent housing connector 9160 may be joined to the short tube assembly 9210 by a tube housing connector 9214. The tube housing connector 9214 may be a snap fit and may be permanent. The vent housing connector 9160 may also include a bayonet connector 9166. The bayonet connector 9166 facilitates a releasable bayonet type connection with the vent housing 9320 or a heat and moisture exchanger (HME) housing 9400, for example, as shown in FIGS. 38A-39C. As such, an HME associated with the HME housing 9400 may be operational and therefore not shown in FIGS. 33A-33G. The bayonet connector 9166 may be male or female. Additionally, by making the vent housing 9320 removably connectable to the vent housing connector 9160, the vent components can be removed and disassembled for cleaning.

[0269] Figures 34A-34G show examples of a vent housing 9320, a flap or membrane 9140, a vent core structure 9300, a diffusion member 9146, a diffuser retaining ring 9148, and a vent diffuser cover 9330. These components may be assembled into a subassembly as shown in Figures 34A-34G and joined to a vent housing connector 9160 for use. The components of the subassembly shown in Figures 34A-34G may be non-separable via a permanent snap fit, or alternatively, the components may be separable by a user. If non-separable, the snap fit may be permanent such that the components cannot be separated without damage.

[0270] The vent housing 9320 may also include a bayonet connector 9322 that corresponds to and connects to a bayonet connector 9166 of the vent housing connector 9160 to removably connect the vent housing 9320 to the vent housing connector 9160. The vent housing 9320 may also include a membrane retainer 9324 that holds the membrane 9140 to the vent core structure 9300 during assembly. The membrane retainer 9324 may include an open radial cage-like structure that allows the vent flow to travel through the membrane retainer 9324 and out of the vent core structure 9300. The membrane retainer 9324 is also open in the center to allow the therapy flow to pass through and reach the patient from the RPT device 4000.

[0271] A flap or membrane 9140 may be disposed between the membrane retainer 9324 and the vent core structure 9300. The membrane 9140 may be held in place between these two structures, but may otherwise be free to deform due to pressure within the vent adapter 9100. The membrane 9140 may function similarly to other embodiments of the membrane 9140 disclosed above.

[0272] The vent core structure 9300 may include an inlet 9301 that allows a flow of gas generated by the RPT device 4000 to be delivered through the vent adapter 9100 to the patient for treatment. The vent core structure 9306 may include a vent core extension 9306 through which the inlet 9301 may be defined. The vent core extension 9306 may extend axially and may include an air circuit connector 9302 that connects the vent core 9300 to the air circuit 4170. As will be appreciated, the vent core extension 9306 is shaped and dimensioned to extend through the diffuser retaining ring 9148, the diffuser 9146, and the vent diffuser cover 9330 to align these components upon assembly of the vent adapter 9100. The vent core structure 9300 may also include a clip 9304 on the alignment structure 9312 that connects to a connection surface 9334 of the vent diffuser cover 9330. The clip 9304 may be connected to the connection surface 9334 by a snap fit such that the vent diffuser cover 9330 can be removed for disassembly for cleaning and / or replacement of the vent adapter component 9100 (e.g., the diffuser 9146). The alignment structure 9312 may also facilitate axial alignment of the vent core structure 9300 with the diffuser 9146 and the vent diffuser cover 9330 by corresponding shapes.

[0273] The vent core structure 9300 may also include a plurality of outer orifices 9308 and a plurality of inner orifices 9310. The plurality of inner orifices 9310 may be configured such that, in use, ventilation flow to atmosphere through the inner orifices 9310 may be blocked or restricted by the membrane 9140. The plurality of outer orifices 9308 may be configured such that, in use, ventilation flow to atmosphere through the outer orifices 9308 is not blocked or restricted by the membrane 9140 at any point. However, the membrane 9140 may be configured such that it does not completely block the inner orifices 9310 at least at any pressure within a typical therapeutic pressure range (e.g., about 6 cm H2O to about 20 cm H2O). In other words, ventilation flow may be released through both the inner orifices 9310 and the outer orifices 9308 at any pressure within a typical therapeutic pressure range. Pressure within the vent adapter 9110 deforms the membrane 9140 to vary the ratio of air flow through the outer orifice 9308 and the inner orifice 9310 to maintain a constant air flow rate as described above.

[0274] The diffuser 9146 may include a diffuser opening 9147 through which the vent core extension 9306 may pass. The diffuser 9146 may include features similar to the diffusers described above.

[0275] The diffuser 9146 may be held in position relative to the vent flow by a diffuser retaining ring 9148 and a vent diffuser cover 9330 downstream of the inner orifice 9310 and the outer orifice 9308. The diffuser retaining ring 9148 may be secured to the vent diffuser cover 9330, for example by a snap fit, to retain the diffuser 9146. The diffuser retaining ring 9148 may include a radial diffuser retainer 9149 that holds the diffuser 9146 against the vent diffuser cover 9330. The diffuser retaining ring 9148 and the radial diffuser retainer 9149 may define a rear vent outlet 9342 around the vent housing 9320. The vent flow exiting the vent core structure 9300 may pass through the diffuser 9148 and exit through the rear vent outlet 9340. The vent diffuser cover 9332 may include a series of cover spacers 9332. The cover spacers 9332 are radially spaced apart around the periphery of the vent diffuser cover 9330 to define a front vent outlet 9342. The air flow exiting the vent core structure 9300 may pass through the diffuser 9148 to exit the front vent outlet 9342.

[0276] The exemplary vent adapter 9100 disclosed above in Figures 33A-34G is shown connected to the patient interface 3000 in Figure 35. In this embodiment, the elbow assembly 9220 is omitted as the plenum chamber 3200 includes a connection port 3600 which is angled to face downward relative to the patient's head in use, thus directing the vent adapter 9100 away from the patient's head. Additionally, the short tube assembly 9210 may be permanently connected to the plenum chamber 3200 at the connection port 3600.

[0277] 37A-37E show another embodiment of a vent adapter 9100 in accordance with the present technology. The vent adapter 9100 may include a plenum chamber connector 9700. The plenum chamber connector 9700 connects the vent adapter 9100 directly to the connection port 3600 of the plenum chamber 3200 and / or its shroud 3305 (see FIG. 41 ) to provide a fluid connection for pressurized gas flow from the vent adapter 9100 to the plenum chamber 3200.

[0278] The vent adapter 9100 may also include a baffle 9600. The baffle 9600 may separate the incoming pressurized gas flow from the RPT device 4000 from the outward vent flow exiting through the outer orifice 9308 and inner orifice 9310 of the vent housing 9120. The baffle 9600 may be disposed inside the plenum chamber connector 9700. The baffle 9600 and the plenum chamber connector 9700 may be aligned to form a coaxial circular shape when connected.

[0279] The vent adapter 9100 may also include a lip seal 9500 that fits around the periphery of the plenum chamber connector 9700. The lip seal 9500 may form a seal with the interior periphery of the connection port 3600 of the plenum chamber 3200 and / or its shroud 3305 to provide a pneumatic seal while allowing rotation of the vent adapter 9100 relative to the patient interface 3000.

[0280] The vent adapter 9140 may also include a flap or membrane 9140 to regulate the vent flow through the inner orifice 9310 and the outer orifice 9308 of the vent housing 9120 as per examples described above (e.g., the embodiments shown in Figures 33A-34G).

[0281] The vent housing 9120 can include an inner orifice 9310 and an outer orifice 9308. These orifices can allow the vent flow to exit the vent adapter 9100 to the atmosphere as described in the embodiments above (e.g., the examples in Figures 33A-34G).

[0282] The vent housing 9120 may also include tabs 9123 and lips 9124 that provide a releasable and rotatable connection with the connection port 3600 of the plenum chamber 3200 and / or its shroud 3305. Manually depressing these tabs 9123 may disengage the lip 9123 from a corresponding annular protrusion (not shown) of the connection port 3600 of the plenum chamber 3200 and / or its shroud 3305. Once connected, the lip 9124 allows the vent adapter 9100 to maintain connection with the connection port 3600 of the plenum chamber 3200 and / or its shroud 3305 while remaining rotatable to reduce the effects of tube drag.

[0283] The vent housing 9120 may be connected to a conduit connector 9110, which may connect the vent adapter 9100 to an air circuit. The conduit connector 9110 may be in the form of an elbow. The conduit connector 9110 may have a conduit end 9111 that connects to the air circuit 4170 and a vent adapter end 9112 that connects to the vent housing 9120. The connection between the vent adapter end 9112 of the conduit connector 9110 and the vent housing 9120 may include a snap fit, may be permanent such that the connection cannot be separated without damaging at least one of the components, and / or may be non-rotatable to prevent the conduit connector 9110 from contacting the tabs 9123. The conduit connector 9110 may also include one or more anti-asphyxiation valve (AAV) openings 9113 for the AAV 9135.

[0284] The vent adapter 9100 may also include an air circuit connector 9116 that may be attached to the conduit end 9111 of the conduit connector 9110. The air circuit connector 9116 may include a bayonet connector 9117 that correspondingly connects to the connector 4175 of the example air circuit 4170 of Figures 36A-36C. The connection between the air circuit connector 9116 and the air circuit 4170 may be releasable.

[0285] The vent adapter shown in Figures 37A-37E may not include a heat and moisture exchanger (HME) material 9145. Without the heat and moisture exchanger material 9145 disposed in the ventilation flow path, the airflow impedance may be minimized, which may minimize CO2 buildup in the plenum chamber 3200. The described vent adapter 9100 is suitable for use with a full face patient interface, for example as shown in Figure 41.

[0286] The vent adapter 9100 shown in Figures 37A-37E may form an elbow assembly that may be removably connected to the patient interface 3000, for example as shown in Figure 41, and may rotate relative to the patient interface.

[0287] 40 and 41 show a further embodiment of a vent adapter 9100 joined to a patient interface 3000.

[0288] FIG. 40 shows a patient interface 3000 with a seal-forming structure 3100, which in use forms a seal only around the patient's nose (i.e., a nasal mask). The ventilation adapter 9100 is shown joined to a shroud 3305 that covers a portion of the plenum chamber 3200. In this embodiment, the features of the ventilation adapter 9100 are combined in an elbow that is directly and rotatably attached to the shroud 3305 to provide a fluid connection with the plenum chamber 3200. However, it should be understood that the ventilation adapter of FIGS. 33A-33G may be attached to the shroud 3305 via an elbow assembly 9220 to form a fluid connection with the plenum chamber 3200. The shroud 3305 has a stiffer arm 3301 joined to the shroud 3305 at a hinge 3307. The lateral arm 3301 may include an upper attachment point 3302 and a lower attachment point 3304 for attaching straps of the positioning and stabilizing structure 3300. The upper attachment point 3302 may form a loop through which the upper straps can be routed, and the lower attachment point 3304 may receive a clip 3306 which receives the lower strap.

[0289] FIG. 40 shows an exemplary patient interface 3000 that may include a seal forming structure 3100 for forming a seal against the patient and oral cavity in use. A vent adapter 9100, such as the embodiment shown in FIGS. 37A-37E, may be connected to a shroud 3305 to provide a fluid connection with the plenum chamber 3200. The shroud 3305 may be joined to a stiffer arm 3301 that may have an upper attachment point 3302 for attaching a strap of the positioning and stabilizing structure 3300. The shroud 3305 may be connected to the stiffer arm 3301 and a separate lower strap connector 3303 to attach the strap of the positioning and stabilizing structure 3300 at a lower attachment point 3304. The upper attachment point 3302 may form a loop through which the upper strap may be routed, and the lower attachment point 3304 may receive a clip 3306 that receives the lower strap.

[0290] 5.5 RPT Devices The RPT device 4000 according to one aspect of the present technology includes mechanical and pneumatic components 4100, electrical components 4200, and is configured to execute one or more algorithms 4300. The RPT device may have an outer housing 4010. The outer housing 4010 is formed by two parts, an upper portion 4012 and a lower portion 4014. Further, the outer housing 4010 may include one or more panel(s) 4015. The RPT device 4000 includes a chassis 4016 that supports one or more internal components of the RPT device 4000. The RPT device 4000 may include a handle 4018.

[0291] The pneumatic pathway of the RPT device 4000 may include one or more air pathway items and a muffler 4120 (e.g., an inlet air filter 4112, an inlet muffler 4122, a pressure generator 4140 (e.g., a blower 4142) capable of supplying air at positive pressure, an outlet muffler 4124 and one or more transducers 4270 (e.g., pressure and flow sensors)).

[0292] One or more of the air path items may be disposed within a removable unitary structure referred to as a pneumatic block 4020. The pneumatic block 4020 may be disposed within the outer housing 4010. In one form, the pneumatic block 4020 is supported by or formed as part of the chassis 4016.

[0293] The RPT device 4000 can have a power supply 4210, one or more input devices 4220, a central controller 4230, a therapy device controller 4240, a pressure generator 4140, one or more protection circuits 4250, a memory 4260, a transducer 4270, a data communication interface 4280, and one or more output devices 4290. The electrical components 4200 can be mounted on a single printed circuit board assembly (PCBA) 4202. In an alternative, the RPT device 4000 can include more than one PCBA 4202.

[0294] 5.5.1 RPT Device Mechanical and Pneumatic Components The RPT device may include one or more of the following components in an integral unit: In one alternative, one or more of the following components may be disposed as their own separate units.

[0295] 5.5.1.1 Air filters An RPT device according to one form of the present technology may include an air filter 4110 or multiple air filters 4110.

[0296] In one form, the inlet air filter 4112 is located at the beginning of the air pressure path upstream of the pressure generator 4140. See Figure 4B.

[0297] In one form, an outlet air filter 4113 (eg, antibacterial agent) is placed between the outlet of the pneumatic block 4056 and the patient interface 3000. See FIG. 4B.

[0298] 5.5.1.2 Mufflers In one form of the present technology, the inlet muffler 4122 is positioned in the pneumatic path above the pressure generator 4140. See Figure 4B.

[0299] In one form of the present technology, the outlet muffler 4124 is positioned in the pneumatic path between the pressure generator 4140 and the patient interface 3000. See Figure 4B.

[0300] 5.5.1.3 Pressure generator In one form of the present technology, the pressure generator 4140 that generates the air flow or supply at positive pressure is a controllable blower 4142. For example, the blower 4142 may include a brushless DC motor 4144 with one or more impellers housed in a volute. The blower may deliver the air supply at a rate of, for example, up to about 120 liters / min, at a positive pressure ranging from about 4 cmH2O to about 20 cmH2O, or in other forms up to about 30 cmH2O. The blower may be described in any one of the following patents or patent applications, which are incorporated herein by reference in their entirety: U.S. Pat. No. 7,866,944; U.S. Pat. No. 8,638,014; U.S. Pat. No. 8,636,479; and PCT Patent Application Publication WO 2013 / 020167.

[0301] The pressure generator 4140 is under the control of the treatment device controller 4240 .

[0302] In other forms, pressure generator 4140 can be a piston-driven pump, a pressure regulator connected to a high pressure source (eg, a compressed air reservoir), or a bellows.

[0303] 5.5.1.4 Converters The transducer may be internal to the RPT device or external to the RPT device. An external transducer may, for example, be located on the air circuit or form part of the air circuit (e.g., a patient interface). An external transducer may take the form of a non-contact sensor (e.g., a Doppler radar movement sensor that transmits or moves data RPT device).

[0304] In one form of the present technology, one or more transducers 4270 may be placed upstream and / or downstream of the pressure generator 4140. The one or more transducers 4270 may be constructed and arranged to measure a property, such as flow rate, pressure or temperature at that point in the pneumatic path.

[0305] In one form of the present technology, one or more transducers 4270 may be positioned proximate the patient interface 3000.

[0306] In one form, the signal from the converter 4270 may be filtered (eg, by low-pass, high-pass or band-pass filtering).

[0307] 5.5.1.4.1 Flow Sensor A flow sensor according to the present technology may be based on a differential pressure transducer (eg, the SDP600 series differential pressure transducers from SENSIRION).

[0308] In one form, a signal representative of the flow rate (eg, the total flow rate Qt from a flow sensor) may be received by the central controller 4230.

[0309] 5.5.1.4.2 Pressure Sensor A pressure sensor according to the present technology may be placed in fluid communication with the pneumatic path. One example of a suitable pressure transducer is a sensor from the HONEYWELL ASDX series. Another suitable pressure transducer is a sensor from the NPA series from GENERAL ELECTRIC.

[0310] In one form, the signal from the pressure sensor may be received by the central controller 4230.

[0311] 5.5.1.4.3 Motor Speed ​​Converters In one form of the present technology, a motor speed transducer may be used to determine the rotational speed of the motor 4144 and / or the blower 4142. A motor speed signal from the motor speed transducer may be provided to the therapy device controller 4240. The motor speed transducer may be, for example, a speed sensor (e.g., a Hall effect sensor).

[0312] 5.5.1.5 Anti-spillback valves In one form of the present technology, an anti-spillback valve 4160 may be disposed between the humidifier 5000 and the pneumatic block 4020. The anti-spillback valve 4160 is constructed and positioned to reduce the risk of water flowing upstream from the humidifier 5000 (e.g., to the blower motor 4144).

[0313] 5.5.1.6 Air circuits An air circuit 4170 in accordance with one aspect of the present technology is a conduit or tube that is constructed and arranged such that, in use, air flow travels between two components (eg, the pneumatic block 4020 and the patient interface 3000).

[0314] In particular, the air circuit 4170 may be fluidly connected to the outlet of the pneumatic block and the patient interface. The air circuit may be referred to as an air delivery tube. In some cases, there may be separate limbs of the circuit for inhalation and exhalation. In other cases, a single limb is used.

[0315] In some forms, the air circuit 4170 may include one or more heating elements configured to heat the air in the air circuit (e.g., to maintain or increase the air temperature). In other words, the air circuit 4170 may be a heated air circuit 4171. The heating element may take the form of a heated wire circuit and may include one or more transducers (e.g., temperature sensors). In one form, the heated wire circuit may be spirally wound around the axis of the air circuit 4170. The heating element may be in communication with a controller (e.g., central controller 4230). One example of an air circuit 4170 including a heated wire circuit is described in U.S. Patent Application No. US / 2011 / 0023874, which is incorporated by reference in its entirety.

[0316] 36A-36C show an example of an air circuit 4170 according to one embodiment of the present technology. The air circuit 4170 may include a tube 4172 including one or more helical coils. The air circuit 4173 may include an RPT device connector 4173 at one end. The RPT device connector 4173 is configured to connect to an RPT device 4000 to receive a pressurized gas flow. At the other end, the air circuit 4170 may include a vent adaptor connector 4174. The vent adaptor connector 4174 may be connected to a vent adaptor 9100, such as the embodiment disclosed in FIGS. 33A-34G above. The vent adaptor connector 4174 may include a connector 4175 for mating with a corresponding air circuit connector 9302 of the vent adaptor 9300. The connector 4175 may take the form of a female bayonet connector that corresponds to the air circuit connector 9302. The ventilation adapter connector 4174 may also include a grip recess 4176 for the patient to grip the ventilation adapter connector 4174 and rotate the air circuit 4170 to connect or disconnect it from the ventilation adapter 9100. The ventilation adapter connector 4174 may also include a seal 4177 that forms a pneumatic seal between the ventilation adapter connector 4174 and a tubing connector 4178 that connects the ventilation adapter connector 4174 to the tubing 4172.

[0317] 5.5.1.7 Oxygen delivery In one form of the present technology, supplemental oxygen 4180 can be delivered to one or more points in the pneumatic pathway (eg, upstream of the pneumatic block 4020), the pneumatic circuit 4170 and / or the patient interface 3000.

[0318] 5.5.2 RPT Device Electrical Components 5.5.2.1 Power supply The power supply 4210 may be located inside or outside the external housing 4012 of the RPT device 4000.

[0319] In one form of the present technology, the power supply 4210 powers only the RPT device 4000. In another form of the present technology, power is provided from the power supply 4210 to both the RPT device 4000 and the humidifier 5000.

[0320] 5.5.2.2 Input Devices In one form of the present technology, the RPT device 4000 includes one or more input devices 4220 in the form of buttons, switches or dials to allow a human to interact with the device. The buttons, switches or dials may be physical or software devices accessible via a touch screen. The buttons, switches or dials may be physically connected to the external housing 4010 in one form or may communicate wirelessly with a receiver electrically connected to the central controller 4230 in another form.

[0321] In one form, the input device 4220 may be constructed and arranged to allow a human to select values ​​and / or menu options.

[0322] 5.5.2.3 Central Controller In one form of the present technology, the central controller 4230 is one or more processors suitable for controlling the RPT device 4000.

[0323] Suitable processors may include x86 INTEL processors, such as processors based on the ARM® Cortex®-M processor from ARM Holdings (e.g., the S®32 series of microcontrollers from ST Microelectronics). In certain alternative forms of the present technology, 32-bit RISC CPUs (e.g., the STR9 series of microcontrollers from ST Microelectronics) or 16-bit RISC CPUs (e.g., processors from the MSP430 family of microcontrollers manufactured by TEXAS INSTRUMENTS) may also be suitable.

[0324] In one form of the present technology, the central controller 4230 is a dedicated electronic circuit.

[0325] In one form, the central controller 4230 is an application specific integrated circuit. In another form, the central controller 4230 includes discrete electronic components.

[0326] The central controller 4230 may be configured to receive input signals from one or more transducers 4270, one or more input devices 4220 and the humidifier 5000.

[0327] The central controller 4230 may be configured to provide output signal(s) to one or more of the output device 4290, the therapy device controller 4240, the data communication interface 4280, and the humidifier 5000.

[0328] In some forms of the present technology, the central controller 4230 is configured to implement one or more methods described herein (e.g., one or more algorithms 4300 expressed as a computer program stored in a non-transitory computer readable recording medium (e.g., memory 4260)). In some forms of the present technology, the central controller 4230 may be integrated with the RPT device 4000. However, in some forms of the present technology, some methods may be performed by a remotely located device. For example, the remotely located device may determine ventilator control settings or detect breathing-related events by analysis of recorded data (e.g., from any of the sensors described herein).

[0329] 5.5.2.4 Clock The RPT device 4000 may include a clock connected to the central controller 4230.

[0330] 5.5.2.5 Therapy Device Controller In one form of the present technology, the therapy device 4350 is a therapy control module 4330 and forms part of the algorithm 4300 executed by the central controller 4230.

[0331] In one form of the present technology, the therapy device controller 4240 is a dedicated motor control integrated circuit. For example, in one form, the MC33035 brushless DC motor controller manufactured by ONSEMI is used.

[0332] 5.5.2.6 Protection circuit The one or more protection circuits 4250 in accordance with the present technology may include electrical protection circuits, temperature and / or pressure safety circuits.

[0333] 5.5.2.7 Memory In accordance with one form of the present technology, the RPT device 4000 includes a memory 4260 (e.g., non-volatile memory). In some forms, the memory 4260 may include battery-powered static RAM. In some forms, the memory 4260 may include volatile RAM.

[0334] The memory 4260 may be located on the PCBA 4202. The memory 4260 may take the form of an EEPROM or a NAND flash.

[0335] Additionally or alternatively, the RPT device 4000 includes removable memory 4260 (eg, a memory card made in accordance with the Secure Digital (SD) standard).

[0336] In one form of the present technology, the memory 4260 functions as a non-transitory computer-readable storage medium on which are stored computer program instructions embodying one or more of the methods described herein (e.g., one or more algorithms 4300).

[0337] 5.5.2.8 Data communication systems In one form of the present technology, a data communication interface 4280 is provided and connected to the central controller 4230. The data communication interface 4280 may be connectable to a remote external communication network and / or a local external communication network. The remote external communication network may be connectable to a remote external device. The local external communication network may be connectable to a local external device.

[0338] In one form, the data communications interface 4280 is part of the central controller 4230. In another form, the data communications interface 4280 is separate from the central controller 4230 and may include an integrated circuit or processor.

[0339] In one embodiment, the remote external communications network is the Internet. Data communications interface 4280 may use wired communications (e.g., via Ethernet or fiber optics) or may use wireless protocols (e.g., CDMA, GSM, LTE) to connect to the Internet.

[0340] In one embodiment, the local external communications network uses one or more communications standards (eg, Bluetooth or Consumer Infrared Protocol).

[0341] In one form, the remote external device is one or more computers (e.g., a cluster of networked computers). In one form, the remote external device may be a virtual computer rather than a physical computer. In either case, such a remote external device may be accessible by appropriately authorized personnel (e.g., a clinician).

[0342] The local external device may be a personal computer, a mobile phone, a tablet or a remote control.

[0343] 5.5.2.9 Optional displays and output devices, including alarms Output devices 4290 according to the present technology may take the form of one or more of visual, audio and tactile units. The visual display may be a Liquid Crystal Display (LCD) or a Light Emitting Diode (LED) display.

[0344] 5.5.2.9.1 Display Drivers A display driver receives as input characters, symbols or images to be displayed on a display and converts them into commands that cause the display to display those characters, symbols or images.

[0345] 5.5.2.9.2 Display The display is configured to visually display characters, symbols, or images in response to commands received from a display driver. For example, the display may be an eight-segment display, in which case the display driver converts each character or symbol (e.g., the number "0") into eight logic signals indicating which of the eight segments should be activated to display the particular character or symbol.

[0346] 5.5.3 RPT Device Algorithm 5.5.3.1 Pre-processing module A pre-processing module 4310 according to one form of the present technology receives as input a signal from a transducer 4270 (e.g., a flow sensor or pressure sensor) and performs one or more process steps to calculate one or more output values ​​that are used as inputs to another module (e.g., a therapy engine module 4320).

[0347] In one form of the present technology, the output values ​​include interface or mask pressure Pm, respiratory flow Qr, and leak flow Ql.

[0348] In various forms of the present technology, the pre-processing module 4310 includes one or more of the following algorithms: pressure compensation 4312, ventilation flow estimation 4314, leak flow estimation 4316, and respiratory flow estimation 4318.

[0349] 5.5.3.1.1 Pressure compensation In one form of the present technology, a pressure compensation algorithm 4312 receives as an input a signal indicative of the pressure in the pneumatic path proximal to the outlet of the pneumatic block. The pressure compensation algorithm 4312 estimates the pressure drop through the pneumatic circuit 4170 and provides as an output the estimated pressure Pm in the patient interface 3000.

[0350] 5.5.3.1.2 Estimation of air flow rate In one form of the present technology, an airflow estimation algorithm 4314 receives as input an estimated pressure Pm in the patient interface 3000 and estimates the airflow Qv of air out of the vent 3400 in the patient interface 3000.

[0351] 5.5.3.1.3 Estimation of leakage flow rate In one form of the present technology, a leak flow estimation algorithm 4316 receives as input the total flow Qt and the ventilation flow Qv and provides as output an estimate of the leak flow Ql. In one form, the leak flow estimation algorithm estimates the leak flow Ql by calculating the average difference between the total flow Qt and the ventilation flow Qv over a period long enough to include several respiratory cycles (e.g., about 10 seconds).

[0352] In one form, the leak flow estimation algorithm 4316 provides a leak flow Ql as an output and receives as inputs the total flow Qt, ventilation flow Qv, and estimated pressure Pm in the patient interface 3000 by calculating the leak conductance and determining the leak flow Ql to be a function of the leak conductance and pressure Pm. The leak conductance is calculated as the low-pass filtered quotient of the non-ventilated flow equal to the difference between the total flow Qt and the ventilation flow Qv, and the low-pass filtered square root of the pressure Pm, with the low-pass filter time constant having a value sufficient to include several respiratory cycles (e.g., about 10 seconds). The leak flow Ql may be estimated as a function of the product of the leak conductance and the pressure Pm.

[0353] 5.5.3.1.4 Respiratory flow estimation In one form of the present technology, the respiratory flow estimation algorithm 4318 receives as inputs the total flow Qt, the ventilation flow Qv and the leak flow Ql and estimates the air respiratory flow Q to the patient by subtracting the ventilation flow Qv and the leak flow Ql from the total flow Qt.

[0354] 5.5.3.2 Treatment Engine Module In one form of the present technology, the therapy engine module 4320 receives as inputs one or more of the pressure in the patient interface 3000, Pm, and the respiratory flow of air to the patient, Qr, and provides one or more therapy parameters as outputs.

[0355] In one form of the present technology, the treatment parameter is a treatment pressure, Pt.

[0356] In one form of the present technology, the therapy parameters are one or more of: level of pressure support, base pressure, and target ventilation.

[0357] In various embodiments, the therapy engine module 4320 includes one or more of the following algorithms: phase determination 4321, waveform determination 4322, ventilation determination 4323, inspiratory flow limitation determination 4324, apnea / hypopnea determination 4325, snoring determination 4326, airway patency determination 4327, target ventilation determination 4328, and therapy parameter determination 4329.

[0358] 5.5.3.2.1 Phase Determination In one form of the present technology, the RPT device 4000 does not determine the phase.

[0359] In one form of the present technology, a phase determination algorithm 4321 receives as an input a signal indicative of respiratory flow, Qr, and provides as an output, Π, the phase of the patient's 1000 current respiratory cycle.

[0360] In some forms, the phase output Π, known as discrete phase determination, is a discrete variable. One implementation of discrete phase determination results in a binary phase output Π with a value of inspiration or expiration. This value is represented, for example, as values ​​of 0 revolutions and 0.5 revolutions when the onset of spontaneous inspiration and expiration, respectively, is detected. The RPT device 4000 that "triggers" and "cycles" effectively performs discrete phase determination because the trigger point and cycle point are the instants at which the phase changes from inspiration to inspiration and inspiration to expiration, respectively. In one implementation of binary phase determination, the phase output Φ is determined to have a discrete value of 0 (thereby "triggers" the RPT device 4000) when the respiratory flow Qr has a value above a positive threshold and a discrete value of 0.5 revolutions (thereby "cycling" the RPT device 4000) when the value of respiratory flow Qr is more negative than a negative threshold.

[0361] Another implementation of the discrete phase decision provides a three-valued phase output Φ with one value of inspiration, pause during inspiration, and expiration.

[0362] In other forms, the phase output Φ, known as continuous phase determination, is a continuous variable, varying, for example, between 0 revolutions to 1 revolution or 0 to 2Φ radians. An RPT device 4000 with continuous phase determination may trigger and cycle when the continuous phase reaches 0 revolutions and 0.5 revolutions, respectively. In one implementation of continuous phase determination, the continuous value of phase Φ is determined using fuzzy logic analysis of respiratory flow Qr. The continuous value of phase implemented in this implementation is often referred to as a "fuzzy phase." In one implementation of the fuzzy phase determination algorithm 4321, the following rules are applied to respiratory flow Qr: 1. If respiratory flow drops to zero and then increases rapidly, the phase is 0 revolutions. 2. If respiratory flow is large positive and stable, the phase is 0.25 revolutions. 3. If respiratory flow is zero and rapidly decreasing, the phase is 0.5 revolutions. 4. If respiratory flow is large negative and stable, the phase is 0.75 revolutions. 5. If respiratory flow is zero and stable and the 5 second low pass filtered absolute value of respiratory flow is large, then the phase is 0.9 revolutions. 6. If respiratory flow is positive and the phase is expiration, the phase is 0 revolutions. 7. Respiratory flow is negative, phase is inspiration, phase is 0.5 revolutions. 8. If the 5 second low pass filtered absolute value of respiratory flow is large, the phase increases at a constant rate equal to the patient's respiratory rate low pass filtered by a time constant of 20 seconds.

[0363] The output of each rule can be represented as a vector whose phase is the result of the rule and whose magnitude is the fuzzy range for which the rule is true. The fuzzy range for which respiratory flow is "high", "stable", etc. is determined by an appropriate membership function. The results of the rules are represented as vectors and then combined by some function such as taking the centroid. In such a combination, the rules may be weighted equally or differently.

[0364] In another implementation of sequential phase determination, inspiration time Ti and expiration time Te are first estimated from respiratory flow Qr. The phase Φ is then determined as half the fraction of inspiration time Ti that has elapsed since the previous trigger instant or 0.5 revolutions plus the fraction of expiration time Te that has elapsed since the previous cycle instant (whichever is more recent).

[0365] 5.5.3.2.2 Waveform determination In one form of the present technology, the therapy parameter determination algorithm 4329 provides a nearly constant therapy pressure throughout the patient's respiratory cycle.

[0366] In another form of the present technology, a therapy parameter determination algorithm 4329 controls a pressure generator 4140 to provide a therapy pressure Pt that varies throughout the phases of the patient's respiratory cycle according to a waveform template.

[0367] In one form of the present technology, the waveform determination algorithm 4322 provides a waveform template Π(Φ) having values ​​in the range [0, 1] for the domain of phase values ​​Φ provided by the phase determination algorithm 4321 to be used by the treatment parameter determination algorithm 4329.

[0368] In one embodiment, suitable for discrete or continuous phases, the waveform template Π(Φ) is a square wave template having a value of 1 for phase values ​​up to 0.5 revolutions and a value of 0 for phase values ​​beyond 0.5 revolutions. In one embodiment, suitable for continuous phases, the waveform template Π(Φ) includes two smoothly curved portions (i.e., a smoothly curved (e.g., rising cosine) rise from 0 to 1 for phase values ​​up to 0.5 revolutions, and a smoothly curved (e.g., exponential) fall from 1 to 0 for phase values ​​beyond 0.5 revolutions). In one embodiment, suitable for continuous phases, the waveform template Π(Φ) is based on a square wave, but has a smooth rise from 0 to 1 for phase values ​​up to a "rise time" substantially less than 0.5 revolutions, and a smooth fall from 1 to 0 for phase values ​​within a "fall time" after 0.5 revolutions.

[0369] In some forms of the present technology, the waveform determination algorithm 4322 selects a waveform template Π(Φ) from a library of waveform templates depending on the settings of the RPT device. Each waveform template Π(Φ) in the library may be provided as a lookup table value Π for a phase value Φ. In other forms, the waveform determination algorithm 4322 calculates the waveform template Π(Φ) "on the fly" using a predetermined functional form, perhaps parameterized by one or more parameters (e.g., time constants of exponential curved portions). The parameters of the functional form may be predetermined or may depend on the current state of the patient 1000.

[0370] In some forms of the present technology suitable for discrete binary phases of inspiration (Φ=0 revolutions) or expiration (Φ=0.5 revolutions), the waveform determination algorithm 4322 calculates the waveform template Π "on the fly" as a function of the discrete phase Φ and time t measured from the most recent trigger instant. In one such form, the waveform determination algorithm 4322 calculates the waveform template Π(Φ,t) in two parts (inspiration and expiration) as follows:

[0371]

number

[0372] where Πi(t) and Πe(t) are the inspiratory and expiratory portions of the waveform template Π(Φ,t). In one such form, the inspiratory portion of the waveform template Πi(t) is a smooth rise from 0 to 1 parameterized by the rise time, and the expiratory portion of the waveform template Πe(t) is a smooth fall from 1 to 0 parameterized by the fall time.

[0373] 5.5.3.2.3 Ventilation determination In one form of the present technology, a ventilation determination algorithm 4323 receives as input the respiratory flow, Qr, and determines a measurement indicative of the current patient ventilation, Vent.

[0374]

[0374] In some embodiments, the ventilation determination algorithm 4323 determines a measurement of ventilation Vent that is an estimate of actual patient ventilation. As one such embodiment, it may take half the absolute value of the respiratory flow rate Qr, which is optionally filtered by a low-pass filter (e.g., a second-order Bessel low-pass filter with a corner frequency of 0.11 Hz).

[0375] In other embodiments, the ventilation determination algorithm 4323 determines a measurement of ventilation Vent that is largely proportional to actual patient ventilation. In one such embodiment, the peak respiratory flow rate Qpeak is estimated at the inspiratory portion of the cycle. Through the above and many other procedures including sampling of the respiratory flow rate Qr, a measurement that is largely proportional to ventilation is obtained, but in the case of these measurements, the variation in the flow waveform shape is not so large (where the shapes of two breaths are taken to be the same as when the flow waveforms of the breaths normalized in time and amplitude are similar). To give some simple examples, there are the median of the positive respiratory flow rates, the median of the absolute values of the respiratory flow rates, and the standard deviation of the flow rates. Any linear combination of any order statistics of the absolute value of the respiratory flow rate using positive coefficients (and even some using both positive and negative coefficients) is roughly proportional to ventilation. As another example, it is the average of the respiratory flow rate at the central K-th percentage (with respect to time) of the inspiratory portion, where 0 < K < 1. When the flow shape is constant, there are any number of measurements that are highly proportional to ventilation.

[0376] 5.5.3.2.4 Determination of Inspiratory Flow Limitation In one form of the present technology, the central controller 4230 executes an inspiratory flow limitation determination algorithm 4324 for determining a range of inspiratory flow limitation.

[0377] In one form, the inspiratory flow limitation determination algorithm 4324 receives the respiratory flow rate signal Qr as an input and provides, as an output, a measure of the range in which the inspiratory portion of a breath indicates an inspiratory flow limitation.

[0378] In one form of the technology, the inspiration portion of each breath is identified by a zero-crossing detector. A number of evenly spaced (e.g., 65) points, indicating time points, are interpolated by an interpolator along the inspiration flow-time curve for each breath. The curve described by these points is then scaled by a scaler to have unit length (duration / period) and unit area, thereby removing the effects of changes in breathing rate and depth. The scaled breath is then compared in a comparator to a pre-stored template (similar to the inspiration portion of the breath shown in FIG. 6A) indicative of a normal, unobstructed breath. If at any time during inspiration the breath deviates from this template due to, for example, coughing, exhaling, swallowing, and hiccuping as determined by the test element, beyond a specified threshold (typically one scale unit), the breath is rejected. For data that was not rejected, a running average of the first such scaled point is calculated by the central controller 4230 for the preceding several inspiration events. This is repeated for the second such point over the same inspiration event, and so on. So, for example, 65 scaled data points are generated by the central controller 4230 to represent a moving average of several preceding inhalation events (e.g., 3 events). Hereinafter, the moving average of the continuously updated (e.g., 65) point values ​​is referred to as the "scaled flow" and denoted by Qs(t). Alternatively, a single inhalation event may be used instead of the moving average.

[0379] From the scaled flow rates, two shape factors relevant to determining partial occlusion can be calculated.

[0380] Shape factor 1 is the ratio of the average of the median (e.g., 32) scaled flow points to the average of the global (e.g., 65) scaled flow points. If this ratio exceeds 1, the breath is considered normal. If this ratio is less than 1, the breath is considered obstructed. A ratio of approximately 1.17 is considered the threshold between partially obstructed and unobstructed breaths, and equates to a certain level of obstruction that allows for the maintenance of adequate oxygenation in a typical patient.

[0381] Shape factor 2 is calculated as the mean square deviation from unit scaled flow over the mean (e.g., 32) points. A mean square deviation of approximately 0.2 units is considered normal. A mean square deviation of zero is considered a totally flow-limited breath. The closer the mean square deviation is to zero, the more the breath is considered to be flow-limited.

[0382] Shape elements 1 and 2 may be used alternatively or in combination. In other forms of the present technology, the number of sampled points, breaths and midpoints may be different from those described above. Additionally, the thresholds may be different from those described above.

[0383] 5.5.3.2.5 Apnea and hypopnea determination In one form of the present technology, the central controller 4230 executes an apnea / hypopnea determination algorithm 4325 for determining the presence of apnea and / or hypopnea.

[0384] The apnea / hypopnea detection algorithm 4325 receives as an input the respiratory flow signal Qr and provides as an output a flag indicating whether an apnea or hypopnea has been detected.

[0385] In one form, apnea is detected when a function of respiratory flow Qr falls below a flow threshold for a predetermined period of time. The function may determine a peak flow, a relatively short-term average flow, or a flow intermediate between the relatively short-term average and peak flow (e.g., RMS flow). The flow threshold may be a relatively long-term measurement of flow.

[0386] In one form, hypopnea is detected when a function of respiratory flow Qr falls below a second flow threshold for a predetermined period of time. The function may determine a peak flow, a relatively short-term average flow, or a flow intermediate between the relatively short-term average and peak flow (e.g., RMS flow). The second flow threshold may be a relatively long-term measurement of flow. The second flow threshold is higher than the flow threshold used to detect apnea.

[0387] 5.5.3.2.6 Snoring Determination In one form of the present technology, a central controller 4230 executes one or more snore determination algorithms 4326 for determining the snore range.

[0388] In one form, the snore detection algorithm 4326 receives as an input the respiratory flow signal Qr and provides as an output a measurement of the extent to which snoring is present.

[0389] The snore detection algorithm 4326 may include determining the strength of the flow signal in the range of 30-300 Hz. Additionally, the snore determination algorithm 4326 may include filtering the respiratory flow signal Qr to reduce background noise (e.g., airflow sounds in the system from the blower).

[0390] 5.5.3.2.7 Determination of airway patency In one form of the present technology, the central controller 4230 executes one or more airway patency determination algorithms 4327 for determining the extent of airway patency.

[0391] In one form, the airway patency determination algorithm 4327 receives as an input the respiratory flow signal Qr and determines the output of the signal within a frequency range of about 0.75 Hz to about 3 Hz. The presence of a peak within this frequency range is taken as indicative of an airway patency. The absence of a peak is taken as an indication of an airway closure.

[0392] In one form, the frequency range in which the peak is sought is the frequency range that results in a small forced oscillation at the therapeutic pressure Pt. In one embodiment, the forced oscillation has a frequency of 2 Hz with an amplitude of approximately 1 cmH2O.

[0393] In one form, the airway patency determination algorithm 4327 receives as an input the respiratory flow signal Qr and determines the presence or absence of a cardiogenic signal, the absence of which is taken as an indication of airway obstruction.

[0394] 5.5.3.2.8 Determining target ventilation In one form of the present technology, the central controller 4230 takes as input a measurement of the current ventilation, Vent, and executes one or more target ventilation determination algorithms 4328 for the determination of a target value, Vtgt, for the ventilation measurement.

[0395] In some forms of the present technology, there is no target ventilation determination algorithm 4328 and the target value Vtgt is predetermined, for example obtained by hard coding during configuration of the RPT device 4000 or by manual entry via the input device 4220.

[0396] In other forms of the present technology, such as adaptive servo ventilation (ASV), the target ventilation determination algorithm 4328 calculates a target value Vtgt from a value Vtyp indicative of the patient's typical recent ventilation.

[0397] In some forms of adaptive servo ventilation, the target ventilation Vtgt is calculated as a high percentage and a value less than the typical recent ventilation Vtyp. The high percentage in such forms can be in the ranges (80%, 100%), or (85%, 95%), or (87%, 92%).

[0398] In other forms of adaptive servo-ventilation, the target ventilation, Vtgt, is calculated as slightly more than a multiple of the typical recent ventilation, Vtyp.

[0399] Typical recent ventilation Vtyp is a value around which measurements of current ventilation Vent over multiple time instants over some predetermined time scale tend to be clustered (i.e., a measure of the central tendency of measurements of current ventilation in the recent history). In one implementation of the target ventilation determination algorithm 4328, the recent history is on the order of minutes, but in any case should be longer than the time scale of a Cheyne-Stokes ramp-up and ramp-down cycle. The target ventilation determination algorithm 4328 may determine typical recent ventilation Vtyp from measurements of current ventilation Vent using any of a variety of well-known measures of central tendency. One such measure is a low pass filter output for measurements of current ventilation Vent with a time constant equal to 100 seconds.

[0400] 5.5.3.2.9 Determination of treatment parameters In some forms of the present technology, the central controller 4230 executes one or more treatment parameter determination algorithms 4329 for determining one or more treatment parameters using values ​​returned from one or more of the other algorithms in the treatment engine module 4320.

[0401] In one form of the present technology, the treatment parameter is the instantaneous treatment pressure, Pt. In one implementation of this form, the treatment parameter determination algorithm 4329 determines the treatment pressure, Pt, using the following equation:

[0402]

number

[0403] where: A is the amplitude, Π(Φ,t) is the waveform template value (ranging from 0 to 1) at the current value of phase Φ and time t; ·P0 is the base pressure.

[0404] If the waveform determination algorithm 4322 provides the waveform template Π(Φ,t) as a lookup table of values ​​Φ indexed by phase, the treatment parameter determination algorithm 4329 applies equation (1) by locating the closest lookup table entry to the current value Φ of the phase returned from the phase determination algorithm 4321 or between two entries that span the current value Φ of the phase.

[0405] The values ​​of amplitude A and base pressure P0 may be set by the treatment parameter determination algorithm 4329 depending on the respiratory pressure treatment mode selected.

[0406] 5.5.3.3 Treatment Control Module A treatment control module 4330 according to one aspect of the present technology receives treatment parameters from a treatment parameter determination algorithm 4329 of the treatment engine module 4320 as input and controls the pressure generator 4140 to deliver airflow from the pressure generator in accordance with these treatment parameters.

[0407] In one form of the present technology, the treatment parameter is a treatment pressure Pt, and the treatment control module 4330 controls the pressure generator 4140 to deliver an airflow such that the mask pressure Pm at the patient interface 3000 is equal to the treatment pressure Pt.

[0408] 5.5.3.4 Detecting fault conditions In one form of the present technology, the central controller 4230 executes one or more methods for detection of a fault condition 4340. The fault condition detected by the one or more methods may include at least one of the following: Power outage (no power or insufficient power) Converter failure detection Unable to detect the presence of the component Operating parameters are outside the recommended range (e.g. pressure, flow, temperature, PaO2) ·Failure of a test alert to produce a detectable warning signal.

[0409] When a fault condition is detected, the corresponding algorithm signal signals the presence of a fault by one or more of the following: Initiation of audible, visual and / or kinetic (e.g. vibration) warnings Send messages to external devices Incident logging

[0410] 5.6 Humidifier 5.6.1 Humidifier Overview In one form of the present technology, a humidifier 5000 is provided for changing the absolute humidity of air or gas to be delivered to a patient relative to the ambient air (e.g., as shown in FIG. 5A). Typically, the humidifier 5000 is used to increase the absolute humidity (relative to ambient air) and increase the temperature of the air stream before delivery to the patient's airway.

[0411] The humidifier 5000 may include a humidifier reservoir 5110, a humidifier inlet 5002 for receiving an airflow, and a humidifier outlet 5004 for delivering a humidified airflow. In some forms, such as shown in Figures 5A and 5B, the inlet and outlet of the humidifier reservoir 5110 may be the humidifier inlet 5002 and the humidifier outlet 5004, respectively. The humidifier 5000 may further include a humidifier base 5006. The humidifier base 5006 may be adapted to receive the humidifier reservoir 5110 and may include a heating element 5240.

[0412] 5.6.2 Humidifier Mechanical Components 5.6.2.1 Water reservoir According to one arrangement, the humidifier 5000 may include a water reservoir 5110 configured to contain or hold a quantity of liquid (e.g., water) to be evaporated for humidification of the airflow. The water reservoir 5110 may be configured to contain a predetermined maximum quantity of water to provide adequate humidification for at least the duration of a respiratory therapy session (e.g., a night's sleep). Typically, the reservoir 5110 is configured to contain several hundred milliliters of water (e.g., 300 milliliters (ml), 325 ml, 350 ml, or 400 ml). In another form, the humidifier 5000 may be configured to receive a water supply from an external water source (e.g., a building's water supply system).

[0413] According to one embodiment, the water reservoir 5110 is configured to humidify the air flow from the RPT device 4000 as the air flow passes through the RPT device 4000. In one form, the water reservoir 5110 may be configured to promote the air flow traveling a tortuous path through the reservoir 5110 while the air flow contacts a volume of water in the reservoir 5110.

[0414] According to one form, the reservoir 5110 may be removable from the humidifier 5000 laterally, for example as shown in Figures 5A and 5B.

[0415] The reservoir 5110 may also be configured to inhibit liquid release from the reservoir 5110, for example, when the reservoir 5110 is displaced and / or rotated from its normal operating orientation (e.g., through any aperture and / or between its subcomponents). Because the air flow to be humidified by the humidifier 5000 is often pressurized, the reservoir 5110 may also be configured to prevent loss of air pressure through leakage and / or flow impedance.

[0416] 5.6.2.2 Conductive Sites According to one arrangement, the reservoir 5110 includes a conductive region 5120 configured to allow efficient heat transfer from the heating element 5240 to the volume of liquid in the reservoir 5110. In one form, the conductive region 5120 may be arranged as a plate, although other shapes may be suitable. All or part of the conductive region 5120 may be constructed of a thermally conductive material such as aluminum (e.g., approximately 2 mm (e.g., 1 mm, 1.5 mm, 2.5 mm, or 3 mm) thick), another thermally conductive metal, or some plastic. In some cases, adequate thermal conductivity may be achieved with a less conductive material of appropriate geometry.

[0417] 5.6.2.3 Humidifier Reservoir Dock In one form, the humidifier 5000 may include a humidifier reservoir dock 5130 (as shown in FIG. 5B) configured to receive the humidifier reservoir 5110. In some arrangements, the humidifier reservoir dock 5130 may include a locking feature (e.g., a locking lever 5135 configured to hold the reservoir 5110 within the humidifier reservoir dock 5130).

[0418] 5.6.2.4 Water Level Indicator The humidifier reservoir 5110 may include a water level indicator 5150 as shown in Figures 5A-5B. In some forms, the water level indicator 5150 may provide one or more indications to a user, such as the patient 1000 or a caregiver, about the amount of water in the humidifier reservoir 5110. The one or more indications provided by the water level indicator 5150 may include an indication of a maximum predetermined amount of water, any portion thereof (e.g., 25%, 50% or 75% or an amount (e.g., 200ml, 300ml or 400ml)).

[0419] 5.6.3 Humidifier Electrical & Thermal Components The humidifier 5000 may include multiple electrical and / or thermal components, such as those listed below.

[0420] 5.6.3.1 Humidifier Transducers The humidifier 5000 may include one or more humidifier transducers (sensors) 5210 instead of or in addition to the transducers 4270 described above. The humidifier transducers 5210 may include one or more of an air pressure sensor 5212, an air flow transducer 5214, a temperature sensor 5216, or a humidity sensor 5218 as shown in FIG. 5C. The humidifier transducers 5210 may generate one or more output signals. These output signals may be communicated to a controller (e.g., the central controller 4230 and / or the humidifier controller 5250). In some forms, the humidifier transducers may be located outside the humidifier 5000 (e.g., within the air circuit 4170) while communicating the output signals to the controller.

[0421] 5.6.3.1.1 Pressure transducers One or more pressure transducers 5212 may be provided to the humidifier 5000 in addition to or instead of a pressure sensor provided in the RPT device 4000.

[0422] 5.6.3.1.2 Flow Converters One or more flow transducers 5214 may be provided to the humidifier 5000 in addition to or instead of a flow sensor provided in the RPT device.

[0423] 5.6.3.1.3 Temperature Converters The humidifier 5000 may include one or more temperature transducers 5216. The one or more temperature transducers 5216 may be configured to measure one or more temperatures (e.g., the temperature of the heating element 5240 and / or the temperature of the air flow downstream of the humidifier outlet 5004). In some forms, the humidifier 5000 may further include a temperature sensor 5216 that detects the temperature of the ambient air.

[0424] 5.6.3.1.4 Humidity Transducers In one form, the humidifier 5000 may include one or more humidity sensors 5218 that detect the humidity of a gas, such as ambient air. In some forms, the humidity sensor 5218 may be positioned toward the humidifier outlet 5004 to measure the humidity of the gas delivered from the humidifier 5000. The humidity sensor may be an absolute humidity sensor or a relative humidity sensor.

[0425] 5.6.3.2 Heating elements In some cases, a heating element 5240 may be provided to the humidifier 5000 to provide heat input to one or more of the volume of water in the humidifier reservoir 5110 and / or the volume of water to the airflow. The heating element 5240 may include a heat-generating component, such as an electrical resistance heating track. One suitable example of the heating element 5240 is a layered heating element, for example, as described in PCT Patent Application Publication No. WO2012 / 171072, the entirety of which is incorporated herein by reference.

[0426] In some forms, the heating element 5240 may be mounted in the humidifier base 5006. In the humidifier base 5006, heat may be transferred to the humidifier reservoir 5110 primarily by conduction, as shown in FIG.

[0427] 5.6.3.3 Humidifier controller According to one arrangement of the present technology, the humidifier 5000 may include a humidifier controller 5250 as shown in FIG. 5C. In one form, the humidifier controller 5250 may be part of the central controller 4230. In another form, the humidifier controller 5250 may be a separate controller that may be in communication with the central controller 4230.

[0428] In one form, the humidifier controller 5250 may receive measurements of characteristics (e.g., temperature, humidity, pressure and / or flow rate) as inputs (e.g., measurements of airflow, water in the reservoir 5110 and / or in the humidifier 5000). The humidifier controller 5250 may also be configured to run or implement a humidifier algorithm and / or deliver one or more output signals.

[0429] As shown in FIG. 5C, the humidifier controller 5250 may include one or more controllers (e.g., a central humidifier controller 5251, a heated air circuit controller 5254 configured to control the temperature of the heated air circuit 4170, and / or a heating element controller 5252 configured to control the temperature of the heating element 5240).

[0430] 5.7 Respiratory Pressure Therapy Mode Depending on the values ​​of parameters A and P0 in the treatment pressure equation (1) used by the treatment parameter determination algorithm 4329 in one form of the present technology, various respiratory pressure treatment modes may be performed by the RPT device 4000.

[0431] 5.7.1 CPAP treatment In some implementations of this form of the technology, the amplitude A is equal to zero, so that the treatment pressure Pt is equal to the base pressure P0 throughout the entire respiratory cycle. Such implementations are primarily grouped under the heading of CPAP treatment. In such implementations, there is no need for a therapy engine module 4320 to determine the phase Φ or waveform template Π(Φ).

[0432] In the CPAP treatment mode, the base pressure P0 may be a constant value, hard-coded or manually entered into the RPT device 4000. This alternative may be referred to as constant CPAP treatment. The constant value of the base pressure P0 may be selected for a given patient through a process known as titration. During titration, the clinician typically adjusts the therapeutic pressure Pt in response to observations of flow limitation, apnea, hypopnea, patency, and snoring during the titration session. The titrated base pressure P0 may then be calculated as a statistical summary of the therapeutic pressure Pt during the titration session.

[0433] Alternatively, the therapy parameter determination algorithm 4329 may continuously calculate the base pressure P0 during CPAP therapy. In this alternative, the therapy parameter determination algorithm 4329 continuously calculates the base pressure P0 as a function of the sleep disorder breathing indicators or measurements (e.g., one or more of flow limitation, apnea, hypopnea, patency, and snoring) returned from each algorithm in the therapy engine module 4320. This alternative is also referred to as APAP therapy. Because such continuous calculation of the base pressure P0 is similar to the manual adjustment of the therapy pressure Pt by the clinician, the APAP therapy is also referred to as auto-titration CPAP.

[0434] 5.7.2 Bilevel therapy In other implementations of this form of the technology, the value of the amplitude A in equation (1) can be positive. Such implementation is known as bilevel therapy, because when the treatment pressure Pt is determined using equation (1) with a positive amplitude A, the treatment parameter determination algorithm 4329 oscillates the treatment pressure Pt between two values ​​or levels in synchronization with the spontaneous breathing efforts of the patient 1000. That is, based on the exemplary waveform template Π(Φ,t) described above, the treatment parameter determination algorithm 4329 increases the treatment pressure Pt to P0+A (known as IPAP) at the beginning of inspiration or during breathing, and decreases the treatment pressure Pt to the base pressure P0 (known as EPAP) at the beginning of expiration or during expiration.

[0435] In some forms of bilevel therapy, IPAP is a prescribed therapeutic pressure with the same purpose as the therapeutic pressure in CPAP therapy mode, and EPAP is IPAP minus amplitude A, which has a "small" value (a few cmH2O), also called expiratory pressure release (EPR). Such forms are also called CPAP therapy with EPR, and are generally considered to be more comfortable than direct CPAP therapy. In the case of CPAP therapy with EPR, either or both of IPAP and EPAP may be constant values, hard-coded or manually entered into the RPT device 4000. Alternatively, the therapy parameter determination algorithm 4329 may continuously calculate IPAP and / or EPAP during CPAP with EPR. In this alternative example, the therapy parameter determination algorithm 4329 continuously calculates EPAP and / or IPAP as a function of the index or measurement of sleep disorder breathing returned from each algorithm in the therapy engine module 4320. This is done similarly to the calculation of base pressure P0 in APAP therapy described above.

[0436] In other forms of bilevel therapy, the amplitude A is large enough that the RPT device 4000 performs some or all of the work of breathing for the patient 1000. In such forms, known as pressure support ventilation therapy, the amplitude A is referred to as pressure support or swing. In pressure support ventilation therapy, IPAP is the base pressure P0 plus pressure support A, and EPAP is the base pressure P0.

[0437] In some forms of pressure support ventilation therapy, known as constant pressure support ventilation therapy, the pressure support A is fixed at a predetermined value (e.g., 10 cmH2O). The predetermined pressure support value is a setting of the RPT device 4000 and may be set, for example, by hard-coded during configuration of the RPT device 4000 or by manual entry via the input device 4220.

[0438] In some forms of pressure assisted ventilation therapy known as servo ventilation, a therapy parameter determination algorithm 4329 takes as input the current measured value of ventilation, Vent, and the target value of ventilation, Vtgt, provided by a target ventilation determination algorithm 4328, and continuously adjusts the parameters of equation (1) to move the current measured value of ventilation, Vent, closer to the target value of ventilation, Vtgt. In a form of servo-ventilation known as adaptive servo ventilation (ASV), which is used for CSR therapy, the target ventilation, Vtgt, is calculated by the target ventilation determination algorithm 4328 from a typical recent ventilation, Vtyp, as described above.

[0439] In some forms of servo ventilation, the therapy parameter determination algorithm 4329 applies a control method to continuously calculate pressure support A to move the current measured ventilation, Vent, towards the target ventilation, Vtgt. One such control method is proportional-integral (PI) control. In one implementation of PI control suitable for ASV mode, where the target ventilation, Vtgt, is set to be slightly lower than a typical recent ventilation, Vtyp, pressure support is calculated as follows:

[0440]

number

[0441] where G is the gain of the PI control. Larger values ​​of the gain G may result in positive feedback in the therapy engine module 4320. Smaller values ​​of the gain G may result in some residual untreated CSR or central sleep apnea. In some implementations, the gain G is fixed at a predetermined value (e.g., -0.4 cmH2O / (L / min) / sec). Alternatively, the gain G may be varied between treatment sessions (starting at a low value and increasing between sessions) until a value that nearly eliminates CSR is reached. Conventional means for retrospectively analyzing parameters of a treatment session to assess the severity of CSR during a treatment session may be used in such implementations. In yet other implementations, the gain G may vary depending on the difference between the current measured value of ventilation, Vent, and the target ventilation, Vtgt.

[0442] Other servo ventilation control methods that may be applied by the therapy parameter determination algorithm 4329 include proportional (P), proportional differential (PD), and proportional integral differential (PID).

[0443] The value of pressure support A calculated via equation (2) may be clipped to a range defined as [Amin, Amax]. In this embodiment, pressure support A defaults to minimum pressure support Amin until the current ventilation Vent is measured below the target ventilation Vtgt. At that point A begins to increase, decreasing back to Amin only if Vent again exceeds Vtgt.

[0444] The pressure support limits Amin and Amax are settings of the RPT device 4000 and are set, for example, hard coded during configuration of the RPT device 4000 or by manual input through the input device 4220. A minimum pressure support Amin of 3 cmH2O is on the order of 50% of the pressure support required to perform all of a typical patient's respiratory efforts at steady state. A maximum pressure support Amax of 12 cmH2O is nearly twice the pressure support required to perform all of a typical patient's respiratory efforts, and is therefore sufficient to assist the patient's breathing when the patient ceases any effort, but below a value that would be uncomfortable or dangerous.

[0445] In the pressure support ventilation treatment mode, the EPAP is the base pressure P0. Similar to the base pressure P0 in CPAP treatment, the EPAP may be a constant value, defined or determined during titration. Such a constant EPAP may be set, for example, by hard-coding during configuration of the RPT device 4000 or by manual input through the input device 4220. This alternative is also referred to as fixed EPAP pressure support ventilation treatment. The titration of the EPAP for a given patient may be performed by a clinician during a titration session with PSG for the purpose of preventing obstructive apnea, thereby maintaining an open airway for pressure support ventilation treatment in a manner similar to the titration of the base pressure P0 in constant CPAP treatment.

[0446] Alternatively, the therapy parameter determination algorithm 4329 may continuously calculate the base pressure P0 during pressure support ventilation therapy. In such an embodiment, the therapy parameter determination algorithm 4329 continuously calculates EPAP as a function of sleep disordered breathing indicators or measurements (e.g., one or more of flow limitation, apnea, hypopnea, patency, and snoring) returned from each algorithm in the therapy engine module 4320. Because the continuous calculation of EPAP is similar to the clinician's manual adjustment of EPAP during titration of EPAP, this process is also referred to as auto-titration of EPAP, and the overall therapy is known as auto-titration EPAP pressure support ventilation therapy or auto EPAP pressure support ventilation therapy.

[0447] 5.8 Glossary For purposes of this disclosure, in certain aspects of the technology, one or more of the following definitions may apply. In other aspects of the technology, other definitions may apply.

[0448] 5.8.1 General Air: In certain forms of the present technology, air may refer to atmospheric air, while in other forms of the present technology, air may refer to combinations of other breathable gases (e.g., oxygen-rich atmospheric air).

[0449] Atmosphere: In certain forms of the present technology, the term "atmosphere" should be taken to mean: (i) that which is external to the treatment system or patient, and (ii) that which immediately surrounds the treatment system or patient.

[0450] For example, the ambient humidity for a humidifier may be the humidity of the air immediately surrounding the humidifier (e.g., the humidity inside the room in which the patient sleeps). Such ambient humidity may differ from the humidity outside the room in which the patient sleeps.

[0451] In another example, the atmospheric pressure may be the pressure immediately surrounding or external to the body.

[0452] In certain embodiments, ambient (e.g., acoustic) noise can be considered the background noise level in the room the patient is in, other than noise emanating from, for example, the RPT device or from the mask or patient interface. Ambient noise can originate from sources outside the room.

[0453] Respiratory Pressure Therapy (RPT): The application to the airway inlet of an air supply at therapeutic pressure, typically a positive pressure relative to the atmosphere.

[0454] Nasal Continuous Positive Airway Pressure (CPAP) Therapy: Respiratory pressure therapy in which the therapeutic pressure is approximately constant throughout the patient's respiratory cycle. In some forms, the pressure at the entrance to the airway increases slightly during expiration and decreases slightly during inspiration. In some forms, the pressure varies during different respiratory cycles of the patient (e.g., increased in response to detection of an indication of partial upper airway obstruction and decreased in the absence of notification of partial upper airway obstruction).

[0455] Patient: A person with or without respiratory disease.

[0456] Automatic Positive Airway Pressure (APAP) Therapy: A CPAP therapy that is capable of automatically adjusting therapeutic pressure between minimum and maximum limits, for example, between breaths, depending on the presence or absence of signs of an SDB episode.

[0457] 5.8.2 Breathing cycle aspects Apnea: According to some definitions, apnea is said to occur when flow below a certain threshold continues for a duration of, for example, 10 seconds. Obstructive apnea is said to occur when some airway obstruction does not allow airflow despite patient effort. Central apnea is said to refer to a condition in which apnea is detected due to reduced or absent respiratory effort despite a patent airway. Mixed apnea is said to refer to a condition in which reduced or absent respiratory effort occurs simultaneously with airway obstruction.

[0458] Respiratory Rate: The patient's spontaneous breathing rate, usually measured in breaths per minute.

[0459] Duty Cycle: The ratio of inspiration time Ti to total breathing time Ttot.

[0460] Effort (breathing): Respiratory effort is said to refer to the movement made by a person's spontaneous breathing as they try to breathe.

[0461] Expiratory portion of the respiratory cycle: the period from the start of the expiratory flow to the start of the inspiratory flow.

[0462] Flow limitation: Flow limitation is understood to be a situation in a patient's breathing where an increase in effort by the patient does not cause a corresponding increase in flow. If the flow limitation occurs during the inhalation portion of the respiratory cycle, the flow limitation may be referred to as inhalation flow limitation. If the flow limitation occurs during the exhalation portion of the respiratory cycle, the flow limitation may be referred to as expiratory flow limitation.

[0463] Flow-limited inspiration waveform types: (i) Flattening: An upswing followed by a relatively flat area and then a downswing. (ii) M-shaped: It has two local peaks, one at the rise and one at the fall, with a relatively flat region between the two peaks. (iii) Chair-like: Has a single local peak that occurs at the rising edge and is followed by a relatively flat region. (iv) Inverted chair shape: A relatively flat region is followed by a single local peak, which occurs on the trailing edge.

[0464] Hypopnea: Preferably, hypopnea refers to a reduction in flow, rather than an interruption of flow. In one form, hypopnea is said to occur when there is a sustained period of reduced flow below a threshold rate. When hypopnea is detected due to a reduction in respiratory effort, central hypopnea is said to occur. In one form in adults, hypopnea may be considered when any of the following occur: (i) A 30% decrease in patient respiration for at least 10 seconds plus an associated 4% desaturation, or (ii) A reduction in patient respiration (less than 50%) lasting for at least 10 seconds and associated with at least 3% desaturation or arousal occurs.

[0465] Hyperventilation: An increase in flow to a level higher than normal.

[0466] Inspiration portion of the respiratory cycle: The period from the start of the inspiratory flow to the start of the expiratory flow is taken as the inspiration portion of the respiratory cycle.

[0467] Patency (Airway): The degree to which the airway is open or the extent to which the airway is open. Airway patency is an opening. Quantification of airway patency may be done with values ​​indicating patency (1) and closure (obstruction) (0).

[0468] Positive end-expiratory pressure (PEEP): The pressure above atmosphere in the lungs that exists at the end of expiration.

[0469] Peak flow (Qpeak): The maximum value of flow during the inspiratory portion of the respiratory flow waveform.

[0470] Respiratory airflow, airflow, patient airflow, respiratory airflow (Qr): these synonyms may be understood to refer to the RPT device's estimate of respiratory airflow and are used in contrast to "true respiratory flow" or "true respiratory airflow", which is the patient's actual respiratory flow, usually expressed in liters / minute.

[0471] Tidal Volume (Vt): The volume of air inhaled or exhaled during normal breathing without extra effort.

[0472] (Inspiration) Time (Ti): The duration of the inspiratory portion of the respiratory flow waveform.

[0473] (Expiratory) Time (Te): The duration of the expiratory portion of the respiratory flow waveform.

[0474] (Total) Time (Ttot): The total duration between the start of one inspiratory portion of the respiratory flow waveform and the start of the next inspiratory portion of the respiratory flow waveform.

[0475] Typical Recent Ventilation: The ventilation values ​​around which recent values ​​over a given time scale tend to cluster (i.e., the degree to which recent values ​​of ventilation tend to be central).

[0476] Upper Airway Obstruction (UAO): Includes both partial and total upper airway obstruction. This may be associated with a state of flow limitation in which flow may increase or decrease slightly as the pressure difference in the upper airway increases (Starling resistor behavior).

[0477] Vent: A measure of the total amount of gas exchange performed by a patient's respiratory system. Measurements of ventilation may include either or both inhalation and exhalation flows per unit of time. When expressed as volume per minute, this amount is often referred to as "minute ventilation." Minute ventilation is sometimes simply given as volume and is understood as volume per minute.

[0478] 5.8.3 RPT Device Parameters Flow rate: The instantaneous volume (or mass) of air delivered per unit time. Flow rate and ventilation have the same magnitude volume or mass per unit time, but flow rate is measured over a much shorter period of time. In some cases, when referring to flow rate, it refers to a scalar quantity (i.e., a quantity with only magnitude). In other cases, when referring to flow rate, it refers to a vector quantity (i.e., a quantity with both magnitude and direction). When referred to as a signed quantity, flow rate can be nominally positive for the inhalation portion of the patient's respiratory cycle, and negative for the exhalation portion of the patient's respiratory cycle. Flow rate is given the sign Q. "Flow rate" is sometimes simply referred to as "flow". Total flow rate Qt is the flow rate of air exiting the RPT device. Vent flow rate Qv is the flow rate of air exiting the vent to allow the outflow of exhaled gases. Leakage flow rate Ql is the flow rate of leakage from the patient interface system. Respiratory flow rate Qr is the flow rate of air received into the patient's respiratory system.

[0479] Leakage: The term "leakage" is taken as an unintended air flow. In one embodiment, a leak may occur due to an imperfect seal between the mask and the patient's face. In another embodiment, a leak may occur at the elbow to the perimeter.

[0480] Noise Conduction (Acoustic): In this document, conducted noise refers to noise that is carried to the patient by the pneumatic pathway (e.g., the air circuit and the patient interface and the air therein). In one form, conducted noise can be quantified by measuring the sound pressure level at the end of the air circuit.

[0481] Noise Emission (Acoustic): In this document, radiated noise refers to the noise carried by the surrounding air to the patient. In one form, radiated noise can be quantified by measuring the sound power / pressure level of the target according to ISO3744.

[0482] Ventilation Noise (Acoustic): In this document, ventilation noise refers to the noise generated by airflow through any vents (eg, vent holes in the patient interface).

[0483] Pressure: Force per unit area. Pressure can be measured in various units (e.g., cmH2O, gf / cm2, hectopascals). 1 cmH2O is equal to 1 g-f / cm2, approximately 0.98 hectopascals. In this specification, pressure is given in cmH2O unless otherwise stated. Pressure in the patient interface is given the symbol Pm, and therapeutic pressure, which represents the target value that the mask pressure Pm should achieve at the current time, is given the symbol Pt.

[0484] Sound power: The energy carried by a sound wave per unit time. Sound power is proportional to the square of the sound pressure multiplied by the wavefront area. Sound power is usually expressed in decibels SWL (i.e., decibels relative to a reference power taken as 10 to 12 watts).

[0485] Sound Pressure: The local deviation from the ambient pressure at a given time resulting from the passage of sound waves through a medium. Sound pressure is usually expressed in decibels SPL (i.e., decibels relative to a reference power, usually taken as 20×10-6 Pascals (Pa), taken as the threshold of human hearing).

[0486] 5.8.4 Ventilator Terminology Adaptive servo-ventilator (ASV): A servo-ventilator that does not have a fixed target ventilation, but rather is variable. The variable target ventilation can be learned from some characteristics of the patient (e.g., the patient's breathing characteristics).

[0487] Backup Rate: A ventilator parameter that establishes the minimum respiratory rate (typically in breaths per minute) that will be delivered from the ventilator to the patient (when not triggered by spontaneous breathing efforts).

[0488] Cycle: The end of the inspiratory phase of a ventilator. When a ventilator delivers breaths to a spontaneously breathing patient, at the end of the inspiratory portion of the breathing cycle, the ventilator is said to be cycled to cease breath delivery.

[0489] Expiratory Positive Airway Pressure (EPAP): The base pressure to which varying pressures are added during a breath to produce the desired mask pressure that the ventilator is attempting to achieve at a given moment.

[0490] End Expiratory Pressure (EEP): The desired mask pressure that the ventilator attempts to achieve at the end of the expiratory portion of the breath. If the pressure waveform template Π(Φ) has a value of zero at the end of expiration (i.e., Π(Φ)=0 when Φ=1), then EEP is equal to EPAP.

[0491] Inspiratory Positive Airway Pressure (IPAP): The maximum desired mask pressure that the ventilator attempts to achieve during the inspiratory portion of the breath.

[0492] Pressure Support: A number indicating the increase in pressure during ventilator inhalation followed by exhalation of the same ventilator, and generally refers to the pressure difference between the maximum inhalation pressure and the base pressure (e.g., PS=IPAP-EPAP). In some contexts, pressure support refers to the difference the ventilator tries to achieve (rather than the difference it actually achieves).

[0493] Servo-ventilator: a ventilator that has patient ventilation and has target ventilation, and adjusts the level of pressure support to approximate the patient ventilation to the target ventilation.

[0494] Spontaneous / Timed (S / T): A mode of a ventilator or other device that attempts to detect the onset of a breath in a spontaneously breathing patient. However, if the device fails to detect a breath within a predetermined period of time, the device automatically begins breath delivery.

[0495] Swing: A term equivalent to pressure assistance.

[0496] Triggered: When a ventilator delivers a breath of air to a spontaneously breathing patient, the ventilator is said to be triggered to deliver a breath when the patient himself initiates the breathing portion of the breathing cycle.

[0497] Typical Recent Ventilation: Typical recent ventilation Vtyp is a range of values ​​around which recent ventilation measurements tend to cluster over a given time scale. For example, a measure of the central tendency of ventilation measurements over the recent history may be an appropriate value of typical recent ventilation.

[0498] Ventilator: A mechanical device that provides pressure support to a patient during some or all of the work of breathing.

[0499] 5.8.5 Facial Anatomy Alar: the outer wall or "wing" of each nostril (plural: alar)

[0500] Alare: The outermost point on the ala of the nose.

[0501] Wing curvature (or apex) point: the rearmost point on the curved baseline of each wing, found at the crease formed by the union of the wing and cheek.

[0502] Pinna: the entire visible part of the ear.

[0503] (Nasal) Skeleton: The nasal skeleton includes the nasal bones, the frontal process of the maxilla, and the nasal part of the frontal bone.

[0504] (Nasal) Cartilaginous folds: The nasal cartilaginous folds include the septal cartilage, lateral cartilage, greater cartilage and lesser cartilage.

[0505] Columella: The piece of skin that separates the nostrils and extends from the tip of the nose to the upper lip.

[0506] Columella angle: the angle between a line drawn through the midpoint of the nostrils and a line drawn perpendicular to the Frankfurt horizontal intersecting the subnasal point.

[0507] Frankfort horizontal plane: A line extending from the inferiormost point of the orbital rim to the left auricular point, which is the deepest point above the notch to the tragus of the pinna.

[0508] Glabellar: Located in the soft tissue, the most prominent point on the midsagittal portion of the forehead.

[0509] Lateral nasal cartilage: A generally triangular plate of cartilage whose upper margin is attached to the nasal bone and the frontal process of the maxilla and whose lower margin is connected to the greater alar cartilage.

[0510] Greater alar cartilage: a plate of cartilage located beneath the lateral nasal cartilage. It curves around the anterior part of the nostril. Its posterior end is attached to the frontal process of the maxilla by a tough fibrous membrane containing three or four alar cartilages.

[0511] Nostrils (alanopsia): roughly ellipsoidal alar openings that form the entrance to the nasal cavity. The singular form of nostril is nostril (alanopsia). The nostrils are separated by the nasal septum.

[0512] Nasolabial fold or nasolabial crease: a fold or groove of skin that runs from each side of the nose to the corners of the mouth and separates the cheeks from the upper lip.

[0513] Nasolabial angle: the angle between the bridge of the nose and the upper lip, intersecting with the subnasal point.

[0514] Inferior tympanic point: lowest point of attachment of the pinna to the facial skin.

[0515] Inferior auricular margin: the highest point of attachment of the pinna to the facial skin.

[0516] Nasal tip: the most prominent point or tip of the nose, which can be seen in a lateral view of the rest of the head section.

[0517] Philtrum: midline groove extending from the inferior border of the nasal septum to the top of the lips in the upper lip area.

[0518] Pogonion: The most anterior midpoint of the jaw, located on the soft tissue.

[0519] Bridge of the nose (nose): The nasal ridge is the midline protuberance of the nose, extending from the septum to the apex.

[0520] Sagittal plane: a vertical plane running from anterior (front) to posterior (back) that divides the body into right and left halves.

[0521] Cerion: Located on the soft tissue, it is the most concave point on the area of ​​the frontonasal suture.

[0522] Septal cartilage (nose): The nasal septal cartilage is part of the septum, which divides the anterior part of the nasal cavity.

[0523] Nasal Alar Lowest Point: The point on the lower margin of the alar base where it joins with the skin of the upper (top) lip.

[0524] Subnasal point: located on the soft tissue where the columella joins the upper lip in the midsagittal direction.

[0525] Supramentale: the most concave point in the midline of the lower lip between the lower lip midpoint and the soft tissue pogonion.

[0526] 5.8.6 Skull anatomy Frontal bone: The frontal bone contains the large vertical portion, the scales frontalis, which correspond to the area known as the forehead.

[0527] Mandible: The mandible forms the lower jaw. The mental protuberance is a bony protuberance in the jaw that forms the chin.

[0528] Maxilla: The maxilla forms the upper jaw and is located below the mandible and below the eye socket. The frontal process of the maxilla projects upwards by the side of the nose and forms part of its lateral border.

[0529] Nasal bones: The nasal bones are two small rectangular bones that vary in size and shape from one individual to another. They lie side by side in the middle and upper parts of the face and their junction forms the "bridge" of the nose.

[0530] Nasion: the intersection of the frontal bone and the two nasal bones; it is the concave area directly between the eyes and the upper side of the bridge of the nose.

[0531] Occipital bone: The occipital bone is located at the back and lower part of the skull. It contains an oval hole, the foramen magnum, through which the intracranial cavity communicates with the vertebral canal. The curved plate posterior to the foramen magnum is the squama occipitalis.

[0532] Orbit: bony cavity in the skull that contains the eyeball.

[0533] Parietal bones: The parietal bones are the bones that, when joined together, form the top and sides of the skull.

[0534] Temporal Bone: The temporal bone is located at the base and on the side of the skull and supports parts of the face known as the temples.

[0535] Cheekbones: The two cheekbones in the face are located in the upper and outer parts of the face and form the cheek ridges.

[0536] 5.8.7 Respiratory System Anatomy Diaphragm: A sheet of muscle that runs over the lower rib cage. It separates the thoracic cavity, which contains the heart, lungs, and ribs, from the abdominal cavity. When the diaphragm contracts, it increases the volume of the thoracic cavity and draws air into the lungs.

[0537] Larynx: The larynx or voice box that contains the vocal folds and connects the lower part of the pharynx (hypopharynx) to the trachea.

[0538] Lung: respiratory organ in humans. The conductive zone of the lung includes the trachea, bronchi, bronchiole, and terminal bronchioles. The respiratory zone includes the respiratory bronchi, alveolar ducts, and alveoli.

[0539] Nasal Cavity: The nasal cavity (or nasal fossa) is a large air-filled space in the center of the face above and behind the nose. The nasal cavity is divided into two by a vertical fin called the nasal septum. On the sides of the nasal cavity are three horizontal extensions called the turbinates or nasal bones. At the front of the nasal cavity is the nose, and at the back it opens into the nasopharynx via the choanae.

[0540] Pharynx: The part of the throat located immediately below (inferior to) the nasal cavity and above the esophagus and larynx. The pharynx is traditionally divided into three parts: the nasopharynx (upper pharynx) (nasal part of the pharynx), the oropharynx (middle pharynx) (oral part of the pharynx), and the hypopharynx (lower pharynx).

[0541] 5.8.8 Materials Silicone or Silicone Elastomer: Synthetic rubber. In this specification, when silicone is mentioned, it refers to liquid silicone rubber (LSR) or compression molded silicone rubber (CMSR). One form of commercially available LSR is SILASTIC (in a family of products sold under this trademark) manufactured by Dow Corning. Another LSR manufacturer is Wacker. Unless otherwise specified to the contrary, exemplary forms of LSR have a Shore A (or Type A) indentation hardness of about 35 to about 45 as measured by ASTM D2240.

[0542] Polycarbonate: Typically a transparent thermoplastic polymer of bisphenol A carbonate.

[0543] 5.8.9 Patient Interface Aspects Anti-asphyxiation valve (AAV): A component or subassembly of a mask system that reduces the risk of excessive rebreathing of CO2 by the patient by venting to atmosphere in a fail-safe manner.

[0544] Elbow: A conduit that directs the air flow axis to change angle through an angle. In one form, the angle may be approximately 90 degrees. In another form, the angle may be less than 90 degrees. The conduit may have a generally circular cross section. In another form, the conduit may have an elliptical or rectangular cross section.

[0545] Frame: Frame is taken to mean a mask structure that supports a tensile load between two or more points that connect the headgear. A mask frame may be a non-airtight load-bearing structure in the mask. However, some forms of mask frames may be airtight.

[0546] Headgear: Headgear is taken to mean a form of positioning and stabilizing structure designed to be used on the head. For example, the headgear may include a collection of one or more posts, ties and stiffeners configured to position and hold the patient interface in place on the patient's face for delivery of respiratory therapy. Some ties are formed from a soft, flexible, elastic material (e.g., a layered composite of foam and fabric).

[0547] Membrane: Membrane is taken to mean a typically thin-walled element, preferably offering substantially no resistance to bending and resistance to stretching.

[0548] Plenum Chamber: Mask plenum chamber is taken to mean a part of a patient interface having a wall that at least partially encloses a volume of space, the air in the volume being pressurized to exceed atmospheric pressure in use. The shell may form part of the wall of the mask plenum chamber.

[0549] Seal: As a noun ("seal"), it is taken to mean a structure or barrier that intentionally resists air flow through the interface of two surfaces. As a verb ("to seal"), it means to resist air flow.

[0550] Shell: A shell is taken to mean a curved, relatively thin structure that has bending, tensile and compressive stiffness. For example, the curved structural wall of a mask may be a shell. In some forms, the shell may be faceted. In some forms, the shell may be airtight. In some forms, the shell may not be airtight.

[0551] Stiffener: A stiffener is taken to mean a structural component designed to increase the bending stiffness of another component in at least one direction.

[0552] Strut: A strut is taken to mean a structural component designed to increase the compressive resistance of another component in at least one direction.

[0553] Swivel: (noun) A subassembly of components configured to rotate, preferably independently, about a common axis, preferably under low torque. In one form, the swivel may be configured to rotate through an angle of at least 360 degrees. In another form, the swivel may be configured to rotate through an angle of less than 360 degrees. When used in the context of an air delivery conduit, the subassembly of components preferably includes a mating cylindrical conduit. In use, there is little or no air leakage from the swivel.

[0554] Tie: A tie is taken as a structural component designed to resist pulling.

[0555] Venting: (noun) A structure that allows airflow to the ambient air inside a mask or conduit, allowing clinically effective flushing of exhaled gases. For example, flow rates of about 10 liters / minute to about 100 liters / minute may be used for clinically effective flushing, depending on mask design and treatment pressure.

[0556] 5.8.10 Terminology used in relation to patient interfaces Curvature (of a surface): A region of a surface that has a saddle shape, that curves upward in one direction and downward in a different direction, is said to have negative curvature. A region of a surface that has a dome shape, that curves in the same direction in both major directions, is said to have positive curvature. A flat surface is taken to have zero curvature.

[0557] Floppy: The quality of a material, structure, or composite having one or more of the following: Easily adapted to finger pressure. -If forced to support its own weight, it will not be able to maintain its shape. ·Non-rigid. -It can be stretched or bent elastically with just a small amount of force.

[0558] "Floppy" may have an associated direction, so that a particular material, structure or composite may be floppy in a first direction, but hard or rigid in a second direction (e.g., a second direction orthogonal to the first direction).

[0559] Elasticity: Capable of substantially elastic deformation and releasing substantially all of its energy under load within a relatively short period of time, such as one second.

[0560] Rigidity: Does not easily deform under finger pressure and / or pulling or loading typically encountered in setting and maintaining a patient interface in a sealing relationship to the entrance to the patient airway.

[0561] Semi-rigid: means sufficiently rigid so as not to substantially distort under the mechanical forces often applied during respiratory pressure therapy.

[0562] 5.8.11 Curvature A product of the present technology may include one or more actual three-dimensional structures (e.g., a mask cushion or impeller). The three-dimensional structures may be bounded by two-dimensional surfaces. These surfaces may be differentiated with labels to describe the orientation, location, function, or some other characteristic of the associated surfaces. For example, the structure may include one or more of a front surface, a back surface, an inner surface, and an outer surface. In another example, the cushion structure may include a face-containing (e.g., outer) surface and a separate face-free (e.g., lower or inner) surface. In another example, the structure may include a first surface and a second surface.

[0563] To facilitate the description of the shape and surface of a three-dimensional structure, a cross section at a point p through the surface of the structure is first considered. See Figures 3B-3F. Figures 3B-3F show an example cross section at a point p on the surface, and an example of the resulting planar curve. Figures 3B-3F also show the outward normal vector at p. The outward normal vector at p points away from the surface. In some examples, the surface is described from the perspective of a fictional little person standing upright on the surface.

[0564] 5.8.11.1 Curvature in one dimension The curvature of a plane curve at p can be described as having a sign (eg, positive, negative) and a magnitude (eg, 1 / radius of the circle tangent to the curve at p).

[0565] Positive curvature: If the curve at p bends towards the outward normal, the curvature at that point is taken to have a positive value (if this imaginary little person walks away from point p, he or she would have to walk uphill). See Figure 3B (relatively large positive curvature compared to Figure 3C) and Figure 3C (relatively small positive curvature compared to Figure 3B). Such curves are often called concave.

[0566] Zero curvature: If the curve at p is a straight line, the curvature is taken as zero (if this imaginary little person walks away from point p, he can walk on a horizontal plane that is neither pointing up nor down). See Figure 3D.

[0567] Negative curvature: If the curve at p bends away from the outward normal, the curvature at that point and in that direction is taken to have a negative value (if this imaginary little person were to walk away from point p, he would have to walk downhill). See Figure 3E (relatively small negative curvature compared to Figure 3F) and Figure 3F (re...

Claims

[Claim 1] A fluid connector for respiratory gas delivery from a respiratory pressure treatment device to a patient as described in the specification and drawings of this application.

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