Nasal cannula assemblies and related parts

Abstract

To provide nasal cannula assemblies for providing respiratory therapy to patients.SOLUTION: A nasal cannula assembly can include a cannula, an optional manifold that may be removable, a gas supply tube, and a securement mechanism. The securement mechanism can include headgear straps, cheek pads, or an adhesive nose strip. A nasal cannula assembly can also include a lanyard, a lanyard clip and / or a lanyard connector to help support the weight of a main gas delivery conduit.SELECTED DRAWING: Figure 83

Description

[Technical field]

[0001] The present disclosure relates to devices and systems for providing gases to a patient for respiratory therapy. More particularly, the present disclosure relates to a nasal (transnasal) cannula interface for providing gases to a patient via the nasal cavity. [Background technology]

[0002] Medical professionals may wish to provide respiratory assistance in the form of supplemental oxygen or airflow to patients for many reasons in an ICU (intensive care unit), other hospital or home environment. Various types of interfaces are available to deliver gas to patients, including a variety of nasal masks, full face masks, oral interfaces, nasal pillows and nasal cannula interfaces. Nasal cannula interfaces typically include two nasal prongs that are placed within the patient's nostrils to deliver gas to the patient.

[0003] Nasal cannula assemblies generally consist of a symmetrical or single-sided inlet tube that sits across the upper lip. From this tube protrude open-ended prongs that extend into the patient's nares to deliver oxygen. Nasal cannulae have the advantage of being more comfortable and acceptable to most patients than face masks. Single-inlet nasal cannulas have the advantage of being unobtrusive, and they may be more suitable for delivering moisture than dual-inlet nasal cannulas because of flow rate and surface area advantages over heat loss. However, the single inlet is provided on one side of the cannula, i.e., the left or right side. For example, if the tube is on the left side, it is difficult for the user to use if the flow source is on the opposite or right side of the user, requiring a longer tube that would cross the body.

[0004] When providing humidified gas to a patient, it is common to use a heated breathing circuit (tubing). This circuit is heavy and can drag and pull on the patient interface. To reduce any torque or kinking, it is common to use a short flexible tube between the heating circuit and the patient interface. To prevent the weight from pulling on the patient interface, a circuit hanger is sometimes used. This is a large extendable metal arm that receives the weight. It is also known in the art to clip a section of the tubing to the patient's clothing or bedding. Both of these solutions have been found to be highly unsuitable for mobile patients, especially when sleeping and tossing and turning in bed.

[0005] In patient interfaces such as nasal cannulae, stability of the nasal prongs on the face is very important because movement of the prongs within the nostrils can cause severe irritation. Current methods employed to hold single inlet nasal cannulas on the face use a simple elastic band of material behind the patient's head. This tends to rotate the nasal cannula relative to the patient's head, especially when the patient turns their head on the pillow. This rotation causes the prongs to move within the nostrils and irritate this sensitive area.

[0006] Where reference is made herein to patents, other external publications or other sources, this is generally for the purpose of providing a context for discussing the features of the present invention. Unless specifically stated otherwise, reference to such external publications should not be construed as an admission that such publications or such sources are prior art or form part of the common general knowledge in the art in any jurisdiction. Summary of the Invention [Problem to be solved by the invention]

[0007] It is an object of the present invention to provide an improved nasal cannula assembly or patient interface headgear, or at least to provide the public with a useful choice. [Means for solving the problem]

[0008] The nasal cannula interfaces described herein can be advantageously used to deliver gases to a patient over a wide range of concentrations and flow rates. The nasal cannula interfaces described herein also include a variety of features designed to improve patient comfort, safety, ease of use and / or efficiency, reduce costs, and / or provide other advantages.

[0009] In some embodiments, the nasal cannula system includes a cannula and a manifold. The cannula includes a central body portion, first and second lateral portions extending laterally in opposite directions from the central body portion and contacting the cheek or other facial feature of a user when the system is in use, and first and second nasal prongs extending from the central body portion. The central body portion includes a patient-facing side and at least one retention strap that cooperate to define a cavity. The first and second nasal prongs communicate with the cavity. The manifold receives a supply of gas from a gas source and includes a gas inlet and a gas outlet. The manifold is receivable within the cavity of the cannula such that the gas outlet is aligned with the first and second nasal prongs. The at least one retention strap defines first and second side edges, and the first and second nasal prongs are located between the first and second side edges.

[0010] In some embodiments, the nasal cannula system includes a cannula and a supply tube. The cannula includes a central body portion, first and second side portions extending laterally in opposite directions from the central body portion and contacting the cheek of a user when the system is in use, and first and second nasal prongs extending from the central body portion. The cannula defines a cavity having an inlet at a first end and a second end in communication with a first and second gas passage. The first and second gas passages are in communication with the first and second nasal prongs, respectively. The inlet is located in one of the first and second side portions, and the first and second gas passages extend laterally toward the first and second nasal prongs. The supply tube has a first end connectable to a supply gas from a gas source and a first end coupled to an inlet of the cavity of the cannula.

[0011] In some embodiments, the nasal cannula system includes a cannula, a manifold, and a supply tube. The cannula includes a central body portion, first and second side portions extending laterally in opposite directions from the central body portion, and first and second nasal prongs extending from the central body portion. The central body portion defines a cavity and a forward-facing inlet to the cavity. The first and second nasal prongs are in communication with the cavity. The manifold receives a supply gas from a gas source and includes a gas inlet and a gas outlet. The manifold is connectable to the cannula such that the gas outlet is aligned with the forward-facing inlet of the cannula and the gas inlet faces laterally. The supply tube is connected to the gas inlet of the manifold and is disposed forward of the forward-facing inlet of the cannula.

[0012] In some embodiments, the nasal cannula patient interface includes first and second nasal prongs, each including an inlet end and an outlet end, and at least one support portion configured to rest on the patient's nose at a point at or above the tip of the nose, In use, no portion of the patient interface contacts the patient's upper lip to provide any substantial support to the patient interface.

[0013] In some embodiments, the nasal cannula system includes a cannula having a central body portion and first and second nasal prongs extending from the central body portion. The cannula defines a cavity in communication with the first and second nasal prongs. An integrated head strap includes first and second sections, the first and second sections extending laterally in opposite directions from the central body portion. The first section defines a rear portion of the head strap. An adjustable coupling device enables coupling of the first and second sections in an adjustable manner such that a circumference of the head strap is adjustable. A supply tube has a first end connectable to a supply gas from a gas source and a second end coupled to the cavity of the cannula.

[0014] In some embodiments, the nasal cannula system includes a cannula having a central body portion and first and second nasal prongs extending from the central body portion. The cannula defines a cavity in communication with the first and second nasal prongs. The cannula defines a lateral slot. A headgear strap extends through the lateral slot of the cannula. A supply tube has a first end connectable to a supply gas from a gas source and a second end coupled to the cavity of the cannula.

[0015] In some embodiments, the nasal cannula system includes a cannula having a central body portion and first and second nasal prongs extending from the central body portion. The cannula defines a cavity in communication with the first and second nasal prongs. The cannula defines a first opening at a first location of the cavity and a second opening at a second location of the cavity spaced from the first location. A valve body is movable within the cavity. A supply tube has a first end connectable to either the first or second opening of the cannula and a second end connectable to a supply gas from a gas source. When the first end of the supply tube is connected to the first opening of the cannula, the valve body moves in response to gas flow in the cavity from the gas source to close the second opening such that gas flow is directed to the first and second nasal prongs, and when the first end of the supply tube is connected to the second opening of the cannula, the valve body moves in response to gas flow in the cavity from the gas source to close the first opening such that gas flow is directed to the first and second nasal prongs.

[0016] In some embodiments, the nasal cannula system includes a cannula having a central body portion and first and second side portions extending from the central body portion. The cannula defines a cavity in communication with the first and second nasal prongs. The cannula defines a first opening at a first location of the cavity and a second opening at a second location of the cavity spaced from the first location. The cannula includes a first valve selectively closing the first opening and a second valve selectively closing the second opening. A supply tube has a first end connectable to either the first or second opening of the cannula and a second end connectable to a supply gas from a gas source. When the first end of the supply tube is connected to the first opening of the cannula, the second valve closes the second opening such that the flow of gas from the gas source is directed to the first and second nasal prongs, and when the first end of the supply tube is connected to the second opening of the cannula, the first valve closes the first opening such that the flow of gas is directed to the first and second nasal prongs.

[0017] In some embodiments, the nasal cannula system includes a cannula including a central body portion and first and second nasal prongs extending from the central body portion. The cannula defines a cavity in communication with the first and second nasal prongs. The cannula defines a first opening at a first end of the cavity and a second opening at a second end of the cavity. The supply tube has a first end with a first insert and a second end with a second insert. Each of the first and second inserts is positionable within the cavity to seal the first and second openings and deliver a flow of gas from a gas source to the first and second nasal prongs. When the first end of the supply tube is connected to the cannula, the second end is connectable to the gas source, and when the second end of the supply tube is connected to the cannula, the first end is connectable to the gas source.

[0018] In some embodiments, the nasal cannula system includes a cannula including a central body portion and first and second nasal prongs extending from the central body portion. The cannula defines a cavity in communication with the first and second nasal prongs. A supply tube has a first end coupled to the cavity of the cannula and a second end connectable to a supply gas from a gas source. The first end of the supply tube defines a connection axis to the cannula. The supply tube includes a flexible portion at or adjacent the first end that can be bent at least about 90 degrees to either the left or right side without substantially obstructing an internal passageway of the supply tube.

[0019] In some embodiments, the nasal cannula system includes a cannula with first and second nasal prongs in communication with the cavities. A supply tube receives a flow of gas from a gas source. The supply tube is connected to the cannula to supply the flow of gas to the cavity of the cannula. A clip removably receives the cannula. A retention device secures the clip to the patient's head. The cannula is positionable within the clip in a first orientation such that the supply tube extends from the clip in a first direction, and the cannula is positionable within the clip in a second orientation such that the supply tube extends from the clip in a second direction.

[0020] In some embodiments, the nasal cannula system comprises a cannula comprising a first nasal prong and a second nasal prong. The cannula defines a cavity in communication with the first nasal prong and the second nasal prong. The cannula defines a first opening at a first location of the cavity and a second opening at a second location of the cavity spaced from the first location. A supply tube assembly comprises a clip releasably coupleable to the cannula in either a first orientation or a second orientation. The supply tube assembly further comprises a supply tube connectable to a supply gas from a gas source. The clip supports the supply tube and comprises a sealing portion. When the clip is connected to the cannula in the first orientation, the supply tube is connected to the first opening of the cannula and extends from the cannula in a first direction, and the sealing portion at least substantially seals the second opening, and when the clip is connected to the cannula in the second orientation, the supply tube is connected to the second opening of the cannula and extends from the cannula in a second direction, and the sealing portion at least substantially seals the first opening.

[0021] In some embodiments, the nasal cannula system includes a cannula clip including a first nasal prong and a second nasal prong. The cannula defines a cavity in communication with the first nasal prong and the second nasal prong. A supply tube assembly includes a manifold having at least one manifold opening and a supply tube connectable to a supply gas from a gas source. The cannula clip is releasably coupled to the manifold in either a first orientation or a second orientation, where the manifold is received within the cavity of the cannula clip and the first and second prongs are aligned with the at least one manifold opening such that a gas flow is provided to the first and second prongs. When the cannula clip is connected to the manifold in the first orientation, the supply tube extends in a first direction relative to the first and second prongs, and when the cannula clip is connected to the manifold in the second orientation, the supply tube extends in a second direction relative to the first and second prongs.

[0022] In some embodiments, a nasal cannula system includes a cannula including a main body defining a cavity and first and second nasal prongs extending from the main body and in communication with the cavity. A supply tube is coupled to the cannula and in communication with the cavity. The supply tube is connectable to a supply of gas from a gas source to deliver a flow of gas to the cavity and the first and second nasal prongs. The first and second nasal prongs are tiltable relative to the main body of the cannula between at least a first position in which the first and second nasal prongs are tilted in a first direction relative to the main body and a second position in which the first and second nasal prongs are tilted in a second direction relative to the main body. A first side of the main body defines a patient-facing side of the cannula in the first position and a second side of the main body defines a patient-facing side of the cannula in the second position, thereby effectively switching the side that the supply tube extends from the cannula between the first and second positions.

[0023] In some embodiments, the nasal cannula system includes a cannula defining a cavity, the cannula including first and second nasal prongs extending from the cannula and in communication with the cavity. A supply tube is coupled to the cannula and in communication with the cavity. The supply tube is connectable to a supply gas from a gas source to deliver a flow of gas to the cavity and the first and second nasal prongs. The first and second nasal prongs are oriented relative to the cannula and are movable between at least a first position in which the first and second nasal prongs are oriented such that openings in the prongs generally face a first direction relative to the cannula and a second position in which the first and second nasal prongs are oriented such that openings in the prongs generally face a second direction relative to the cannula. A first side of the cannula defines a surface that faces the patient in a first position and a second side of the cannula defines a surface that faces the patient in a second position, thereby effectively switching the side that the supply tube extends from the cannula between the first and second positions.

[0024] In some embodiments, a nasal cannula system includes a cannula defining a patient-facing surface and a cavity, the cannula including first and second nasal prongs extending from the cannula and in communication with the cavity. A manifold supports the cannula for rotation about at least one axis between at least a first position and a second position opposite the first position. A supply tube is coupled to the manifold and in communication with the cavity. The supply tube is connectable to a supply gas from a gas source to deliver a flow of gas to the cavity and the first and second nasal prongs. When the cannula is in the first position, the supply tube is disposed on a first side of the first and second nasal prongs, and when the cannula is in the second position, the supply tube is disposed on a second side of the first and second nasal prongs, thereby effectively switching the side on which the supply tube extends from the cannula between the first and second positions.

[0025] In some embodiments, the nasal cannula system includes a cannula defining a cavity, the cannula including first and second nasal prongs extending from the cannula and in communication with the cavity. A supply tube is coupled to the cannula and in communication with the cavity. The supply tube is connectable to a supply gas from a gas source to deliver a flow of gas to the cavity and the first and second nasal prongs. A pressure line is in communication with the cavity and configured to be connectable to a control or display unit of the gas source to provide a signal to the control or display unit indicative of the pressure within the cavity.

[0026] In some embodiments, the nasal cannula comprises a cannula body defining a cavity, the cannula body including first and second nasal prongs extending from the cannula and in communication with the cavity. The cannula defines a patient-facing surface having one or more comfort features selected from a plurality of piercing holes, a plurality of raised ridges, a plurality of grooves, and a gel pad.

[0027] In some embodiments, the nasal cannula comprises a cannula body defining a cavity, the cannula body including first and second nasal prongs extending from the cannula and in communication with the cavity. The cannula body comprises a central portion including the first and second nasal prongs and first and second lateral portions extending from either side of the central portion. The central portion is spaced forward of adjacent portions of the first and second lateral portions such that, in use, a patient-facing surface of the central portion is spaced from the patient's upper lip.

[0028] In some embodiments, a supply tube for a nasal cannula comprises a tube body having a first end and a second end, the tube body comprising a malleable section capable of being shaped by an external force and substantially maintaining the shape after the external force is removed.

[0029] In some embodiments, the nasal cannula system includes a cannula defining a cavity, the cannula including first and second nasal prongs extending from the cannula and in communication with the cavity. A supply tube is coupled to the cannula and in communication with the cavity. The supply tube is connectable to a supply gas from a gas source to deliver a flow of gas to the first and second nasal prongs. A support device supports the supply tube at a spaced apart location from the cannula. The support device includes a fastener having a first portion coupled to the supply tube and a second portion located at the spaced apart location.

[0030] In some embodiments, the nasal cannula system includes a cannula defining a cavity, the cannula including first and second nasal prongs extending from the cannula and in communication with the cavity. A supply tube is coupled to the cannula and in communication with the cavity. The supply tube is connectable to a supply gas from a gas source to deliver a flow of gas to the cavity and the first and second nasal prongs. A retaining device secures the cannula to the patient. A support device supports the supply tube at a location on the retaining device spaced from the cannula.

[0031] In some embodiments, the nasal cannula system includes a cannula defining a cavity, the cannula including first and second nasal prongs extending from the cannula and in communication with the cavity. A supply tube is coupled to the cannula and in communication with the cavity. The supply tube is connectable to a supply gas from a gas source to deliver a flow of gas to the cavity and the first and second nasal prongs. A support device supports the supply tube at a spaced apart location from the cannula. The support device includes a fastener that engages the piece of fabric at the spaced apart location.

[0032] In some embodiments, the nasal cannula system includes a cannula defining a cavity, the cannula including first and second nasal prongs extending from the cannula and in communication with the cavity. A supply tube is coupled to the cannula and in communication with the cavity. The supply tube is connectable to a supply gas from a gas source to deliver a flow of gas to the cavity and the first and second nasal prongs. A support device supports the supply tube at a location spaced apart from the cannula. The support device includes at least one of an arm band that engages the supply tube, an adhesive pad including a fastener that releasably fastens the supply tube to the adhesive pad, a generally U-shaped support that overlies the patient's shoulder and engages the supply tube, and a headgear strap including a strap that extends over a top of the patient's head and engages the supply tube.

[0033] In some embodiments, a retainer for a nasal cannula assembly includes a headgear strap with first and second ear loops each at least partially encircling an ear of a patient. A connecting portion connects the retainer to the nasal cannula assembly. A strap portion extends around a rear of the patient's head between the first and second ear loops.

[0034] In some embodiments, a retention device for a nasal cannula includes a headgear strap strap with strap portions. A first pad and a second pad contact a first cheek and a second cheek of a patient in use. A connecting portion connects the retention device to the nasal cannula. The strap portion extends around the patient's head and extends from the first pad and the second pad at an angle to the nasal cannula.

[0035] In some embodiments, a retainer for a nasal cannula includes a frame with a connecting portion that connects the retainer to the nasal cannula. A first ear stem portion and a second ear stem portion extend rearwardly from opposite sides of the connecting portion. The ear stem portion is configured to be positioned above the patient's ear.

[0036] In some embodiments, the nasal cannula system includes a cannula including a central portion defining a cavity and first and second nasal prongs extending from the central portion and in communication with the cavity. First and second side portions extend laterally from opposite sides of the central portion. A supply tube is coupled to the cannula and in communication with the cavity. The supply tube is connectable to a supply gas from a gas source to deliver a flow of gas to the cavity and the first and second nasal prongs. First and second adhesive pads are configured to be adhesively secured to a patient's face and are connectable to respective ones of the first and second side portions of the cannula via an adjustable fastening device.

[0037] In some embodiments, the nasal cannula system includes a cannula defining a cavity, the cannula including first and second nasal prongs extending from the cannula and communicating with the cavity. A modular retention device secures the cannula to the patient. The cannula is configured for use with any one of retention devices selected from a set of adhesive pads that attach to the patient's face, headgear straps, and a halo-style headgear strap having a strap portion that extends over the top of the patient's head.

[0038] In some embodiments, the nasal cannula system includes a cannula defining a cavity, the cannula including first and second nasal prongs extending from the cannula and communicating with the cavity. A modular retention device secures the cannula to the patient. The retention device includes a nasal strip coupled to the cannula and attachable to the patient's nose, and a headgear strap including a clip configured to receive the cannula. The cannula can be secured to the patient using either the nasal strip or the headgear strap.

[0039] In some embodiments, the retention device for the nasal cannula comprises a headgear strap connectable to the nasal cannula and capable of being pulled around the patient's head, the headgear strap having a tension indicator that provides a first indication when the tension is at an incorrect value and a second indication when the tension is at a correct value.

[0040] In some embodiments, a retention device for a nasal cannula includes headgear straps connectable to the nasal cannula. At least one strap extends around the patient's head from one side of the cannula to the other. A tension adjuster applies tension to the headgear straps by varying the effective length of at least one strap by reeling in a portion of the at least one strap.

[0041] In some embodiments, a headgear strap for a nasal cannula includes a first portion connectable to the nasal cannula and a second elastic portion positioned at the rear of the patient's head in use, with a pad extending at least partially along the second elastic portion.

[0042] In some embodiments, the nasal cannula assembly includes a cannula defining a cavity, the cannula having first and second nasal prongs extending from the cannula and communicating with the cavity. A head strap is positioned around the head and above the patient's ears in use. A first arm is coupled to a first side of the cannula and a second arm is coupled to a second side of the cannula. An upper end portion of each of the first and second arms is attached to the head strap.

[0043] In some embodiments, the nasal cannula system includes a cannula defining an open cavity, with first and second nasal prongs extending from the cannula and communicating with the cavity. A manifold is configured to be removably coupled to the cannula, with a portion of the manifold being received within the cavity of the cannula. The manifold has first and second holes that align with the first and second nasal prongs when coupled to the cannula, and the manifold also includes a side opening configured to be coupled to a tube. An inner surface of the cavity of the cannula includes a first mounting portion, and an outer surface of a portion of the manifold includes a second mounting portion. The first and second mounting portions can be configured to engage one another to secure the manifold to the cannula.

[0044] In some embodiments of the nasal cannula system, the first and second attachment portions comprise cooperating portions of a hook-and-loop material fastener. The nasal cannula system can also include an arrangement in which the portions of the cavity and manifold have corresponding symmetrical shapes such that portions of the exterior surface of the manifold can be positioned in multiple orientations within the cavity. In some embodiments, the portions of the cavity and manifold are circular or elliptical in shape. In some embodiments, the first and second attachment portions are substantially planar.

[0045] In some embodiments, the nasal cannula assembly includes a cannula defining a cavity, the cannula including first and second nasal prongs extending from the cannula and in communication with the cavity. The cannula includes first and second outer surfaces that are substantially planar and extend along a length of the cannula. The cannula also includes a first end and a twenty-first end. A retention device is coupled to the cannula and configured to support the cannula on the patient's face. A tube can be coupled to the cannula adjacent either the first or twenty-first end of the cannula and configured to be in communication with the cavity. The cannula has a first position in which the first outer surface contacts the patient's face and the first and second nasal prongs extend into the patient's nares. The cannula has a second position in which the second outer surface contacts the patient's face and the first and second nasal prongs extend into the patient's nares.

[0046] In some embodiments of the nasal cannula system, the cannula has a substantially triangular cross-sectional shape. The nasal cannula assembly can be positioned such that an angle between the first and second nasal prongs and the first exterior surface is substantially the same as an angle between the first and second nasal prongs and the second exterior surface. In some embodiments, the first and second nasal prongs extend outwardly from the cannula at a corner of the substantially triangular cross-sectional shape between the first and second exterior surfaces.

[0047] In some embodiments, the nasal cannula assembly comprises a cannula body defining a cavity, and first and second nasal prongs extending from the cannula and in communication with the cavity. The first and second nasal prongs have a relaxed position in the absence of any substantial external force. An outer portion is configured to be movably coupled to the cannula body and configured to surround at least a portion of the cannula body. The outer portion defines at least one opening through which the first nasal prong extends and includes at least one edge defining the at least one opening. The outer portion is movable relative to the cannula body and the first and second nasal prongs, and the at least one edge is configured to engage the first and second prongs and deflect the first and second prongs from their relaxed positions.

[0048] In some embodiments of the nasal cannula assembly, the cannula body and the outer portion are substantially cylindrical, the outer portion extends around the circumference of the cannula body, and the outer portion can rotate about the cannula body. Each of the first and second nasal prongs can include a flexible base portion configured to allow the angle at which the prongs extend from the cannula body to vary. The at least one opening can include a first opening and a second opening, and the at least one edge can include a first edge and a second edge, the first opening defining a first edge and the second opening defining a second edge. The first nasal prong can extend through the first opening and the second nasal prong extends through the second opening. In some embodiments of the nasal cannula assembly, the outer portion includes a slot and the cannula body includes a protrusion extending into the slot. The protrusion can be configured to move within the slot and the slot can have a sidewall configured to engage the protrusion and limit an amount of movement of the outer portion relative to the cannula body.

[0049] In some embodiments, the nasal cannula system comprises a cannula defining a cavity, and first and second nasal prongs extending from the cannula and in communication with the cavity. A frame portion is configured to support the cannula, and at least one head strap is coupled to the frame portion and positioned around the patient's head in use. The cannula is slidably supported by the frame portion and is movable relative to the frame portion, and the cannula includes an aperture through which the frame portion extends. The cannula system may further comprise a tube support member supported by the frame portion or the head strap, and the tube support member may be configured to support and selectively release the tube.

[0050] In some embodiments of the nasal cannula system, the tube support member is configured to loosely support the tube such that the tube can slide within the support member. The tube support member can include a strap configured to wrap around the tube and a clip configured to couple the strap to a head strap or a frame portion. The frame portion can have a circular or round cross-section and the cannula can move laterally relative to the frame portion and can rotate relative to the frame portion. In some embodiments of the nasal cannula system, the interface between the cannula and the frame portion is a friction fit that allows the cannula to hold its position relative to the frame portion when not being moved by the user. The frame portion can include a plurality of notches configured to provide distinct positions along the frame portion at which the cannula can interact with and support the cannula.

[0051] In some embodiments, the nasal cannula system comprises a cannula defining a cavity, with first and second nasal prongs extending from the cannula and in communication with the cavity. The cannula includes an aperture extending through a portion of the cannula, and a head strap is positioned around the patient's head in use. The aperture of the cannula is configured to receive a head strap such that the head strap extends through the aperture and supports the cannula, and the cannula is configured to slide relative to and reposition along the head strap.

[0052] In some embodiments of the nasal cannula system, the cannula further comprises a planar outer surface configured to contact the patient's face when the first and second prongs are inserted into the patient's nares. The head strap is made of an elastic material and is configured to hold the cannula against the patient's face.

[0053] In some embodiments, the nasal cannula system includes a cannula defining a cavity with at least one nasal prong extending from the cannula and in communication with the cavity. The cannula includes a first slot and a second slot. A first rim portion is configured to be slidably received by the first slot of the cannula, and a second rim portion is configured to be slidably received by the second slot. At least one head strap is coupled to the first and second rim portions and is positioned around the patient's head in use. The cannula is slidably supported by the first and second rim portions, and the cannula is selectively movable relative to the first and second rim portions.

[0054] In some embodiments of the nasal cannula system, the cannula includes a side opening configured to receive a feeding tube, and the first and second rim portions are configured to allow the tube to pass therebetween. The nasal cannula system also includes a tube support member supported by the first and second rim portions and configured to slide relative to the first and second rim portions to position the feeding tube relative to the first and second rim portions. The first and second rim portions can have a circular cross section, and the first and second slots can be configured to retain the first and second rim portions. In some embodiments of the nasal cannula system, the first rim portion is disposed above the second rim portion, and the first and second slots are located on an exterior side of the cannula facing away from the patient. The cannula can include a flat surface facing the patient's face.

[0055] In some embodiments, the nasal cannula system includes a cannula defining a cavity, the cannula including at least one nasal prong extending from the cannula and communicating with the cavity. The cannula includes a slot, and a first rim portion is configured to be slidably received by the slot of the cannula. A second rim portion is fixedly coupled to the cannula. A first dial and a second dial are coupled to both the first and second rim portions, respectively. At least one head strap is coupled to the first and second rim portions and is positioned around the patient's head in use. The cannula is slidably supported by the first rim portion, and the dial can be configured to rotate to move a section of the second rim portion and the cannula relative to the first rim portion. The first and second rim portions can be wires coated with a soft material. In some embodiments, the second rim portion is located above the first rim portion when the patient wears the cannula system.

[0056] In some embodiments, a retaining device for a nasal cannula includes a band configured to extend around a patient's head and a first arm pivotally coupled to the band at a first joint. A second arm is pivotally coupled to the first arm at a second joint and may be connectable to the nasal cannula at a third joint. The first joint, second joint, and third joint are configured to allow three dimensional movement and to maintain the relative positions of the band, first arm, second arm, and cannula unless moved by a user.

[0057] In some embodiments of the retention device, the band includes a stabilizing portion that is wider than the band and configured to contact the patient's head. The third fitting can be coupled to a side of the cannula. In some embodiments, the first fitting, the second fitting, and the third fitting are ball joints.

[0058] In some embodiments, the nasal cannula system includes a cannula defining a cavity and at least one nasal prong extending from the cannula and in communication with the cavity. The cannula includes a slot and has a clip portion extending from the cannula. A frame is configured to support the cannula and to be coupled to a head strap. The frame includes an opening configured to receive the clip portion of the cannula, and the clip portion may be movable within the opening such that the cannula can assume different positions relative to the frame while supported by the frame.

[0059] In some embodiments of the nasal cannula system, the cannula is disposed between the frame and the patient's face when in use. The frame can include at least one pad member disposed to contact the patient's face when in use. In some embodiments, an interface between the clip portion and the frame opening allows the cannula to move laterally and rotate relative to the frame. The cannula system can also further include a head strap coupled to the frame and a tube support member supported by the head strap or the frame.

[0060] In some embodiments, the nasal cannula system includes a cannula defining a cavity and at least one nasal prong extending from the cannula and communicating with the cavity. The cannula has a first end portion and a second end portion. A first corrugated tube section is coupled to the first end portion of the cannula and a second corrugated tube section is coupled to the second end portion of the cannula. The position of the cannula relative to the patient's face can be adjusted by expanding and compressing the first and second corrugated tube sections. In some embodiments, the cannula system also includes a first non-corrugated tube coupled to the first corrugated tube section and a second non-corrugated tube coupled to the second corrugated tube section. The first and second corrugated tube sections can be backed by a head strap.

[0061] In some embodiments, a prong arrangement for a nasal cannula includes a prong including a first prong portion including a first slot and a second prong portion including a first flange. The second prong portion is coupled to the first prong portion, and the first flange extends longitudinally within the first slot. The first and second prong portions are configured to extend away from the cannula and define a passageway, and the first flange is movable within the first slot such that the first and second prong portions can be moved toward and away from each other to adjust an outer dimension of the prong.

[0062] In some embodiments of the prong device, the first and second prong portions each include a sealing member adjacent the cannula, the sealing members being configured to overlap and slide relative to one another. The prongs can further include a size indicator configured to indicate a relative outer dimension of the prongs. In some embodiments, the prongs include a second slot and a second flange, the second flange extending longitudinally within the second slot. The first slot can include two side walls configured to limit the extent to which the first flange can move within the first slot.

[0063] In some embodiments, a prong apparatus for a nasal cannula includes a prong with a first foldable portion configured to be coupled to a cannula. The first foldable portion includes a first passageway. A second foldable portion is coupled to the first foldable portion and has a second passageway. A third foldable portion is coupled to the second foldable portion and has a third passageway. The first foldable portion, the second foldable portion, and the third foldable portion are configured to collapse and expand telescopically relative to one another such that the height of the prongs can be adjusted.

[0064] In some embodiments of the prong device, the third foldable portion includes an upper edge configured to form a seal with the patient's nares. An outer dimension of the third foldable portion can be greater than an outer dimension of the second foldable portion, and an outer dimension of the second foldable portion can be greater than an outer dimension of the first foldable portion. The first passageway, the second passageway, and the third passageway can be coaxial.

[0065] In some embodiments, a prong apparatus for a nasal cannula includes a cannula defining a cavity, the cannula including a slot. A first prong extends from the cannula and is fixed relative to the cannula. A second prong extends from the cannula through the slot and is movable relative to the cannula. The second prong can be moved within the slot to adjust the distance between the first prong and the second prong.

[0066] In some embodiments of the prong device, the second prong includes a pin and the slot includes a plurality of notches, the notches configured to receive the pin as the second prong moves to distinct positions within the slot. In some embodiments, the second prong can include a rib extending from a base of the prong and the slot can include a plurality of grooves configured to receive the rib. In some embodiments, the second prong includes a tab having a plurality of notches, the notches configured to engage an edge of the slot such that the second prong can be held in a plurality of distinct positions relative to the slot.

[0067] In some embodiments, a prong for a nasal cannula comprises a membrane having a substantially cylindrical shape and a plurality of ribs coupled to the membrane around its circumference. The membrane and ribs expand outwardly when gas flow through the prongs increases, causing the outer diameter of the prongs to increase to form a seal with the patient's nares. In some embodiments, the ribs are substantially fixed and do not flex or move relative to one another.

[0068] In some embodiments, the nasal cannula system includes a cannula defining a cavity and at least one nasal prong extending from the cannula and in communication with the cavity. A support member is coupled to the cannula and configured to support the cannula. The support member is configured to extend upwardly from the cannula around the patient's nose when in use. The support member includes a bendable material that can be shaped to contact an upper portion of the tip of the patient's nose and to correspond to the shape of the patient's face.

[0069] In some embodiments, the nasal cannula system also includes a head strap configured to wrap around the patient's head, the head strap being removably coupled to the support member at one end and adjustably coupled to the support member at the other end. In some embodiments, the bendable material is a metallic material and is located at an upper portion of the support member. The support member can include an attachment portion having a plurality of notches, and the cannula can include an aperture configured to receive the attachment portion. The notches can be configured to interact with the aperture to couple the support member to the cannula and allow adjustment of the support member relative to the cannula. In some embodiments, the cannula includes a first tube extending from one side of the cannula and a second tube extending from the other side of the cannula, and the support member is coupled to the first tube and the second tube of the cannula. The first tube can be supported by a first padded member, the second tube can be supported by a second padded member, and the first padded member and the second padded member can be configured to abut against the patient's face. In some embodiments, the nasal cannula system also includes a head strap coupled to the first and second padded members and configured to extend around the patient's head. The first and second tubes can be detachable from the cannula such that the cannula can be removed and rotated relative to the remainder of the system.

[0070] In some embodiments, a tubing apparatus for a nasal cannula system includes a cannula tube having an outer wall and an opening, the tube having a longitudinal axis, the outer wall comprising a thin material that is folded or rolled and sealed at an angle.

[0071] In some embodiments of the tube device, the outer wall is made from a fabric that provides thermal insulation. The tube device embodiments can also include a spring extending into the outer wall. The cannula tube can also be coupled to a connector at its opening, and the connector can include a valve. In some embodiments, the cannula tube further includes an extruded tube extending into the outer wall. The outer wall can include a tab with one or more holes configured to be coupled to a head strap. In some embodiments, the outer wall is made from a thermal insulating material, the spring extends into the outer wall, and the breathing tube extends into the spring.

[0072] In some embodiments of the tube device, the outer wall is made of an insulating material, the breathing tube extends within the outer wall, the spring extends within the breathing tube, and at least the pressure line tube extends within the outer wall in addition to the breathing tube. Some embodiments also include a breathing tube within the outer wall, the breathing tube having a cannula portion with at least one prong extending therefrom, the cannula tube being flexible so that it can be curved around the patient's face. Each end of the cannula tube can include a tab with a hole configured to receive a pin located on the head strap. Each end of the cannula tube can include a connector configured to receive an inhalation tube connector, each connector including a valve. In some embodiments, the outer wall is made of a breathable material.

[0073] In some embodiments, a tubing apparatus for a nasal cannula system comprises a tube with an outer wall and an opening. The tube has a longitudinal axis, the outer wall comprises a folded or rolled thin material, the outer wall including one or more cutouts extending therethrough. In some embodiments, the one or more cutouts include a tab that can be pulled away from the tube, the tab configured to engage a support device for suspending the tube.

[0074] In some embodiments of the tube device, the tab includes a hole configured to receive a hook or hanger. The cutout portion can include a slot that defines a portion of material that can be pulled away from the tube while remaining connected on two sides, and the pulled away material can form a hook portion that can engage a hanger. In some embodiments, the cutout portion can include two tabs that can be pulled away from the tube, the ends of the tabs being configured to be coupled to each other or to another structure. The tube can also include an inner tube and a spring within the inner tube.

[0075] In some embodiments, a cannula tubing apparatus for a nasal cannula system includes a tube having an outer wall, the outer wall including a membrane having a first edge and a second edge. The membrane is folded or rolled and the first edge and the second edge are sealed together. A bead is located on the outer wall and configured to provide structural support to the tube.

[0076] In some embodiments of the cannula tube device, the bead includes a cannula portion configured to receive a cannula with the prongs, the cannula portion includes two holes extending through the membrane. The tube can include a first end and a twenty-first end portion, and the first end and the twenty-first end can be coupled to a connector having a valve. In some embodiments, the first end and the second end can each include a tab with a hole configured to be coupled to a head strap. In some embodiments, the first and second edges of the membrane are heat sealed to form a tube. The bead can be printed or extruded on the exterior wall. The bead can have a pattern configured to create a bend region along the tube length. In some embodiments, the bead is on the inside of the tube. The bead can include a thermal element and a structural element printed on the membrane. In some embodiments, the first edge can overlap the second edge, and the first and second edges can extend into the tube.

[0077] In some embodiments, a cannula tubing apparatus for a nasal cannula system includes a tube having an outer wall. The outer wall includes a plastic film having a first edge and a second edge. A substantially planar sidewall is coupled to the outer wall, and a bead is located on the other wall and configured to provide structural support to the tube. The first edge is coupled to the sidewall and the second edge is also coupled to the sidewall, such that a cavity exists between the outer wall and the sidewall. In some embodiments, the first edge and the second edge are heat sealed to the sidewall, and the sidewall is made from a fabric material.

[0078] In some embodiments, the cannula tubing arrangement includes a spring having a length and a cross-section having at least one substantially planar surface. A tube surrounds the spring and defines a passageway through which gas can pass. At least one nasal prong is coupled to the tube and in communication with the passageway.

[0079] In some embodiments of the cannula tube apparatus, the spring has a V-shaped or triangular cross-section. The spring can comprise a thin folded sheet of metal with cutouts along the length of the spring. The spring includes a middle section and first and second ends, and the cross-section of the middle section can be smaller than the cross-sections at the first and second ends. In some embodiments, the spring is a coil spring with a triangular cross-section. The spring can be a helical wire with a bent end extending in the direction of the third side. The spring can also have a substantially triangular cross-section with a curved surface. In some embodiments, the spring has a cross-section shaped like a semicircle.

[0080] In some embodiments, the cannula breathing tube apparatus includes a tube made at least partially from a foam material, the tube having a length and a substantially planar surface extending along the length of the tube and defining a passageway, and a spring extending within the passageway and along the length of the tube and configured to prevent kinking of the tube.

[0081] In some embodiments of the cannula tube apparatus, the tube includes a cavity extending along the length of the tube and a moldable rod extending through the cavity. In some embodiments, the foam material is a closed cell foam material. The tube can include a slot extending along the length of the tube, the slot configured to receive a coupling member. In some embodiments, the coupling member is a mushroom head member configured to slide within the slot.

[0082] In some embodiments, the cannula tube apparatus comprises a tube having a length, the tube having a substantially planar surface extending along the length of the tube, the tube defining a passageway and having an interior surface, the tube including at least one rib located on the interior surface and extending along the length of the tube, the at least one rib configured to provide structural support and prevent kinking of the tube.

[0083] In some embodiments of the cannula tube arrangement, the at least one rib comprises a plurality of ribs on an inner surface. The tube has a rectangular cross-section and can include a fabric material surrounding the tube. In some embodiments, the tube has a substantially triangular cross-section, and in other embodiments, a substantially semicircular cross-section.

[0084] In some embodiments, the cannula tube apparatus includes a cannula tube defining a passageway and having an end. A connector is coupled to the end of the cannula tube, and a support tube is configured to be coupled to the connector of the cannula tube. A wire configured to transfer heat extends from the supply tube. The cannula tube is configured to receive the wire within the passageway, and the wire is configured to transfer heat within the cannula tube.

[0085] In some embodiments of the cannula tube arrangement, the wires are insulated and bendable so that they can conform to the shape of the cannula tube. The wires can be sufficiently stiff to support the cannula tube.

[0086] In some embodiments, the cannula and tubing apparatus includes a cannula tube having a length and defining a passageway. A heating element extends along the length of the cannula tube and is configured to transfer heat to gas passing through the cannula tube. The cannula includes at least one nasal prong and is coupled to the cannula tube.

[0087] In some embodiments of the cannula and tube apparatus, the heating element is a coiled wire extending into the cannula tube. The cannula tube can include an end and an electrical connector coupled to the end of the cannula tube. In some embodiments, the electrical connector is also a tube connector configured to attach a second tube to the cannula tube. The heating element can be surrounded by a thin film. In some embodiments, the heating element comprises two wires coupled to a conductive polymer, the two wires configured such that a voltage can be applied through the polymer to generate heat. In some embodiments, the heating element is configured to provide structural support to the cannula tube. In some embodiments, the heating element is wrapped around an exterior surface of the cannula tube.

[0088] In some embodiments of the cannula tube arrangement, the heating element comprises a membrane having a conductive strip, the membrane wrapped around the cannula tube, and the conductive strip configured to generate heat when an electrical current passes through it. In some embodiments, the heating element is made of a positive temperature coefficient material configured to have a resistance that increases with temperature such that a constant voltage power source can be used to power the heating element. In some embodiments, the cannula tube is made of a flexible and lightweight material and is coupled to a connector, the connector is coupled to a tube that is less flexible and heavier than the cannula tube, and the heating element extends along substantially the entire length of the cannula tube and the tube. The connector can include an opening configured to receive a temperature sensor, and the cannula tube can be configured to be removably attached to the cannula.

[0089] In some embodiments, the cannula tube arrangement includes a cannula tube having a length and defining a first passageway. The cannula tube has an outer surface and a spiral tube is wrapped around the outer surface of the cannula tube. The spiral tube defines a second passageway and has an inner wall adjacent the cannula tube and an outer wall facing away from the cannula tube. A first opening extends through the cannula tube and through the inner wall of the spiral tube such that gas flowing inside the cannula tube can enter the spiral tube through the first opening.

[0090] In some embodiments of the cannula tube apparatus, the spiral tube includes a second opening extending through an outer wall of the spiral tube, allowing gas flowing within the spiral tube to escape to the surrounding environment. In some embodiments, the second opening is located at an opposite end of the cannula tube from the first opening.

[0091] In some embodiments, the cannula tube apparatus includes a cannula tube having a length and defining a passageway, the cannula tube having an outer portion, the outer portion including a textile material and a heating element knitted or woven within the textile material, the heating element configured to transfer heat to gas passing through the passageway.

[0092] In some embodiments of the cannula tube arrangement, the heating element is a wire configured to generate heat when an electrical current is passed through it, hi some embodiments, the heating element is made from a semi-rigid material that provides structural support to the cannula tube.

[0093] In some embodiments, a manifold for a cannula assembly includes a manifold body having an inlet opening and including a connector portion configured to receive a tube. The manifold also includes a port configured to facilitate measuring a pressure of the gas flow, and an outlet portion configured to be in fluid communication with the port and configured to be coupled to a pressure sensor.

[0094] In some embodiments of the manifold, the port is a static pressure valve located on an inner wall of the manifold that is substantially parallel to the bulk direction of gas within the manifold. In some embodiments, the port is a total pressure port oriented in the bulk flow direction and configured to measure a combination of static and dynamic pressures. In some embodiments, the port includes a shroud and is oriented in the bulk flow direction.

[0095] In some embodiments, the nasal cannula assembly includes a cannula defining a cavity, the cannula including first and second nasal prongs extending from the cannula and in fluid communication with the cavity. The cannula also includes an opening. A valve is supported within the opening and configured to form a seal when nothing is inserted therein. The cannula and valve are configured to allow a tube to extend through the valve into the cavity and through the second nasal prong.

[0096] In some embodiments of the nasal cannula assembly, the valve is located substantially below the second prong. The valve can be configured to form a seal around a tube extending therethrough. In some embodiments, the valve is a duckbill valve. The embodiments of the nasal cannula assembly can further include a removable cover coupled to an exterior surface of the cannula and covering the opening. The cannula includes two openings and two corresponding valves, each of the valves configured to receive either a cannula tube or a nasogastric tube. In some embodiments, the cannula includes a first side and a second side, one of the valves located on each of the first side and the second side. In some embodiments, the second prong is removable from the cannula.

[0097] In some embodiments, the nasal cannula assembly includes a cannula defining a cavity, the cannula including a first nasal prong extending from the cannula and in communication with the cavity. The cannula includes a first groove and the first prong includes a second groove. The first groove is aligned with the second groove such that a portion of a tube can extend through the first and second grooves and is directed into the patient's nostril.

[0098] In some embodiments of the nasal cannula assembly, the first and second grooves are configured to accommodate a nasogastric tube. The first prong can include an outer surface, and the second groove can be located on the outer surface of the first prong and extend longitudinally relative to the first prong. In some embodiments, the cannula includes a second prong and a third groove, and the second prong includes a fourth groove, and the third and fourth grooves are aligned such that a portion of the tube can extend through the third and fourth grooves and is directed into the patient's nares.

[0099] In some embodiments, the nasal cannula can include nasal prongs having an outer wall and an end. The outer wall includes a cutout portion defining a flap that can be pressed into the prong to form an opening in the outer wall of the prong. The opening is configured to receive a tube such that the tube can extend through the opening and out the end of the prong.

[0100] In some embodiments of the nasal cannula, the outer wall defines a passageway and the flap is configured to close the passageway when the tube is inserted into the opening. In some embodiments, the flap is configured to align with the outer wall and form at least a substantial seal when the tube is not inserted into the opening. The prong may also include a slit extending from the cutout portion to an end of the prong, the slit configured to selectively allow the tube to pass through the slit.

[0101] In some embodiments, the nasal cannula assembly includes a cannula defining a cavity, the cannula including a first nasal prong extending from the cannula and in communication with the cavity. The cannula includes an aperture and a valve supported within the aperture. An inner member is supported within the cavity and is movable relative to the cannula. The inner member includes an aperture configured to receive a tube. The aperture is disposed substantially below the first nasal prong, and the inner member can be moved such that the aperture is aligned with the valve such that the tube can extend through the valve and aperture into the first prong.

[0102] In some embodiments of the nasal cannula assembly, the cannula includes a second opening having a second valve disposed substantially below the second nasal prong, and the inner member includes a second aperture that can align with the second valve and the second prong. In some embodiments, the inner member is substantially cylindrical and configured to be coupled to a supply tube. The valve can be configured to form a seal when nothing extends through it.

[0103] In some embodiments, the nasal cannula assembly includes a cannula body having a first slot and a second slot. The assembly also includes a first sliding portion having a first prong coupled to the first tube and a second sliding portion having a second prong coupled to the second tube. A portion of the first sliding portion is configured to slide within the first slot and a portion of the second sliding portion is configured to slide within the second slot. The first prong and the second prong are movable relative to the cannula body such that each of the first prong and the second prong can be adjusted relative to the cannula body. In some embodiments, the first slot and the second slot extend substantially horizontally and are disposed side-by-side on the cannula body.

[0104] In some embodiments, the nasal cannula assembly includes a cannula defining a cavity, the cannula including a first nasal prong extending from the cannula and in communication with the cavity. The assembly also includes a slider member engaging an exterior surface of the cannula, the slider member configured to move relative to the cannula. The slider member is configured to selectively move along the exterior surface of the cannula and over the first nasal prong.

[0105] In some embodiments of the nasal cannula assembly, the slider member includes a groove configured to receive a portion of the tube. In some embodiments, the first nasal prong is flexible and capable of folding under the slider member when the slider member is moved over the first nasal prong.

[0106] In some embodiments, the nasal cannula assembly includes a cannula defining a cavity, the cannula including a single nasal prong extending from the cannula and in communication with the cavity. The assembly also includes a strap configured to support the prong and engage the patient's face. The strap includes an adhesive material configured to selectively couple the strap to the patient's face. The strap includes an opening through which the prong extends, and the strap is configured to extend from below and above the patient's nose along a side of the patient's nose.

[0107] In some embodiments of the nasal cannula assembly, the strap includes at least one slot configured to receive the tube. In some embodiments, the strap includes holes positioned to align with the patient's nares when in use. The prongs can include corrugations configured to allow the prongs to bend and change shape. In some embodiments, the prongs include a tapered base portion configured to form a seal with the patient's nares. In some embodiments, the cannula is coupled to a tube, the tube including a support member configured to support the tube and to be selectively coupled to the patient's face. The support member can also include a support portion configured to receive and support the nasogastric tube. The nasal cannula embodiments can further include a cheek pad configured to attach to the patient's cheek and to be selectively coupled to the support member. In some embodiments, the prongs include a tapered base portion that narrows toward the top and widens toward the bottom, the prongs including a recess below the tapered portion, the recess configured to hold a portion of the strap adjacent the opening.

[0108] In some embodiments, the nasal cannula assembly includes a cannula defining a cavity, the cannula including a single nasal prong extending from the cannula and in communication with the cavity. The assembly also includes a frame having a bridge portion extending away from the patient's face, the bridge portion creating a space between the bridge portion and the patient's face. The bridge portion is configured to support the cannula, the bridge portion including a slot, and a portion of the cannula can move within the slot. A tube is coupled to the cannula and extends from a bottom portion of the cannula. The tube is configured to extend from an underside of the cannula and bend upward to extend over the frame.

[0109] In some embodiments of the nasal cannula assembly, the cannula is supported by the frame and is disposed substantially within a space between the bridge portion and the patient's face when the cannula assembly is in use. In some embodiments, the bridge portion of the frame includes a cutout portion configured to receive a portion of the tube. In some embodiments, the cannula includes a grip portion extending through the slot. The frame can include a pad configured to contact the patient's face when in use. In some embodiments, the frame includes one or more openings configured to receive a head strap. In some embodiments, the bridge portion includes tube arms that define a tube recess through which the tube can at least partially extend.

[0110] In some embodiments, the nasal cannula assembly includes a cannula frame having an upper extension portion having a single prong and a prong opening in communication with the prong. The assembly also includes a retainer portion coupled to the extension portion and having a retainer opening aligned with the prong opening. The assembly also includes a manifold pivotally coupled to the retainer portion, the manifold having a manifold opening aligned with the retainer opening and the prong opening. The manifold is configured to pivot relative to the cannula frame about an axis of the manifold opening, and gas can pass through the manifold into the prong.

[0111] In some embodiments of the nasal cannula assembly, the cannula frame includes a lower extension portion and the retainer portion includes a lower portion that engages with a bottom portion of the manifold. In some embodiments, the bottom portion of the manifold includes a pin and the lower portion of the retainer portion includes a hinge recess, the pin is configured to be received within the hinge recess, and the manifold is configured to pivot about the pin. In some embodiments, the manifold is configured to rotate approximately 180 degrees relative to the cannula frame to allow tubing coupled to the manifold to exit in opposite directions.

[0112] In some embodiments, the nasal cannula assembly includes a cannula frame having an upper extension portion. The upper extension portion has a single prong and a prong opening in communication with the prong. The upper extension portion also has a bottom side. The assembly includes a tube rotatably coupled to the bottom side of the upper extension portion and in communication with the prong such that gas can enter the prong from the tube through the prong opening. The tube is configured to bend and rotate relative to the cannula frame.

[0113] In some embodiments, the nasal cannula assembly includes a cannula defining a cavity with a single nasal prong extending from the cannula and in communication with the cavity. The assembly includes a cable configured to slidably support the cannula and a tube coupled to the cannula and configured to provide gas to the cavity. The position of the cannula can be adjusted by sliding the cannula along the cable.

[0114] In some embodiments of the nasal cannula assembly, the tube is tapered such that its cross section is narrower closer to the cannula. Some embodiments further comprise an attachment portion coupled to the cable and configured to receive a portion of the tube. In some embodiments, the tube includes an attachment member configured to engage and be coupled to the attachment portion. In some embodiments, the cable can include a recessed portion configured to hold the cannula in a selected position.

[0115] In some embodiments, a nasal cannula assembly includes a cannula frame having a bridge portion extending away from a patient's face, the bridge portion creating a space between the bridge portion and the patient's face. The bridge portion supports a single nasal prong. The assembly includes a first tube coupled to and extending downwardly from the prong. The cannula frame defines a recess through which a second tube can extend between the bridge portion and the patient's face when in use.

[0116] In some embodiments of the nasal cannula assembly, the bridge portion includes a cutout portion configured to receive a portion of the first tube and bend the tube to extend away from the assembly toward the patient, hi some embodiments, the cannula rim includes a contact portion configured to contact the patient's face and including a soft material.

[0117] In some embodiments, the nasal cannula assembly includes a cannula defining a cavity, with a single nasal prong extending from the cannula and in communication with the cavity. The cannula has a cannula opening in communication with the cavity, the opening having an axis. The assembly also includes a manifold pivotally coupled to the cannula and configured to pivot about the axis of the cannula opening. The assembly also includes a tube coupled to the manifold and configured to supply gas to the manifold. The manifold includes a manifold opening aligned with the cannula opening and in communication with the cavity.

[0118] In some embodiments of the nasal cannula assembly, the cannula includes a rim portion extending outwardly from the cannula, the rim portion forming one or more recesses between the cannula and the patient's face when in use, the one or more recesses configured to receive the second tube. In some embodiments, the cannula includes a soft material on a side of the cannula that faces the patient when in use. In some embodiments, the cannula includes a recess on each side of a prong, allowing the second tube to extend between the manifold and the cannula.

[0119] For the purpose of summarizing the present disclosure and the advantages achieved over the prior art, certain objects and advantages are described herein. Of course, it is understood that not all such objects or advantages need to be achieved in accordance with any particular embodiment. Thus, for example, one skilled in the art will understand that the present disclosure can be embodied or carried out to achieve or optimize one advantage or group of advantages as may be taught or suggested herein, without necessarily achieving other objects or advantages as may be taught or suggested herein. All of these embodiments are intended to be within the scope of the disclosure of this specification. These and other embodiments will be readily apparent to those skilled in the art from the following detailed description, with reference to the accompanying figures. The present disclosure is not limited to any particular disclosed embodiment(s).

[0120] In some embodiments, the nasal cannula assembly comprises: a cannula component comprising a pair of tubular nasal prongs for insertion into the patient's nares and a manifold in fluid communication with the nasal prongs, the manifold comprising an opening at a left end thereof and an opening at a right end thereof; a connector adapted to receive an end of a gas flow conduit and to be removably received in an opening at a left end of the manifold and an opening at a right end of the manifold; a plug adapted to be removably received in an opening at a left end of the manifold and an opening at a right end of the manifold; Equipped with In use, the connector or plug fits into one of the left and right openings of the manifold and the plug fits into the other of the left and right openings of the manifold, thereby configuring the conduit to extend from either the left or right side of the nasal cannula assembly.

[0121] Preferably, the plug and the connector are separate components.

[0122] Preferably, the plug and connector are joined or attached to one another by a transverse member to form a clip, optionally the transverse member is a connecting portion.

[0123] Preferably, the clip is an integrally formed, unitary member.

[0124] Preferably, the clip and cannula part are complimentary adapted such that, in use, the transverse members are resiliently biased to mate the clip with the cannula part.

[0125] Preferably, the clip fits onto the cannula parts by forcing the clip onto the cannula parts in a direction perpendicular to the lateral direction of the cannula.

[0126] Preferably, the cannula component includes a rigid member that interfaces with the clip, and the prongs are formed from a resilient material attached to the rigid member.

[0127] Preferably, the rigid member and the lateral member are adapted such that when the clip is attached to the cannula part, the lateral member flexes to spread the plug and connector apart.

[0128] Preferably, the clip is substantially "C" or "U" shaped.

[0129] Preferably, the plug and connector each extend into an opening at the end of the manifold.

[0130] Preferably, the clip provides a positive force against the manifold to grip the manifold between the plug and the connector.

[0131] Preferably, the cannula part includes a recessed portion sized and shaped to receive the transverse member.

[0132] Preferably, the manifold and the cannula components including the nasal prongs are integrally formed.

[0133] Preferably, the elastic material is overmolded onto the rigid material.

[0134] Preferably, the cannula part includes a side arm, the rigid member extending along the side arm.

[0135] Preferably, the rigid part includes a through hole in the side arm through which the elastic material extends by an overmolding or assembly process.

[0136] Preferably, the rigid member includes a recessed portion sized and shaped to receive the transverse member.

[0137] Preferably, the openings at the ends of the manifold are formed in the rigid member.

[0138] Preferably, the transverse members are length adjustable.

[0139] Preferably, the clip comprises a first part and a second part, the first part comprising one of the plug and the connector and the second part comprising the other of the plug and the connector, the first part comprising a first transverse member and the second part comprising a second transverse member; The first and second lateral members are coupled to one another in a nested arrangement and include complementary features to set a lateral distance between the plug and the connector.

[0140] Preferably, the complementary feature comprises a projection on one of the first and second parts and a corresponding opening in the other of the first and second parts, the projection being received within the opening to set a lateral distance between the plug and the connector.

[0141] Preferably, one of the first and second parts includes a plurality of corresponding openings, the projection being received in one of the plurality of openings to set a lateral distance between the plug and the connector, and the plurality of openings providing for a range of cannula part sizes.

[0142] Preferably, the clip is movably attached to the cannula part.

[0143] Preferably, the clip is rotatably mounted on the cannula part.

[0144] Preferably, the clip is rotatably coupled to the cannula component at the axis of rotation of the cannula or parallel to the sagittal plane of the cannula to position the conduit on the left or right side of the nasal cannula assembly.

[0145] Preferably, the manifold is formed from a relatively rigid material, the cannula component comprises a resilient material overmolded to the manifold, the nasal prongs are integrally formed with the resilient material, the cannula component comprises a shaft extending from the manifold, and the clip is rotatably mounted on the shaft.

[0146] Preferably, the shaft is integrally formed with the manifold.

[0147] Preferably, the clip is keyed so that the clip can be removably attached to the cannula component.

[0148] Preferably, the cannula part is provided with a flange at the end of the shaft to retain the clip on the shaft in an axial orientation.

[0149] Preferably, the end of the manifold is curved with a centre of curvature at the axis of rotation, and the plug and connector each have a complementary curvature so that the clip can rotate on the axis of rotation to position the connector on either end of the manifold.

[0150] Preferably, an overmolded elastomeric material covers the ends of the manifold to provide a seal with the plugs and connectors.

[0151] In some embodiments, a nasal cannula assembly includes such an assembly, for example, when a plug and connector are joined or attached together by a lateral member to form a clip, and the clip fits onto the cannula parts by forcing the clip laterally into the manifold through one of the left and right end openings, whereby the connector is received in one of the left and right end openings and the plug is received in the other of the left and right end openings to configure a conduit to extend from either the left or right side of the nasal cannula assembly.

[0152] Preferably, the cannula component includes a rigid member that interfaces with the clip, the prongs are formed from a resilient material attached to the rigid member, and the cannula component and rigid member each include a side arm extending laterally from the manifold.

[0153] In some embodiments, the nasal cannula assembly comprises: a cannula component comprising a pair of tubular nasal prongs for insertion into the patient's nostrils; a connector adapted to receive an end of a gas flow conduit; a manifold attached to or integrally formed with the connector, the connector providing an inlet to the manifold, the manifold having at least one outlet; Equipped with The cannula component is movably mounted to the manifold so as to be mounted to the manifold in two orientations, configuring the conduit to extend from either the left or right side of the nasal cannula assembly.

[0154] Preferably, the cannula part is rotatable relative to the manifold about a substantially vertical axis.

[0155] Preferably, the manifold has an open top where the manifold exits, and the cannula part fits over the open top such that the prongs communicate with the connector.

[0156] Preferably, the manifold includes a lip on the surface of the manifold to which the cannula component connects.

[0157] Preferably, an axis extends from either the manifold or the cannula part, the cannula part rotating relative to the manifold on the axis.

[0158] In some embodiments, the nasal cannula assembly comprises: a cannula component comprising a pair of tubular nasal prongs for insertion into the patient's nares and left and right lateral side arms for attachment of headgear; a first conduit for providing a flow of gas to one of said nasal prongs, and a second conduit for providing a flow of gas to the other of said nasal prongs; a first fitting for connecting a first conduit to the nasal prong and a second fitting for connecting a second conduit to the other of the nasal prongs, the first fitting and the second fitting being adapted to enable the first conduit and the second conduit to be defined on a left or right side of the nasal cannula assembly; a left clip for the left lateral side arm and a right clip for the right lateral side arm; Equipped with In use, the first conduit is held by the left or right clip to configure the first conduit to extend from either the left or right side of the nasal cannula assembly, and the second conduit is held by the left or right clip to configure the second conduit to extend from either the left or right side of the nasal cannula assembly.

[0159] Preferably, the cannula part is an integrally formed part.

[0160] Preferably, each fitting is a flexible tube adapted to bend at least 90 degrees in any direction without substantial occlusion.

[0161] Preferably, the flexible tube is provided with circumferentially extending ribs to prevent bending of the flexible conduit section from collapsing the flexible conduit section.

[0162] Preferably, each joint is a swivel joint.

[0163] Preferably, each swivel joint rotates on an axis that is angled relative to the axis of the corresponding nasal prong, whereby rotation of the swivel joint allows both conduits to be passed to the left or right side without overlapping.

[0164] Preferably, each swivel joint is a swivel elbow.

[0165] Preferably, each said clip comprises two channels or receptacles, one for each of the tubes.

[0166] Preferably, each flexible tube is integrally formed with a nasal prong.

[0167] Preferably, each clip is integrally formed with said side arm.

[0168] With respect to the above embodiments, reference to a manifold may be to an open cavity formed by a cannula part, such as a cannula body, and in such an embodiment, the connector forms a component to engage the open cavity, and the connector forms a flow path for delivering gas to the open cavity. Such an embodiment is also described below.

[0169] In some embodiments, the nasal cannula system comprises: a cannula body defining an open cavity and including at least one nasal prong extending from the cannula in communication with the cavity; a manifold comprising a manifold body capable of receiving a gas delivery tube, the manifold body being attachable to the cannula in a first position and a second position, the second position being different from the first position; Equipped with An end of the manifold body projects into the open cavity of the cannula body, and the cannula body includes a recess for retaining the manifold body.

[0170] Preferably, the manifold comprises a first lateral portion and a second lateral portion extending from the manifold body and adapted to be attached to headgear.

[0171] Preferably, the recess in the cannula body retains the first and second lateral portions of the manifold.

[0172] Preferably, one end of the manifold comprises a cap, the cap comprising a hinge region dividing the cap into inner and outer regions connected by a band, the hinge region permitting relative movement between the inner and outer regions at the band.

[0173] In some embodiments, the nasal cannula comprises: a cannula body defining an open cavity and including at least one (preferably a pair of) nasal prongs extending from the cannula in fluid communication with the open cavity; a manifold comprising a manifold body engageable with a cannula in fluid communication with the open cavity, the manifold body being orientable in either a first operating position or a second operating position, the first operating position and the second operating position being distinct from one another; Equipped with The manifold body is adapted to receive a gas supply conduit at a first end of the manifold body or at a gas inlet to the manifold body, the first end being adapted to engage one end of the open cavity to deliver gas into the open cavity, and the second end of the manifold body being adapted to form a seal or connection with the other end of the open cavity, the manifold body forming a housing for the open cavity.

[0174] Preferably, the cannula body includes at least one recess or at least one surface relief or area to engage and retain the manifold body in either the first or second operative position.

[0175] Preferably, the first and second ends of the manifold body are connected to one another, the first end providing a gas inlet to the open cavity and the second end providing a plug or cap to substantially seal the open cavity and provide a fluid delivery path for supply gas from the first end of the manifold body into the open cavity to the terminus of at least one nasal prong.

[0176] Preferably, the first and second ends of the manifold body are connected to one another by one or more connecting portions.

[0177] Preferably, the connecting portion is one or more of at least one arm or at least one finger or at least one frame member.

[0178] Preferably, the first and second ends of the manifold body are integrally formed.

[0179] Preferably, either the connecting portion or the cannula body defining the at least partially open cavity, or both, are provided with alignment features adapted to allow a predetermined geometric orientation of the manifold body relative to the cannula body.

[0180] Preferably, the alignment features may be one or more areas of associated male and female components, or one or more areas of associated surface relief.

[0181] Preferably, the alignment mechanism is adapted to provide an audible response to engagement of the manifold with the cannula body when in the engaged operative first position or the engaged operative second position.

[0182] Preferably, the connecting portion of the manifold body connecting the first and second ends to each other extends through an interior region of the open cavity such that, in situ, the first end of the manifold body is adapted to engage one end of the open cavity to deliver gas into the open cavity and the second end of the manifold body is adapted to form a seal or connection with the other end or any remaining portion of the open cavity requiring sealing to enable delivery of gas to the open cavity.

[0183] Preferably, the connecting portion extending through the interior region of the open cavity is shaped or configured to engage or be received by an associated surface or region of the cannula body or an associated surface or region of the cannula body that defines the open cavity.

[0184] Preferably, the connecting portion of the manifold body connecting the first and second ends to one another extends around an outer surface or area of ​​the cannula body that at least partially defines the open cavity, such that, in situ, the first end of the manifold body is adapted to engage one end of the open cavity to deliver gas to the open cavity, and the second end of the manifold body is adapted to form a seal or connection with the other end or any remaining portion of the open cavity, requiring sealing to enable delivery of gas to the open cavity.

[0185] Preferably, the connecting portion extending around the exterior surface or outer region of the cannula body is shaped or configured to engage or be received by an associated surface or region of the cannula body, or an associated surface or region of the cannula body that defines an open cavity.

[0186] Preferably, the gas supply conduit is positioned or disposed substantially around the side or area of ​​the cannula body from which the first end of the manifold body is positioned or protrudes from the cannula body.

[0187] Preferably, the manifold is oriented or orientable relative to the cannula body such that the gas delivery tube is positioned or disposed substantially to one side of the user in use.

[0188] Preferably, the first operating position allows the first end of the manifold body to be positioned at either the left or right end of the cannula bodies defining the open cavity, and the second operating position allows the first end of the manifold body to be positioned at either the respective right or respective left end of the cannula bodies defining the open cavity.

[0189] Preferably, the first or second operating position allows connection of a gas supply conduit to the first end of the manifold body from either the left or right side.

[0190] The cannula body further includes side arms or portions extending away from the cannula body defining an open cavity, each of the side arms or portions adapted to extend at least partially along a portion of the user's face in use.

[0191] Preferably, a nasal cannula as described above comprises a first section formed from a first material and a second section formed from a second material, the first section being relatively softer than the second section.

[0192] Optionally, the embodiments described above in relation to a first section formed from a first material and a second section formed from a second material are repeated here.

[0193] Preferably, the terminal ends of the side arms are adapted to allow engagement therewith by the headgear.

[0194] Optionally, headgear associated with the nasal cannulas described herein may be as defined above in any of the other embodiments as described herein.

[0195] In some embodiments, the nasal cannula system comprises a nasal cannula assembly as defined by any one of the above embodiments, and headgear attached to the nasal cannula assembly for attaching the nasal cannula assembly to a patient's head.

[0196] In some embodiments, there is a system for providing a flow of respiratory gas to a user or patient, comprising a blower, a humidifier, a conduit and a nasal cannula system as defined in the embodiments described herein.

[0197] In some embodiments the headgear comprises: a strap, each end of the strap adapted to be attached to the patient interface and extend around the patient's head to hold the patient interface in place on the patient's face, at least a portion of the strap configured to branch into two or more bands to extend around the patient's head. It is equipped with:

[0198] Preferably, the strap includes a longitudinal weakened section extending along a portion of the strap that can be torn by a user to separate that portion of the strap into two or more bands.

[0199] Preferably, the weakened section comprises a relatively thin section.

[0200] Preferably, the weakened section is a perforated section.

[0201] Preferably, the bands are separated by weakened sections.

[0202] Preferably, the straps include finger holes at the weakened portions to aid in separating the bands by tearing the weakened sections.

[0203] Preferably, the strap includes a hole at the end of the weakened section, the hole including a rounded portion defining the end of the weakened section to prevent tearing of the strap beyond the weakened section.

[0204] Preferably, the holes are finger holes.

[0205] Preferably, at least a portion of the strap is formed from a fabric forming bands, the fabric being coated with a polymer when the bands are placed together, the coating providing a flexible section between the bands, the coating being adapted to be torn to separate the bands.

[0206] Preferably, the bands are formed by longitudinal cuts in the fabric along portions of the strap, with the polymeric coating spanning the cuts to hold the bands together in a non-branching configuration.

[0207] Preferably the fabric is a foam fabric.

[0208] Preferably, the bands are separated by a removable section of a strap that includes a lift tab, the removable section being joined to the bands by a weakened section.

[0209] Preferably, the headgear includes a clasp that is slidable along at least a portion of the strap that is configured to diverge.

[0210] Preferably, the clasp is slidable to the end of the band to branch the straps to separate the bands, and the clasp is slidable to the midpoint of the band to hold the bands together as a single strap.

[0211] Preferably, the clasp is slidable to an end of the band to branch the strap to separate the bands, and the clasp is slidable to the opposite end of the band to hold the bands together as a single strap.

[0212] Preferably, each band includes a feature that interfaces with a corresponding feature on the clasp to bind the bands together when in the undiverged configuration.

[0213] Preferably, the band includes interlocking teeth that are separated or interlocked by sliding the clasp along the band.

[0214] Preferably, the headgear comprises a web extending between the bands, and in the unbranched configuration the web is bundled or folded into an unexpanded configuration, and in the branched configuration where the bands are spaced apart the web is spread or unfolded to cover the areas between the spaced apart bands.

[0215] Preferably, the headgear has two clasps, and in the non-diverging configuration, both clasps slide toward a central position of the strap to hold the bands together, and in the branching configuration, each clasp slides to an end of the band so that the bands can separate between the two ends of the band.

[0216] Preferably, the clasps and straps are complementarily adapted such that moving each clasp to an end of the band pulls the bands apart to separate the bands into a bifurcated configuration.

[0217] Preferably, each clasp comprises two spaced flanges and three pins extending between the spaced flanges, a band extending between the flanges, one said pin being located between the bands and the other two pins being located at the outer edge of the band, the band comprising a cross portion near the end of the band.

[0218] Preferably, the or each band may include a central tab or stop for limiting the amount of clasp movement along the band.

[0219] Preferably, the portions of the straps which are configured to diverge extend from behind the patient's ears and around the back of the patient's head in use.

[0220] Preferably, the ends of the band are pivoted together.

[0221] Preferably, the bands in their non-branched form are arranged edge to edge.

[0222] Preferably, the non-divided bands are arranged side-by-side.

[0223] Preferably, the bands in non-branched form are held together by one or more of a tearable suture, one or more clasps, buttons, clips, hook-and-loop fasteners or magnets.

[0224] In some embodiments, there is headgear to secure the patient interface to the face of a user, the headgear comprising: a strap, each end of the strap attached to the patient interface and adapted to extend around the patient's head to hold the patient interface in place on the patient's face, the strap comprising a non-elastic section and an elastic section, the non-elastic section attached to the patient interface and adapted to support a gas delivery conduit coupled to the patient interface. It is equipped with:

[0225] Preferably, each end of the strap is a non-elastic section adapted to be attached to a patient interface, with the elastic section being a middle section extending between the non-elastic sections around the back of the patient's head.

[0226] Preferably, the non-elastic section is adapted to be attached to one side of the patient interface and the elastic section is adapted to be attached to the opposite side of the patient interface.

[0227] Preferably, the non-elastic section includes a mechanism for securing the conduit.

[0228] In some embodiments, a headgear for securing a patient interface to a face of a user, comprising: a strap comprising a first elastic section adapted to be attached to one side of a patient interface and a second elastic section adapted to be attached to an opposite side of the patient interface, and a non-elastic intermediate section extending between each end of the elastic sections; There is head gear that includes:

[0229] Preferably, the intermediate portion is an annular portion and each of the elastic sections is attached to the annular portion.

[0230] Preferably, the headgear comprises a first non-elastic sleeve and a second non-elastic sleeve each extending from a non-elastic intermediate section, the first elastic section extending along an inner side of the first non-elastic sleeve and the second elastic section extending along an inner side of the second non-elastic sleeve.

[0231] Preferably, the first non-elastic sleeve and the second non-elastic sleeve extend from the intermediate portion to in front of the patient's ear in use.

[0232] Preferably, the first and second non-elastic sleeves are not attached to the first and second non-elastic sleeves along the length of the sleeves from the intermediate portion.

[0233] Preferably, one or both sleeves are adapted to support a gas conduit which provides gas flow to the patient interface.

[0234] Preferably, the headgear comprises a lanyard connected to said sleeve adapted to secure a gas conduit.

[0235] Preferably the lanyard is elastic.

[0236] Preferably, the inelastic middle section is bifurcated to comprise two separate bands.

[0237] Preferably, the non-elastic section is configured to branch into two or more bands to extend around the patient's head.

[0238] Preferably, the headgear comprises a bifurcated section comprising two bands, one said band being a non-elasticated middle section.

[0239] Preferably, the headgear includes a non-elastic "Y" connector connecting between the first elastic section and one end of the two bands, and a second non-elastic "Y" connector connecting between the second elastic section and the opposite ends of the two bands.

[0240] Preferably, one of the two bands is an elastic band.

[0241] Preferably, the upper one of the bands is an elastic band and the lower one of the two bands is a non-elastic band.

[0242] Preferably, the non-elastic band is adjustable in length.

[0243] Preferably, at least one of the bands is adjustable in length.

[0244] Preferably, the upper of the two bands is adjustable in length.

[0245] In some embodiments, there is provided headgear for a patient interface, comprising: The headgear includes an elasticated region and a non-elasticated region, the elasticated region being positioned sufficiently away from the tube loading region.

[0246] In some embodiments, there is a headgear, interface and tube assembly comprising at least one elasticated region and at least one non-elasticated region, the elasticated region positioned sufficiently away from a tube loading region, the elasticated region positioned at the rear of a patient's head in use, and the tubes configured to be attached to either side of the interface.

[0247] In some embodiments, there is a headgear, interface and tube assembly comprising at least one elastic region and at least one non-elastic region, the elastic region being positioned sufficiently away from a tube loading region, the tube loading region being an area where a tube is connected to the headgear or interface.

[0248] In some embodiments, a nasal cannula for administering a source of gas, such as a breathable gas, to a patient (or user), comprising: a first section formed from a first material; a second section formed from a second material; and Equipped with There is a nasal cannula in which the first section is relatively softer than the second section.

[0249] Preferably, the second material is the same as the first material (eg, it may be the same material, but a different grade of such material having different properties, such as a different Shore hardness or other grade).

[0250] Preferably, the second material is different from said first material (eg it may be a different material having different properties such as a different Shore hardness or other rating).

[0251] Preferably, the sections are integrally formed with one another.

[0252] Preferably, the sections are assembled using one or more mechanical fasteners or one or more chemical fastening systems (e.g., adhesives or plastic welding or ultrasonic welding the first and second sections or portions thereof together, etc.).

[0253] Preferably, the first section provides a friendly or comfortable contact component for the user of the nasal cannula.

[0254] Preferably, the second section provides a structural or supportive or shape-defining component of the nasal cannula. Alternatively, the second section does not contact the user in use.

[0255] Preferably, the configuration or shape of the first section is at least partially defined by parts or portions of the second section.

[0256] Preferably, the first section forms a patient contacting surface and the second section forms a frame to which said first section is mounted.

[0257] Preferably, the first section encloses at least a portion of the second section.

[0258] Preferably, the second section is at least partially overmolded by the first section.

[0259] Preferably, the first section is at least one arm or a pair of arms extending outwardly from a central body portion that includes at least one (preferably a pair) nasal prongs.

[0260] Preferably, headgear is connectable to one or each arm and extends substantially around the rear portion of the user's head.

[0261] Preferably, the first section is adapted to receive a manifold connection to deliver a source of gas to a nasal cannula, or a body of the nasal cannula, which in use is in fluid communication with a delivery system that delivers gas to a user, such as via at least one nasal prong (or preferably a pair of nasal prongs) to one or both nostrils of the user.

[0262] Preferably, the second section is adapted to receive a manifold connection to deliver a source of gas to a nasal cannula, or a body of the nasal cannula, which in use is in fluid communication with a delivery system that delivers gas to a user, such as via at least one nasal prong (or preferably a pair of nasal prongs) to one or both nostrils of the user.

[0263] Preferably, the manifold is a component of a relatively rigid material to the first material, and the manifold is connectable to the nasal cannula and associated regions of the body of the nasal cannula.

[0264] Preferably, the first section comprises one or more relief portions, and the relief portion(s) of the first section are engageable with one or more associated correspondingly or complimentary shaped or configured relief portions of the second section.

[0265] Preferably, the first section includes at least one raised area receivable by an associated opening or detent area in the second section.

[0266] Preferably, the first section includes a raised tab or mushroom shaped head and the second section includes an associated opening capable of receiving the raised tab or mushroom shaped head.

[0267] Preferably, the first section comprises a cannula body portion at least partially defining an open cavity capable of receiving a supply of gas directed via the manifold, the open cavity being in fluid communication with one or a pair of nasal prongs.

[0268] Preferably, the first section and the second section are correspondingly or complimentary shaped or configured to jointly receive a manifold connection for delivering the supply gas to be delivered to a user.

[0269] Preferably, the first section is a nasal cannula body that at least partially defines an open cavity.

[0270] Preferably, the second section at least partially surrounds the nasal cannula body defining the open cavity.

[0271] Preferably, the second section supports the first section in a predetermined configuration.

[0272] Preferably, the second section extends substantially around the length of the nasal cannula defined by the first section. Alternatively, the second section extends substantially a greater length of the nasal cannula defined by the first section. In a further alternative, the second section extends a lesser length of said nasal cannula defined by the first section.

[0273] Preferably, the nasal cannula includes a pair of side arms extending outwardly from the cannula body that at least partially define an open cavity capable of receiving a supply gas, such as via a manifold connection.

[0274] Preferably, the connection system for connecting the headgear worn by the user, i.e. in use, is located substantially towards each end of said side arms.

[0275] Preferably, the connection system is part of the second section.

[0276] Preferably, the first section provides a gasket-type seal for a manifold connection or manifold receivable by at least a portion of the first section, such as that which defines the open cavity of the cannula body.

[0277] Preferably, the second section provides a structure against which a manifold connection can be made, and the first section provides a seal, such as a fluidic seal, for the manifold when making such a manifold connection.

[0278] Preferably, the nasal cannula comprises an open cavity engageable by the manifold, a rear portion of the body substantially adjacent the nasal septum area of ​​the user in use, and the rear portion is substantially conformable or deformable in response to pressure applied to the rear portion by the user.

[0279] Preferably, the rear portion is a substantially thinned wall section of the body. The rear portion is defined by a hollow section of the body and the open cavity is a separate and distinct region of the body.

[0280] In an alternative embodiment, the rear portion defines at least a portion of a wall of the open cavity.

[0281] Preferably the rear portion is substantially elastic.

[0282] Preferably, the rear portion is elastically deformable.

[0283] Preferably, the body comprises a hollow housing substantially adjacent the nasal septum region of the user.

[0284] Preferably, the body includes a pillow section substantially adjacent the user's nasal septum region.

[0285] Preferably, the pillow section is a hollow region bounded by a wall of the body and separated from an open chamber (such as a plenum chamber) and having a relatively thin wall or elastic section in a region substantially adjacent the user's nasal septum in use. Alternatively, the pillow section is formed by a rear wall of such an open cavity, the rear wall being a relatively thin wall or elastic section in a region substantially adjacent the user's nasal septum in use.

[0286] Preferably, the pillow section is formed from a material that is capable of deforming when a user applies pressure thereto during use.

[0287] As discussed above, in some configurations or embodiments, the nasal cannula interface may comprise a first section and a second section. The first section may comprise a relatively soft material. The second section may comprise a relatively hard material. Preferably, the first section contacts the patient's face in use and the second section does not contact the patient's face in use.

[0288] The sections can be assembled together by any manufacturing method. In some configurations, the sections can be overmolded, for example, on top of one another. In some configurations, the sections can be affixed together using an adhesive. In some configurations, the sections can be assembled together using ultrasonic welding. In some configurations, the sections can be assembled together using one or more mechanical or other fasteners or fastening systems.

[0289] Preferably, a nasal cannula as defined above may be utilized in combination with each of the other details described herein to provide a nasal cannula interface.

[0290] In some embodiments, a patient interface, such as a nasal cannula, comprises a gas delivery mechanism (such as one or a pair of nasal prongs that engage one or both nostrils of a user's nose), a body with which the gas delivery mechanism is associated and a pair of side arms extending from the body, the body and side arms connected such that application of tension to the side arms tends to move the gas delivery mechanism away from a position where it would otherwise interfere with the user's nasal spine.

[0291] In some embodiments, a nasal cannula comprises a cannula body having a nasal prong or a pair of nasal prongs extending from the cannula body for engaging the nares of a user, a pair of side arms extending outwardly from the cannula body, a headgear system connectable to the cannula body, the cannula body substantially conforming to the user's face but providing sufficient rigidity such that, in use, force or tension applied to the outer portions of the side arms tends or encourages one or both nasal prongs to be less intrusive against the user's nasal spine area.

[0292] Preferably, a continuous section of material extends along each side arm and is interlocked or mechanically joined in the region of one or both nasal prongs.

[0293] Preferably, the continuous section of material is a material that is capable of transferring an applied force or tension from the side arm to the area of ​​one or both nasal prongs.

[0294] Preferably, each of the side arms defines a pre-shape or configuration such that prior to application of force or tension from the headgear, the side arms curve outwardly away from the user's face and extend more outwardly so that the side arms extend further away from the gas delivery mechanism or the nasal prong or pair of nasal prongs of the interface.

[0295] Preferably, each of the side arms substantially contacts the user's face as the arm extends outwardly away from the gas delivery mechanism or the nasal prong or pair of nasal prongs, and the further away (or both) each of the side arms is from or out of contact with the user's face, the further the arm extends from the gas delivery mechanism or the nasal prong or pair of nasal prongs.

[0296] Preferably, the side arms define a preliminary shape or configuration such that, in use, application of force or tension to the side arms via the headgear encourages (or directs) the side arms to move into a position that is more in facial contact with the user's face or cheeks and encourages (or directs) the main body to move into a position that is less engaged with or out of the way of or further away from the user's nasal spine area.

[0297] Preferably, the side arms are configured to facilitate movement or repositioning or relocation or distribution or redistribution of force or tension applied to the nasal cannula by the headgear, during use, towards the user's cheek and away from the user's nasal spine area or away from forces or tension applied to the user's nasal spine area.

[0298] Preferably, each of the side arms is pre-formed or shaped such that, in use, application of force or tension to the side arm requires the side arm, or at least a portion of the side arm, to move closer to the user's face such that a hinge or flex point (or bending point) of the side arm to the user's face is established over the cheek area and one or both nasal prongs or another gas delivery mechanism is encouraged to move out of the way relative to the user's nasal spine area.

[0299] Preferably, the hinge or flexion point (or bending point) established in use is in any one or more of the user's left or right (or both) areas on or around the area of ​​the lateral inferior maxilla, lateral superior maxilla, zygomatic arch, chin recess (or inferior zygomatic arch).

[0300] In some embodiments, a connector for connecting a breathing tube to a device (such as a humidifier, ventilator or other gas source) or at least to another breathing tube, the connector comprising: An inner body and an outer body Equipped with The inner body and the outer body each have a first end and a second end; a first end of the inner body and the outer body for receiving a terminal end of a first respiratory tube, and a second end of the inner body and the outer body for connecting to a further component, such as a breathable tube or device (e.g., a humidifier, a ventilator, or a gas source); a first end of the inner body receiving and fluidly connecting a terminal end of the first respiratory tube, the inner body providing a lumen for fluid connection between the first and second ends of the inner body; The connector inner body is adapted to pivot relative to the outer body, the inner body being rotatable relative to the outer body.

[0301] Preferably, the inner body is adapted to pivot relative to the outer body.

[0302] Preferably, the outer body may include one or more surface relief features, more preferably such surface relief features providing finger grips for a user in use.

[0303] Preferably, the second end of the inner body and / or the outer body is adapted to provide a connection system for connecting to another breathing tube or device (e.g., a humidifier or a ventilator or a gas source).

[0304] Preferably, the terminal end of the first respiratory tube connected to the first end of the inner body may be longitudinally rotatable relative to the outer body in use.

[0305] Preferably the inner body is sleeved relative to the outer body.

[0306] Preferably, a connector as defined above may be provided as a connector for use with a gas delivery tube for a nasal cannula or other patient interface as shown or described herein.

[0307] Preferably, the second end of the outer body is adapted to connect to a further component, the outer body being non-pivotable relative to a connection engaging the further component, for example at the machine end of a breathing circuit.

[0308] Various references herein to tubes or conduits optionally, but not necessarily, relate to the application of such tubes or conduits to what are commonly understood to be "respiratory tubes", such as those referenced in ISO5367:2000(E) (4th edition, 2000-06-01). The tubes or conduits of the present invention relate to or may be particularly applicable to such respiratory tubes used to deliver gas to a user or patient.

[0309] As used herein, the term "and / or" means "and" or "or" or both.

[0310] As used herein, the word "(s)" following a noun refers to the plural and / or the singular form of that noun.

[0311] The sagittal plane of a nasal cannula or other patient interface is defined as the sagittal plane of the user extending through the cannula or patient interface when the cannula or patient interface is positioned on the user's face in use. For example, the sagittal plane of a nasal cannula with a nasal prong for each nostril is centered between the nasal prongs.

[0312] The lateral direction for a nasal cannula is the direction extending between the left and right ends of the cannula. The lateral direction is perpendicular to the direction extending between the front and back of the cannula. The sagittal plane of the cannula is perpendicular to the lateral direction.

[0313] The present invention also contemplates constructions that include those mentioned above, the following of which are given by way of example only.

[0314] These and other features, aspects, and advantages of the present disclosure are described with reference to the following drawings, which are illustrative and should not be construed as limiting the disclosure. [Brief description of the drawings]

[0315] [Figure 1A] 1 illustrates an example embodiment of a nasal cannula assembly coupled to a patient. [Figure 1B] 1B shows a partial front perspective view of the nasal cannula assembly of FIG. 1A. [Figure 1C] FIG. 1C shows an exploded view of the nasal cannula assembly of FIGS. 1A and 1B. [Figure 2A] 1 illustrates a front perspective view of an example embodiment of a nasal cannula assembly including a cannula and a manifold. [Figure 2B] 2B shows a partial rear perspective view of the nasal cannula assembly of FIG. 2A. [Figure 3A] 1 illustrates a front perspective view of an example embodiment of a nasal cannula assembly including a cannula and a manifold. [Figure 3B] 3B shows a partial rear perspective view of the nasal cannula assembly of FIG. 3A. [Figure 4]3C shows a partial front perspective view of an alternative configuration of the nasal cannula assembly of FIGS. 3A and 3B. FIG. [Figure 5A] FIG. 1 illustrates a front perspective view of an example embodiment of a nasal cannula assembly including a cannula without a manifold. [Figure 5B] 5B shows a partial rear perspective view of the nasal cannula assembly of FIG. 5A. [Figure 6A] 1 illustrates a front perspective view of an example embodiment of a nasal cannula assembly including cheek pads. [Figure 6B] 6B shows a partial rear perspective view of the nasal cannula assembly of FIG. 6A. [Figure 7A] 1 illustrates a front perspective view of an example embodiment of a nasal cannula assembly including a cannula with an integrated head strap. [Figure 7B] 7B shows a partial rear perspective view of the nasal cannula assembly of FIG. 7A. [Figure 7C] 1 illustrates an example embodiment of a lanyard connector of a nasal cannula assembly. [Figure 8A] 1 illustrates a front perspective view of an example embodiment of a nasal cannula assembly including a cannula and a manifold. [Figure 8B] 8B shows a partial rear perspective view of the nasal cannula assembly of FIG. 8A. [Figure 8C] 8C shows an exploded view of the nasal cannula assembly of FIGS. 8A and 8B. FIG. [Figure 9A] 1 illustrates a front perspective view of an example embodiment of a nasal cannula assembly including a cannula and a manifold. [Figure 9B] 9B shows a partial rear perspective view of the nasal cannula assembly of FIG. 9A. [Figure 9C] 9C shows a variation of the nasal cannula assembly of FIGS. 9A and 9B. [Figure 10A] 1 illustrates a side perspective view of an example embodiment of a nasal cannula assembly including a cannula and a nasal strip attached to a patient's face. [Figure 10B] 10B shows a partial rear perspective view of the nasal cannula assembly of FIG. 10A. [Figure 11]10C shows an alternative configuration of the nasal cannula assembly of FIGS. 10A and 10B. [Figure 12A] 1 illustrates a partial front perspective view of an example embodiment of a nasal cannula assembly including two cannulas. [Figure 12B] 12B shows top, front and side views of one of the cannulas of FIG. 12A. [Figure 12C] 12B illustrates a front perspective view of the nasal cannula assembly of FIG. 12A coupled to a patient. [Figure 13A] 1 illustrates a front perspective view of an example embodiment of a nasal cannula assembly including a cannula and a retainer. [Figure 13B] 13B shows a partial side perspective view of the nasal cannula assembly of FIG. 13A. [Figure 13C] 13C shows a partial front perspective view of the nasal cannula assembly of FIGS. 13A and 13B coupled to a patient. FIG. [Figure 14A] FIG. 2 shows a front perspective view of a nasal cannula assembly including a manifold and a cannula having nasal flaps. [Figure 14B] 14B shows an exploded view of the nasal cannula assembly of FIG. 14A. [Figure 14C] 14A and 14B are shown coupled to a patient. [Figure 15A] 1 illustrates an example embodiment of a nasal cannula assembly with a shuttle valve. [Figure 15B] 1 illustrates an example embodiment of a nasal cannula assembly with a shuttle valve. [Figure 15C] 1 illustrates an example embodiment of a nasal cannula assembly with a shuttle valve. [Figure 15D] 1 illustrates an example embodiment of a nasal cannula assembly with a shuttle valve. [Figure 15E] 1 illustrates an example embodiment of a nasal cannula assembly with a shuttle valve. [Figure 15F] 1 illustrates an example embodiment of a nasal cannula assembly with a shuttle valve. [Figure 15G] 1 illustrates an example embodiment of a nasal cannula assembly with a shuttle valve. [Figure 16A] 1 illustrates an example embodiment of a nasal cannula assembly with a manifold having a one-way valve formed from an exhalation-type valve with a loosely hinged flap. [Figure 16B] 1 illustrates an example embodiment of a nasal cannula assembly with a manifold having a one-way valve formed from an exhalation-type valve with a loosely hinged flap. [Figure 16C] 1 illustrates an example embodiment of a nasal cannula assembly with a manifold having a one-way valve formed from an exhalation-type valve with a loosely hinged flap. [Figure 16D] 1 illustrates an example embodiment of a nasal cannula assembly with a manifold having a one-way valve formed from an exhalation-type valve with a loosely hinged flap. [Figure 16E] 1 illustrates an example embodiment of a nasal cannula assembly with a manifold having a one-way valve formed from an exhalation-type valve with a loosely hinged flap. [Figure 16F] 1 illustrates an example embodiment of a nasal cannula assembly with a manifold having a one-way valve formed from an exhalation-type valve with a loosely hinged flap. [Figure 16G] 1A-1C illustrate an embodiment of a nasal cannula assembly with a manifold having one-way valves formed from various types of slit valves. [Figure 16H] 1A-1C illustrate an embodiment of a nasal cannula assembly with a manifold having one-way valves formed from various types of slit valves. [Figure 16I] 1A-1C illustrate an embodiment of a nasal cannula assembly with a manifold having one-way valves formed from various types of slit valves. [Figure 16J] 1A-1C illustrate an embodiment of a nasal cannula assembly with a manifold having one-way valves formed from various types of slit valves. [Figure 16K] 1A-1C illustrate an embodiment of a nasal cannula assembly with a manifold having one-way valves formed from various types of slit valves. [Figure 16L] 1A-1C illustrate an embodiment of a nasal cannula assembly with a manifold having one-way valves formed from various types of slit valves. [Figure 17A] 1 illustrates an example embodiment of a nasal cannula assembly in which the tubes are threaded into a manifold to allow selective side switching of the tube outlet side. [Figure 17B] 1 illustrates an example embodiment of a nasal cannula assembly in which the tubes are threaded into a manifold to allow selective side switching of the tube outlet side. [Figure 18A] 1 shows an example embodiment of a nasal cannula assembly in which each tube exit hole is sealed by a thin membrane that is pierced by the sharp end of the feeding tube. [Figure 18B] 1 shows an example embodiment of a nasal cannula assembly in which each tube exit hole is sealed by a thin membrane that is pierced by the sharp end of the feeding tube. [Figure 19] 1 shows an example embodiment of a manifold with flexible tubing exiting the front tube exit holes. [Figure 20A] 1 illustrates an example embodiment of a manifold that snaps into an assembly fixture or clip. [Figure 20B] 1 illustrates an example embodiment of a manifold that snaps into an assembly fixture or clip. [Figure 20C] 1 illustrates an example embodiment of a manifold that snaps into an assembly fixture or clip. [Figure 21A] 1 illustrates an example embodiment of a nasal cannula assembly including a removable tubing assembly and a manifold. [Figure 21B] 1 illustrates an example embodiment of a nasal cannula assembly including a removable tubing assembly and a manifold. [Figure 21C] 1 illustrates an example embodiment of a nasal cannula assembly including a removable tubing assembly and a manifold. [Figure 21D]1 illustrates an example embodiment of a nasal cannula assembly including a removable tubing assembly and a manifold. [Figure 21E] 1 illustrates an example embodiment of a nasal cannula assembly including a removable tubing assembly and a manifold. [Figure 21F] 1 illustrates an example embodiment of a nasal cannula assembly including a removable tubing assembly and a manifold. [Figure 21G] 1 illustrates an example embodiment of a nasal cannula assembly with a manifold receiving structure, separate nasal prong inserts, and a manifold. [Fig. 21H] 1 illustrates an example embodiment of a nasal cannula assembly with a manifold receiving structure, separate nasal prong inserts, and a manifold. [Figure 22A] 1 illustrates an example embodiment of a nasal cannula assembly with a manifold insert and a manifold receiving structure. [Figure 22B] 1 illustrates an example embodiment of a nasal cannula assembly with a manifold insert and a manifold receiving structure. [Figure 22C] 1 illustrates an example embodiment of a nasal cannula assembly with a manifold insert and a manifold receiving structure. [Figure 22D] 1 illustrates an example embodiment of a nasal cannula assembly with a manifold insert and a manifold receiving structure. [Figure 23A] 1 illustrates an example embodiment of a nasal cannula assembly with a manifold insert that can be clipped onto a tubing assembly. [Figure 23B] 1 illustrates an example embodiment of a nasal cannula assembly with a manifold insert that can be clipped onto a tubing assembly. [Figure 23C] 1 illustrates an example embodiment of a nasal cannula assembly with a manifold insert that can be clipped onto a tubing assembly. [Figure 24A]1 illustrates an example embodiment of a nasal cannula assembly having prongs formed in a wavy pattern around the periphery of the base to allow for flexibility of the prongs. [Figure 24B] 1 illustrates an example embodiment of a nasal cannula assembly having prongs formed in a wavy pattern around the periphery of the base to allow for flexibility of the prongs. [Figure 24C] 1 illustrates an example embodiment of a nasal cannula assembly having prongs formed in a wavy pattern around the periphery of the base to allow for flexibility of the prongs. [Figure 24D] 13 illustrates an example embodiment of a prong formed with a wavy shape to allow for flexibility of the prong. [Figure 24E] 13 illustrates an example embodiment of a prong formed with a wavy shape to allow for flexibility of the prong. [Figure 24F] 13 illustrates an example embodiment of a prong formed with a wavy shape to allow for flexibility of the prong. [Figure 25A] 1 illustrates an example embodiment of a nasal cannula assembly including individually rotatable prongs. [Figure 25B] 1 illustrates an example embodiment of a nasal cannula assembly that includes a pair of prongs mounted on a vertical shaft and rotatable as a unit. [Figure 25C] 1 illustrates an example embodiment of a nasal cannula assembly that includes a pair of prongs mounted on a vertical shaft and rotatable as a unit. [Figure 26A] 1 illustrates an example embodiment of a nasal cannula assembly configured to allow insertion of a removable prong insert in at least two orientations. [Figure 26B] 1 illustrates an example embodiment of a nasal cannula assembly configured to allow insertion of a removable prong insert in at least two orientations. [Figure 26C] 1 illustrates an example embodiment of a nasal cannula assembly configured to allow insertion of a removable prong insert in at least two orientations. [Figure 26D]1 illustrates an example embodiment of a nasal cannula assembly configured to allow insertion of a removable prong insert in at least two orientations. [Figure 26E] 1 illustrates an example embodiment of a nasal cannula assembly configured to allow insertion of a removable prong insert in at least two orientations. [Figure 26F] 1 illustrates an example embodiment of a nasal cannula assembly configured to allow insertion of a removable prong insert in at least two orientations. [Figure 27A] 1 illustrates an example embodiment of a nasal cannula assembly including a manifold that is rotatable about an axis extending generally in the anterior-posterior direction. [Figure 27B] 1 illustrates an example embodiment of a nasal cannula assembly including a manifold that is rotatable about an axis extending generally in the anterior-posterior direction. [Figure 27C] 1 illustrates an example embodiment of a nasal cannula assembly including a manifold that is rotatable about an axis extending generally in the anterior-posterior direction. [Figure 27D] 1 illustrates an example embodiment of a nasal cannula assembly including a manifold that is rotatable about an axis extending generally in the anterior-posterior direction. [Figure 28A] 1 illustrates an example embodiment of a nasal cannula assembly that includes a manifold and a supply tube that can be coupled to the cannula in at least two orientations. [Figure 28B] 1 illustrates an example embodiment of a nasal cannula assembly that includes a manifold and a supply tube that can be coupled to the cannula in at least two orientations. [Figure 29A] 1 illustrates an example embodiment of a respiratory assistance system including a nasal cannula assembly with pressure measurement capabilities. [Figure 29B] 1 illustrates an example embodiment of a nasal cannula assembly with pressure measurement capabilities. [Figure 29C] 1 illustrates an example embodiment of a nasal cannula assembly with pressure measurement capabilities. [Figure 29D] 1 illustrates an example embodiment of a nasal cannula assembly with pressure measurement capabilities. [Figure 29E] 1 illustrates an example embodiment of a nasal cannula assembly with pressure measurement capabilities. [Figure 29F] 1 illustrates an example embodiment of a nasal cannula assembly with pressure measurement capabilities. [Figure 29G] 1 illustrates an example embodiment of a nasal cannula assembly with pressure measurement capabilities. [Figure 29H] 1 illustrates an example embodiment of a nasal cannula assembly with pressure measurement capabilities. [Figure 29I] 1 illustrates an example embodiment of a nasal cannula assembly with pressure measurement capabilities. [Figure 29J] 1 illustrates an example embodiment of a nasal cannula assembly with pressure measurement capabilities. [Figure 29K] 1 illustrates an example embodiment of a nasal cannula assembly with pressure measurement capabilities. [Figure 29L] 1 illustrates an example embodiment of a nasal cannula assembly with pressure measurement capabilities. [Figure 30A] An example embodiment of a nasal cannula assembly is shown having features that address, reduce or minimize patient discomfort, particularly in or near the upper lip area. [Figure 30B] An example embodiment of a nasal cannula assembly is shown having features that address, reduce or minimize patient discomfort, particularly in or near the upper lip area. [Figure 30C] An example embodiment of a nasal cannula assembly is shown having features that address, reduce or minimize patient discomfort, particularly in or near the upper lip area. [Figure 30D] An example embodiment of a nasal cannula assembly is shown having features that address, reduce or minimize patient discomfort, particularly in or near the upper lip area. [Figure 30E] An example embodiment of a nasal cannula assembly is shown having features that address, reduce or minimize patient discomfort, particularly in or near the upper lip area. [Figure 30F]An example embodiment of a nasal cannula assembly is shown having features that address, reduce or minimize patient discomfort, particularly in or near the upper lip area. [Figure 30G] An example embodiment of a nasal cannula assembly is shown having features that address, reduce or minimize patient discomfort, particularly in or near the upper lip area. [Figure 30H] An example embodiment of a nasal cannula assembly is shown having features that address, reduce or minimize patient discomfort, particularly in or near the upper lip area. [Figure 30I] An example embodiment of a nasal cannula assembly is shown having features that address, reduce or minimize patient discomfort, particularly in or near the upper lip area. [Figure 31A] 1 illustrates an example embodiment of an adjustable or formable feeding tube for a nasal cannula assembly. [Figure 31B] 1 illustrates an example embodiment of an adjustable or formable feeding tube for a nasal cannula assembly. [Figure 31C] 1 illustrates an example embodiment of an adjustable or formable feeding tube for a nasal cannula assembly. [Figure 31D] 1 illustrates an example embodiment of an adjustable or formable feeding tube for a nasal cannula assembly. [Figure 31E] 1 illustrates an example embodiment of an adjustable or formable feeding tube for a nasal cannula assembly. [Fig. 31F] 1 illustrates an example embodiment of an adjustable or formable feeding tube for a nasal cannula assembly. [Figure 32A] 1 illustrates an example embodiment of a nasal cannula assembly having devices and features that govern the positioning of a feeding tube. [Figure 32B] 1 illustrates an example embodiment of a nasal cannula assembly having devices and features that govern the positioning of a feeding tube. [Figure 32C] 1 illustrates an example embodiment of a nasal cannula assembly having devices and features that govern the positioning of a feeding tube. [Fig. 32D] 1 illustrates an example embodiment of a nasal cannula assembly having devices and features that govern the positioning of a feeding tube. [Figure 32E] 1 illustrates an example embodiment of a nasal cannula assembly having devices and features that govern the positioning of a feeding tube. [Fig. 32F] 1 illustrates an example embodiment of a nasal cannula assembly having devices and features that govern the positioning of a feeding tube. [Fig. 32G] 1 illustrates an example embodiment of a nasal cannula assembly having devices and features that govern the positioning of a feeding tube. [Fig. 32H] 1 illustrates an example embodiment of a nasal cannula assembly having devices and features that govern the positioning of a feeding tube. [Fig. 32I] 1 illustrates an example embodiment of a nasal cannula assembly having devices and features that govern the positioning of a feeding tube. [Fig. 32J] 1 illustrates an example embodiment of a nasal cannula assembly having devices and features that govern the positioning of a feeding tube. [Figure 32K] 1 illustrates an example embodiment of a nasal cannula assembly having devices and features that govern the positioning of a feeding tube. [Figure 32L] 1 illustrates an example embodiment of a nasal cannula assembly having devices and features that govern the positioning of a feeding tube. [Figure 32M] 1 illustrates an example embodiment of a nasal cannula assembly having devices and features that govern the positioning of a feeding tube. [Figure 32N] 1 illustrates an example embodiment of a nasal cannula assembly having devices and features that govern the positioning of a feeding tube. [Figure 33A] 1 illustrates an example embodiment of an apparatus for providing support to a feeding tube. [Figure 33B] 1 illustrates an example embodiment of an apparatus for providing support to a feeding tube. [Figure 33C] 1 illustrates an example embodiment of an apparatus for providing support to a feeding tube. [Figure 33D]1 illustrates an example embodiment of an apparatus for providing support to a feeding tube. [Figure 33E] 1 illustrates an example embodiment of an apparatus for providing support to a feeding tube. [Figure 33F] 1 illustrates an example embodiment of an apparatus for providing support to a feeding tube. [Figure 33G] 1 illustrates an example embodiment of an apparatus for providing support to a feeding tube. [Fig. 33H] 1 illustrates an example embodiment of an apparatus for providing support to a feeding tube. [Figure 33I] 1 illustrates an example embodiment of an apparatus for providing support to a feeding tube. [Figure 33J] 1 illustrates an example embodiment of an apparatus for providing support to a feeding tube. [Figure 33K] 1 illustrates an example embodiment of an apparatus for providing support to a feeding tube. [Figure 33L] 1 illustrates an example embodiment of an apparatus for providing support to a feeding tube. [Figure 33M] 1 illustrates an example embodiment of an apparatus for providing support to a feeding tube. [Figure 33N] 1 illustrates an example embodiment of an apparatus for providing support to a feeding tube. [Fig. 33O] 1 illustrates an example embodiment of an apparatus for providing support to a feeding tube. [Figure 33P] 1 illustrates an example embodiment of an apparatus for providing support to a feeding tube. [Figure 33Q] 1 illustrates an example embodiment of an apparatus for providing support to a feeding tube. [Figure 33R] 1 illustrates an example embodiment of an apparatus for providing support to a feeding tube. [Figure 33S] 1 illustrates an example embodiment of an apparatus for providing support to a feeding tube. [Figure 34A] 1 illustrates an example embodiment of a headgear apparatus for securing a cannula to a patient's face. [Figure 34B] 1 illustrates an example embodiment of a headgear apparatus for securing a cannula to a patient's face. [Figure 34C] 1 illustrates an example embodiment of a headgear apparatus for securing a cannula to a patient's face. [Fig. 34D] 1 illustrates an example embodiment of a headgear apparatus for securing a cannula to a patient's face. [Figure 34E] 1 illustrates an example embodiment of a headgear apparatus for securing a cannula to a patient's face. [Fig. 34F] 1 illustrates an example embodiment of a headgear apparatus for securing a cannula to a patient's face. [Figure 34G] 1 illustrates an example embodiment of a headgear apparatus for securing a cannula to a patient's face. [Fig. 34H] 1 illustrates an example embodiment of a headgear apparatus for securing a cannula to a patient's face. [Fig. 34I] 1 illustrates an example embodiment of a headgear apparatus for securing a cannula to a patient's face. [Fig. 34J] 1 illustrates an example embodiment of a headgear apparatus for securing a cannula to a patient's face. [Figure 34K] 1 illustrates an example embodiment of a headgear apparatus for securing a cannula to a patient's face. [Figure 35A] 1 illustrates an example embodiment of a retention device for a nasal cannula assembly. [Figure 35B] 1 illustrates an example embodiment of a retention device for a nasal cannula assembly. [Figure 35C] 1 illustrates an example embodiment of a retention device for a nasal cannula assembly. [Figure 35D] 1 illustrates an example embodiment of a retention device for a nasal cannula assembly. [Figure 35E] 1 illustrates an example embodiment of a retention device for a nasal cannula assembly. [Fig. 35F] 1 illustrates an example embodiment of a retention device for a nasal cannula assembly. [Figure 35G] 1 illustrates an example embodiment of a retention device for a nasal cannula assembly. [Figure 36A] 13 illustrates an example embodiment of a retention device, such as a headgear strap, that includes an indicator of tightness, such as strap tension. [Figure 36B] 13 illustrates an example embodiment of a retention device, such as a headgear strap, that includes an indicator of tightness, such as strap tension. [Figure 36C] 13 illustrates an example embodiment of a retention device, such as a headgear strap, that includes an indicator of tightness, such as strap tension. [Figure 36D] 13 illustrates an example embodiment of a retention device, such as a headgear strap, that includes an indicator of tightness, such as strap tension. [Figure 36E] 13 illustrates an example embodiment of a retention device, such as a headgear strap, that includes an indicator of tightness, such as strap tension. [Figure 36F] 13 illustrates an example embodiment of a retention device, such as a headgear strap, that includes an indicator of tightness, such as strap tension. [Figure 36G] 13 illustrates an example embodiment of a retention device, such as a headgear strap, that includes an indicator of tightness, such as strap tension. [Fig. 36H] 13 illustrates an example embodiment of a retention device, such as a headgear strap, that includes an indicator of tightness, such as strap tension. [Figure 36I] 13 illustrates an example embodiment of a retention device, such as a headgear strap, that includes an indicator of tightness, such as strap tension. [Figure 36J] 13 illustrates an example embodiment of a retention device, such as a headgear strap, that includes an indicator of tightness, such as strap tension. [Figure 36K] 13 illustrates an example embodiment of a retention device, such as a headgear strap, that includes an indicator of tightness, such as strap tension. [Figure 37A] 1 illustrates an example embodiment of a headgear strap having strap pads. [Figure 37B] 1 illustrates an example embodiment of an adjustable headgear strap arrangement for a nasal cannula assembly. [Figure 37C] 1 illustrates an example embodiment of an adjustable headgear strap arrangement for a nasal cannula assembly. [Figure 37D] 1 illustrates an example embodiment of an adjustable headgear strap arrangement for a nasal cannula assembly. [Figure 37E] 1 illustrates an example embodiment of an adjustable headgear strap arrangement for a nasal cannula assembly. [Figure 38A] 1 illustrates an example embodiment of an adjustable cannula and prong arrangement for a nasal cannula assembly. [Figure 38B] 1 illustrates an example embodiment of an adjustable cannula and prong arrangement for a nasal cannula assembly. [Figure 38C] 1 illustrates an example embodiment of an adjustable cannula and prong arrangement for a nasal cannula assembly. [Figure 38D] 1 illustrates an example embodiment of an adjustable cannula and prong arrangement for a nasal cannula assembly. [Figure 38E] 1 illustrates an example embodiment of an adjustable cannula and prong arrangement for a nasal cannula assembly. [Figure 38F] 1 illustrates an example embodiment of an adjustable cannula and prong arrangement for a nasal cannula assembly. [Figure 38G] 1 illustrates an example embodiment of an adjustable cannula and prong arrangement for a nasal cannula assembly. [Figure 39A] 1 illustrates an example embodiment of a cannula and prong arrangement with adjustable position for a nasal cannula assembly. [Figure 39B] 1 illustrates an example embodiment of a cannula and prong arrangement with adjustable position for a nasal cannula assembly. [Figure 39C] 1 illustrates an example embodiment of a cannula and prong arrangement with adjustable position for a nasal cannula assembly. [Figure 39D] 1 illustrates an example embodiment of a cannula and prong arrangement with adjustable position for a nasal cannula assembly. [Figure 39E] 1 illustrates an example embodiment of a cannula and prong arrangement with adjustable position for a nasal cannula assembly. [Figure 39F] 1 illustrates an example embodiment of a cannula and prong arrangement with adjustable position for a nasal cannula assembly. [Figure 39G] 1 illustrates an example embodiment of a cannula and prong arrangement with adjustable position for a nasal cannula assembly. [Fig. 39H] 1 illustrates an example embodiment of a cannula and prong arrangement with adjustable position for a nasal cannula assembly. [Figure 39I] 1 illustrates an example embodiment of a cannula and prong arrangement with adjustable position for a nasal cannula assembly. [Figure 40A] 1 illustrates an example embodiment of an adjustable prong arrangement for a nasal cannula assembly. [Figure 40B] 1 illustrates an example embodiment of an adjustable prong arrangement for a nasal cannula assembly. [Figure 40C] 1 illustrates an example embodiment of an adjustable prong arrangement for a nasal cannula assembly. [Figure 40D] 1 illustrates an example embodiment of an adjustable prong arrangement for a nasal cannula assembly. [Figure 40E] 1 illustrates an example embodiment of an adjustable prong arrangement for a nasal cannula assembly. [Diagram 40F] 1 illustrates an example embodiment of an adjustable prong arrangement for a nasal cannula assembly. [Figure 40G] 1 illustrates an example embodiment of an adjustable prong arrangement for a nasal cannula assembly. [Figure 40H] 1 illustrates an example embodiment of an adjustable prong arrangement for a nasal cannula assembly. [Fig. 40I] 1 illustrates an example embodiment of an adjustable prong arrangement for a nasal cannula assembly. [Figure 40J] 1 illustrates an example embodiment of an adjustable prong arrangement for a nasal cannula assembly. [Figure 41A] 1 illustrates an example embodiment of a support device for a nasal cannula assembly. [Figure 41B] 1 illustrates an example embodiment of a support device for a nasal cannula assembly. [Figure 41C] 1 illustrates an example embodiment of a support device for a nasal cannula assembly. [Figure 41D] 1 illustrates an example embodiment of a support device for a nasal cannula assembly. [Figure 42A]1 illustrates an example embodiment of an insulation and tubing arrangement for a nasal cannula assembly. [Figure 42B] 1 illustrates an example embodiment of an insulation and tubing arrangement for a nasal cannula assembly. [Figure 42C] 1 illustrates an example embodiment of an insulation and tubing arrangement for a nasal cannula assembly. [Fig.42D] 1 illustrates an example embodiment of an insulation and tubing arrangement for a nasal cannula assembly. [Figure 42E] 1 illustrates an example embodiment of an insulation and tubing arrangement for a nasal cannula assembly. [Fig.42F] 1 illustrates an example embodiment of an insulation and tubing arrangement for a nasal cannula assembly. [Fig.42G] 1 illustrates an example embodiment of an insulation and tubing arrangement for a nasal cannula assembly. [Fig. 42H] 1 illustrates an example embodiment of an insulation and tubing arrangement for a nasal cannula assembly. [Fig.42I] 1 illustrates an example embodiment of an insulation and tubing arrangement for a nasal cannula assembly. [Fig.42J] 1 illustrates an example embodiment of an insulation and tubing arrangement for a nasal cannula assembly. [Figure 42K] 1 illustrates an example embodiment of an insulation and tubing arrangement for a nasal cannula assembly. [Figure 42L] 1 illustrates an example embodiment of an insulation and tubing arrangement for a nasal cannula assembly. [Figure 42M] 1 illustrates an example embodiment of an insulation and tubing arrangement for a nasal cannula assembly. [Figure 42N] 1 illustrates an example embodiment of an insulation and tubing arrangement for a nasal cannula assembly. [Fig.42O] 1 illustrates an example embodiment of an insulation and tubing arrangement for a nasal cannula assembly. [Figure 43A] 1 illustrates an example embodiment of a tubing arrangement for a nasal cannula assembly. [Figure 43B] 1 illustrates an example embodiment of a tubing arrangement for a nasal cannula assembly. [Figure 43C] 1 illustrates an example embodiment of a tubing arrangement for a nasal cannula assembly. [Fig. 43D] 1 illustrates an example embodiment of a tubing arrangement for a nasal cannula assembly. [Figure 43E] 1 illustrates an example embodiment of a tubing arrangement for a nasal cannula assembly. [Figure 43F] 1 illustrates an example embodiment of a tubing arrangement for a nasal cannula assembly. [Figure 43G] 1 illustrates an example embodiment of a tubing arrangement for a nasal cannula assembly. [Fig. 43H] 1 illustrates an example embodiment of a tubing arrangement for a nasal cannula assembly. [Figure 43I] 1 illustrates an example embodiment of a tubing arrangement for a nasal cannula assembly. [Figure 43J] 1 illustrates an example embodiment of a tubing arrangement for a nasal cannula assembly. [Figure 43K] 1 illustrates an example embodiment of a tubing arrangement for a nasal cannula assembly. [Figure 43L] 1 illustrates an example embodiment of a tubing arrangement for a nasal cannula assembly. [Figure 43M] 1 illustrates an example embodiment of a tubing arrangement for a nasal cannula assembly. [Figure 43N] 1 illustrates an example embodiment of a tubing arrangement for a nasal cannula assembly. [Fig. 43O] 1 illustrates an example embodiment of a tubing arrangement for a nasal cannula assembly. [Figure 44A] 1 illustrates an example embodiment of a tubing arrangement for a nasal cannula assembly. [Figure 44B] 1 illustrates an example embodiment of a tubing arrangement for a nasal cannula assembly. [Figure 44C] 1 illustrates an example embodiment of a tubing arrangement for a nasal cannula assembly. [Fig.44D] 1 illustrates an example embodiment of a tubing arrangement for a nasal cannula assembly. [Figure 44E] 1 illustrates an example embodiment of a tubing arrangement for a nasal cannula assembly. [Fig.44F] 1 illustrates an example embodiment of a tubing arrangement for a nasal cannula assembly. [Figure 44G] 1 illustrates an example embodiment of a tubing arrangement for a nasal cannula assembly. [Figure 45A]1 illustrates an example embodiment of a temperature adjustment device for a nasal cannula assembly. [Figure 45B] 1 illustrates an example embodiment of a temperature adjustment device for a nasal cannula assembly. [Figure 45C] 1 illustrates an example embodiment of a temperature adjustment device for a nasal cannula assembly. [Figure 45D] 1 illustrates an example embodiment of a temperature adjustment device for a nasal cannula assembly. [Figure 45E] 1 illustrates an example embodiment of a temperature adjustment device for a nasal cannula assembly. [Fig.45F] 1 illustrates an example embodiment of a temperature adjustment device for a nasal cannula assembly. [Figure 45G] 1 illustrates an example embodiment of a temperature adjustment device for a nasal cannula assembly. [Fig. 45H] 1 illustrates an example embodiment of a temperature adjustment device for a nasal cannula assembly. [Fig.45I] 1 illustrates an example embodiment of a temperature adjustment device for a nasal cannula assembly. [Figure 45J] 1 illustrates an example embodiment of a temperature adjustment device for a nasal cannula assembly. [Figure 45K] 1 illustrates an example embodiment of a temperature adjustment device for a nasal cannula assembly. [Figure 45L] 1 illustrates an example embodiment of a temperature adjustment device for a nasal cannula assembly. [Figure 45M] 1 illustrates an example embodiment of a temperature adjustment device for a nasal cannula assembly. [Figure 45N] 1 illustrates an example embodiment of a temperature adjustment device for a nasal cannula assembly. [Fig. 45O] 1 illustrates an example embodiment of a temperature adjustment device for a nasal cannula assembly. [Figure 45P] 1 illustrates an example embodiment of a temperature adjustment device for a nasal cannula assembly. [Figure 45Q] 1 illustrates an example embodiment of a temperature adjustment device for a nasal cannula assembly. [Figure 46A] 1 illustrates an example embodiment of a pressure measurement port arrangement for a nasal cannula assembly. [Figure 46B]1 illustrates an example embodiment of a pressure measurement port arrangement for a nasal cannula assembly. [Figure 46C] 1 illustrates an example embodiment of a pressure measurement port arrangement for a nasal cannula assembly. [Figure 46D] 1 illustrates an example embodiment of a pressure measurement port arrangement for a nasal cannula assembly. [Figure 46E] 1 illustrates an example embodiment of a pressure measurement port arrangement for a nasal cannula assembly. [Figure 47A] 1 illustrates an example embodiment of a nasal cannula device configured to accommodate a nasogastric (NG) tube or a nasojejunal (NJ) tube. [Figure 47B] 1 illustrates an example embodiment of a nasal cannula device configured to accommodate a nasogastric (NG) tube or a nasojejunal (NJ) tube. [Figure 47C] 1 illustrates an example embodiment of a nasal cannula device configured to accommodate a nasogastric (NG) tube or a nasojejunal (NJ) tube. [Figure 47D] 1 illustrates an example embodiment of a nasal cannula device configured to accommodate a nasogastric (NG) tube or a nasojejunal (NJ) tube. [Figure 47E] 1 illustrates an example embodiment of a nasal cannula device configured to accommodate a nasogastric (NG) tube or a nasojejunal (NJ) tube. [Fig.47F] 1 illustrates an example embodiment of a nasal cannula device configured to accommodate a nasogastric (NG) tube or a nasojejunal (NJ) tube. [Figure 47G] 1 illustrates an example embodiment of a nasal cannula device configured to accommodate a nasogastric (NG) tube or a nasojejunal (NJ) tube. [Fig. 47H] 1 illustrates an example embodiment of a nasal cannula device configured to accommodate a nasogastric (NG) tube or a nasojejunal (NJ) tube. [Fig.47I] 1 illustrates an example embodiment of a nasal cannula device configured to accommodate a nasogastric (NG) tube or a nasojejunal (NJ) tube. [Figure 47J] 1 illustrates an example embodiment of a nasal cannula device configured to accommodate a nasogastric (NG) tube or a nasojejunal (NJ) tube. [Figure 47K]1 illustrates an example embodiment of a nasal cannula device configured to accommodate a nasogastric (NG) tube or a nasojejunal (NJ) tube. [Figure 47L] 1 illustrates an example embodiment of a nasal cannula device configured to accommodate a nasogastric (NG) tube or a nasojejunal (NJ) tube. [Figure 47M] 1 illustrates an example embodiment of a nasal cannula device configured to accommodate a nasogastric (NG) tube or a nasojejunal (NJ) tube. [Figure 47N] 1 illustrates an example embodiment of a nasal cannula device configured to accommodate a nasogastric (NG) tube or a nasojejunal (NJ) tube. [Fig.47O] 1 illustrates an example embodiment of a nasal cannula device configured to accommodate a nasogastric (NG) tube or a nasojejunal (NJ) tube. [Figure 48A] 1 illustrates an example embodiment of a single prong device for a nasal cannula assembly. [Figure 48B] 1 illustrates an example embodiment of a single prong device for a nasal cannula assembly. [Figure 48C] 1 illustrates an example embodiment of a single prong device for a nasal cannula assembly. [Figure 48D] 1 illustrates an example embodiment of a single prong device for a nasal cannula assembly. [Figure 48E] 1 illustrates an example embodiment of a single prong device for a nasal cannula assembly. [Fig.48F] 1 illustrates an example embodiment of a single prong device for a nasal cannula assembly. [Figure 48G] 1 illustrates an example embodiment of a single prong device for a nasal cannula assembly. [Fig. 48H] 1 illustrates an example embodiment of a single prong device for a nasal cannula assembly. [Fig.48I] 1 illustrates an example embodiment of a single prong device for a nasal cannula assembly. [Fig.48J] 1 illustrates an example embodiment of a single prong device for a nasal cannula assembly. [Figure 48K] 1 illustrates an example embodiment of a single prong device for a nasal cannula assembly. [Figure 48L] 1 illustrates an example embodiment of a single prong device for a nasal cannula assembly. [Figure 48M] 1 illustrates an example embodiment of a single prong device for a nasal cannula assembly. [Figure 48N] 1 illustrates an example embodiment of a single prong device for a nasal cannula assembly. [Fig.48O] 1 illustrates an example embodiment of a single prong device for a nasal cannula assembly. [Figure 48P] 1 illustrates an example embodiment of a single prong device for a nasal cannula assembly. [Figure 48Q] 1 illustrates an example embodiment of a single prong device for a nasal cannula assembly. [Figure 48R] 1 illustrates an example embodiment of a single prong device for a nasal cannula assembly. [Figure 48S] 1 illustrates an example embodiment of a single prong device for a nasal cannula assembly. [Figure 49] 1 illustrates a respiratory humidifier system that may be used with a nasal cannula assembly according to one or more embodiments of the present invention. [Figure 50A] 1 shows a nasal cannula assembly comprising a cannula part and separate plug and conduit connectors. [Figure 50B] 1 shows a nasal cannula assembly comprising a cannula part and separate plug and conduit connectors. [Figure 51] 1 shows a nasal cannula assembly including a cannula part and a clip with a plug and conduit connector for connecting a gas conduit to the cannula part. [Figure 52A] 1 shows a nasal cannula assembly including a cannula part and a clip with a plug and conduit connector for connecting a gas conduit to the cannula part, the cannula part including a rigid member that interfaces with the clip. [Figure 52B] 1 shows a nasal cannula assembly including a cannula part and a clip with a plug and conduit connector for connecting a gas conduit to the cannula part, the cannula part including a rigid member that interfaces with the clip. [Figure 53A] 53A shows a clip with a conduit connector and a plug that connects a gas conduit to a cannula component. The lateral distance between the plug and the connector is adjustable. FIG. 53B is an exploded view. [Figure 53B] 53A shows a clip with a conduit connector and a plug that connects a gas conduit to a cannula component. The lateral distance between the plug and the connector is adjustable. FIG. 53B is an exploded view. [Figure 54A] 1 shows a nasal cannula assembly comprising a cannula part and a clip with a plug and conduit connector for connecting a gas conduit to the cannula part, the clip being rotatably attached to the cannula part. [Figure 54B] 1 shows a nasal cannula assembly comprising a cannula part and a clip with a plug and conduit connector for connecting a gas conduit to the cannula part, the clip being rotatably attached to the cannula part. [Fig. 54C] 1 shows a nasal cannula assembly comprising a cannula part and a clip with a plug and conduit connector for connecting a gas conduit to the cannula part, the clip being rotatably attached to the cannula part. [Figure 55A] 1 shows a nasal cannula assembly comprising a cannula part and a conduit connector with a manifold, the cannula part being rotatably mounted to the manifold; [Figure 55B] 1 shows a nasal cannula assembly comprising a cannula part and a conduit connector with a manifold, the cannula part being rotatably mounted to the manifold; [Figure 56A] 1 shows a nasal cannula assembly including a cannula part and a clip with a plug and conduit connector that connects a gas conduit to the cannula part, the clip being inserted laterally into the manifold of the cannula part. [Figure 56B]A nasal cannula assembly is shown that includes a cannula component and a clip having a plug and a conduit connector for connecting a gas conduit to the cannula component. The clip is inserted laterally into the manifold of the cannula component. [Figure 56C] A nasal cannula assembly is shown that includes a cannula component and a clip having a plug and a conduit connector for connecting a gas conduit to the cannula component. The clip is inserted laterally into the manifold of the cannula component. [Figure 57A] A cannula assembly is shown that includes a pair of gas supply conduits, each connected to a nasal prong via a flexible tube section, and clips on each side of the cannula assembly configured to extend from the left or right side of the cannula. [Figure 57B] A nasal cannula assembly is shown that includes a pair of gas supply conduits, each connected to a nasal prong via a swivel elbow. [Figure 57C] A nasal cannula assembly is shown that includes a pair of gas supply conduits, each connected to a nasal prong via a swivel elbow. [Figure 58A] A bifurcatable strap for a headgear is shown that includes a frangible section that branches a portion of the strap into two separate bands. [Figure 58B] A bifurcatable strap is shown in a non-bifurcated configuration. [Figure 58C] A bifurcatable strap is shown in a bifurcated configuration. [Fig. 58D] Shows how a bifurcatable strap with a frangible section separates to form a bifurcated portion with two separate bands. [Figure 58E] A bifurcatable strap is shown in a non-bifurcated configuration. [Fig. 58F] Shows a cross-section of the strap of FIG. 58E. [Figure 58G] Shows a cross-section of the strap of FIG. 58A. [Figure 59]1 shows a forkable strap for headgear with a lift portion defined by a weakened section that causes a portion of the strap to branch into two separate bands. [Figure 60A] 1 shows a forkable strap for headgear with a clasp that is slidable along the forkable section of the strap to configure the forkable section into a forkable or non-forkable configuration. [Figure 60B] 1 shows a forkable strap for headgear with a clasp that is slidable along the forkable section of the strap to configure the forkable section into a forkable or non-forkable configuration. [Figure 61A] 1 shows a forkable strap for headgear with two clasps that are slidable along the forkable section of the strap to configure the forkable section in a forkable or non-forkable configuration. [Figure 61B] 1 shows a forkable strap for headgear with two clasps that are slidable along the forkable section of the strap to configure the forkable section in a forkable or non-forkable configuration. [Figure 61C] 1 shows a forkable strap for headgear with two clasps that are slidable along the forkable section of the strap to configure the forkable section in a forkable or non-forkable configuration. [Figure 62] 1 shows a forkable strap with the ends of separate bands of the strap pivotally connected. [Figure 63] 1 shows a headgear strap with an elasticated portion and a non-elasticated portion, where the non-elasticated portion is bifurcated into two separate bands. [Figure 64] 1 shows a headgear strap with branched portions, at least one band of the branched portion being elastic, and the ends of the branched bands being joined by a non-elastic Y-connector. [Figure 65] 1 shows a headgear strap with elastic and non-elastic portions, the non-elastic portion supporting a gas delivery conduit. [Figure 66]1 shows a headgear strap comprising a first non-elastic section attached to one side of a patient interface and a second non-elastic section attached to an opposite side of the patient interface, and an elastic intermediate section extending between the first and second non-elastic sections. [Figure 67] 1 shows a headgear strap comprising a first elastic section attached to one side of a patient interface and a second non-elastic section attached to an opposite side of the patient interface, and a non-elastic annular intermediate section extending between the first and second non-elastic sections. [Figure 68] 1 shows a headgear strap with branched portions, at least one band of which is adjustable in length. [Figure 69] FIG. 1 is a perspective view of a compartmentalized nasal cannula system arranged and configured in accordance with certain features, aspects, and advantages of the present disclosure. [Figure 70] FIG. 1 is an exploded view of a compartmented nasal cannula configured with multiple sections that are mechanically fastened together. [Figure 71] FIG. 71 is an enlarged view of the mechanical fastening means of FIG. 70 in use. [Figure 72] Similar to the exploded view shown in FIG. 70, but includes a clip-on gas flow supply tube. [Figure 73] FIG. 73 is a perspective view of a compartmentalized nasal cannula system similar to that of FIG. 72, except that the cannula system has been assembled from disassembled components. [Figure 74] FIG. 1 is a perspective view of a disassembled cannula system with a clip-on feeding tube attachment. [Figure 75] FIG. 75 is a perspective view of an alternative disassembled cannula system (to FIG. 74) with a clip-on feeding tube attachment. [Figure 76] FIG. 76 is a perspective view of the cannula system of FIG. 75, except that the cannula system has been assembled from disassembled components. [Figure 77]FIG. 76 is a perspective view of an alternative disassembled cannula system (to FIGS. 74 and 75) with a clip-on feeding tube attachment. [Figure 78] FIG. 1 is a perspective view of a clip-on feeding tube fitting with a hinged end cap. [Figure 79] FIG. 79 is a close-up view of the hinged end cap of FIG. [Figure 80] FIG. 79 is a top view of the clip-on supply tube of FIG. 78 with the hinged end cap moved toward the gas supply tube. [Figure 81] FIG. 79 is a top view of the clip-on delivery tube of FIG. 78, with the hinged end cap moved away from the gas delivery tube. [Figure 82] FIG. 79 is a perspective view of an assembled cannula assembly including the clip-on feeding tube attachment of FIG. 78. [Figure 83] 1 is an embodiment of a nasal cannula system including a pair of nasal prongs, a cannula body, a pair of side arms extending from the cannula body, headgear connected to the side arms, a gas delivery tube providing a source of gas in fluid communication with the pair of nasal prongs, and a connector associated with the gas delivery tube. [Figure 84] FIG. 1 is another embodiment of a nasal cannula system including a pair of nasal prongs, a cannula body, a pair of side arms extending from the cannula body, headgear connected to the side arms, a gas delivery tube providing a source of gas in fluid communication with the pair of nasal prongs, and a connector associated with the gas delivery tube. [Figure 85] FIG. 85 is a cross-sectional view of the embodiment shown in FIG. 84, the cross-section showing an example of how a first section of a first material can be provided in combination with a second section of a second material in combination with an example of a pivoting or swivel type manifold. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0316] Although several embodiments and examples are described below, those skilled in the art will understand that the disclosure extends beyond the specifically disclosed embodiments and / or uses obvious modifications and equivalents thereof. Thus, it is intended that the scope of the disclosure disclosed herein should not be limited by any particular embodiment described below. The various features described herein can be used individually or in various combinations and subcombinations in existing and / or improved respiratory interfaces.

[0317] Whether used in a hospital or home environment, a system providing a gas flow to a patient or user may include four main pieces of equipment. First, a blower that provides a pressurized gas flow to the patient. Second, an active humidifier that controls the temperature of a heater plate that heats a large amount of water to achieve the desired temperature and humidity of the gas flow. Third, a transport conduit from the humidifier to the patient is also required, which may be heated to reduce condensation, or "rainout." Fourth, a patient interface that delivers the pressurized humidified gas flow to the patient, for example a nasal cannula designed to fit into the patient's or user's nasal passages. In some circumstances, the pressurized gas flow may be provided to the patient without humidification, in which case a humidifier is not a required device.

[0318] Referring to Fig. 49a, a humidification circuit such as may be used in a patient interface incorporating the present invention is shown. A patient 100001 receives humidified, pressurized gas through a nasal cannula assembly 10020 connected to a humidified gas delivery pathway or expiratory conduit 100003 which is further connected to a humidifier 100008 (including a humidification chamber 100005) which is supplied with gas from a blower 10015 or other suitable gas supply means. The expiratory conduit 100003 is connected to an outlet 100004 of the humidification chamber 100005 which contains a volume of water 100006. The humidification chamber 100005 is preferably formed from a plastic material and may have a highly thermally conductive base (e.g. an aluminium base) which is in direct contact with a heater plate 100007 of the humidifier 100008. The humidifier 100008 is provided with a control means or electronic controller 100009, which may comprise a microprocessor based controller executing computer software commands stored in associated memory. Gases flowing through the expiratory conduit 100003 are passed to the patient by a nasal cannula assembly 100020.

[0319] The controller 100009 receives input from input sources such as user input means or dial 10010, through which a user of the device can set, for example, a predetermined required value (preset value) of humidity or temperature of the gas to be supplied to the patient 100001. Depending on the user set humidity or temperature value entered via dial 10010 and other possible inputs such as internal sensors sensing the gas flow rate or temperature, or by parameters calculated in the controller, the controller 100009 determines when (or to what level) to energize the heater plate 100007 to heat the water 100006 in the humidification chamber 10005. As the water 100006 in the humidification chamber 100005 is heated, water vapor begins to fill the volume of the chamber above the water level and exits through the humidification chamber 100005 outlet 100004 along with a flow of gas (e.g. air) provided from a gas supply means or blower 10015 which enters the chamber through an inlet 10016. It should be noted that it is possible to obtain a relationship between the humidity of the gas in the humidification chamber 100005 and the temperature of the heater plate 100007. Thus, it is possible to determine the humidity of the gas by utilizing the heater plate temperature in an algorithm or look-up table.

[0320] The blower 10015 may be provided with a variable speed pump or fan 100002 which draws in air or other gas through a blower inlet 10017. The speed of the variable speed pump or fan 100002 may be controlled by a further control means or electronic controller 10018 (or alternatively the functions of this controller 10018 may be performed by another controller 100009) in response to inputs from the controller 100009 and predetermined required values ​​(preset values) set by the user of pressure or fan speed via dial 10019.

[0321] A heating element 10011 may be provided within the conduit or tube 100003 to help prevent condensation of the humidified gas within the conduit. Such condensation occurs because the temperature of the walls of the conduit is closer to the ambient temperature (which is the temperature of the surrounding atmosphere), which is typically lower than the temperature of the humidified gas within the conduit. The heater element effectively replaces the energy lost from the gas via conduction and convection during its passage through the conduit. The conduit heater element thus ensures that the delivered gas is at an optimum temperature and humidity.

[0322] 1A-1C, an example embodiment of a nasal cannula assembly or system includes a manifold 12 and a cannula 14. The cannula 14 includes nasal prongs 20a, 20b, side straps 22, and a tubular opening 24 defined or surrounded by a retaining strap 26 and configured to receive the manifold 12. In some embodiments, the manifold is generally tubular and includes a circular inlet 16 and an elongated oval outlet 18. In use, the manifold 12 is coupled to the cannula 14 by inserting the manifold 12 into the opening 24 such that the manifold outlet 18 is aligned with and in fluid communication with the nasal prongs 20a, 20b. The manifold inlet 16 is configured to be removably or permanently coupled to a gas delivery tube 50. In use, the gas supply tube 50 is coupled to and in fluid communication with a main delivery conduit 90, which is configured to connect to and supply gas from a gas source, e.g., a ventilator, a gas tank, a wall outlet, and / or a humidifier that heats and / or humidifies the gas before delivery to a patient. The gas supply tube 50 may be coupled to the main delivery conduit 90 by a connector 52.

[0323] The nasal cannula system may further include a securing mechanism for securing the cannula 14 on the user's head in a suitable operating position. In the illustrated embodiment, the securing mechanism includes a headgear strap 40. The strap 40 may be coupled to the side strap 22 of the cannula 14. The nasal cannula system may also include a lanyard 46 that is placed around the patient's neck during use. The lanyard 46 may be coupled to the supply tube 50 and / or the connector 52 via a lanyard connector 54, which may also allow for adjustment of the length of the lanyard. The lanyard 46 advantageously helps to support the weight of the main delivery conduit 90 so as to reduce patient discomfort and the likelihood of the cannula 14 becoming dislodged. Further details regarding an example nasal cannula assembly or system may be found in U.S. Patent Application Publication No. 2010 / 0192957, the entirety of which is incorporated herein by reference. Various components and features of such nasal cannula assemblies may be selected and modified to achieve various benefits as described herein.

[0324] 2A and 2B, an embodiment of a nasal cannula assembly or system includes a cannula 114, a manifold 112, a headgear strap 140, a gas delivery tube, and a lanyard 146. The cannula 114 can be formed from a thermoplastic, silicone-like material and includes nasal prongs 120a, 120b, a side strap 122, and two spaced apart manifold retaining portions or straps 126a, 126b that define / surround an opening configured to receive the manifold 112. In some embodiments, the nasal prongs 120a, 120b, the side strap 122, and the manifold retaining straps 126a, 126b are integrally formed. The cannula 114 is configured such that the manifold 112 can be inserted into the opening of the manifold retaining straps 126a, 126b from either side such that the manifold inlet 116 can be located on either side of the cannula 114. The side straps 122 may include flex slots 128 to provide ventilation and allow the cannula 114 to bend or stretch more easily, for example, when adjusting the headgear straps 140 and when adjusting the cannula 114 relative to the user's face to help achieve a more effective and / or comfortable fit. The flex slots 128 may be generally vertical as shown or angled diagonally. As shown in FIG. 2B, the patient-facing and contacting side 130 of the cannula 114 may have a curved surface to better and more comfortably fit the patient's face, reduce the overall thickness of the cannula system, and help align the feeding tube 150. For example, the transition portion 132 disposed between the central body portion 134 of the cannula 114 and the side straps 122 may curve toward the patient's face to abut the nasolabial fold. The side straps 122 may taper in thickness toward the outer edges of the straps 122, providing a thin thickness and further helping to reduce the thickness of the cannula system.

[0325] The headgear straps 140 can be coupled to the side straps 122 via clips or buckles 142. The clips 142 can include openings 144 so that an inner edge 145 of the clip 142 on the side closest to the center of the cannula 114 can engage a corresponding undercut in the side strap 122. As shown in FIG. 2B, the clips 142 do not substantially contact the patient's skin, thereby maintaining a smooth and more comfortable patient-contacting surface. The side of the clips 142 furthest from the center of the cannula 114 can include a buckle mechanism that is configured to receive an end of the headgear straps 140 and allow the circumference of the headgear straps 140 to be adjusted to fit the patient's head. In some embodiments, the straps 140 can be flexible (e.g., elastic) to allow the straps 140 to accommodate a wide range of patient head sizes with minimal adjustment required.

[0326] In use, the manifold 112 is coupled to the cannula 114 by inserting the manifold 112 into the opening 124 and stretching the flexible cannula 114 around the manifold 112. As mentioned above, the manifold 112 can be inserted into the opening 124 of the manifold retaining straps 126a, 126b from either side so that the manifold inlet 116, and therefore the supply tube 150, can be positioned on either side of the cannula 114. In some embodiments, the manifold 112 is made from a relatively hard plastic material that can withstand relatively high load conditions to protect the manifold 112 from crushing. Additionally, the retaining straps 126a, 126b can be spaced apart from one another to provide support to the manifold 112 at spaced apart locations, thereby preventing or resisting undesired movement (e.g., rotation or twisting) of the manifold 112, such as that caused by forces acting on the supply tube 150. In some configurations, the outer edges of the retention straps 126a, 126b are spaced outwardly of the nasal prongs 120a, 120b such that the nasal prongs 120a, 120b are located between the side edges of the retention straps 126a, 126b. In some configurations, the inner edges of the retention straps 126a, 126b can be substantially aligned with or spaced outwardly from the nasal prongs 120a, 120b. Although a pair of retention straps 126a, 126b are shown, other suitable retention devices or configurations are possible, such as, for example, a single retention strap. In the illustrated embodiment, the manifold inlet 116 has an inner diameter that is slightly larger than the outer diameter of the supply tube 150 so that the tube 150 can be coupled to the manifold 112 by inserting an end of the tube 150 into the manifold inlet 116. The supply tube 150 can have a reduced diameter compared to the other supply tubes to allow this coupling. The end of the tube opposite the manifold can include a connector 152 configured to couple the supply tube 150 to a main delivery conduit that is coupled to a gas source.In the illustrated embodiment, the connector 152 is a 22 mm taper connector.

[0327] The cannula system can include a lanyard connector 154, which in the illustrated embodiment is located proximal (closer to the patient) to the connector 152 on the supply tube 150. The lanyard connector 154 can include a mechanism 155 for receiving an end of the lanyard 146 on either side. For example, each side of the lanyard connector 154 can include three or more offset slots or posts through which the end of the lanyard 146 is threaded. The slots or posts can be internal or exposed to the lanyard connector 154. This configuration advantageously allows one or both ends of the lanyard to be adjusted as needed or desired, allowing the weight of the connector 152 (and main delivery conduit 90) to be hung or oriented in a vertical orientation or direction. In some embodiments, the lanyard 146 is inelastic. The lanyard 146 is secured to the lanyard connector 154 via friction between the lanyard 146 and the slots or posts. The lanyard 146 can be ribbed to help secure the lanyard 146 to the lanyard connector 154. However, the lanyard 146 and lanyard connector 154 can be designed such that if the connector 154 is pulled too far away from the patient and / or the lanyard 146 is pulled with enough force to avoid choking or otherwise causing discomfort to the patient, the frictional forces are overcome and the lanyard 146 is released from the lanyard connector 154. The lanyard connector 154 can include a grip 156 so that the patient or other person can better grasp the lanyard connector 154 for adjustment and / or easy removal of the connector 152 from the main delivery conduit 90.

[0328] 3A and 3B, a nasal cannula assembly or system includes a cannula 214, a manifold 212, a headgear strap 240, a gas delivery tube 250, and a lanyard 246. The cannula 214 includes nasal prongs 220a, 220b, side straps 222, and a manifold retaining strap 226 that defines or surrounds an opening configured to receive the manifold 212. The cannula 214 is configured such that the manifold 212 can be inserted into the opening of the manifold retaining strap 226 from either side such that the manifold inlet 216 can be positioned on either side of the cannula 214. In the illustrated embodiment, the manifold retaining strap 226 is wider than the retaining strap 26 shown in FIGS. 1A and 1B and the straps 126a, 126b shown in FIG. 2. The retention strap 226 may include a window 227 that makes a portion of the manifold 212 visible and may indicate, for example, that the manifold 212 is properly inserted into the manifold retention strap 226. The window 227 may display, for example, brand, size and / or other information that is printed, stamped, attached or otherwise provided on the visible portion of the manifold 212.

[0329] The cannula 214 is generally soft and flexible for patient comfort. The outer portions 223 of the side straps 222 may be made to have increased strength, for example, by being relatively thicker or otherwise reinforced, such as via reinforcing ribs that may be located at the top and / or bottom edges of the side straps 222. The additional strength allows the headgear straps 240 to be directly coupled to the outer portions 223 of the side straps 222 without the need for additional clips, buckles, or other attachment mechanisms, allowing the cannula 214 and side straps 222 to retain their molded shape to prevent or inhibit deformation during tensioning. The outer portions 223 of the side straps 222 may include two or more slits or openings through which the ends 243 of the straps 240 may be threaded and pulled a desired length to obtain a circumference of the headgear straps 240 appropriate for fitting the patient. The ends 243 of the headgear straps 240 can be folded over and removably secured to the portions of the headgear straps 240 proximate the outer portions 223 of the side straps 222 via hook-and-loop closures. For example, a segment of fabric including hooks can be attached (e.g., sewn, adhered, etc.) to the ends 223 of the headgear straps 240 and a segment of fabric including loops can be attached (e.g., sewn, adhered, etc.) to the portions of the headgear straps 240 proximate the outer portions 223 of the side straps 222. The opposite ends 243 of the straps 240 that are visible when worn can be printed, die-cut, adhered, or otherwise affixed with branding or other information.

[0330] 3B, the rear or patient-facing side of the side strap 222 can include a recessed area 221 to accommodate the portion of the headgear strap 240 that is looped through the side strap 222 so that the strap 240 does not significantly compress the patient's face. The section of the headgear strap 240 that is configured to be placed against the rear of the patient's head in use can include a padded section 241 for patient comfort. The padded section can be inserted between the two halves of the headgear strap 240 or can be placed on top of or around the headgear strap 240.

[0331] In use, the manifold 212 is coupled to the cannula 214 by inserting the manifold 212 into an opening defined by the manifold strap 226. The manifold 212 can be inserted into the opening of the manifold retaining strap 226 from either side such that the manifold inlet 216 can be located on either side of the cannula 214. In the illustrated embodiment, the manifold 212 includes a cylindrical inlet 216. The inlet 216 has an inner diameter slightly larger than the outer diameter of the supply tube 250 such that the tube 250 can be coupled to the manifold 212 by inserting the end of the tube 250 into the manifold inlet 216. The end of the tube 250 opposite the manifold 212 can include a connector 252 configured to couple the supply tube 250 to a main delivery conduit that is coupled to and in fluid communication with a gas source.

[0332] The cannula system may further include a lanyard connector 254 located proximal to the connector 252 in the supply tube 250. In some embodiments, the lanyard connector 254 is color coded to indicate size or other information. One side of the lanyard connector 254 may include a mechanism 255 to adjustably receive one end of the lanyard 246. For example, one side of the lanyard connector 254 may include two slits or openings through which the end of the lanyard 246 may pass. This mechanism 255 allows the lanyard 246 to be easily placed around the patient's neck and coupled to the lanyard connector 254 without having to place the lanyard 246 on the patient's head. The lanyard connector 254 may also include a grip 256 to allow the patient or other person to better grip the lanyard connector 254 for adjustment and / or easy removal of the connector 252 from the main delivery conduit 90.

[0333] One side of the lanyard connector 254 can include a separable clip 257. An end of the lanyard 246 can include a molding configured to be inserted into the separable clip 257 to secure the lanyard 246 to the lanyard connector 254. The separable clip 257 is configured such that if the lanyard 246 exerts too much force on the patient's neck, for example by the main delivery conduit, connector 252, supply tube 250 and / or lanyard connector 254 being pulled away from the patient with a force that exceeds a predetermined threshold, the separable clip 257 releases or removes the lanyard 246 from the lanyard connector 254 to avoid injury or discomfort to the patient. This configuration advantageously allows the weight of the connector 252 (and main delivery circuit 90) to be hung or oriented in a vertical orientation or direction. In some embodiments, the lanyard 246 is made from a non-elastic material to improve the functionality of the separable clip 257 so that the weight of the main delivery conduit coupled to the connector 252 does not stretch the lanyard 246 and place additional force on the patient's neck. In some embodiments, the separable clip 257 allows the lanyard 246 to be easily looped around the patient's neck and then inserted into the separable clip 257.

[0334] Figure 4 shows a cannula system having a cannula 314 and headgear straps 340 that are similar in some respects to the cannula 214 and headgear straps 240 shown in Figures 3A and 3B. However, the cannula system of Figure 4 lacks the manifold retaining straps and includes a reversible manifold 312. The manifold 312 can be pivoted or rotated, or separated from the cannula 314 and reoriented 180 degrees, allowing the inlet 316 to be positioned on either side of the cannula 214.

[0335] An embodiment of a nasal cannula assembly or system as shown in Figures 5A and 6B includes a cannula 414, a headgear strap 440, and a gas delivery tube 450. The cannula 414 includes nasal prongs 420a, 420b, side straps 422, and an inlet 416. In the illustrated embodiment, an end of the gas delivery tube 450 is directly coupled to the inlet 416 of the cannula 414. The delivery tube 450 may have a reduced diameter so that the end of the delivery tube 450 can be received within the inlet 416. The delivery tube 450 may be secured to the cannula 414 by extending the cannula inlet 416 over the end of the delivery tube 450 using adhesives (e.g., glue), a mechanical interference fit mechanism, and / or other means. The cannula 414 further includes two gas passages 417a, 417b extending from and in fluid communication with the inlet 416, where the first gas passage 417a extends to and is in fluid communication with the first nasal prong 420a and the second gas passage 417b extends to and is in fluid communication with the second nasal prong 420b. The geometry of the gas passages 417a, 417b can be designed to balance the gas flow between the two gas passages 417a, 417b and the nasal prongs 420a, 420b such that the patient receives a balanced flow in both nares. The flow paths have reduced, minimal or not significantly abrupt transitions or sharp corners, which advantageously reduces or minimizes resistance to flow.

[0336] The ends of the side straps 422 may include openings or slots 421 designed to receive the ends of the headgear straps 440. The headgear straps 440 may be formed from a highly elastic material that allows for a significant degree of stretching that allows the straps 440 to accommodate and conform to various patient head sizes, especially if, as in the illustrated embodiment, the side straps 422 do not include clips or buckles that allow for adjustment of the circumference of the headgear straps 440. For example, the headgear straps 440 may be made from a material that has a relatively flat force-extension curve so as to maintain the same or substantially the same tension over various degrees of stretching. The ends of the headgear straps 440 may be overmolded with a rigid material to help secure the ends of the straps 440 within the openings 421. The straps 440 may also or alternatively be secured to the cannula 414 by adhesive (e.g., glue), ultrasonic welding, and / or other means.

[0337] The cannula system may include a tube clip 442 coupled (permanently or removably, non-removably or removably) to the headgear strap 440. The tube clip 442 may be located on the side of the cannula 414 closest to the inlet 416 and may receive the supply tube 450 to help hold the tube 450 away from the patient's mouth and face during use. The end of the supply tube 450 opposite the end coupled to the cannula inlet 416 may include a connector 452 configured to couple the supply tube 450 to the main delivery conduit. The cannula system may include a lanyard clip 454 located on the supply tube 450 proximal to the connector 452. The lanyard clip 454 may releasably clip to a lanyard worn around the patient's neck during use. Alternatively, the lanyard clip 454 may be attached directly to, for example, the patient's clothing or hospital gown, bed sheets, or another nearby location to help support the weight of the main delivery conduit. 5A and 5B does not include a manifold or clips or buckles that attach the headgear straps 440 to the cannula 414. This configuration minimizes parts in the nasal cannula system, which can advantageously help provide easier manufacturing and / or reduce costs.

[0338] Another embodiment of a nasal cannula assembly or system includes a cannula 514, a manifold 512, a gas delivery tube 550, and a lanyard 546, as shown in Figures 6A and 6B. The cannula 514 includes nasal prongs 520a, 520b, a manifold retaining strap 526, and a cheek pad 522. The cheek pad 522 is designed to be placed on the cheek and / or upper cheek of the patient during use. The cannula 514 includes a thin flexure area 532 located in a transition area between a central body portion 534 of the cannula 514 and the cheek pad 522. The thin flexure area 532 has a reduced cross-sectional thickness, which allows the cheek pad 522 to more easily move and adjust relative to the central body portion 534, improving the fit, positioning, and comfort of the cannula 514 on the patient's face. The rear or patient-contacting side of the central body portion 534 may include a soft and / or thin wall cushion detail 535. Cushion detail 535 may include, for example, a ribbed, corrugated, folded, or other surface designed to space central body portion 534 of cannula 514 slightly away from the patient's face, advantageously allowing airflow between central body portion 534 and the patient's face and providing a foldable area that helps absorb forces that press cannula 514 into the patient's face.

[0339] The rear surface of the cheek pad 522 includes an attachment pad 560 that is either integrally formed with the cheek pad 522 or sewn, adhered or otherwise attached thereto. The attachment pad 560 may include a releasable and repositionable adhesive that attaches the cheek pad 522 to the patient's face. Alternatively, the attachment pad 560 may include a portion of a hook-and-loop fastener, e.g., a fabric segment that includes a hook. The other portion of the fastener, e.g., a patch that includes a loop, may be attached to the patient's face at a desired location on the cheek and / or upper cheek to releasably attach the attachment pad 560 to the patient's face.

[0340] The manifold 512 includes an inlet 516 designed to receive the gas delivery tube 550440 and an outlet designed to align with and be in fluid communication with the nasal prongs 520a, 520b in use. The manifold 512 is coupled to the cannula 514 by sliding the manifold 512 into the opening defined by the manifold retaining strap 526 such that the outlets are aligned with the nasal prongs 520a, 520b, and stretching the cannula 514 around the edge of the manifold 512. The manifold 512 can be inserted into the opening of the manifold retaining strap 526 from either side such that the manifold inlet 516 can be positioned on either side of the cannula 514. The retaining strap 526 can include a window 527 that allows a portion of the manifold 512 to be visible, for example, to indicate that the manifold 512 is correctly inserted into the manifold retaining strap 526. Window 527 may display, for example, brand, size, and / or other information that is printed, stamped, attached, or otherwise presented on the visible portion of manifold 512.

[0341] In the illustrated embodiment, the supply tube 550 is a small diameter spiral tube. Other types of gas supply conduits are possible. The end of the supply tube 550 opposite the end coupled to the manifold 512 can include a connector 552 configured to be connected to a main delivery conduit. The cannula system can include a lanyard retaining connector 554 located at the connector 552 or proximal to the connector 552 on the supply tube 550. One end of the lanyard 546 can be integrally formed with or coupled to one side of the lanyard retaining connector 554. The other side of the lanyard retaining connector 554 can include a slot designed to receive the free end 547 of the lanyard 5464. The free end 547 of the lanyard 546 can include a series of projections or notches 548. The projections 548 can be pulled through slits in the lanyard retaining connector 554 to adjust the circumference of the lanyard 546 but resist sliding through the slots if not adjusted to help secure the lanyard 546 to the desired circumference. The lanyard 546 may be made from a die-cut fabric, such as white non-woven laminated polyethylene, which may advantageously help reduce the cost of the cannula system.

[0342] An example embodiment of a cannula system as shown in Figures 7A and 7B includes a cannula 614, a gas delivery tube 650, and a lanyard 646. The cannula 614 includes nasal prongs 620a, 620b, a retention strap 626, and an integrated headgear strap 640. In some embodiments, the headgear strap 640 can include a break on one side such that the headgear strap 640 includes a first section 640 and a second section 640b. The free end of one section (in the illustrated embodiment, the first section 640a) can include a slot 642 configured to receive the free end of the other section (in the illustrated embodiment, the second section 640b). A segment of the strap proximate to the free end of the second section 640b can include teeth 643 configured to engage a side of the slot 642 to help prevent the second section 640b from being pulled out of the slot 642. In the illustrated embodiment, a rear portion 641 of the headgear strap 640 that is part of the first section 640a can be separated into a dual strap configuration to assist in stability of the headgear strap 640 on the patient's head and / or help distribute forces on the patient's head and improve patient comfort.

[0343] In the illustrated embodiment, the end of the gas supply tube 650 is directly coupled to the cannula 614. The supply tube 650 may have a reduced diameter so that the end of the supply tube 650 can be received within an opening defined by the retaining strap 626. The supply tube 650 may be secured to the cannula 614 by stretching the manifold retaining strap 626 over the end of the supply tube 650 using an adhesive (e.g., glue), a mechanical interference fit mechanism, and / or other means. The cannula system may include a tube clip 642 coupled (permanently or removably, non-removably or removably) to the supply tube 650. The tube clip 642 may include a hook configured to be positioned on the headgear strap 640 to help hold the tube 650 away from the patient's mouth and face during use.

[0344] An end of the supply tube 650 opposite the end coupled to the cannula 614 can include a connector 652 configured to be connected to a main delivery conduit. The cannula system can further include a lanyard retaining connector 654. The connector 652 can include a lower portion and an upper portion 653 including a gripping mechanism. In some embodiments, the connector 652 includes a reduced diameter section between the upper and lower portions to receive the lanyard retaining connector 654. Alternatively, the upper and lower portions can be separate pieces. In use, the lanyard retaining connector 654 is pressed over a portion of the connector 652 and held in place between the upper and lower portions or in the reduced diameter section.

[0345] In the illustrated embodiment, the lanyard 646 is integrally formed on one side of the lanyard retaining connector 654. Alternatively, the lanyard 646 can be coupled to the lanyard retaining connector 654. The other side of the lanyard retaining connector 654 can include a slot designed to receive the free end 647 of the lanyard 646. The free end 647 of the lanyard 646 can include a series of notches 648 along the side. In use, the lanyard 646 is wrapped around the patient's neck and the free end 647 of the lanyard is threaded through the slots of the lanyard retaining connector 654 to achieve a desired circumference of the lanyard 646. The notches 648 can resist sliding through the slots when the free end 647 of the lanyard 646 is pulled through the slots of the lanyard retaining connector 654 to adjust the circumference of the lanyard 646 but not adjusted to help secure the lanyard 646 at the desired circumference. The lanyard 646 can be made from a die-cut fabric, for example, white non-woven laminated polyethylene, which can advantageously help reduce the cost of the cannula system.

[0346] 7C, the cannula system can include a connector 752, a lanyard connector 754 disposed proximal to the connector 752 on the supply tube 650, and a separate lanyard 746. The lanyard connector 754 includes two slots that receive ends of the lanyard 746. Both ends of the lanyard 746 can include a series of notches 748 similar to the notches 648 described herein that allow for adjustment of one or both ends of the lanyard 746. This configuration advantageously allows the weight of the connector 752 (and main delivery circuit 90) to be hung or oriented in a vertical orientation or direction.

[0347] In some embodiments, as shown, for example, in FIGS. 8A-8C, the cannula system includes a cannula 814, a manifold 812, a headgear strap 840, a gas delivery tube 850, and a lanyard 846. The cannula 814 includes nasal prongs 820a, 820b and an inlet 824. As shown in FIG. 8C, a flange 825 surrounds the outer periphery of the inlet 824. The manifold 812 includes an inlet 816 and an outlet 818 configured to receive a delivery tube 850. The outlet 818 of the manifold 812 includes a recess 819 configured to receive the flange 825 of the cannula 814. In some embodiments, the manifold 812 and the cannula 814 can be designed to be reduced in size to advantageously reduce the thickness of the cannula system on the patient's face, thereby improving patient comfort and reducing the possibility of obstructing the face or mouth in some circumstances.

[0348] In use, manifold 812 is coupled to cannula 814 by inserting one side of manifold 812 into cannula 814 inlet 824 so that flange 825 of cannula 814 sits within recess 819 of manifold 812, and stretching cannula 814 around manifold 812 outlet 818 so that flange 824 sits around the entire circumference of cannula 814 outlet 824 and manifold 812 outlet 818 within recess 819. Flange 824 and corresponding recess 819 advantageously help to secure the connection between cannula 814 and manifold 812, and can also help to prevent air leaks at the connection. Manifold 812 may further include tabs 880 designed to fit within corresponding recesses or openings 882 in cannula 814 to help further secure manifold 812 to cannula 814 and to indicate that manifold 812 is properly inserted into cannula 814. As shown in FIG. 8C , manifold 812 is reversible, i.e., manifold 812 may be coupled to cannula 814 such that manifold inlet 816 extends to either side of cannula 814. Manifold 812 may include grips 815 that advantageously help a user to grasp manifold 812 to couple and / or remove manifold 812 from cannula 814.

[0349] In the illustrated embodiment, the headgear straps 840 are directly coupled to the cannula 814, and the cannula system does not include clips, buckles, or other mechanisms that allow for adjustment of the circumference of the straps 840. The sides of the cannula 814 may include openings or slots 821 designed to receive the ends of the headgear straps 840. The ends of the straps 840 may be secured to the cannula 814 by adhesive (e.g., glue), ultrasonic welding, and / or other means. The headgear straps 840 may be formed from a highly elastic material that allows for a significant degree of stretch that allows the straps 840 to adapt and conform to various patient head sizes. For example, the headgear straps 840 may be made from a material that has a relatively flat force-elongation curve such that the straps 840 maintain the same or substantially the same tension over various degrees of stretch. The thread pitch of the headgear straps 840 material may be varied to adjust the tightness of the straps 840.

[0350] The gas supply tube 850 can be coupled to a connector 852 configured to couple the supply tube 850 to the manifold 812 inlet 816 on one end and to a main delivery conduit on the other end. The gas supply tube 850 can have a reduced diameter to allow the end of the tube 850 to be inserted into the manifold inlet 816. In some embodiments, the connector 852 can include a grip detail 856 to help a user more easily grip the connector 852 to adjust various components of the cannula system. In some embodiments, the gas supply tube 850 can include a pressure line 870. The pressure line 870 can be configured to transport pressure feedback from the end of the supply tube 850 coupled to the manifold 812 to a pressure sensor and / or controller. The pressure line 870 can be integral with or coupled to the supply tube 850. In some embodiments, the pressure line 870 is located within the main flow path of the supply tube 850. In other embodiments, the pressure line 870 is located adjacent to the main flow path of the supply tube 8570. For example, in some embodiments, supply tube 850 can be a spiral vial and pressure line 870 can be located in the hollow spiral of spiral vial supply tube 850 .

[0351] The cannula system may further include a lanyard connector 854 located proximal to the connector 852 on the supply tube 850. In some embodiments, the lanyard connector 854 is fixed relative to the tube 850. In other embodiments, the lanyard connector 854 is slidable relative to the tube 850. The lanyard connector 854 may include an opening or slot on either side to receive the end of the lanyard 846. In the illustrated embodiment, the lanyard connector 854 also acts as a separation point for the pressure line 870 from the supply tube 850. In use, the lanyard 846 is wrapped around the patient's arm and the end of the lanyard 846 is threaded through an opening or slot in the lanyard connector 854 to achieve the desired circumference of the lanyard 846. The end of the lanyard 846 may include a notch 848 along the side. The notches 848 allow the lanyard 846 to be pulled through a slot in the lanyard connector 854 to adjust the circumference of the lanyard 846, but resist sliding through the slot when the lanyard 846 is not adjusted to help secure the lanyard 846 at the desired circumference. This configuration advantageously allows the weight of the connector 852 (and main delivery circuit 90 shown in FIG. 1A) to be hung or oriented in a vertical orientation or direction. The lanyard 846 can be made from a die-cut fabric, for example, a white non-woven laminate polyethylene, which can advantageously help reduce the cost of the cannula system.

[0352] An example embodiment of a cannula system as shown in Figures 9A and 9B includes a cannula 914, a manifold 912, a headgear strap 940, and a gas delivery tube 950. As shown, the cannula 914 can include a manifold opening 924 configured to receive the manifold 912 and a headgear strap opening 921 configured to receive the headgear strap 940. The manifold 91221 can be inserted into the opening of the cannula 914 from either side such that the manifold inlet 916 can be located on either side of the cannula 914. In the illustrated embodiment, the manifold 912 is generally cylindrical and therefore the manifold opening 924 is also generally cylindrical. The manifold 912 can be substantially hollow to allow for gas flow. The cannula 914 can include a window 927 that allows a portion of the manifold 912 to be visible, for example, to indicate that the manifold 912 is properly inserted into the cannula 914. The window 927 may display, for example, brand, size or other information that is printed, stamped, attached or otherwise presented on the visible portion of the manifold 912 .

[0353] One end of the cylindrical manifold 912 is open and forms an inlet 916 configured to receive one end of a gas supply tube 950. The opposite end of the manifold 912 is closed as shown in FIG. 9B. In some embodiments, the closed end of the manifold 912 includes a removable cap. In some such embodiments, the solid cap may be replaceable with a cap 913 that may include a pressure line 970 as shown in FIG. 9C, for example. As described above, the manifold 912 may be inserted into the opening of the cannula 914 from either side, such that the manifold inlet 916 may be located on either side of the cannula 914. Thus, the cap 913 may be located on either side of the cannula 914.

[0354] In the illustrated embodiment, the headgear strap 940 is threaded through the headgear strap opening 921 of the cannula 914. In some embodiments, the headgear strap 940 is secured to the cannula 914 by an adhesive (e.g., glue), ultrasonic welding, or another mechanism. However, in some embodiments, the cannula 914 and the headgear strap 940 are slidable relative to each other. The headgear strap 940 can be a single strap. One end of the single strap can be secured to a clasp 943a and the opposite end of the single strap can be secured to a clasp 943b. The clasps 943a, 943b are coupled to the strap 940 and slidable thereat to allow the circumference of the strap 940 to be adjusted to fit the patient's head. In some embodiments, the headgear strap 940 is made of a non-stretchable material.

[0355] The cannula system can include a connector 952 for the supply tube 950 at an end opposite the manifold 912. The connector 952 can be configured to couple the supply tube 950 to a main supply conduit. The cannula system can further include a lanyard clip 954 that surrounds a proximal portion of the connector 952 or surrounds the supply tube 950 proximal to the connector 952. The lanyard clip 954 can releasably receive a lanyard. Alternatively, the lanyard clip 954 can be clipped directly to the patient's clothing or hospital gown, bedding, or a lanyard placed around the patient's neck to help support the weight of the main supply conduit coupled to the connector 952.

[0356] An example embodiment of a cannula system as shown in FIGS. 10A and 10B includes a cannula 1014, a nasal strip 1022, a supply tube 1050, and nasal prongs 1020a, 1020b. The cannula 1014 is shaped and sized to be placed on the tip of the patient's nose. For example, a portion of the cannula 1014 can have a curved contour designed to follow the curvature of the nose. The cannula 1014 can be secured to the patient's nose via the nasal strip 1022. In some embodiments, the nasal strip 1022 resembles a bandage. A central portion of the nasal strip 1022 can include a comfort pad 1035 configured to abut the patient's nose and provide additional cushioning during use. An adhesive portion of the nasal strip 1022 extends from the central portion to adhere to a portion of the patient's cheek. A mounting pad 1062 is coupled (e.g., stitched, adhered, or otherwise attached) to the side of the nasal strip 1022 facing away from the patient's face. The patient-facing side of the cannula 1014 includes corresponding mounting pads 1060. For example, in some embodiments, the mounting pads 1060, 1062 are components of a hook-and-loop fastener, such as Velcro®. Thus, the mounting pads 1060, 1062 allow the cannula 1014 to be releasably attached to the nasal strip 1022.

[0357] In some embodiments, the nasal strip 1022 includes a strip 1064 designed to help hold the patient's nasal passages open. In some embodiments, the strip 1064 can be made from a flexible, spring-like metal that is biased toward a substantially straight state. When the nasal strip 1022 is placed across a curved nasal bridge, the strip 1064 attempts to straighten, thereby gently lifting both sides of the patient's nose to open the nasal passages. In some embodiments, the strip 1064 can be made from a shape-memory material, such as Nitinol, where heat from the patient's face causes the strip 1064 to return to a straighter state. The strip 1064 can be placed on either side of the nasal strip 1022, i.e., the side facing away from the patient or the side facing the patient, for example, between the nasal strip 1022 and the comfort pad 1035. In some embodiments, the nasal strip 1022 can also act as an acne removal strip. The patient-contacting side of the nasal strip 1022 may include a binding agent that can bind to dirt and / or other impurities in the patient's pores so that they are removed along with the nasal strip 1022 when it is removed.

[0358] In the illustrated embodiment, the supply tube 1050 is a dual tube including two small diameter tubes extending between the main delivery conduit connector 1052 and the nasal prongs 1020a, 1020b. The cannula system may include an adapter 1053 designed to receive the small diameter supply tube 1050 and couple to the main delivery conduit connector 1052. The adapter 1053 may be integrally formed with, attached to, or proximal to the connector 1052. Each of the supply tubes 1050 may be integrally formed with or coupled to one of the nasal prongs 1020a, 1020b. In some alternative embodiments, the supply tube 1050 may include a single tube for some or all of its length. The single tube may be separated at the nasal prongs 1020a, 1020b or may be separated into two tubes distal to the nasal prongs 1020a, 1020b. As shown in Figures 10A and 10B, the two feeding tubes 1050 travel downward and enter a portion of the cannula 1014. The nasal prongs 1020a, 1020b extend downward from the feeding tubes 1050 and the cannula 1014, then turn approximately 180 degrees to extend upward on the patient-facing side of the cannula 1014. In the illustrated embodiment, the nasal prongs 1020a, 1020b are molded or formed to retain their shape and orientation. In some embodiments, the nasal prongs 1020a, 1020b may include wires made from a shape memory material, for example Nitinol. Gas flow through the nasal prongs 1020a, 1020b or heat radiating from the patient's face may cause the wires to assume and / or maintain a molded shape. The nasal prongs 1020a, 1020b extend upwardly into the patient's nostrils when the cannula 1014 is coupled to the nasal strips 1022.

[0359] In some alternative embodiments, the cannula system may include nasal pillows 1120a, 1120b instead of nasal prongs, as shown for example in FIG. 11. As shown, the supply tube 1050 passes down through a portion of the cannula 1014 and hangs freely. The nasal pillows 1120a, 1120b are coupled to the free end of the supply tube 1050. In some embodiments, the nasal pillows 1120a, 1120b may be self-inflating pillows. In use, the nasal pillows 1120a, 1120b are turned up and inserted into the patient's nares and the cannula 1014 is coupled to the nasal strips 1022.

[0360] The cannula system may further include cheek pads 1042. The cheek pads 1042 may include adhesive strips that may be used to secure a portion of the supply tube 1050 to the patient's cheek. The cheek pads 1042 may advantageously help to hold the supply tube 1050 away from the patient's mouth and may help to support a portion of the weight of the supply tube 1050. The cheek pads 1042 may be printed or otherwise marked with branding or other information. In some embodiments, the supply tube 1050 includes an anti-kink spring, which may advantageously help to allow the tube 1050 to be manipulated without interfering with the gas supply, for example, when placing the cannula 1014 or cheek pads 1042 on the patient.

[0361] An example embodiment of the cannula system can include two cannulas 1220a, 1220b, a nasal strip 1222, and a supply tube 1250a, 1250b, as shown in Figures 12A-12C. The nasal strip 1222 can be similar to the nasal strip 1022 shown in Figures 10A and 10B and described in the accompanying text. However, in the embodiment of Figures 12A-12C, the cannulas are separated into a right cannula 1214a and a left cannula 1214b. In some embodiments, the cannulas 1214a, 1214b are symmetrical rather than offset. The right cannula 1214a includes an integral nasal prong 1220a, and the left cannula 1214b includes an integral nasal prong 1220b. The patient-facing surface of each cannula 1214a, 1214b includes mounting pads 1260a, 1260b for removably attaching the cannula 1214a, 1214b to the mounting pads of the nasal strip 1222. In some embodiments, the nasal strip 1222 includes strips 1264 to help hold the patient's nasal passages open, as described with respect to Figures 10A and 10B.

[0362] The feeding tubes include small diameter right and left feeding tubes 1250a, 1250b that extend from the main delivery conduit connector 1252 to the right and left cannulas 1214a, 1214b. The feeding tubes 1250a, 1250b are received within the inlets 1224a, 1224b of the cannulas 1214a, 1214b. As shown, the feeding tubes 1250a, 1250b can be looped around the patient's ears to help hold the tubes 1250a, 1250b away from the patient's mouth and to support some of the weight of the tubes 1250a, 1250b. The tubes 1250a, 1250b can include spring windings to help provide kink resistance and strength. In some embodiments, only one of the cannulas 1214a, 1214b can be used at a given time for a given patient, as needed or desired.

[0363] 13A-13C, an example embodiment of a cannula system may include a cannula 1314, a retainer 1322, and a supply tube 1350. The cannula 1314 may have a minimal size and thickness. In the illustrated embodiment, the cannula 1314 includes a generally cylindrical body having an inlet 1324 and integrally formed nasal prongs 1320a, 1320b. The retainer 1322 includes a cannula-engaging portion 1321 and a nasal strip portion 1323. In some embodiments, the cannula-engaging portion 1321 is attached to the cylindrical body of the cannula 1314 by an adhesive, such as glue. In some embodiments, the cannula-engaging portion 1321 is molded as part of the cannula 1314. In some embodiments, the cannula-engaging portion 1321 has a molded shape configured to snap-fit ​​or clip onto the cannula 1314. The nasal strip portion 1323 is designed to adhere across the patient's nose to help secure the cannula 1314 to the patient. The patient-facing side of the nasal strip portion 1323 may include an adhesive strip covered by a protective backing for storage. The protective backing is peeled away to expose the adhesive strip when needed to secure the cannula 1314 to the patient. The retainer 1322 may be removed and replaced as needed during the course of treatment. In embodiments where the cannula engaging portion 1321 is molded as part of the cannula 1314, the adhesive strip may be removed and / or replaced as needed.

[0364] In some embodiments, the supply tube 1350 is a small diameter spring tube. The supply tube 1350 can be coupled at one end to the main delivery conduit connector 1352 and at the opposite end to the cannula 1314 inlet 1324. The supply tube 1350 diameter can be sized such that the supply tube 1350 can be inserted into the cannula inlet 1324 and the cannula 1314 can be stretched or otherwise formed or positioned around the tube 1350 to secure the tube 1350 to the cannula 1314. The cannula system can also include a lanyard clip 1354 positioned on the connector 1352 or proximal to the connector 1352 on the supply tube 1350. The lanyard clip 1354 can releasably receive a lanyard positioned around the patient's neck. Alternatively, the lanyard clip 1354 can be attached to, for example, the patient's clothing or hospital gown, bed sheets, or another nearby location to help support the weight of the main delivery conduit.

[0365] An example embodiment of a cannula system as shown in Figures 14A-14C includes a cannula 1414, a manifold 1412, and a gas delivery tube 1450. The cannula 1414 includes nasal prongs 1420a, 1420b, nose flaps 1422a, 1422b, and a manifold retaining strap 1426 that defines / surrounds an opening 1424 configured to receive the manifold 1412. In use, the manifold 1412 is coupled to the cannula 1414 by inserting the manifold 1412 into the opening 1424 and stretching the manifold retaining strap 1426 around the manifold 1412. In the illustrated embodiment, the manifold includes an inlet or collar 1416 and two outlets 1418. In use, the outlets 1418 are aligned with and in fluid communication with the nasal prongs 1420a, 1420b.

[0366] The nose flaps 1422a extend from either side of the cannula 1414 and are configured to fold over either side of the patient's nares. The nose flaps 1422a, 1422b include a thin section near the manifold retention strap 1426 to allow the nose flaps 1422a, 1422b to easily bend and conform to the shape of the nose. In some embodiments, each nose flap 1422a, 1422b includes an attachment pad 1460, which may be one part of a hook-and-loop fastener. The attachment pads 1460 may be removably coupled over the user's nose to a corresponding attachment pad 1462, which may be the other part of the hook-and-loop fastener. The attachment pads 1462 may be attached by an adhesive to the outside of the patient's nares. In some embodiments, the attachment pads 1460 of the nose flaps 1422a, 1422b may be adhesive patches that adhere directly to the user's nose. In some embodiments, the nose flaps 14221 a, 1422b can include a malleable material that can retain its shape once deformed, such that the nose flaps 1422a, 1422b remain substantially in place once folded. In such an arrangement, the mounting pads 1460 can be grip pads that comprise a gripping material to grip the patient's skin and prevent unwanted movement of the cannula 1414.

[0367] In some embodiments, the supply tube 1450 is a small diameter spring tube. The supply tube 1450 can be coupled at one end to a main delivery conduit connector 1452 and at the opposite end to a manifold inlet or collar 1416. In some embodiments, the supply tube 1450 is permanently attached to the collar 1416 and / or the collar 1416 is permanently attached to the manifold 1412. Alternatively, the supply tube 1450 can be removably coupled to the collar 1416 and / or the collar 1416 can be removably coupled to the manifold 1412. As shown in FIG. 14B, the manifold 1412 can be inserted into the opening 1424 of the cannula 1414 from either side such that the supply tube 1450 can extend from either side of the cannula 1414. The cannula system can further include a lanyard clip 1454 disposed on the connector 1452 or proximal to the connector 1452 on the supply tube 1450. The lanyard clip 1454 can be releasably coupled to a lanyard placed around the patient's neck, or can be attached, for example, to the patient's clothing or hospital gown, bed sheet, or another nearby location to help support the weight of the main delivery conduit.

[0368] 15-18 show embodiments of a nasal cannula assembly including a cannula, preferably including a pair of nasal prongs. The cannula can be integral with a supply conduit or tube, or the cannula can be coupled to a separate supply conduit or tube, such as by any of the manifold arrangements disclosed herein. In some configurations, the cannula has a tubular shape with a first end, a 21st end, and a body extending between the first end and the 21st end, with one of the ends being coupled to a supply tube. The cannula body can thus define a hollow "manifold" space that is at least partially defined by the manifold in other embodiments disclosed herein. Additionally, in some embodiments, the cannula can include one or more prong exit holes intermediate the cannula body that can be positioned to allow gases to exit to the pair of nasal prongs. In some embodiments, the cannula can be a hollow space cannula that includes at least one inlet that can be positioned and shaped to be attached to a supply tube or conduit. In some embodiments, the cannula can include an inlet at each end of the cannula. The cannula can be configured to be connected to or integrated into an assembly securing device, such as a headgear strap. The cannula can be configured to be integrally or permanently connected to a supply tube or conduit, such as via any of the manifold devices described herein or via a connector. In some embodiments, the cannula can be integrated or one-piece with the tube to create a cannula / tube assembly or structure. In some embodiments, the cannula can be flexible to allow bending or manipulation of the cannula. In other embodiments, the manifold can be relatively stiff or rigid. Any of the cannula embodiments discussed herein can include attached or clip-on or sliding prongs, and / or fixed or angled / adjustable prongs, as described herein.

[0369] In some embodiments, the cannula can have a tube exit hole at each end, the first end and the second end of the cannula. In some embodiments, the first end or the second end can be configured to be connected to a supply conduit or tube that connects to a humidifier, circuit, or other gas or flow supply device. The end that is not connected to the tube can be selectively closed. For example, selective side switching of the device can be achieved through a system in which the second end is closed when the first end is connected to a tube to allow air to enter the manifold space of the cannula, and the first end is closed when the second end is connected to a tube to allow air to enter the manifold space of the cannula. Figures 15-18 show an embodiment of selective side switching in a manifold.

[0370] 15A-15D show embodiments of a nasal cannula assembly incorporating a shuttle valve that selectively blocks one end of a cannula or manifold (hereafter referred to as the "manifold"). In some embodiments, the manifold 1501 can have an opening, port or inlet 1507, preferably an opening 1507, on each side of the manifold 1501. In particular, a first opening 1507 of the manifold 1501 can be located at the second end and a second opening 1507 can be located at the first end of the manifold 1501. In some embodiments, a lightweight shuttle object or valve body 1508, e.g., a ball or disk, can move (e.g., slide or rotate) freely within the manifold space or hollow cavity 1509. Preferably, the shuttle object 1508 is larger in diameter than the prongs 1505 and the opening 1507 such that the shuttle object 1508 does not exit the hollow cavity 1509.

[0371] In some embodiments, a supply tube 1502 can be connected to one of the openings or inlets 1507. The supply tube 1502 can supply a positive pressure resulting from a flow of air or gas from a humidifier or other device into the hollow cavity 1509. The positive pressure resulting from the flow of air or gas pushes the shuttle object 1508 along the hollow cavity 1509 until it closes the opposing opening 1507. Closing the opposing opening 1507 can prevent air from passing through that opening 1507 while still allowing air to flow through the prongs 1505. In some embodiments, the supply tube 1502 can be attached to one opening 1507 of the manifold 1501, with the opposing opening 1507 being closed by the shuttle object 1508. For example, to switch sides of the supply tube 1502 relative to the manifold 1501, the supply tube 1502 can be removed from one opening 1507 and pushed into the opposite opening 1507, and the shuttle object 1508 will automatically switch sides. In some embodiments, the opening 1507 can have a local thin-walled section 1510 that preferably defines an annular shape surrounding the opening 1507. The local thin-walled section 1510 can deform relative to at least a perimeter portion of the manifold 1501 to help seal the hollow cavity 1509 at its end when the shuttle object 1508 is forced against that side. In some embodiments, the shuttle object 1508 can be made from a relatively soft material, such as a material used to make compressible earplugs (e.g., compressible PVC foam), to further help seal the hollow cavity 1509.

[0372] In some embodiments of the nasal cannula assembly 1500, the manifold 1501 has at least one prong 1505 and preferably a pair of prongs 1505. Preferably, the nasal cannula assembly 1500 includes prongs 1505 disposed or configured to be disposed on the manifold 1501. In some embodiments, the prongs 1505 on the manifold 1501 may be flexible or rotatable to allow for use of the nasal cannula assembly 1500 in either orientation. The prongs 1505 shown in FIG. 15 include a distal end 1521 and a proximal end 1522. The distal end 1521 of each prong 1505 is configured to be disposed in the user's nose during use. The proximal end 1522 of each prong 1505 is configured to be attached to or flush with a prong exit hole 1520 of the manifold 1501 that communicates with the interior space of the manifold 1501 and the prongs 1505. In some embodiments, the prongs 1505 are twin nasal prongs and are located in the middle of the body of the manifold 1501 .

[0373] The supply tube 1502 may be coupled to the manifold 1501 by any suitable arrangement. For example, the supply tube 1502 may include a connector 1530 coupled to an end of the supply tube 1502 and configured to be coupled to the manifold 1501. The connector 1530 may have a snap-fit ​​arrangement with the openings 1507 of the manifold 1501. In some configurations, the connector 1530 may include a groove that engages with either one of the openings 1507 of the manifold 1501, and the thin-walled section 1510 may facilitate a seal between the manifold 1501 and the connector 1530.

[0374] 15E-15G show an alternative coupling arrangement between the supply tube 1502 and the manifold 1501 incorporating an insert 1540 that facilitates connection between the supply tube 1502 and the manifold 1501. In some configurations, the manifold 1501 is constructed from a soft and / or stretchy material, which can provide improved comfort to the user. The insert 1540 can be constructed from a relatively stiff material, preferably stiffer than the material of the manifold 1501, such that the insert 1540 can be positioned within one or both openings 1507 of the manifold 1501 with a relatively tight fit therebetween. In some configurations, the manifold 1501 and the insert 1540 can form at least a substantial seal therebetween, at least at the expected operating pressure of the nasal cannula system 1500. The insert 1540 can include one or more interference fit features that secure the insert 1540 to the manifold 1501 via a complementary interference fit feature of the manifold 1501. For example, the insert 1540 can include at least one protrusion, and preferably a pair of opposing protrusions 1542 that engage with recesses or openings 1544 in the manifold 1501. In the illustrated arrangement, the protrusions 1542 are button-headed or mushroom-headed protrusions with an enlarged head distal to the shaft portion relative to the body of the insert 1540. The openings 1544 can engage the shaft portion of the protrusions 1542 when the insert 1540 is assembled to the manifold 1501. The soft and / or stretchy material of the manifold 1501 can aid in assembling the insert 1540 to the manifold 1501 and threading the protrusions 1542 through the openings 1544.

[0375] The connector 1530 can be shaped or otherwise configured to engage the insert 1540 to fixedly connect the supply tube 1502 to the manifold 1501. In the illustrated arrangement, the connector 1530 includes at least one mating member, such as a resilient arm portion 1546. Preferably, the connector 1530 includes a pair of resilient arm portions 1546. Each arm portion 1546 includes an engagement protrusion 1548 that engages a portion (e.g., an end face) of the insert 1540. The illustrated connector 1530 includes a cylindrical base portion 1550 between a flange 1552 and the arm portion 1546. The flange 1552 has an enlarged diameter or circumference dimension relative to the base portion 1550 to define a shoulder 1554 that can abut an end face of the insert 1540 opposite the end face with which the protrusion 1548 engages. Thus, the linear distance between the shoulder 1554 and the protrusion 1548 can be approximately equal to the length of the insert 1540. In some configurations, the arm portions 1546 can flex toward a central axis of the connector 1530 to facilitate passage of the arm portions 1546 through the interior space of the insert 1540. Preferably, the length of the manifold 1501 and the length of the insert 1540 are configured such that neither the insert 1540 nor the shuttle object 1508 closes the prongs 1505.

[0376] Figures 16A-16F show an embodiment of a nasal cannula assembly with a manifold having a one-way valve at each end. Similar to the embodiment discussed in Figure 15, Figures 16A-16F show a nasal cannula assembly 1600 having a manifold 1601 with a central nasal prong 1605, a hollow cavity 1609, and an inlet or opening 1607 on each side. A supply tube 1602 can be attached to either opening 1607 of the manifold 1601. However, a one-way valve 1608 is used instead of or in addition to a shuttle object (e.g., valve body 1508) sealing the hollow cavity 1609 at one opening 1607. In some embodiments, the one-way valve 1608 is disposed at one opening 1607 of the hollow cavity 1609 of the manifold 1601, and the supply tube 1602 is disposed in the opening 1607 by being pushed into the one-way valve 1608 or is disposed against the one-way valve 1608. In some embodiments, the opposite one-way valve 1608 remains sealed, so that the flow of air or gas from the supply tube 1620 is directed towards the nasal prongs 1605. In some embodiments, the one-way valve 1608 can be molded into the manifold 1601. In other embodiments, the one-way valve 1608 can be fabricated as an insert configured to be inserted into the manifold 1601. In some embodiments, the one-way valve 1608 can also function as a pressure pop-off relief valve to release any excess pressure.

[0377] 16A-16F show an embodiment of a nasal cannula assembly 1600 with a manifold 1601 having a one-way valve 1608 formed from an exhalation type valve with a loosely hinged flap 1608a (FIG. 16E). In some embodiments, a supply tube 160220 can be inserted through the one-way valve 1608 as shown in FIG. 16C, such that the flap can be held open by the supply tube 1602. In some embodiments, the supply tube 1602 is positioned against the one-way valve 1608, and the valve 1608 is held open by airflow from the supply tube 1602 as shown in FIG. 16D. The supply tube 1602 can be connected to the manifold 1601 directly or through any suitable connector, such as any of the connectors disclosed herein. The valve 1608 can have any suitable shape, such as circular (FIGS. 16A-16E) or rectangular (FIG. 16F).

[0378] 16G-16L show an embodiment of a nasal cannula assembly 1600 with a manifold 1601 having one-way valves 1608 formed from slit valves of various shapes. Preferably, the one-way valves 1608 comprise a stretchable material. In some embodiments, the one-way valves 1608 can be slit valves (FIGS. 16G and 16H), which can be duckbill valves (FIGS. 16I and 16J), joker or tricuspid valves (FIG. 6K), slit-dome valves (FIG. 16L), and / or any other slit valves known in the art, among others. A supply tube 1602 can be connected to the manifold 1601 by any suitable device, either directly or via a connector 1630.

[0379] 17 illustrates an embodiment of a nasal cannula assembly 1700 in which a supply tube 1702 is threaded through a manifold 1701 to enable selective side switching of an outlet side of the supply tube 1702 relative to the manifold 1701. In some embodiments, the supply tube 1702 can have a first end 1710 and a twenty-first end 1711. The first end 1710 and the twenty-first end 1711 can have attached thereto respective manifold inserts 1712, 1713. The manifold inserts 1712, 1713 can each have one or more manifold insert openings 1714 (e.g., a pair of openings 1714 on opposing sides of the inserts 1712, 1713) extending along a length of the manifold inserts 1712, 1713. Additionally, each insert 1712, 1713 can include a pair of spaced apart flanges 1716 disposed on either side of the openings 1714 and configured to create at least a substantial seal with the manifold 1701. A recess 1718 is defined between the flanges 1716 to ensure air or gas communication between the opening 1714 and the nasal prongs 1705 regardless of the location of the opening 1714 .

[0380] In some embodiments, the tube exit side can be selectively selected by pushing or pulling the supply tube 1702 in some way to the desired side. In some embodiments, when the supply tube 1702 is pulled or pushed to one side, the manifold insert 1712, 1713 on the opposite side can seal against the manifold 1701 and the manifold insert 1712, 1713 on the side being pulled can be connected to a gas or air supply circuit. For example, if the supply tube 1702 is pulled through the manifold 1701 and the manifold insert 1712 is sealed against the manifold 1701, the manifold insert 1713 on the opposite end is connected to a gas or air supply circuit (FIG. 17B). Alternatively, if the tube 1702 is pulled through the manifold 1701 and the manifold insert 1713 is sealed against the manifold 1701, the manifold insert 1712 on the opposite end is connected to a gas or air supply circuit. In some embodiments, a connector or adapter 1715 may be required to connect the supply tube 1702 to the circuit so that a suitable attachment can be achieved for connecting to a humidifier or other gas or air supply source. Additionally, in other embodiments, a native connection is used to connect the supply tube to the gas or air supply circuit, thereby eliminating the need for an adapter or connector 1715. In some embodiments, when the manifold inserts 1712, 1713 are placed within the manifold 1701, the manifold insert openings 1714 can be aligned with the nasal prongs 1705 of the manifold. Additionally, in some embodiments, the manifold inserts 1712, 1713 can be held in place by a locking mechanism once the supply tube 1702 is pulled to the desired side of the manifold 1701. In some embodiments, the locking mechanism can include a twist lock, a press fit, a screw, or any other locking mechanism known in the art.

[0381] 18A and 18B show an embodiment of a nasal cannula assembly in which each tube exit hole is sealed by a pierceable thin membrane or other member. Similar to the embodiment described with reference to FIGS. 15A-15G, FIGS. 18A and 18 show a nasal cannula assembly 1800 having a manifold 1801 with a central nasal prong 1805, a hollow cavity (not shown), and openings 1807 on each side. A supply tube 1802 can be attached to either opening 1807 of the manifold 1801. In some embodiments, the openings 1807 of the manifold 1801 are sealed by a thin membrane 181001. The thin membrane 181001 can be a thin film, a pierceable membrane, or other pierceable material known in the art. In some embodiments, the connector or end 1811 of the supply tube 1802 includes a piercing portion, such as a sharp tip 1812, that can pierce the membrane 1810 at any opening 1807 of the manifold 1801 into which the supply tube 1802 is inserted. The sharp tip 1812 can be located in any suitable location, such as at or near the periphery (FIG. 18A) or at or near the center (FIG. 18B). When the sharp tip 1812 is at or near the center, the end portion 1811 can define one or more openings 1814 that allow air or gas to pass through the end portion 1811. In some embodiments, the user can select which side the supply tube 1802 is placed on and the end portion 1811 of the supply tube 1802 can pierce the membrane 1810 at its opening 1807. In some embodiments, the membrane 1810 is a single-use configuration, such that once one side of the membrane 1810 is punctured, the membrane 1810 cannot be reused. However, in some embodiments, the membrane 1810 may be replaceable or resealable. In some embodiments, the end portion 1811 may include one or more barbs to aid in puncturing the membrane 1810 and / or securing the end portion 1811 within the manifold 1801.In some embodiments, the barbs or sharp sections can be removed before the supply tube 1802 is inserted and the supply tube 1802 can be press fit into the opening 1807 of the manifold 1801. In some embodiments, the barbs or end portion 1811 can remain on the supply tube 1802 and help secure the supply tube 1802 within the manifold 1801. In some embodiments, the end portion 1811 can have a covering to prevent injury to the user or damage to the end portion 1811 when not in use and to ensure that the end portion remains clean and sterile prior to use.

[0382] In some embodiments, selective side switching of the manifold and prongs relative to the feeding tube can be accomplished by manipulation of the feeding tube. FIGS. 19A and 19B show an embodiment of a manifold 1901 in which a flexible feeding tube 1902 exits from an opening 1907 in the manifold 1901. In the illustrated arrangement, only one opening 1907 is provided because the flexible feeding tube 1902 is used for selective side switching. However, in other arrangements, more than one opening 1907 can be provided. In some embodiments, the feeding tube 1902 attached to and / or exiting the manifold 1901 can be a highly flexible tube. A highly flexible tube allows the feeding tube 1902 to be routed to either side of the face and away from the mouth. In some embodiments, a highly flexible tube is used that can be bent at a zero radius without substantial kinking or at least without completely blocking the internal passage of the tube. Preferably, bending the highly flexible tube does not substantially block the internal passage of the tube. In some embodiments, the highly flexible supply tube 1902 can exit the front of the manifold 19012 and be routed to either side of the patient without disassembling the nasal cannula assembly 1900 and / or moving any of the nasal cannula assembly parts. In some embodiments, the flexible supply tube 1902 can exit an opening 1907 in the front of the manifold 1901, allowing the flexible supply tube 1902 to bend at least about 90° to either the left or right side of the face.

[0383] Additionally, in some embodiments, the manifold can be configured such that the assembly fastener can be inserted in either direction such that the nasal cannula assembly can be interchangeably used with tubes coming from the patient's right side or the patient's left side. FIGS. 20A-20C show an embodiment of a nasal cannula assembly 2000 including a manifold 2001 that snaps into a manifold fastener or clip 2003. In some embodiments, the manifold 2001 and the supply tubes 2002 can be incorporated into one manifold / tubing assembly 2004. The manifold 2001 can be interchangeably switched on which side the supply tubes 2002 are positioned by allowing the manifold 2001 to be inserted into the clip 2003 in at least two different orientations. In some embodiments, the manifold 2001 and the supply tubes 2002 can be integrated into one manifold / tubing assembly 2004. For example, to change the direction in which the supply tube 2002 extends relative to the patient's nose, the manifold / tube assembly 2004 can be removed from the clip 2003, flipped over approximately 180 degrees, and then re-clipped. Figures 20A and 20B respectively show two available orientations for the supply tube 2002. The clip 2003 can be coupled to any suitable type of retention device, such as a headgear strap 20430, including any of the devices disclosed herein or other suitable devices.

[0384] Additionally, in some embodiments, the manifold can be configured for use with a clip-on feeding tube. For example, FIGS. 21A-21D show a nasal cannula assembly 2100 including a separable feeding tube assembly 2102 and a manifold 2101. In some embodiments, the nasal cannula assembly 2100 can include a manifold 2101 including prongs 2105 and two openings 2107 at each end. In some embodiments, the manifold 2101 can be connected to a feeding tube assembly 2111. In some embodiments, the feeding tube assembly 2111 can include a feeding tube 21101 and a manifold receiving structure 2112. The manifold receiving structure 2112 can be assembled to the feeding tube 2102 during manufacture or can be connectable to the feeding tube 2102 prior to use. In some embodiments, the manifold receiving structure 2112 can be a "C" shaped manifold receiving structure or clip 2112 as shown in Figures 21A-21D, or the manifold receiving structure 2112 can have any shape that allows for a complementary coupling to the manifold 2101. In some embodiments, the manifold 2101 has a complementary or matching shape that receives the manifold receiving structure 211201, and the manifold receiving structure 2112 can be slid, clipped, or otherwise attached by any means known in the art onto the manifold 2101, positioned to face the supply tube 2102 in either direction, as desired. In some embodiments, the manifold receiving structure 2112 can have positioning and / or sealing details 2113 incorporated inside or elsewhere on the manifold receiving structure 2112 to ensure a fixed connection and / or proper seal with the manifold 2101. In some configurations, the sealing details 2113 are protrusions, such as spherical protrusions.A sealing detail 2113 preferably seals one of the openings 2107, and an end portion 2130 of the supply tube 2102, which may be defined by the manifold receiving structure 2112 or may be a separate component, engages the other opening 2107. The end portion 2130 may abut and be flush with the outer surface of the manifold 2101 surrounding the opening 2107 (FIG. 21C), or may extend into the opening 2107 (FIG. 21D).

[0385] In some embodiments, one or more stops 2104 can be molded or otherwise secured to the manifold 2101 to block or prevent downward movement of the manifold receiving structure 2112 when pulled during use. For example, as shown in FIG. 21A, a pair of stops 2104, each defining a stop surface, can be formed on each side of the manifold 2101. In some embodiments, the manifold receiving structure 2112 can be slid upward relative to the manifold 2101 to remove and invert the tube side. In some configurations, as shown in FIG. 21E, a portion of the manifold receiving structure 2112, such as end portion 2116, can engage a complementary portion, such as recess 2118, of the manifold 2101 to help secure the manifold receiving structure 2112 to the manifold 2101. As shown in FIG. 21F, the manifold 2101 can include a recessed portion 2120 that is sized and shaped to receive the manifold receiving structure 2112. The recessed portions 2120 can be located in the forward and lateral portions of the manifold 2101 and can have a depth suitable to accommodate the entire thickness of the manifold receiving structure 2112 such that the outwardly facing surface of the manifold receiving structure 2112 is flush with or recessed into the outer surface of the manifold 2101. Such an arrangement can aid in securing the manifold receiving structure 2112 to the manifold 2101 and / or inform a user how to position and secure the manifold receiving structure 2112 to the manifold 2101. The recessed portions 2120 can be utilized separately or in combination with the recesses 2118.

[0386] 21G and 21H show an embodiment of a nasal cannula assembly 2100 having a manifold receiving structure 2132, a separate nasal prong insert 2125, and a manifold 2121. In some embodiments, the manifold 2121 does not have prongs and can have an opening 2126 in the manifold 2121 that communicates with the prong insert 2125. The prong insert 2125 can be formed with different sized prongs 2105 such that an appropriate sized prong 2105 can be selected for different nose sizes and such prongs 2105 can ensure correct prong sizing for the patient. In some embodiments, the manifold 2121 and the prong insert 2125 can be connected to a manifold receiving structure 2132, such as, for example, a C-shaped clip. In some embodiments, the manifold receiving structure 2132 can be used to hold the prong insert 2125 in place and is a complementary fit to the manifold 2121. Thus, the manifold receiving structure 2132 can include one or more openings 2128 that accommodate the prongs 2105. The manifold 2121 can include a recess 2134 that surrounds the opening 2126 and accommodates the base of the prong insert 2125. The manifold 2121 can also include recessed portions 2136 on its lateral sides configured to accommodate the manifold receiving structure 2132 and help secure the manifold receiving structure 2132 to the manifold 2121. In the illustrated arrangement, the openings 2126 are located on the top surface of the manifold 2121, although the openings 2126 can additionally or alternatively be located on other portions of the manifold 2121 (e.g., on the front surface).

[0387] 22A-22D show an embodiment of a nasal cannula assembly 2200 having a manifold insert 2201 and a manifold receiving structure 2210. In some embodiments, the manifold insert 2201 can include prongs 2205 and openings 2207 at each end of the manifold insert 2201. The manifold insert 2201 can be made from a soft or flexible material. The prongs 2205 of the manifold insert 2201 can be flexible or rigid. In some embodiments, the manifold insert 2201 can be inserted into the manifold receiving structure 2210. In some embodiments, the manifold receiving structure 2210 can be attached to or integral with an assembly fastener 2203, such as a headgear strap. The manifold receiving structure 2210 has one closed end 2213 and one open end 2214. In some embodiments, the manifold receiving structure 2210 can be attached to the supply tube 2202 at an open end 2214 of the manifold receiving structure 2210 to allow for the passage of air or gas. In some embodiments, the manifold insert 2201 can be clipped or slid into the manifold receiving structure 2210. In some embodiments, the manifold receiving structure 2210 can have a rounded or spherical boss or protrusion 2211 at one end 2213 of the manifold receiving structure 2210, which can provide an effective radial seal with one opening 2207 of the manifold insert 2201 and help hold the manifold insert 2201 in place. The other end 2212 can be integral with or separate from the supply tube 2202 and can include a connector 2214 that can engage with the other opening 2207 of the manifold insert 2201. In some embodiments, once the manifold insert 2201 is placed into the manifold receiving structure 221001, the manifold insert 2201 and / or the prongs can be oriented or tilted into the correct comfortable configuration for the user.For example, in some embodiments, to flip the tube side, the manifold insert 2201 is removed and the remaining portions of the nasal cannula assembly, including the manifold receiving structure 2210, the assembly locking device 2203 and / or the supply tube 2202, are flipped over so that the supply tube 2202 faces the desired orientation, and then the manifold insert 2201 along with the prongs 2205 are reassembled so that they are again facing towards the patient's nose.

[0388] 23A-23C show embodiments of a nasal cannula assembly with a manifold receiving structure or cannula that can be clipped onto a supply tube assembly, including a manifold. In some embodiments, the nasal cannula assembly 2300 includes a supply tube assembly 2311 with a manifold 2301 and a supply tube 2302. The nasal cannula assembly 2300 also includes a manifold receiving structure or cannula 2310 with a pair of prongs 2305. The supply tube 2302 connects the manifold 2301 to an air or gas supply circuit. In some embodiments, the manifold receiving structure 2310 can be a generally tubular member with openings or slots 2313 extending partially or completely along its length to form a "C" shaped section that can be clipped onto the manifold 2301. In some embodiments, the manifold 2301 can have ledges or ribs 2312 that are complementary to openings or slots 2313 in the "C" shaped manifold receiving structure 2310 such that the ribs 2312 can be received within the slots 2313. Advantageously, such an arrangement helps to secure or lock the manifold receiving structure 2310 in place on the manifold 2301. In some embodiments, the supply tube assembly 2311 can be attached to or integrated into an assembly securing device 2303, such as a headgear strap. For example, in some embodiments, to reverse the direction of the supply tubes 2302, the manifold receiving structure 2310 is removed or disconnected from the manifold 2301, turned over, and reconnected so that the supply tubes 2302 face the desired orientation.

[0389] 24A-F show embodiments of flexible, angled or adjustable prongs and an embodiment of a nasal cannula assembly 2400 having such flexible, angled or adjustable prongs 2405. Such prongs 2405 allow the outlet side of the supply tube 2402 to be changed by simply adjusting the orientation of the prongs 2405 and rotating the manifold / tubing assembly 2404 180 degrees on the patient's face.

[0390] 24A-24C, in some embodiments, the prongs 2405 can be deflected to the side of the manifold 2401 desired for use. In particular, the prongs 2405 can be formed with a ripple around the base of the prongs 2405. FIGS. 24B and 24C show an embodiment of a prong 2405 with a ripple 2408 formed around the base to allow for flexibility of the prongs 2405. In some embodiments, the ripple 2408 includes at least one, and preferably multiple, ripples. In the arrangement shown, two ripples are provided, but in other embodiments, three or more ripples can be provided. The ripples are shown as annular in shape and having a semicircular cross section. The ripples can have a reduced wall thickness relative to the portion of the manifold 2401 adjacent to the ripples, or can have the same or similar wall thickness. The ripples 2408 can be shaped to the prongs 2405 in any direction desired for use. In some embodiments, the prongs 2405 can have a scalloped shape 2408 around the base so that they can be tilted in either direction. In some embodiments, the prongs 2405 can have a thickened section(s) or reinforcing rib(s) 2407 to favor some tilt directions, allowing the prongs 2405 to bend in a first direction, but inhibiting or preventing them from bending in a second direction, which may be substantially perpendicular to the first direction. In the illustrated arrangement, two reinforcing ribs 2407 are provided on each side of each prong 2405, extending substantially radially relative to the prongs 2405.

[0391] 24D-24F may define a portion or substantially the entirety of the prong 2405. An embodiment of the prong 2405 is shown with a foldable corrugated bellows section. Preferably, forming the prong 2405 with such a shape allows the prong 2405 to bend in any direction and retain that shape. In some embodiments, the prong 2405 may be compressed and expanded to change its length, as shown in FIG. 24D and FIG. 24E. In some embodiments, the prong 2405 may be expanded from a compressed state and bent into a desired direction or shape, as shown in FIG. 24F. For example, in some embodiments, the prong 2405 is packaged in a compressed form and then unfolded and bent by a healthcare provider or user to configure into the appropriate direction and shape.

[0392] In some embodiments, the nasal cannula assembly can include rotating prongs. Figures 25A-25C show an embodiment of a nasal cannula assembly 2500 with rotating prongs. In some embodiments, the nasal cannula assembly 2500 can be flipped over to change the side of the feeding tube 2502, and then the prongs 2505 can be rotated to face the appropriate orientation toward the patient's nose. Figure 25A shows an embodiment of a nasal cannula assembly 2500 including individually rotatable prongs 2505. In some embodiments, the prongs can be freely rotated in a clockwise or counterclockwise direction relative to the manifold 2505. In some embodiments, when the manifold 2501 and prongs 2505 are configured as a unit, the prongs 2505 can be rotated to a limited extent.

[0393] 25B and 25C show an embodiment of a nasal cannula assembly 2500 comprising a prong insert 2506 having a pair of prongs 2505. Preferably, the prong insert 2506 is rotatable relative to the manifold 2501. The illustrated prong insert 2506 is mounted on and rotatable about a vertical shaft 2508 such that the prongs 2505 rotate together. In some embodiments, the prong insert 2506 is a separate component from the manifold / tube assembly 2504, and the removable prong insert 2506 can allow for the use of different sized prongs 2505 for different nose sizes while using a single sized manifold 2501. Additionally, in some embodiments, the manifold 2501 can have a lip 2510 on a surface of the manifold 2501 to which the prong insert 2506 mates. The prong insert 2506 can have a mating section 2511 that is complementary to the lip 251001. In some embodiments including a lip 2510 on the manifold 2501, the prong insert 2506 can be lifted off the surface of the manifold 2501 and rotated about a vertical shaft 2508, thereby repositioning the prongs 2505 in the appropriate orientation. The prong insert 2506 can be rotatable about a vertical central axis of the manifold 2501, or an axis that is central to the opening 2518 in the manifold 2501 that communicates with the nasal prong 2505, as shown in FIG. 25B, thereby switching the opening 2518 between the two orientations.

[0394] In some embodiments, the manifold can have prong exit holes in a central portion of the manifold configured to receive a prong-containing insert or clip-on attachment. FIGS. 26A-26F show an embodiment of a nasal cannula assembly 2600 configured to allow insertion of a removable prong insert 2606. In some embodiments, the prong insert 2606 can be pressed into an opening 2607 in a hollow manifold 2601. This allows the prongs 2605 to be configured in a suitable orientation for use by a patient with the same manifold 2601 and / or manifold / tube assembly 2604. The manifold 2601 and / or manifold / tube assembly 2604 can be connected to an assembly fixation device 2603, such as a headgear strap. For example, in some embodiments, the supply tube 2602 and manifold 2601 are assembled with the fixation device 2603, and the nasal prongs 2605 are supported by the removable nasal prong insert 2606. The manifold / tube assembly 2604 and assembly fixture 2603 may be symmetrical so that they can be assembled to face one direction (e.g., FIG. 26B) or the opposite direction (e.g., FIG. 26C). In some embodiments, the assembly fixture 2603 and manifold / tube assembly 2604 can be flipped to accommodate whatever orientation it is desired that the supply tube 2602 be placed in. For example, in some embodiments, to switch the side on which the supply tube 2602 is placed, the nasal prong insert 2606 is removed and the remaining portion of the manifold / tube assembly 2604 is flipped so that the supply tube 2602 faces the desired direction, and then the nasal prong insert 2606 is reinserted into the receiving opening 2607 of the manifold / tube assembly 2604 in the appropriate orientation so that it faces toward the patient's nose.Additionally, the nasal prong inserts 2606 can be different sizes (FIGS. 26D-26F) and different size inserts can be interchanged in the same assembly 2604 to be used and accommodate different patient nose sizes and to ensure correct prong sizing for the patient.

[0395] In some embodiments, a nasal cannula assembly can include a manifold, a supply tube, and a cannula that is removable from the manifold and / or adjustable about at least one axis relative to the manifold. The cannula can be adjustable about two axes relative to the manifold and can be available in different prong sizes to allow the assembly to fit a variety of patients. In particular, with reference to FIGS. 27A-27D, a nasal cannula assembly 2700 includes a pivoting cannula 2714 that preferably incorporates a pair of nasal prongs 2705. The cannula 2714 is pivotally coupled to a molding (head strap molding) or manifold 2701, which can include side portions 2722 extending laterally in opposite directions from the cannula 2714. A suitable retention assembly (not shown), such as a head gear strap, can secure the manifold 2701 and cannula 2714 to the patient. In some arrangements, the headgear straps are elastic, high-tensile straps that can aid in or enhance the seal between the manifold 2701 and the cannula 2714. The headgear straps can be separate, integral, or distinct from the manifold / molding 2701.

[0396] Preferably, the manifold 2701 defines a conduit or passageway 2709 that allows air or gas to flow from the supply tube 2702 to the cannula 2714. The passageway 2709 may be defined by the molding from which the manifold 2701 and side strap 2722 are constructed (e.g., a single integral structure) or may be defined by a separate member. The supply tube 2702 may be coupled to the manifold 2701 by any suitable device, such as a jaw expander device or any other device disclosed herein. A clip 2742 may secure the supply tube 2702 to the side strap 2722. The end of the supply tube 2722 opposite the manifold 2701 may include a connector 2652 that allows for coupling of the supply tube 2722 to an air or gas source.

[0397] In some embodiments, the cannula 2714 can be rotated relative to the manifold 2701 about an axis extending generally in the anterior-posterior direction or a generally horizontal axis located in the sagittal plane. Preferably, the cannula 2714 can be rotated at least 180 degrees, which allows the prongs 2705 to be rotated from the top (orientation in FIG. 27A) to the bottom, thereby allowing for an effective change of the outlet side of the supply tube 2702. In some embodiments, the cannula 2714 is coupled to the manifold 2701 by a ball-and-socket joint 2726, which allows the cannula 2714 to also be rotated about an axis extending generally in the lateral direction or a generally horizontal axis located in the coronal plane. Such an arrangement allows for a simple change of the outlet side of the supply tube 2702 as well as adjustment of the orientation of the nasal prongs 2705 relative to the manifold 2701 to improve patient comfort and / or accommodate a wider range of patients.

[0398] In some embodiments, the size of the prongs 2705 is adjustable. For example, as shown in FIGS. 27B and 27C, the ball joint portion 2730 may be separable from the prong portion 2732 of the cannula 2714. Several prong portions 2732 providing several different sizes of nasal prongs 2705 may be included in a kit or may be otherwise available. For example, FIG. 27C shows three different prong portions 2732 including three different sizes of prongs 2705. An appropriate or desired one of the available prong portions 2732 may be coupled to the ball joint portion 2730, such as via a snap fit or other suitable device. Alternatively, two or more completed cannulas 2714 may be provided, each provided with a different size of prongs 2705. Thus, in such an arrangement, the cannula 2714 may be constructed as a single piece.

[0399] However, the cannula 2714 need not be rotatable in multiple axes or even through an arc. Instead, the cannula 2714 can have a separate adjustment position relative to the manifold 2701. Preferably, at least the position shown in FIG. 27A and a 180 degree rotation of the cannula 2714 are provided to allow for switching the outlet side of the supply tube 2702. Other separate position options can be provided if desired. The cannula 2714 and manifold 2701 can include interference fit surface features to help secure the cannula 2714 at a desired position relative to the manifold 2701. For example, as shown in FIG. 27D, the cannula 2714 can include one or more teeth 2760 or other protrusions that engage corresponding recesses in the manifold 2701. In the illustrated arrangement, the cannula 2714 includes a plurality of teeth 2760 on each lateral side of the ball joint 2726 that can extend radially relative to the ball joint 2726. Other suitable arrangements may also be employed.

[0400] 28A, the nasal cannula assembly 2800 includes a manifold 2801 capable of being coupled to the cannula 2814 in at least two orientations to allow for simple switching of the outlet side of the supply tube 2802. The cannula 2814 can include a central portion including the prongs 2805 and a side portion 28212 on each lateral side of the central portion. The manifold 2801 can include a side portion 2812 that overlaps with a side portion 2822 of the cannula 2814. The side portions 2812 and 2822 can facilitate a fixed connection between the manifold 2801 and the cannula 2814. For example, the side portions 2812 or 2822 of one or both of the manifold 2801 and the cannula 2814 can include a coupling or coupling mechanism that couples or serves to couple the manifold 2801 and the cannula 2814. In the illustrated arrangement, the side portion 2812 includes a first component 28030 of the fastener (e.g., a hook and loop fastener) and the side portion 2822 of the cannula 2814 includes a second component 2832 of the fastener (e.g., a hook and loop fastener). One or both of the side portions 2812 of the manifold 2801 include tabs 2850 that provide a finger grip surface to facilitate removal of the manifold 2801 from the cannula 2814. Additionally, one or both of the side portions 2812 can include flex slots 2828 that facilitate flexing of the side portion 2812, which can aid in removal of the manifold 2801 from the cannula 2814 and can also facilitate the manifold 2801 conforming to the shape of the cannula 2814.

[0401] The manifold 2801 and the cannula 2814 may include cooperating structure to provide a seal between the two components. For example, the manifold 2801 may include a protruding portion 2860 that defines a cavity in communication with the supply tube 2802 and includes at least one, and preferably a pair of openings 2862 that allow air or gas communication with the prongs 2805 when the manifold 2801 is assembled to the cannula 2814. The protruding portion 2860 engages an opening 2864 in the cannula 2814 and preferably defines at least a substantial seal therewith. The seal may be created by contact or engagement between the protruding portion 2860 and the opening 2864 (e.g., a lip and groove), or a separate sealing member (e.g., a peripheral seal or an O-ring) may be used.

[0402] A fastening device such as a headgear strap 2840 can be used to secure the cannula 2814, and therefore the manifold 2801, to the patient. In some embodiments, the headgear strap 2840 is a non-elastic strap that is coupled to the side portion 2822 of the cannula 2814. The end of the headgear strap 2840 can be heat welded to the side portion 2822 and can include a second component 2832 of the coupling between the manifold 2801 and the cannula 2814. The headgear strap 2840 can include a suitable adjuster 2842 that allows the circumference of the strap 2840 to be adjustable. In other arrangements, an elastic headgear strap 2840 can be used.

[0403] 28B, the cannula 2814 may be of composite construction, including a frame member 2870 constructed from a relatively rigid material and a body 2872 constructed from a relatively soft material. For example, the frame 2870 may be a rigid plastic or metal material that is deformable and capable of substantially retaining its shape once deformed. The frame 2870 may be external to the body 2872, or the body 2872 may be molded onto the frame 2870. Preferably, the frame 2870 is located on a lateral portion 2822 of the cannula 2814, and may be formed to bridge a central portion including the prongs 2805 away from the nose to reduce pressure directly under the nose and distribute pressure applied to the patient across the lateral portion 2822 for improved comfort. The frame 2870 may also surround or partially or completely define the opening 2864 instead of or in addition to extending into the lateral portion 2822.

[0404] Referring to FIG. 29A, in some embodiments of a respiratory assistance system utilizing a nasal cannula system 2900, it is desirable to be able to measure the pressure in a flow path near the patient (e.g., at or near the cannula or manifold 2901) for at least one or both of: 1) monitoring the pressure delivered to the patient; and 2) pressure feedback control of the blower flow source (e.g., blower and humidifier 2990). FIG. 29A shows a basic arrangement for providing pressure feedback control. In particular, a pressure line 2910 connects the manifold 2901 (or manifold / cannula assembly, hereafter "manifold") to a flow source control system that may be part of the blower / humidifier 2990. In such an arrangement, the flow source 2990 can utilize information about the pressure at or near the manifold 2901 provided by the pressure line 2910 in the operation of the flow source 2990, such as to adjust the supply pressure to achieve a desired delivery pressure at the patient. Advantageously, this arrangement can compensate for factors that may cause the delivery pressure to differ from that predicted, such as, for example, the length, cross-sectional area or other geometry of the supply tube 2902. If pressure monitoring is required or desired, the pressure line 2910 can instead be connected to a pressure gauge or pressure indicator.

[0405] 28B, a pressure line 2910 may pass through a wall of the manifold 2901 and terminate within the manifold space of the manifold 2901. In the arrangement shown, the terminal portion 2912 of the pressure line 2910 is perforated with a number of holes 2914 such that if some of the holes 2914 become blocked with condensation, the other holes 2914 still function to communicate the pressure within the manifold 2901 to the pressure source 2990. The terminal portion 2912 of the pressure line 2910 may be located anywhere within the manifold 2901, such as, for example but without limitation, between the supply tube 2902 and the prong 2905 along the flow path of the supply air or gas.

[0406] 29C, pressure line 2910 can allow direct or indirect communication between manifold 2901 and pressure source 2990. The arrangement of FIG. 29C separates manifold chamber 2909 of manifold 2901 from pressure chamber 2916 which is in series communication or directly sensed by pressure line 2910. For example, a thin flexible diaphragm seal 2918 (or other moveable membrane or member, such as a floating or sliding piston) separates manifold chamber 2909 from pressure chamber 2916, thereby preventing condensation from entering pressure line 2910 and keeping it clean.

[0407] 29D, pressure line 2910 can include a pressure sensor 2930 that can sense pressure in manifold chamber 2909. Pressure sensor 2930 can be disposed within manifold 2901, such as configured as a plug that engages and / or closes one end of manifold 2901. In some embodiments, a separator, such as a wall or membrane 2918, is disposed between pressure sensor 2930 and manifold chamber 2909. Membrane 2918 can be of any suitable type, such as an ultra-thin silicone membrane. Pressure sensor 2930 can be of any suitable type, such as an electrical pressure sensor. By pushing pressure sensor 2930 against membrane 2918, which can conform to the shape of pressure sensor 2930, pressure can be measured without direct contact with the air or gas flow, thus avoiding condensation buildup on pressure sensor 2930. Furthermore, such an arrangement allows the membrane 2918 to be configured to close and seal the end of the manifold 2901 such that the nasal cannula assembly 2900 can be used with or without the pressure sensor 2930.

[0408] 29E, the membrane 2918 may be a self-sealing slit valve into which the pressure line 2910 and / or pressure sensor 2930 can be inserted, if desired. Advantageously, the self-sealing slit valve 2918 can close in the absence of the pressure line 2910 and / or pressure sensor 2930, thereby eliminating substantial leakage when removed. Thus, the nasal cannula assembly 2900 can function with or without the pressure line 2910 and / or pressure sensor 2930.

[0409] 29F, the pressure line 2910 and the supply tube 2902 can be incorporated into one connector 2931 that is connectable to the manifold 2901 to allow connection of both the pressure line 2910 and the supply tube 2902 at once. Advantageously, such an arrangement simplifies the set-up of the nasal cannula assembly 2900 by eliminating the need to connect multiple tubes or components to the manifold 2901.

[0410] 29G, a pressure line 2910 can be connected as an optional attachment in series with the supply tube 2902. The pressure line 2910 can include a plug portion 2932 that connects to the manifold 2910, and the supply tube 2902 can be connected to the plug portion 2932. Alternatively, with reference to FIG. 29H, the pressure line 2910 can be connected as an optional attachment separately from the supply tube 2902, such as on the opposite side of the manifold 2901 from the supply line 2902. The pressure line 2910 can have a plug portion 2932 that replaces the plug 2934 of the manifold 2901.

[0411] 29I, a small blower 2940 or other source of air or gas flow can be connected to pressure line 2910 to provide a small flow of air or gas through pressure line 2910, preferably sufficient to dislodge some or all of any condensate that accumulates inside pressure line 2910. The air flow through pressure line 2910 can be provided intermittently or continuously and can be taken into account in the calculation of the pressure in manifold 2901 by the control system.

[0412] 29J, a thin flexible diaphragm seal 2918 (or other movable barrier) can separate the manifold chamber 2909 from the pressure measurement chamber 2916 to block or prevent condensation from entering the pressure line 2910 and keep the pressure line 2910 clean. If the pressure measurement function is not utilized and therefore the pressure line 2910 is not needed, an opening or port 2942 in the manifold 2901 that receives the pressure line 2910 can be left open and can function as a vent to the pressure measurement chamber 2916. Alternatively, the port 2942 can be closed, such as by a suitable plug, if desired.

[0413] 29K, for example, electrical wiring 2944 is incorporated into a helical bead 2946 of the supply tube 2902. The electrical wiring 2944 can be coupled to an electrical pressure sensor 2930 attached to the manifold 2901. The wiring 2944 (or additional wiring) can also be used to heat the supply tube 2902. In some arrangements, the wiring 2944 can be switched between pressure measurement and temperature readings and heating.

[0414] 29L, the spiral stiffener 2946 of the supply tube 290220 can be hollow or otherwise include a passageway that acts as a pressure line (similar to pressure line 2910 disclosed herein). In such an arrangement, no additional pressure line (e.g., 2910) needs to be used. The spiral stiffener can be connected at one end to a chamber of the manifold 2901 and at the other end to an operating system for an air or gas supply or a pressure monitor or gauge 2948.

[0415] In some embodiments, the nasal cannula assembly includes features that enhance patient comfort. Some patients using some nasal cannula assemblies may experience discomfort. For example, two types of discomfort include: 1. a hot, moist, clammy sensation of the cannula / manifold in contact with the skin at the upper lip, which may be caused by moisture from sweating and the circulation of warm humidified gases in this area, and 2. pain and numbness associated with pressure exerted by the cannula / manifold on the upper lip. Some embodiments of the nasal cannula assembly 3000 address one or both of these types of discomfort, at least to some extent.

[0416] Referring to FIG. 30A, holes, recesses or depressions 3020 of any desired shape can be cut or otherwise formed in the cannula or manifold (hereinafter "cannula") material to allow fresh air to reach the skin to help keep the area cooler and reduce moisture buildup. In some embodiments, the holes, recesses or depressions 3020 are cut or formed in areas that will not result in leakage of therapeutic airflow from the cannula 3014. For example, the holes, recesses or depressions 3020 are provided in the side portions 3022 of the cannula 3014 rather than the central portion including the prongs 3005. In the illustrated arrangement, holes 3020 are provided that extend completely through the side portions 3022 of the cannula 3014. The holes, recesses or depressions 3020 can also improve the flexibility of the cannula 3014, allowing it to more easily conform to the shape of the patient's lips and distribute pressure more evenly for improved comfort.

[0417] 30B, the cannula 3014 may also include a small raised ridge or protrusion 3030 on the back or patient-facing surface of the cannula 3014. The ridge 3030 holds some or all of the remaining back or patient-facing surface of the cannula 3014 away from the patient's lips, allowing fresh air to reach the skin, helping to keep the area cooler and reducing moisture build-up. The ridge 3030 may be provided over the entire back surface, as shown, or over only a portion of the back surface, such as, for example, a side portion 3022 similar to the cannula 3014 of FIG. 30A.

[0418] With reference to FIG. 30C, a groove 3040 can be cut or otherwise formed in the back of the cannula 3014. The groove 3040 allows fresh air to reach the skin, helping to keep the area cooler and reducing moisture buildup. In some embodiments, the groove 3040 extends generally vertically or perpendicular to the lateral direction of the cannula 3014. Additionally, the groove 3040 can extend partially through the cannula 3014 such that one end is closed, or can extend completely through the cannula 3014 such that both ends are open, as shown in FIG. 30C. The groove 3040 can also improve the flexibility of some (e.g., the lateral portion 3022) or all of the cannula 3014, allowing it to more easily conform to the shape of the patient's lips and distribute pressure more evenly for improved comfort.

[0419] 30D-30H, in some embodiments, the cannula 3014 can include a cannula lip bridge device, where the cannula 3014 is shaped to curve away from the face at the upper lip, reducing pressure or completely avoiding any contact with the upper lip, thereby promoting fresh air circulation in that area and reducing (e.g., little or no) pressure on the lips. Instead, pressure is applied by the side portions 3022 and absorbed by the cheeks, which are less sensitive to pressure. In some arrangements, the prongs 3005 are mounted horizontally opposite the inside of the cannula 3014 and curve upward into the nostrils. This design has the added benefit of allowing clearance for whiskers.

[0420] Preferably, such embodiments of the cannula 3014 have some rigidity, which may be achieved by any suitable structure or device, such as the use of structural members such as a relatively stiff material for the cannula 3014 (FIGS. 30D-30F), reinforcing ribs, or internal (FIG. 30G) or external (FIG. 30H) wires or strips 3050, which may be malleable so as to be tailored to fit an individual patient. The cannula 3014 may have an integral or directly connected supply tube 3002, or may be in any suitable arrangement, such as by utilizing a manifold 3001 connected to the supply tube 3002 and received within the cannula 3014.

[0421] Referring to FIG. 30I, in some embodiments, a comfort pad or insert 3060, such as a gel pad or other type of pad, can be provided on the back or patient-facing side of the cannula 3014. At least the back of the cannula 3014, which is in contact with the patient's upper lip, can be made from a soft gel material, or in some arrangements, such a side can include a soft gel pad 3060 that is molded to the shape of the individual patient's lips to provide a relatively large contact surface area to distribute pressure evenly across the skin. The pad 3060 can be deformed like a head gear strap or other retention mechanism (not shown) is tightened to accommodate the shape of the patient's face and prevent localized pressure areas. The pad 3060 preferably occupies a substantial portion, such as substantially the entire back. The pad 3060 can be scented to make the cannula 3014 smell more pleasant.

[0422] In some embodiments of the nasal cannula assembly, the feeding tube can be manually shaped or positioned, and the feeding tube can remain in or substantially in that shape or position. One of the main benefits of some nasal cannula assemblies, such as the Optiflow® nasal cannula assembly sold by Fisher & Paykel Healthcare Ltd., is the ability to eat, drink, and speak during treatment. In some cases, the shape or position of the feeding tube exiting the cannula may prevent these actions. Thus, in some embodiments, it may be desirable to be able to shape or position the feeding tube as desired. Any suitable device or technique may be used to enable shaping or positioning of the tube, such as those described herein with reference to FIGS. 31A-31F.

[0423] 31A and 31B, the feeding tube 3102 can include an internal axially malleable wire or strip 3150. The feeding tube 3102 can be assembled or formed with an internal axially malleable wire or strip 3150 that can be deformed into various shapes. Preferably, the stiffness of the wire is significantly greater than the stiffness of the feeding tube 3102, so that the shape is maintained or substantially maintained after forming. The wire or strip 3150 can be contained within, formed in, or otherwise coupled to the feeding tube 3102 in any suitable manner. For example, as shown in FIG. 31A, the wire or strip 3150 can be embedded within the wall of the feeding tube 3102 outside of the feeding passage of the feeding tube 3012. Alternatively, as shown in FIG. 31B, the wire or strip 3150 can be provided within the feeding passage or bore of the feeding tube 3102. In such an arrangement, it may be desirable to construct or coat the wire or strip 3150 from a suitable (e.g., inert) material that is resistant or suitable for contact with the supply air or gas. With reference to FIG. 31C, the wire or strip 3150 may be a malleable, spirally wound wire or strip that is wound around the supply tube 310012, such as in a helix. The wire or strip 3150 may be covered or included in another material (e.g., plastic) to form a bead 3152. The bead 3152 may provide a tube structure (e.g., a reinforcing bead) and may be moldable or formable to retain or at least substantially retain the adjusted shape or form of the supply tube 3102. Advantageously, with such an arrangement, the supply tube 3102 is sealed off from the air or gas path by the bead helix 3152 wound around the outside of the supply tube 3102.

[0424] 31D and 31E, the feeding tube 3102 may be in the form of a folded corrugated tube having sections or substantially all of the folded corrugations 3160 that can be used to set one or both of the length and position of the feeding tube 3102 as desired. The corrugations 3160 may be manufactured such that when the feeding tube 3102 is compressed lengthwise or axially, the corrugations 3160 fold over each other. FIG. 31D shows the feeding tube 3102 in an axially compressed orientation, and FIG. 31E shows the feeding tube 3102 in an axially uncompressed or extended position. The feeding tube 3102 may be coupled to the cannula 3114 by any suitable device, such as directly or via a suitable connector. Referring to FIG. 31F, the feeding tube 3102 may alternatively include sections or substantially all of the feeding tube 3102 configured as a ball and socket chain. In particular, at least a section of the supply tube 3102 is comprised of a plurality of individual segments or members 3162 or the like that together form a sealed or substantially sealed but positionable or formable tube. Preferably, one end of each segment 3162 includes a ball end 3164 and the other end includes a socket 3166. Thus, a plurality of segments 3162 can be assembled with the ball end 3164 of one segment 3162 positioned within the socket 3166 of an adjacent segment 3162. In some arrangements, the fit of the ball end 3164 within the socket 3166 allows each segment 3162 to rotate or move relative to the adjacent segment 3152, but seals or substantially seals and provides sufficient friction to remain in place or substantially within a range of positions once adjusted. If desired, additional structures or devices, such as sleeves extending over the segments 3162, can be used to hold the segments 3162 in the assembled state or to assist in holding or sealing the segments 3162.Advantageously, these and similar embodiments allow the feeding tube 3102 to be positioned out of the way of the patient, reducing or minimizing interruptions to eating, drinking, and talking during treatment.

[0425] In some existing nasal cannula assemblies, the supply tube hangs down from its attachment point to the cannula or manifold, which is often just above the corner of the mouth. This arrangement can result in the supply tube hanging very close to the mouth, which can be uncomfortable for the patient as it interferes with eating, drinking and speaking, among other issues. Furthermore, the weight of the supply tube hanging so close to the nose tends to drag one side of the cannula or manifold down and away from the nose. This is true for high flow therapies that require relatively large supply tubes that cannot be comfortably threaded behind the patient's ears, as is the case for relatively small low flow systems. Thus, some embodiments route the supply tube from the nasal cannula assembly further out from the patient's nose and / or mouth to partially or fully address the two problems discussed above.

[0426] 32A-32C, one portion 3250 of a fitting, such as a hook and loop fastener, is provided on the supply tube 3202 of the nasal cannula assembly 3200. For example, the portion 3250 can be a sheath of hook and loop material. The sheath 3250 can be coupled to the supply tube 3202 by any suitable device and can be removable or non-removable from the supply tube 3202. In the illustrated embodiment, the sheath 3250 is permanently attached to the supply tube 3202. The sheath 3250 can be movable along the supply tube 3202 or can be provided at a fixed location on the supply tube 3202, preferably spaced from the manifold or cannula 3214 (hereinafter "cannula"). The sheath 3250 may be secured to another portion 3252 of a hook and loop fastener or other coupling that may be aligned with the sheath 3250 and preferably positioned appropriately to space the vertically depending portion of the feeding tube 3202 from the patient's nose or mouth. Preferably, the other portion 3252 of the coupling is a pad on the other portion of the hook and loop fastener relative to the sheath 3250. In one arrangement, as shown in FIG. 32A, a pad 3252 is provided on each side of the headgear strap 3240 or other retention mechanism of the nasal cannula assembly 3200. Thus, the feeding tube 3202 may be passed to either side of the patient's face and supported to hang down in a position spaced from the patient's nose and / or mouth, as desired. In another arrangement, as shown in FIG. 32C, the pad 3252 is an adhesive pad that is preferably positioned on the patient's face, such as on the cheek, in a position spaced from the nose and / or mouth. In such an arrangement, the pad 3252 may be applied only to the desired side of the face for routing the feeding tube 3202 as desired.

[0427] Additionally or alternatively, other suitable mechanisms for similarly securing the feeding tube 32020 may be used. FIGS. 32D-32F show several mechanical fastening mechanisms for securing the feeding tube 3202 such that the downwardly depending portion is spaced from the patient's nose and / or mouth. Preferably, a first portion 3250 of the mechanical fastener is permanently or removably and fixedly or movably disposed on the feeding tube 3202. A second portion 3252 of the mechanical fastener is disposed on a portion of the nasal cannula assembly 3200, such as the headgear strap 3240 (or in another arrangement, the lateral portion 3222 of the cannula 3214). Thus, similar to the arrangement of FIGS. 32A-32C, the first portion 3250 may be coupled to the second portion 3252 of the mechanical fastener such that the feeding tube 3202 may be supported away from the patient's nose or mouth. In FIG. 32D, the mechanical fastener is a button and button loop. In Fig. 32E, the mechanical fastener is a popper dome or other snap-fit ​​device. In Fig. 32F, the mechanical fastener is a hook that can engage the feeding tube 3202 and the headgear straps 3240. Thus, in such an arrangement, the first portion 3250 and the second portion 3242 of the mechanical fastener are formed by a single component. Thus, the portions 3250 and 3252 can be permanently attached to one another and detachable from one or both of the feeding tube 3202 and the headgear straps 3240, or other portions of the nasal cannula assembly 3200.

[0428] In some embodiments, the feeding tube 3202 can be secured by a permanent fastening device provided on a portion of the nasal cannula assembly 3200, such as the headgear straps 3240 or the side portions 3222 of the cannula 3214, especially in cannula designs with extended or large side portions 3222. For example, the fastening device can be a permanent loop 3260 on the headgear straps 3240. Preferably, a permanent loop 3260 is present on each side of the headgear straps 3240 to allow the feeding tube 3202 to be threaded on either side. The feeding tube 3202 can be threaded through either loop 3260 to allow support and positioning of the feeding tube 3202. The loop 3260 can be, for example, injection molded or die cut, or formed by any suitable process. FIG. 32G shows the loop 3260 to be a hoop or ring generally disposed in the plane of the headgear straps 3240. The illustrated loop 3260 extends below the headgear strap 3240, but could also be above the headgear strap 3240. Preferably, the loop 3260 can rotate relative to the headgear strap 3240 to better accommodate the supply tube 3202 and any other components, such as the pressure measurement tube 3210. The headgear strap 3240 can include a portion that spaces the loop 3260 from a circumferential portion of the headgear strap 3240 to facilitate rotation of the loop 3260. FIG. 32H illustrates a molded loop 3260 that is positioned near the headgear strap 3240. FIG. 321 illustrates a loop 3260 formed by a section 3262 of the headgear strap 3240 defined by a pair of spaced slits 3264 that allow the section 3262 to be pulled away from an adjacent portion of the headgear strap 3240 to form a passageway therewith. The slits 3264 can be substantially parallel to one another and oriented substantially vertically, as shown, or axially along a perimeter defined by the headgear straps 3240.However, in other arrangements, the slits 3264 can be non-parallel and oriented in other directions.

[0429] In some embodiments, the loop 3260 may be a breakable loop that facilitates positioning of the feeding tube 3202 within the loop 3260. Preferably, at least one breakable loop 3260 is present on each side of the cannula assembly 3200, such as on the headgear strap 3240. The feeding tube 3202 may be clipped to either loop 3260. The loop 3260 may be breakable via any suitable device, such as, for example, a hook-and-loop fastener (FIG. 32), a die-cut or otherwise formed tab-and-slot device (FIG. 32K), a popper dome or other snap-fit ​​device (FIG. 32L), an injection molded or otherwise formed mushroom-head-and-recess device (FIG. 32M), or a push-in clip (FIG. 32N). The loop 3260 may be breakable at any location, such as at the center of the loop 3260 or at the headgear strap 3240. Preferably, any of these devices for manipulating the supply tube 3202 can be used or modified to operate the pressure line 3210 in addition to or instead of the supply tube 3202 .

[0430] The circuit that delivers air or gas to the patient interface (e.g., cannula or manifold) is reasonably long to reach between the flow source and the patient. Without some circuit support device, the mass of this long circuit transfers the load directly to the patient interface. The load of the circuit may displace the cannula and pull it away from the patient's nares, thereby interrupting treatment. It may also be uncomfortable for the patient to directly support the load of the circuit on the face. The circuit includes the supply tubes described herein (e.g., supply tube 50 of FIG. 1) and may also include other conduits (e.g., main delivery conduit of FIG. 1 and / or pressure line 872 of FIG. 8A). To address this issue, several techniques or arrangements may be used to support at least a portion of the load or mass of the circuit, as described in connection with FIGS. 33A-33S.

[0431] Figures 33A-33H show a support device 3350 that can be used to couple a portion of the circuitry generally 3352 to a patient's clothing, bedsheet or other fabric or thin material and support at least a portion of the load or mass of the circuitry 3352. Figures 33A and 33B show a support device 3350 that includes a two-part dome 3354 that is attached to the circuitry 3352 by any suitable device and that when assembled sandwiches bedding / garment 3356 between parts 3354a, 3354b, such as by a snap fit device.

[0432] 33C-33F, the support device 3350 can include a clip-and-post (e.g., mushroom head) device 3354 that, when the clip 3354a is assembled to the post or mushroom head 3354b, sandwiches the bedding / garment 3356 between the clip 3354a and the post or mushroom head 3354b. Any portion of the support device 3350 can be attached to the circuit 3352 by any suitable device. In the illustrated arrangement, the post or mushroom head 3354b is secured to the circuit 3352 by a sleeve 3360. If desired, the clip 3354a can be coupled to the sleeve 3360 by a tether 3362. The clip 3354a can be any suitable device that allows for fixed engagement and disengagement with the post or mushroom head 3354b, with the garment, sheet or other fabric or material 3356 therebetween. For example, FIG. 33C shows a simple C-shaped elastic clip 3354a. FIG. 33D shows a clip 3354a that can engage the post or mushroom head 3354b radially or axially relative to the post or mushroom head 3354b. FIG. 33E shows a hinged clip 3354a, which can have a snap fit arrangement or other mechanism that joins the non-hinged ends of the clip 3354a. FIG. 33F shows a clip 3354a with a resilient retaining portion 3364. The clip 3354a is shown as a hinged clip, but can also be non-hinged. Alternatively, the clip 3354a can be replaced entirely with a resilient member.

[0433] 33G, the support device can include a tag 3350 that is coupled to a circuit 3352 and includes a buttonhole feature 3366 that can be attached to an existing button 3368 on the patient's shirt or other article of clothing. Alternatively, a given garment or other piece of material can be provided with a given button 3368 that engages with the buttonhole feature 3366. The tag 3350 can feature a tear feature (e.g., a slit, perforation, or weakened portion) that tears before the patient's shirt or other article supports the button 3368.

[0434] Referring to FIG. 33H, the support device can include a clip 3350 having a portion 3372 that encloses the circuit 3352 and a portion 3374 that can grip bedding, clothing, or other fabric or thin material. In the arrangement shown, the clip 3350 has two arms that cross over one another and are movable relative to one another between an open position and a closed position. The portion 3372 is defined by the portion of the arms that extends between the intersection or connection to one another and where they cross over one another. The portion 3374 is defined by both end portions of the arms. The clip 3350 can include a finger grip portion 3376 that facilitates squeezing the clip 3350 to move the clip to the open position. Additionally, the clip 3350 can include a retention, gripping, or friction promoting mechanism or traction element 3378 (e.g., a tab or protrusion) that helps to prevent the bedding, clothing, or other material from being released from between the arms of the clip 3350 when in the closed position.

[0435] In other arrangements, the support device can include a lanyard 3380 that can be placed around the patient's neck or another body part or object and used to support at least a portion of the circuit 3352. With reference to FIG. 33I, the lanyard 3380 can be used in combination with the clip 3350 of FIG. 33H. For example, the clip 3350 can be a dual-use clip having at least one opening or hole 3382, such as in the center of an arm in portion 3374, so that it can be used to pass the lanyard 3380 and / or another support device through. The lanyard 3380 can be used instead of or in combination with clipping onto the patient's clothing, bedding, or another piece of material.

[0436] The lanyard 3380 can be of any suitable construction. For example, referring to Fig. 33J, the lanyard 3380 can include a series of clasps, hook and loop fasteners or other fasteners 3384 that can be used to adjust the length of the lanyard 3380. Additionally, the fasteners 3384 can act ...

Claims

1. 1. A nasal cannula for administering breathable gas to a patient (or user), comprising: a first section formed from a first material; a second section formed from a second material; Equipped with A nasal cannula, wherein the first section is relatively softer than the second section.

2. The nasal cannula of claim 1 , wherein the second material is the same as the first material.

3. The nasal cannula of claim 1 , wherein the second material is different from the first material.

4. A nasal cannula according to any one of claims 1 to 3, wherein the sections are assembled through the use of one or more mechanical fasteners.

5. The cannula of any one of claims 1 to 4, wherein the sections are assembled together by using one or more fastening systems.

6. The cannula of any one of claims 1 to 5, wherein the first section provides a friendly or comfortable contact component for a user of the nasal cannula.

7. The cannula of any one of claims 1 to 6, wherein the second section provides a structural or supporting or shape-defining component of the nasal cannula.

8. The cannula of any one of claims 1 to 7, wherein the configuration or shape of the first section is defined, at least in part, by parts or portions of the second section.

9. A cannula according to any preceding claim, wherein the first section forms a patient contacting surface and the second section forms a frame to which the first section is attached.

10. The cannula of any one of claims 1 to 9, wherein the first section encloses at least a portion of the second section.

11. A cannula according to any preceding claim, wherein the second section is at least partially overmolded by the first section.

12. 12. A cannula according to any one of the preceding claims, wherein the first section is at least one arm or a pair of arms extending outwardly from a central body portion comprising at least one (or preferably a pair) nasal prong(s).

13. 13. A cannula according to any one of claims 1 to 12, wherein the first section is adapted to receive a manifold connection to deliver a source of gas to the nasal cannula, or a body of the nasal cannula, which in use is in fluid communication with a delivery system that delivers gas to the user, such as via at least one nasal prong (or preferably a pair of nasal prongs) to one or both nostrils of the user.

14. 14. A cannula according to any one of claims 1 to 13, wherein the second section is adapted to receive a manifold connection to deliver a source of gas to the nasal cannula, or a body of the nasal cannula, which in use is in fluid communication with a delivery system that delivers gas to the user, such as via at least one nasal prong (or preferably a pair of nasal prongs) to one or both nostrils of the user.

15. A cannula according to any one of claims 1 to 14, wherein a manifold is a component of a relatively rigid material to the first material, the manifold being connectable to the nasal cannula and relevant regions of the body of the nasal cannula.

16. 16. The cannula of any one of claims 1 to 15, wherein the first section comprises one or more contoured portions, the contoured portion(s) of the first section being engageable with one or more associated correspondingly or complementarily shaped or configured contoured portions of the second section.

17. The cannula of any one of claims 1 to 16, wherein the first section includes at least one raised area receivable by an associated opening or detent area in the second section.

18. 18. The cannula of any one of claims 1 to 17, wherein the first section comprises a cannula body portion at least partially defining an open cavity capable of receiving a supply of gas directed via a manifold, the open cavity in fluid communication with one or a pair of nasal prongs.

19. 19. A cannula according to any one of claims 1 to 18, wherein the first section and the second section are correspondingly or complementarily shaped or configured to jointly receive a manifold connection for delivering a supply gas to a user.

20. The cannula of any one of claims 1 to 19, wherein the first section is a nasal cannula body defining, at least in part, an open cavity.

21. The cannula of any one of claims 1 to 20, wherein the second section at least partially surrounds a nasal cannula body defining an open cavity.

22. A cannula according to any one of claims 1 to 21, wherein the second section supports the first section in a predetermined configuration.

23. 23. The cannula of any one of claims 1 to 22, wherein the second section extends substantially around a length of the nasal cannula defined by the first section, or for a length substantially longer than the length of the nasal cannula defined by the first section, or the second section extends for a length shorter than the length of the nasal cannula defined by the first section.

24. 24. A cannula according to any one of claims 1 to 23, wherein the nasal cannula includes a pair of side arms extending outwardly from the cannula body defining, at least in part, an open cavity capable of receiving a supply gas, such as via a manifold connection.

25. A cannula according to any one of claims 1 to 24, wherein a connection system for connecting a headgear worn by a user, i.e. the headgear in use, is arranged substantially towards each end of the side arms.

26. The cannula of any one of claims 1 to 25, wherein the connection system is part of the second section.

27. 27. The cannula of any one of claims 1 to 26, wherein the first section provides a gasket-type seal for a manifold connection or manifold receivable by at least a portion of the first section, such as one that defines an open cavity in the cannula body.

28. 28. A cannula according to any one of claims 1 to 27, wherein the second section provides a structure upon which a manifold connection can be made and the first section provides a seal, such as a manifold fluid-type seal, when making such a manifold connection.

29. 29. The cannula of any one of claims 1 to 28, wherein the nasal cannula comprises an open cavity engageable by a manifold, a rear portion of the body being substantially adjacent to a user's nasal septum region in use, the rear portion being substantially conformable or deformable in response to pressure applied to the rear portion by a user.

30. 30. The cannula of claim 29, wherein the rearward portion is a substantially thinned wall section of the body.

31. 31. The cannula of claim 29 or 30, wherein the rearward portion is defined by a hollow section of the body and the open cavity is a separate and distinct region of the body.

32. A cannula according to any one of claims 29 to 31, wherein the rear portion defines at least a portion of a wall of the open cavity.

33. A cannula according to any one of claims 29 to 32, wherein the rear portion is substantially elastic.

34. A cannula according to any one of claims 29 to 33, wherein the rear portion is elastically deformable.

35. The cannula of any one of claims 29 to 34, wherein the body comprises a hollow housing substantially adjacent the user's nasal septum region.

36. The cannula of any one of claims 29 to 35, wherein the body comprises a pillow section substantially adjacent the user's nasal septum region.

37. 37. The cannula of claim 36, wherein the pillow section is a hollow region bounded by a wall of the body and separate from an open chamber, the hollow region having a relatively thin wall or elastic section in a region substantially adjacent the user's nasal septum in use.

38. 38. A cannula according to claim 36 or 37, wherein the pillow section is formed by a rear wall of such an open cavity, the rear wall being a relatively thin wall or elastic section in an area that is substantially adjacent the user's nasal septum in use.

39. A cannula according to any one of claims 36 to 38, wherein the pillow section is formed from a material that can deform when a user applies pressure to it during use.

40. a strap at each end attached to a patient interface and adapted to extend around the patient's head to hold the patient interface in place on the patient's face; Equipped with At least a portion of the strap is configured to branch into two or more bands to extend around the patient's head. headgear.

41. 41. The headgear of claim 40, wherein the strap includes a longitudinal weakened section extending along a portion of the strap that can be torn by a user to separate the portion of the strap into two or more bands.

42. 42. Headgear according to claim 41, wherein the weakened section is a relatively thin section.

43. 43. The headgear of claim 42, wherein the weakened sections are perforated sections.

44. Headgear according to any one of claims 41 to 43, wherein the bands are separated by the weakened sections.

45. 45. Headgear according to any one of claims 41 to 44, wherein the strap comprises a hole at one end of the weakened section, the hole comprising a rounded portion defining an end of the weakened section to prevent tearing of the strap beyond the weakened section.

46. 46. ​​Headgear according to any one of claims 41 to 45, wherein at least the portions of the straps are formed from a fabric which forms the bands, the fabric being coated with a polymer once the bands are placed together, the coating providing the weakened sections between the bands, the coating being adapted to be torn to separate the bands.

47. 47. The headgear of claim 46, wherein the bands are formed by longitudinal cuts in the fabric along the portions of the straps, the polymeric coating spanning the cuts to hold the bands together in a non-diverging configuration.

Images