Woven Vent Assembly
The patient interface with a plenum chamber, seal-forming structure, and vent assembly enhances respiratory therapy compliance and comfort by addressing fit and noise issues, offering a stable and efficient respiratory therapy delivery system for home use.
Patent Information
- Application Number
- JP2024078507
- Authority / Receiving Office
- JP · JP
- Patent Type
- Patents
- Current Assignee / Owner
- Priority Date
- 2019-07-30
- Filing Date
- 2024-05-14
- Publication Date
- 2025-10-23
- Estimated Expiration
- 2040-02-21
AI Technical Summary
Existing respiratory treatment devices and systems, such as CPAP masks and RPT devices, suffer from discomfort, poor fit, complexity, and lack of patient compliance due to inadequate seal-forming structures, noisy ventilation, and cumbersome design, which affects the effectiveness and ease of use.
A patient interface with a plenum chamber, seal-forming structure, and vent assembly that maintains therapeutic pressure, allows oral breathing, and features a woven vent member to reduce noise and discomfort, along with a positioning device for stable fit, and a vent assembly with multiple orifices for efficient gas exchange.
Improves patient compliance and comfort by providing a stable, quiet, and effective respiratory therapy delivery system that is easy to use and maintain, suitable for home use without specialized clinical staff.
Smart Images

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Abstract
Description
[Technical Field]
[0001] A portion of the disclosure of this patent document contains material that is entitled to copyright protection. The copyright owner has no objection to the facsimile reproduction by anyone of this patent document or this patent disclosure, as it appears in the Patent and Trademark Office patent file or records, but reserves all copyright rights therefor for all other purposes.
[0002] 1 Cross-reference to related applications This application claims the benefit of U.S. Provisional Application No. 62 / 808,901, filed February 22, 2019, and U.S. Provisional Application No. 62 / 880,338, filed July 30, 2019, each of which is incorporated by reference in its entirety. [Background technology]
[0003] 2. Technical Background 2.1 Technology field The present technology relates to one or more of screening, diagnosing, monitoring, treating, preventing, and ameliorating respiratory-related disorders. The present technology also relates to medical devices or apparatus and uses thereof.
[0004] 2.2 Description of Related Art 2.2.1 The human respiratory system and its diseases The body's respiratory system facilitates gas exchange. The nose and oral cavity form the entrance to a patient's airways.
[0005] These airways contain a series of branching tubes that become narrower, shorter, and more numerous the deeper they travel into the lungs. The primary function of the lungs is gas exchange, allowing oxygen from the air to enter the venous blood and carbon dioxide to leave. The trachea divides into right and left main bronchi, which further divide into terminal bronchioles. The bronchi constitute conducting airways and do not participate in gas exchange. The airways further divide into respiratory bronchioles and ultimately into alveoli. Gas exchange occurs in the alveolar region of the lung, which is called the respiratory region. See: "Respiratory Physiology," by John B. West, Lippincott Williams & Wilkins, 9th edition published 2012.
[0006] There is a range of respiratory diseases. Particular diseases can be characterized by particular manifestations such as apnea, hypopnea and hyperpnea.
[0007] Examples of respiratory diseases include obstructive sleep apnea (OSA), Cheyne-Stokes respiration (CSR), respiratory failure, obesity hyperventilation syndrome (OHS), chronic obstructive pulmonary disease (COPD), neuromuscular diseases (NMD), and chest wall diseases.
[0008] Obstructive sleep apnea (OSA) is a form of sleep-disordered breathing (SDB) characterized by episodes of upper airway closure or obstruction during sleep. This is the result of an abnormally small upper airway combined with the normal loss of muscle tone in the tongue region, soft palate, and posterior oropharyngeal wall during sleep. This condition causes affected individuals to experience breathing pauses typically lasting 30 to 120 seconds, sometimes 200 to 300 times per night. This can result in excessive daytime sleepiness, which can lead to cardiovascular disease and brain damage. This condition is common, particularly among middle-aged, overweight men, but patients often experience no symptoms. See U.S. Patent No. 4,944,310 (Sullivan).
[0009] Cheyne-Stokes respiration (CSR) is another form of sleep-disordered breathing. CSR is a disorder of a patient's respiratory regulator, characterized by alternating periods of waxing and waning ventilation, known as the CSR cycle. CSR is characterized by repeated deoxygenation and reaeration of arterial blood. CSR can be harmful due to repeated hypoxia. In some patients, CSR is associated with recurrent sleep arousals, which can cause severe insomnia, increased sympathetic nervous activity, and increased afterload. See U.S. Patent No. 6,532,959 (Berthon-Jones).
[0010] Respiratory failure is a general term for respiratory disorders that refers to the inability of the lungs to take in enough oxygen or exhale enough CO2 to meet the patient's needs. Respiratory failure can include some or all of the following conditions:
[0011] Patients with respiratory failure (a type of respiratory insufficiency) may experience unusual shortness of breath during exercise.
[0012] Obesity hyperventilation syndrome (OHS) is defined as the combination of severe obesity and chronic awake hypercapnia in the absence of any other clear cause of hypoventilation. Symptoms include dyspnea, morning headache, and excessive daytime sleepiness.
[0013] Chronic obstructive pulmonary disease (COPD) encompasses any of a group of lower respiratory tract diseases that share certain common characteristics, including increased resistance to air movement, prolonged expiratory phase of breathing, and a decrease in normal lung elasticity. Examples of COPD include emphysema and chronic bronchitis. Causes of COPD include chronic smoking (the primary risk factor), occupational exposure, air pollution, and genetic factors. Symptoms include dyspnea on exertion, chronic cough, and sputum production.
[0014] Neuromuscular disease (NMD) is a broad term encompassing numerous diseases and illnesses that impair muscle function directly through intrinsic muscle pathology or indirectly through neuropathology. Some NMD patients are characterized by progressive muscle impairment, resulting in the inability to walk, wheelchair confinement, difficulty swallowing, respiratory muscle weakness, and ultimately death from respiratory failure. Neuromuscular disorders can be categorized as rapidly progressive or slowly progressive: (i) rapidly progressive disorders, characterized by muscle impairment that worsens over months and leads to death within a few years (e.g., amyotrophic lateral sclerosis (ALS) and Duchenne muscular dystrophy (DMD) in teenagers); (ii) variable or slowly progressive disorders, characterized by muscle impairment that worsens over years and results in only a modest reduction in life expectancy (e.g., limb-girdle, facioscapulohumeral, and myotonic muscular dystrophy). Symptoms of respiratory failure in NMD include: increasing general weakness, difficulty swallowing, difficulty breathing on exertion and at rest, fatigue, drowsiness, morning headache, and difficulty concentrating and mood changes.
[0015] Chest wall disorders are a group of thoracic deformities that result in ineffective connections between the respiratory muscles and the rib cage. These disorders are primarily characterized by restrictive obstruction and share the potential for long-term hypercapnic respiratory failure. Scoliosis and / or kyphoscoliosis can lead to severe respiratory failure. Symptoms of respiratory failure include: dyspnea on exertion, peripheral edema, orthopnea, recurrent chest infections, morning headache, fatigue, poor sleep quality, and loss of appetite.
[0016] A range of treatments are available to treat or ameliorate these conditions, and preventative treatments for respiratory disease are also available to benefit otherwise healthy individuals. However, these suffer from several deficiencies.
[0017] 2.2.2 Treatment A variety of therapies are used to treat one or more of the above respiratory disorders, such as continuous positive airway pressure (CPAP) therapy, non-invasive ventilation (NIV), and invasive ventilation (IV).
[0018] Continuous positive airway pressure (CPAP) therapy is used in the treatment of obstructive sleep apnea (OSA). Its mechanism of action is that continuous positive airway pressure acts as a pneumatic splint, for example, by pushing the soft palate and tongue forward or backward against the posterior oropharyngeal wall, thereby preventing closure of the upper airway. Because treatment of OSA with CPAP therapy can be voluntary, patients may choose not to adhere to treatment if they perceive one or more of the following about the device used to deliver the treatment: uncomfortable, difficult to use, expensive, or aesthetically unappealing.
[0019] Noninvasive ventilation (NIV) provides ventilatory support to a patient through the upper airway to assist the patient in breathing and / or maintain adequate oxygen levels in the body by performing some or all of the respiratory functions. Ventilatory support is provided through a noninvasive patient interface. NIV is used to treat CSR and respiratory failure in forms such as OHS, COPD, NMD, and chest wall disorders. In some forms, it can improve the comfort and effectiveness of these treatments.
[0020] Invasive ventilation (IV) provides ventilatory support to patients who are no longer able to breathe effectively on their own and may be provided using a tracheostomy tube. In some forms, the comfort and effectiveness of these treatments may be improved.
[0021] 2.2.3 Treatment System These treatments may be provided by therapeutic systems or devices. Such systems and devices may also be used to screen, diagnose, or monitor a disease without treating it.
[0022] The treatment system may include a respiratory pressure treatment device (RPT device), an air circuit, a humidifier, a patient interface, and data management.
[0023] Another form of treatment system is a mandibular repositioning device.
[0024] 2.2.3.1 Patient Interface A patient interface may be used to provide a wearer with an interface to a respiratory appliance, for example, by providing airflow to the airway entrance. Airflow may be provided via a mask to the nose and / or mouth, a tube to the mouth, or a tracheostomy tube to the patient's trachea. Depending on the therapy being applied, the patient interface may form a seal with, for example, an area of the patient's face, thereby facilitating gas delivery at a pressure sufficient to disperse with atmospheric pressure for therapy implementation (e.g., at a positive pressure of about 10 cmH2O relative to atmospheric pressure). In other forms of therapy, such as oxygen delivery, the patient interface may not include a seal sufficient to facilitate delivery of a gas supply to the airways at a positive pressure of about 10 cmH2O.
[0025] Certain other mask systems may be functionally inadequate in this field. For example, masks intended for purely decorative purposes may not be able to maintain adequate pressure. Mask systems used for underwater swimming or diving may be configured to protect against water intrusion from higher external pressures and not maintain internal air at pressures higher than ambient.
[0026] Certain masks may be clinically unsuitable for this technology (for example, if the mask blocks airflow through the nose and only allows airflow through the mouth).
[0027] In certain masks, the patient must insert part of the mask structure into their mouth and create and maintain a seal via their lips, which may be uncomfortable or impractical in this technology.
[0028] Certain masks may be impractical for use while sleeping (eg, when sleeping on your side in bed with your head resting on a pillow).
[0029] There are multiple challenges in designing a patient interface. The face has a complex three-dimensional shape. The size and shape of the nose and head vary greatly between individuals. Because the head contains bone, cartilage, and soft tissue, different regions of the face respond differently to mechanical forces. That is, the chin or mandible can move relative to the other bones of the skull. The entire head can move throughout the respiratory treatment period.
[0030] These challenges can lead to one or more of the following: some masks can be intrusive, aesthetically undesirable, costly, poor fit, difficult to use, and uncomfortable, especially if worn for extended periods or if the patient is unfamiliar with the system. If the wrong size mask is used, this can lead to reduced compliance, reduced comfort, and poor patient outcomes. While masks specifically designed for aviators, personal protective equipment (e.g., filter masks), SCUBA masks, or anesthesia administration masks may be durable for their intended use, such masks may be undesirably uncomfortable to wear for extended periods (e.g., several hours). Such discomfort can reduce patient compliance with treatment. This is especially true if the mask must be worn while sleeping.
[0031] CPAP therapy is highly effective in treating certain respiratory conditions when patients comply with the therapy. However, if the mask is uncomfortable or difficult to use, patients may not comply. Patients are often encouraged to clean their masks regularly, but if the mask is difficult to clean (e.g., difficult to assemble or disassemble), patients may not be able to clean the mask, which may affect patient compliance.
[0032] Therefore, a mask designed for use in treating sleep-disordered breathing may be suitable for other uses.
[0033] For these reasons, patient interfaces for CPAP delivery during sleep form a distinct field.
[0034] 2.2.3.1.1 Seal formation structure The patient interface may include a seal-forming structure. Because the patient interface is in direct contact with the patient's face, the shape and configuration of the seal-forming structure may have a direct impact on the effectiveness and comfort of the patient interface.
[0035] Patient interfaces can be characterized in part according to the design intent of where the seal-forming structure engages with the face during use. In one form of patient interface, the seal-forming structure can include a first sub-portion for forming a seal around the left nostril and a second sub-portion for forming a seal around the right nostril. In one form of patient interface, the seal-forming structure can include a single element that surrounds both nostrils during use. Such a single element can be designed, for example, to rest on the upper lip region and nose bridge region of the face. In one form of patient interface, the seal-forming structure can include an element that surrounds the oral cavity region during use, for example, by forming a seal on the lower lip region of the face. In one form of patient interface, the seal-forming structure can include a single element that surrounds both nostrils and the mouth region during use. These different types of patient interfaces can be known by various names depending on their manufacturers, such as nasal masks, full face masks, nasal pillows, nasal puffs, and oronasal masks.
[0036] A seal-forming structure that may be effective in one area of a patient's face may be inappropriate in another area due to, for example, different shapes, structures, variability, and sensitive areas of the patient's face. For example, the seal of swim goggles that rests on the patient's forehead may be inappropriate for use on the patient's nose.
[0037] A particular seal-forming structure may be designed for mass production so that one design is compatible, comfortable, and effective for a wide range of different face shapes and sizes. To the extent there is a mismatch between the shape of the patient's face and the seal-forming structure of the mass-manufactured patient interface, one or both may need to be adapted to form a seal.
[0038] One type of seal-forming structure extends around the periphery of the patient interface and is intended to seal against the patient's face when force is applied to the patient interface with the seal-forming structure engaging against the patient's face. This seal-forming structure may include an air or fluid-filled cushion, or may include a molded or shaped surface of a resilient sealing element constructed of an elastomer such as rubber. With this type of seal-forming structure, if the fit is improper, a gap will form between the seal-forming structure and the face, requiring additional force to press the patient interface against the face to achieve a seal.
[0039] Another type of seal-forming structure uses a thin flap seal positioned around the periphery of the mask to provide a self-sealing seal against the patient's face when positive pressure is applied within the mask. As with the previous type of seal-forming portion, poor fit between the face and the mask can require additional force to achieve a seal or the mask can leak. Furthermore, if the shape of the seal-forming structure does not match the shape of the patient, the seal-forming portion can fold or buckle during use, causing leakage.
[0040] Other types of seal-forming structures may include friction-fit elements that are inserted into the nostrils, for example, but some patients find these seal-forming parts uncomfortable.
[0041] Another form of seal-forming structure may use adhesives to achieve a seal, as some patients find it inconvenient to constantly apply and remove adhesives from their face.
[0042] A range of patient interface seal forming structures are disclosed in the following patent applications (assigned to ResMed Limited: WO1998 / 004,310; WO2006 / 074,513; WO2010 / 135,785).
[0043] One form of nasal pillow is found in the Adam line manufactured by Puritan Bennett. Another nasal pillow or nasal puff is the subject of U.S. Pat. No. 4,782,832 (Trimble et al.), assigned to Puritan-Bennett Corporation.
[0044] ResMed Limited manufactures the following products that use nasal pillows: SWIFT® Nasal Pillows Mask, SWIFT® II Nasal Pillows Mask, SWIFT® LT Nasal Pillows Mask, SWIFT® FX Nasal Pillows Mask, and MIRAGELIBERTY® Full Face Mask. Embodiments of nasal pillow masks are described in the following patent applications assigned to ResMed Limited: International Patent Application WO 2004 / 073,778 (which describes, among other things, aspects of ResMed Limited's SWIFT® Nasal Pillows); U.S. Patent Application No. 2009 / 0044808 (which describes, among other things, aspects of ResMed Limited's SWIFT® LT Nasal Pillows); International Patent Applications WO 2005 / 063,328 and WO 2006 / 130,903 (which describe, among other things, aspects of ResMed Limited's MIRAGE LIBERTY® Full Face Mask); and International Patent Application WO 2009 / 052,560 (which describes, among other things, aspects of ResMed Limited's SWIFT® FX Nasal Pillows).
[0045] 2.2.3.1.2 Positioning and stabilization The seal-forming structures of patient interfaces used in positive air pressure therapy are subjected to corresponding forces of air pressure that disrupt the seal, and therefore a variety of techniques are used to position the seal-forming structures and maintain a seal against the appropriate portion of the face.
[0046] One technique involves the use of adhesives, see, for example, U.S. Patent Application Publication No. US2010 / 0000534, but adhesives can be uncomfortable.
[0047] Another technique involves the use of one or more straps and / or stabilizing harnesses, many of which suffer from one or more of the following problems: poor fit, bulky, uncomfortable, and cumbersome.
[0048] 2.2.3.2 Respiratory Pressure Therapy (RPT) Devices Respiratory pressure therapy (RPT) devices can be used individually or as part of a system to deliver one or more of the above-mentioned therapies, for example, by actuating the device to generate a delivery flow of air to an interface with the airway. This air flow can be pressurized. Examples of RPT devices include CPAP devices and mechanical ventilators.
[0049] Air pressure generators are known for a wide range of applications (e.g., industrial-scale ventilation systems). However, air pressure generators for medical applications have specific requirements that cannot be met by more common air pressure generators (e.g., the reliability, size, and weight requirements of medical equipment). In addition, even devices designed for medical treatment may suffer from deficiencies related to one or more of the following: comfort, noise, ease of use, effectiveness, size, weight, manufacturability, cost, and reliability.
[0050] One example of a special requirement for a particular RPT device is acoustic noise.
[0051] Table of noise output levels of conventional RPT devices (measured on one sample only at 10cmH2O in CPAP mode using the test method specified in ISO3744). [Table 1]
[0052] One known RPT device used to treat sleep-disordered breathing is the S9 Sleep Therapy System (manufactured by ResMed Limited). Another example of an RPT device is a ventilator. Ventilators (e.g., the ResMed Stellar® series of adult and pediatric ventilators) can provide invasive and non-invasive independent respiratory support for patients for a range of conditions, including, but not limited to, NMD, OHS, and COPD.
[0053] The ResMed Elis Accent-Aiguée® 150 ventilator and ResMed VSIII® ventilators can provide invasive and non-invasive dependent respiratory support suitable for adult or pediatric patients for the treatment of multiple conditions. These ventilators offer volumetric and pressure ventilation modes using single or dual limb circuits. RPT devices typically include a pressure generator (e.g., an electric blower or compressed gas reservoir) and are configured to deliver airflow to the patient's airway. In some cases, the airflow can be delivered to the patient's airway at positive pressure. The outlet of the RPT device is connected via an air circuit to a patient interface, as described above.
[0054] A device designer may be presented with a myriad of choices. Often, conflicting design criteria may make certain design choices unconventional or unavoidable. Furthermore, the comfort and effectiveness of a particular implementation may be significantly affected by minor changes in one or more parameters.
[0055] 2.2.3.3 Humidifier Delivery of airflow without humidification can lead to dryness of the airway. When a humidifier is used with an RPT device and patient interface, humidified gas is produced, minimizing drying of the nasal mucosa and increasing comfort of the patient's airway. Additionally, in cooler climates, the application of warm air to the facial area surrounding the patient interface generally provides more comfort than cool air.
[0056] A range of artificial humidification devices and systems are known, but do not meet the special requirements of medical humidifiers.
[0057] Medical humidifiers are typically used when a patient is sleeping or resting (e.g., in a hospital) to increase the humidity and / or temperature of an air stream relative to the ambient air when needed. Bedside medical humidifiers may be compact. Medical humidifiers may be configured to only humidify and / or heat the air stream delivered to the patient, not the patient's surroundings. For example, while room-based systems (e.g., saunas, air conditioners, or evaporative coolers) may also humidify the air breathed into the patient's body, these systems also humidify and / or heat the entire room, which may be uncomfortable for occupants. Additionally, medical humidifiers may have more stringent safety constraints than industrial humidifiers.
[0058] Although many medical humidifiers are known, such medical humidifiers may suffer from one or more deficiencies, such that some provide inadequate humidification or are difficult or inconvenient for the patient to use.
[0059] 2.2.3.4 Data Management For clinical reasons, data may be obtained to determine whether a patient prescribed respiratory therapy is "compliant" (e.g., whether the patient adheres to one or more "compliance rules" with their RPT device). An example of a compliance rule for CPAP therapy may require a patient to use the RPT device for at least four hours per night for at least 21 days out of 30 consecutive days to be considered compliant. To determine patient compliance, a provider of the RPT device (e.g., a healthcare provider) may manually obtain data describing the patient's treatment with the RPT device, calculate usage rates over a given period, and compare this to the compliance rules. Once the healthcare provider determines that the patient has used their RPT device in accordance with the compliance rules, the healthcare provider may notify a third party that the patient is compliant.
[0060] There may be other aspects of patient care that benefit from communication of treatment data to third parties or external systems.
[0061] Existing processes for communicating and managing such data can be costly, time consuming, and / or error prone.
[0062] 2.2.3.5 Mandibular repositioning A mandibular repositioning device (MRD) or mandibular advancement device (MAD) is one treatment option for sleep apnea and snoring. It is an adjustable oral appliance available from dentists or other suppliers that holds the mandible (lower jaw) in an anterior position during sleep. MRDs are removable devices that are inserted into the mouth before a patient goes to sleep and removed afterward. As such, MRDs are not designed for full-time wear. MRDs can be custom-made or manufactured in standard forms and include bite impression sections designed to fit the patient's teeth. This mechanical protrusion from the mandible expands the space behind the tongue and applies tension on the pharyngeal walls, reducing airway collapse and palatal vibration.
[0063] In certain embodiments, the mandibular advancement device may include an upper splint intended to engage or mate with teeth on the upper jaw or maxilla, and a lower splint intended to engage or mate with teeth on the upper jaw or mandible. The upper and lower splints are laterally connected to each other via a pair of connecting rods that are fixed symmetrically on the upper and lower splints.
[0064] In such a design, the length of the connecting rod is selected so that the mandible is held in a forward position when the MRD is placed in the patient's mouth. The length of the connecting rod can be adjusted to change the level of mandibular protrusion. The dentist can determine the level of protrusion required for the mandible, and the length of the connecting rod is then determined.
[0065] Some MRDs are configured to push the mandible forward relative to the maxilla, while others, such as the ResMed Narval CC® MRD, are designed to hold the mandible in a forward position. The devices also reduce or minimize dental and temporomandibular joint (TMJ) side effects. As such, the devices are configured to minimize or prevent any movement of one or more teeth.
[0066] 2.2.3.6 Ventilation technology Some forms of treatment systems may include a vent to push out exhaled carbon dioxide, which may allow gas flow from an interior space of the patient interface (e.g., a plenum chamber) to an exterior of the patient interface (e.g., ambient).
[0067] The vents may include orifices through which gas can flow when the mask is in use. Many such vents are noisy. Others may become blocked during use, resulting in insufficient pumping. Some vents may disrupt sleep for the patient 1000 and bed companion 1100, for example, due to noise or concentrated airflow.
[0068] ResMed Limited has developed several improved mask ventilation technologies, see International Patent Application Publication No. WO 1998 / 034,665; International Patent Application Publication No. WO 2000 / 078,381; U.S. Patent No. 6,581,594; U.S. Patent Application Publication No. US 2009 / 0050156; and U.S. Patent Application Publication No. 2009 / 0044808.
[0069] Conventional mask noise table (ISO17510-2:2007, 10cmH2O pressure at 1m) [Table 2]
[0070] (*Measured using only one sample at 10cmH2O in CPAP mode using the test method specified in ISO3744)
[0071] The sound pressure values of various objects are listed below [Table 3]
[0072] 2.2.4 Screening, diagnostic, and surveillance systems Polysomnography (PSG) is a conventional system for diagnosing and monitoring cardiopulmonary diseases, but it typically requires specialized clinical staff for system application. PSG typically involves placing 15–20 contact sensors on the human body to record various body signals (e.g., electroencephalography (EEG), electrocardiography (ECG), electrooculography (EOG), and electromyography (EMG)). PSG for sleep-disordered breathing requires patients to be observed for two nights in a specialized hospital: the first night for pure diagnosis and the second night for clinician-assisted titration of treatment parameters. Therefore, PSG is expensive and inconvenient. Screening, diagnosing, and monitoring sleep-disordered breathing is particularly unsuitable for home use.
[0073] In general, screening and diagnosis involve identifying disease through signs and symptoms. Screening typically produces a true / false result indicating whether a patient's SDB warrants further investigation, while diagnosis often produces clinically actionable information. Screening and diagnosis tend to be one-time procedures, whereas monitoring the progression of disease can continue indefinitely. While some screening / diagnostic systems are adapted solely for screening / diagnosis, some can also be used for monitoring.
[0074] A clinical expert may adequately screen, diagnose, or monitor a patient based on visual observation of the PSG signal. However, there are situations where a clinical expert is not available or cannot be paid for. Different clinical experts may have different opinions about a patient's condition. Furthermore, some clinical experts may apply different criteria at different times. [Prior art documents] [Patent documents]
[0075] [Patent Document 1] U.S. Patent No. 4,944,310 [Patent Document 2] U.S. Patent No. 6,532,959 Summary of the Invention [Means for solving the problem]
[0076] 3. Brief description of the technology The present technology relates to the provision of medical devices for use in screening, diagnosing, monitoring, ameliorating, treating or preventing respiratory diseases, which medical devices have one or more of improved comfort, cost, effectiveness, ease of use and manufacturability.
[0077] A first aspect of the present technology relates to devices used in screening, diagnosing, monitoring, ameliorating, treating or preventing respiratory disease.
[0078] Another aspect of the present technology relates to methods used in the screening, diagnosis, monitoring, amelioration, treatment or prevention of respiratory disorders.
[0079] An aspect of certain forms of the present technology is to provide methods and / or devices that improve patient compliance with respiratory therapy.
[0080] Another aspect of the present technology relates to a patient interface including: a plenum chamber pressurizable to a therapeutic pressure of at least 6 cmH2O above ambient air pressure, the plenum chamber including a plenum chamber inlet port sized and configured to receive a flow of air at the therapeutic pressure for breathing of the patient; a seal-forming structure constructed and arranged to seal against an area of the patient's face surrounding an entrance to the patient's airways, the seal-forming structure having holes therein whereby the flow of air at the therapeutic pressure is delivered to at least entrances to the patient's nares, the seal-forming structure constructed and arranged to maintain said therapeutic pressure within the plenum chamber throughout the patient's respiratory cycle in use; and a positioning device providing a force to hold the seal-forming structure in a therapeutically effective position on the patient's head. and a stabilizing structure, the positioning and stabilizing structure including a tie, the tie constructed and arranged such that in use at least a portion of the tie rests on a region of the patient's head above the superior ear-base point of the patient's head; and a venting structure that allows gases exhaled by the patient to flow continuously from within the plenum chamber to the surroundings, the venting structure being sized and shaped to maintain the therapeutic pressure within the plenum chamber in use, wherein the patient interface is further configured to leave the patient's oral cavity exposed or, if the seal-forming structure is configured to seal around the patient's nose and mouth, the patient interface is configured to allow the patient to breathe from the atmosphere through their oral cavity in the absence of pressurized air flow through the plenum chamber inlet port.
[0081] Another aspect of the present technology relates to a CPAP system that provides a patient with positive pressure gas for respiratory therapy. The CPAP system includes an RPT device configured to supply a gas flow at a therapeutic pressure, a patient interface forming a plenum chamber pressurizable to the therapeutic pressure, the patient interface including a seal-forming structure constructed and arranged to form a seal with a patient's facial area surrounding an entrance to the patient's airway, an air delivery conduit configured to pass the gas flow at the therapeutic pressure from the RPT device to the patient interface, and a vent assembly configured to provide a ventilation gas flow for releasing exhaled gas from the pressurized volume to atmosphere. The vent assembly includes at least one first orifice extending through a base to allow gas from the pressurized volume to be released to atmosphere along a primary ventilation flow path and at least one second orifice to allow gas from the pressurized volume to be released to atmosphere along a secondary ventilation flow path, a diffusion member disposed in the base, and a membrane disposed in the base. The diffusing member is constructed and arranged to cause the ventilation flow to pass through the diffusing member along a primary ventilation flow path by having at least one first orifice covered by the diffusing member and to cause the ventilation flow to bypass the diffusing member along a secondary ventilation flow path by having at least one second orifice uncovered by the diffusing member. The membrane is constructed and arranged to distribute the gas ventilation flow along the primary and secondary ventilation flow paths throughout respiratory therapy.
[0082] Another aspect of the present technology relates to a CPAP system that provides a patient with positive pressure gas for respiratory therapy. The CPAP system includes an RPT device configured to deliver a gas flow at a therapeutic pressure, and a patient interface that forms a plenum chamber pressurizable to the therapeutic pressure, the patient interface including a seal-forming structure constructed and arranged to form a seal with a patient's facial area surrounding an entrance to the patient's airway, an air delivery conduit configured to pass the gas flow at the therapeutic pressure from the RPT device to the patient interface, and a ventilator assembly configured to provide a ventilation gas flow for releasing exhaled gas from the pressurized volume to atmosphere. The ventilator assembly includes a ventilator component including at least one first orifice extending through a base to allow gas from the pressurized volume to be released to atmosphere along a primary ventilation flow path and at least one second orifice to allow gas from the pressurized volume to be released to atmosphere along a secondary ventilation flow path, a diffusing member disposed in the base, and a plurality of vent orifices disposed in the at least one second orifice in the base. The diffusing member is constructed and arranged such that at least one first orifice is covered by the diffusing member along the primary ventilation flow path and at least one second orifice is not covered by the diffusing member along the secondary ventilation flow path. The ventilation component includes an expanding polymer material that is constructed and arranged to regulate gas ventilation flow along the secondary ventilation flow path throughout treatment.
[0083] Another aspect of the present technology relates to a CPAP system that provides a patient with positive pressure gas for respiratory therapy. The CPAP system includes an RPT device configured to supply a gas flow at a therapeutic pressure, and a patient interface that forms a plenum chamber that can be pressurized to the therapeutic pressure. The patient interface includes a seal-forming structure constructed and arranged to form a seal with a facial area of the patient surrounding an entrance to the patient's airway, an air delivery conduit configured to pass the gas flow at the therapeutic pressure from the RPT device to the patient interface, and a vent assembly configured to provide a ventilation gas flow for releasing exhaled gas from the pressurized volume to atmosphere. The vent assembly includes a vent member, a diffusion member, and a support structure, the vent member including a woven material and including a plurality of vent holes that allow gas to be released from the pressurized volume to atmosphere, the diffusion member including a woven material and configured and arranged such that the plurality of vent holes are covered by the diffusion member, and the support structure supports the diffusion member at a distance from the vent member. The support structure includes an opening that allows gas to escape along a primary air flow path and a side opening that allows gas to escape along a secondary air flow path, and the diffusing member is supported by the support structure such that the opening is covered by the diffusing member to cause the air flow to pass through the diffusing member along the primary air flow path and the side opening is covered by the diffusing member to cause the air flow to bypass the diffusing member along the secondary air flow path.
[0084] Another aspect of the present technology relates to a vent assembly, the vent assembly including a base, a diffusing member, a membrane, and / or a vent component.
[0085] Another aspect of the present technology relates to a vent assembly including at least one first orifice extending through a base to allow gas from a pressurized volume to be released to atmosphere along a primary vent flow path, at least one second orifice to allow gas from the pressurized volume to be released to atmosphere along a secondary vent flow path, a diffusing member disposed in the base, and a membrane disposed in the base. The diffusing member is configured and arranged to cover the at least one first orifice, thereby causing the vent flow to pass through the diffusing member along the primary vent flow path, and to leave the at least one second orifice uncovered, thereby causing the vent flow to bypass the diffusing member along the secondary vent flow path. The membrane is constructed and configured to distribute the gas vent flow along the primary and secondary vent flow paths throughout respiratory therapy.
[0086] Another aspect of the present technology relates to a ventilation assembly including a ventilation component including at least one first orifice extending through a base to allow gas from the pressurized volume to be released to atmosphere along a primary ventilation flow path and at least one second orifice to allow gas from the pressurized volume to be released to atmosphere along a secondary ventilation flow path, a diffusing member disposed in the base, and a plurality of ventilation orifices disposed in the at least one second orifice in the base. The diffusing member is configured and arranged such that the at least one first orifice is covered by the diffusing member along the primary ventilation flow path and the at least one second orifice is not covered by the diffusing member along the secondary ventilation flow path. The ventilation component includes an expandable polymer material that is constructed and arranged to regulate gas ventilation flow along the secondary ventilation flow path throughout treatment.
[0087] Another aspect of the present technology relates to a vent assembly that includes a woven vent member, a woven diffusion member, and / or a support structure.
[0088] Another aspect of the present technology relates to a vent assembly including a vent member, a diffusion member, and a support structure. The vent member includes a woven fabric material and includes a plurality of vent holes that allow gas to be released from a pressurized space to the atmosphere. The diffusion member includes a woven fabric material and is constructed and arranged such that the plurality of vent holes are covered by the diffusion member. The support structure supports the diffusion member at a distance from the vent member. The support structure includes openings that allow gas to be released along a primary vent flow path and side openings that allow gas to be released along a secondary vent flow path. The diffusion member is supported by the support structure such that the diffusing member covers the openings to direct the vent flow through the diffusion member along the primary vent flow path and the diffusing member covers the side openings to direct the vent flow around the diffusion member along the secondary vent flow path.
[0089] Another aspect of the present technology relates to a vent assembly configured to provide a ventilation gas flow for releasing gas from a pressurized volume to atmosphere. The vent assembly includes at least one first orifice to allow gas from the pressurized volume to be released to atmosphere along a primary ventilation flow path, at least one second orifice to allow gas from the pressurized volume to be released to atmosphere along a secondary ventilation flow path, a diffusing member constructed and arranged such that the at least one first orifice is covered by the diffusing member, thereby causing the ventilation flow to pass through the diffusing member along the primary ventilation flow path and the at least one second orifice is not covered by the diffusing member, thereby causing the ventilation flow to bypass the diffusing member along the secondary ventilation flow path; and a membrane constructed and arranged to distribute the gas ventilation flow along the primary ventilation flow path and the secondary ventilation flow path. In an example, the vent assembly is provided in a patient interface. In one example, the vent assembly is provided in an air delivery conduit.
[0090] One aspect of certain forms of the present technology is a medical device that is easy to use, for example, by individuals without medical training, individuals with limited dexterity or acumen, or individuals with limited experience using such medical devices.
[0091] An aspect of one form of the present technology is a patient interface that can be cleaned in the patient's home, for example with soap and water, without the need for special cleaning equipment.
[0092] Of course, some of the above aspects may form sub-aspects of the present technology, and various sub-aspects and / or aspects may be combined in various ways to form further aspects or sub-aspects of the present technology.
[0093] Other features of the present technology will become apparent in light of the information contained in the following detailed description, abstract, drawings, and claims.
[0094] 4 Brief description of the drawings The present technology is illustrated by way of example and not limitation in the accompanying drawings, in which like reference numerals include like elements: [Brief explanation of the drawings]
[0095] [Figure 1A] 4.1 Treatment System: A system is shown including a patient 1000 wearing a patient interface 3000. The system takes the form of nasal pillows and receives air at positive pressure supplied by an RPT device 4000. The air from the RPT device 4000 is humidified by a humidifier 5000 and travels along an air circuit 4170 to the patient 1000. A bed companion 1100 is also shown. The patient is sleeping in a supine sleeping position. [Figure 1B] A system is shown including a patient 1000 wearing a patient interface 3000, which takes the form of a nasal mask and receives air at positive pressure supplied by an RPT device 4000. The air from the RPT device is humidified by a humidifier 5000 and travels along an air circuit 4170 to the patient 1000. [Figure 1C] The system includes a patient 1000 wearing a patient interface 3000. The patient interface 3000 takes the form of a full face mask and receives a positive pressure air supply from an RPT device 4000. Air from the RPT device is humidified by a humidifier 5000 and travels along an air circuit 4170 to the patient 1000. The patient is sleeping in a lateral sleep position. 4.2 Respiratory System and Facial Anatomy [Figure 2A] An outline of the human respiratory system including the nasal and oral cavities, larynx, vocal folds, esophagus, trachea, bronchi, lungs, alveolar sacs, heart and diaphragm. [Figure 2B] Diagram of the human upper respiratory tract including the nasal cavity, nasal bones, lateral nasal cartilages, greater alar cartilages, nostrils, upper lip, lower lip, larynx, hard palate, soft palate, oropharynx, tongue, epiglottis, vocal folds, esophagus, and trachea. [Figure 2C] A front view of the face including several features of the surface anatomy including upper lip, vermilion, lower lip, mouth width, medial canthus, alae of the nose, nasolabial folds, and corners of the mouth. The superior, inferior, radially inward, and radially outward directions are also indicated. [Figure 2D] A lateral view of the head including several features of the surface anatomy, including the glabella, serrion, nasal tip, subnasal point, upper lip, lower lip, supramenton, nasal ridge, alar crest, superior and inferior ear base points. The directions of superior and inferior, and anterior and posterior are also indicated. [Figure 2E]
[0023] Figure 1 is a further lateral view of the head, showing the approximate locations of the Frankfort horizontal and nasolabial angle. The coronal view is also shown. [Figure 2F] A bottom view of the nose including several features including the nasolabial fold, lower lip, upper lip vermilion, nostrils, subnasal point, columella, nasal tip, major axis of the nostrils and midsagittal plane. [Figure 2G] FIG. 1 is a side view of the surface features of the nose. [Figure 2H] Shown are the subcutaneous structures of the nose, including the lateral nasal cartilages, nasal septum cartilage, greater alar cartilage, lesser alar cartilage, nasal sesamoid cartilage, nasal bones, epidermis, adipose tissue, frontal process of the maxilla, and fibro-adipose tissue. [Figure 2I]The mid-nasal incision is shown approximately a few millimeters from the midsagittal plane, with particular attention paid to the septal cartilage and the medial crus of the greater alar cartilage. [Figure 2J] FIG. 1 is a frontal bony view of the skull, including the frontal, nasal, and cheekbones, with the nasal turbinates shown along with the maxilla and mandible. [Figure 2K] This is a side view of the skull, showing the outline of the head surface and some muscles. The following bones are shown: frontal, sphenoid, nasal, zygomatic, maxilla, mandible, parietal, temporal, and occipital. The mental protuberance is shown. The following muscles are shown: digastric, masseter, sternocleidomastoid, and trapezius. [Figure 2L] An anterior lateral view of the nose is shown. 4.3 Patient Interface [Figure 3A] 1 shows a patient interface in the form of a nasal mask in accordance with one form of the present technology. [Figure 3B] 3C is a schematic cross-sectional view of the structure cut at a point, with the outward normal at this point shown, and the curvature at this point has a positive sign and a relatively large magnitude compared to the magnitude of the curvature shown in 3C. [Figure 3C] 3B is a schematic cross-sectional view of the structure cut at a point, showing the outward normal at this point, where the curvature at this point has a positive sign and a relatively small magnitude compared to the magnitude of the curvature shown in FIG. [Figure 3D] Schematic cross-section of a structure cut at a point, where the outward normal at this point is shown and the curvature value at this point is zero. [Figure 3E] 3B is a schematic cross-sectional view of the structure cut at a point, showing the outward normal at this point. The curvature at this point has a negative sign and a relatively small magnitude compared to the magnitude of the curvature shown in FIG. 3F. [Figure 3F] 3B is a schematic cross-sectional view of the structure cut at a point, showing the outward normal at this point, where the curvature at this point has a negative sign and a relatively large magnitude compared to the magnitude of the curvature shown in FIG. [Figure 3G]1 shows a mask cushion including two pillows, the outer surface of the cushion is shown, the edge of the surface is shown, and the dome and saddle regions are shown. [Figure 3H] 1 shows a cushion for a mask. The outer surface of the cushion is illustrated. The edge of the surface is illustrated. The path on the surface between points A and B is illustrated. The linear distance between A and B is illustrated. Two saddle regions and a dome region are illustrated. [Figure 3I] The surface of a structure is shown, with a one-dimensional hole drilled into the surface. The planar curves shown form the boundary of the one-dimensional hole. [Figure 3J] 3B is a cross-sectional view through the structure of Figure 3I. The surfaces shown bound a two-dimensional hole in the structure of Figure 3I. [Figure 3K] 3I includes a two-dimensional hole and a one-dimensional hole, and the surfaces bounding the two-dimensional hole in the structure of FIG. 3I are also shown. [Figure 3L] 1 shows a mask with an inflatable bladder as a cushion. [Figure 3M] 3L is a cross-sectional view of the mask of FIG. 3L showing the inner surface of the bladder, which bounds the two-dimensional hole in the mask. [Figure 3N] 3D shows a further cross section through the mask of FIG. 3L, with the interior surface also shown. [Figure 3O] Demonstrates the left-hand rule. [Figure 3P] Demonstrates the right-hand rule. [Figure 3Q] 1 shows the left ear including the left ear helix. [Figure 3R] The right ear is shown, including the right ear helix. [Figure 3S] Shows a right-handed spiral. [Figure 3T] 1 is a diagram of a mask including the signature of the twist of the space curve defined by the edges of the sealing membrane in different regions of the mask. [Figure 3U] A view of the plenum chamber 3200 showing the midsagittal plane and the central contact plane. [Figure 3V]A posterior view of the plenum chamber of Figure 3U. Directions in the figure are perpendicular to the central contact plane. In Figure 3V, the midsagittal plane bisects the plenum chamber into a left-hand side and a right-hand side. [Figure 3W] 3V is a cross-sectional view through the plenum chamber of FIG. 3V, where the cross-section is taken in the midsagittal plane shown in FIG. 3V. The "central contact" plane is shown. The central contact plane is perpendicular to the midsagittal plane. The orientation of the central contact plane corresponds to the orientation of the tendon 3210. The tendon 3210 rests on the midsagittal plane and contacts the cushion of the plenum chamber only at two points on the midsagittal plane (i.e., superior point 3220 and inferior point 3230). Depending on the geometry of the cushion in this region, the central contact plane may contact both the superior and inferior points. [Figure 3X] The plenum chamber 3200 of Figure 3U is shown in a use position on the face. The mid-sagittal plane of the plenum chamber 3200 generally coincides with the mid-sagittal plane of the face when the plenum chamber is in the use position. The central contact plane generally corresponds to the "face plane" when the plenum chamber is in the use position. In Figure 3X, the plenum chamber 3200 is that of a nasal mask, with the upper point 3220 resting approximately on the selion and the lower point 3230 resting on the upper lip. 4.4 Vent Assembly [Figure 4A] 12 is a perspective view of a vent assembly provided in an air delivery conduit according to an embodiment of the present technology; FIG. [Figure 4B] 12 is a cross-sectional view of a vent assembly provided in an air delivery conduit according to an embodiment of the present technology; [Figure 4C] FIG. 13 is an exploded view of a vent assembly and air delivery conduit according to an example of the present technology. [Figure 4D] FIG. 10 is another exploded view of a vent assembly and air delivery conduit in accordance with an embodiment of the present technology. [Figure 4E]
[0023] FIG. 10 is a perspective view of a vent assembly according to an embodiment of the present technology; [Figure 4F] FIG. 4F is a cross-sectional view of the vent assembly of FIG. 4E. [Figure 4G] FIG. 4F is an exploded view of the vent assembly of FIG. 4E. [Figure 4H]FIG. 4F is another exploded view of the vent assembly of FIG. 4E. [Figure 4I] FIG. 4F is a cross-sectional view illustrating air passing through the vent assembly of FIG. 4E when there is no or low air pressure in the air delivery conduit and the fabric material is not obstructed in accordance with an embodiment of the present technology. [Figure 4J] FIG. 4F is a cross-sectional view illustrating air passing through the vent assembly of FIG. 4E when air pressure is present in the air delivery conduit and the woven material is not obstructed in accordance with an embodiment of the present technology. [Figure 4K] FIG. 4F is a cross-sectional view illustrating air passing through the vent assembly of FIG. 4E when air pressure is present in the air delivery conduit and the fabric material is occluded in accordance with an embodiment of the present technology. [Figure 5A]
[0023] FIG. 10 is a perspective view of a vent assembly according to an embodiment of the present technology; [Figure 5B] FIG. 5B is a cross-sectional view of the vent assembly of FIG. 5A. [Figure 5C] FIG. 5B is an exploded view of the vent assembly of FIG. 5A. [Figure 5D] FIG. 5B is another exploded view of the vent assembly of FIG. 5A. [Figure 5E] FIG. 5B is a cross-sectional view illustrating air passing through the vent assembly of FIG. 5A when there is no or low air pressure in the air delivery conduit and the woven material is not obstructed in accordance with an embodiment of the present technology. [Figure 5F] FIG. 5B is a cross-sectional view illustrating air passing through the vent assembly of FIG. 5A when air pressure is present in the air delivery conduit and the woven material is not obstructed in accordance with an embodiment of the present technology. [Figure 5G] FIG. 5B is a cross-sectional view illustrating air passing through the vent assembly of FIG. 5A when air pressure is present in the air delivery conduit and the woven material is occluded in accordance with an embodiment of the present technology. [Figure 6A] 12 is a perspective view of a vent assembly provided in an air delivery conduit according to an embodiment of the present technology; FIG. [Figure 6B] 12 is a cross-sectional view of a vent assembly provided in an air delivery conduit according to an embodiment of the present technology; [Figure 6C]FIG. 13 is an exploded view of a vent assembly and air delivery conduit according to an example of the present technology. [Figure 6D] FIG. 10 is another exploded view of a vent assembly and air delivery conduit in accordance with an embodiment of the present technology. [Figure 6E]
[0023] FIG. 10 is a perspective view of a vent assembly according to an embodiment of the present technology; [Figure 6F] FIG. 6F is a cross-sectional view of the vent assembly of FIG. 6E. [Figure 6G] FIG. 6F is an exploded view of the vent assembly of FIG. 6E. [Figure 6H] FIG. 6F is another exploded view of the vent assembly of FIG. 6E. [Figure 6I] FIG. 6F is a cross-sectional view illustrating air passing through the vent assembly of FIG. 6E when there is no or low air pressure in the air delivery conduit and the woven material is not obstructed in accordance with an embodiment of the present technology. [Figure 6J] FIG. 6F is a cross-sectional view illustrating air passing through the vent assembly of FIG. 6E when air pressure is present in the air delivery conduit and the woven material is not obstructed in accordance with an embodiment of the present technology. [Figure 6K] FIG. 6F is a cross-sectional view illustrating air passing through the vent assembly of FIG. 6E when air pressure is present in the air delivery conduit and the fabric material is occluded in accordance with an embodiment of the present technology. [Figure 7A] FIG. 13 is an exploded view of a vent assembly according to an embodiment of the present technology. [Figure 7B] FIG. 7B is another exploded view of the vent assembly of FIG. 7A. [Figure 7C] FIG. 7B is a perspective view of the activator and sensor of the vent assembly of FIG. 7A. [Figure 8A]
[0023] FIG. 10 is a perspective view of a vent assembly according to an embodiment of the present technology; [Figure 8B] FIG. 8B is a cross-sectional view of the vent assembly of FIG. 8A. [Figure 8C] FIG. 8B is an exploded view of the vent assembly of FIG. 8A. [Figure 8D]FIG. 8B is a cross-sectional view illustrating air passing through the vent assembly of FIG. 8A when air pressure is present in the air delivery conduit and the woven material is not obstructed in accordance with an embodiment of the present technology. [Figure 8E] FIG. 8B is a cross-sectional view illustrating air passing through the vent assembly of FIG. 8A when air pressure is present in the air delivery conduit and the woven material is occluded in accordance with an embodiment of the present technology. [Figure 9A] FIG. 10 is a top perspective view of a vent assembly according to an embodiment of the present technology. [Figure 9B] FIG. 9B is a bottom perspective view of the vent assembly of FIG. 9A. [Figure 9C] FIG. 9B is an exploded view of the vent assembly of FIG. 9A. [Figure 9D] FIG. 9B is a cross-sectional view of the vent assembly of FIG. 9A. [Figure 9E] FIG. 9B is a cross-sectional view illustrating air passing through the vent assembly of FIG. 9A when air pressure is present and the diffusing member is not blocked in accordance with an embodiment of the present technology. [Figure 9F] FIG. 9B is a cross-sectional view illustrating air passing through the vent assembly of FIG. 9A when air pressure is present and the diffusing member is blocked in accordance with an embodiment of the present technology. [Figure 10A] FIG. 10 is a top perspective view of a vent assembly according to an embodiment of the present technology. [Figure 10B] FIG. 10B is a bottom perspective view of the vent assembly of FIG. 10A. [Figure 10C] FIG. 10B is an exploded view of the vent assembly of FIG. 10A. [Figure 10D] FIG. 10B is a cross-sectional view of the vent assembly of FIG. 10A. [Figure 10E] FIG. 10B is a cross-sectional view illustrating air passing through the vent assembly of FIG. 10A when air pressure is present and the diffusing member is not blocked in accordance with an embodiment of the present technology. [Figure 10F] FIG. 10B is a cross-sectional view illustrating air passing through the vent assembly of FIG. 10A when air pressure is present and the diffusing member is blocked in accordance with an embodiment of the present technology. [Figure 11A]10 is a graph illustrating an exemplary vent flow for a vent assembly in accordance with an embodiment of the present technology; [Figure 11B] 10 is a graph illustrating an exemplary vent flow for a vent assembly in accordance with an embodiment of the present technology; [Figure 11C] 10 is a graph illustrating an exemplary vent flow for a vent assembly in accordance with an embodiment of the present technology; [Figure 11D] 10 is a graph illustrating an exemplary vent flow for a vent assembly in accordance with an embodiment of the present technology; [Figure 11E] 10 is a graph illustrating an exemplary vent flow for a vent assembly in accordance with an embodiment of the present technology; [Figure 11F] 10 is a graph illustrating an exemplary vent flow for a vent assembly in accordance with an embodiment of the present technology; DETAILED DESCRIPTION OF THE INVENTION
[0096] 5 Detailed Description of the Embodiments of the Present Technology Before describing the present technology in further detail, it is to be understood that the present technology is not limited to the specific embodiments described herein, which may vary. It is also to be understood that the terminology used in the present disclosure is for the purpose of describing the specific embodiments described herein, and is not intended to be limiting.
[0097] The following description is provided in connection with various embodiments that may share one or more common characteristics and / or features. It should be understood that one or more features of any one embodiment may be combined with one or more features of another embodiment or other embodiments. In addition, any single feature or combination of features in any of these embodiments may constitute an additional embodiment.
[0098] 5.1 Treatment In one form, the present technology includes a method of treating a respiratory disorder, the method including applying positive pressure to the entrance of the airways of a patient 1000.
[0099] In certain embodiments of the present technology, a supply of air at positive pressure is provided to the patient's nasal passages via one or both nostrils.
[0100] In certain embodiments of the present technology, mouth breathing is restricted, limited or prevented.
[0101] 5.2 Treatment System In one form, the present technology includes an apparatus or device for the treatment of respiratory disorders. The apparatus or device may include an RPT device 4000 that supplies pressurized air to a patient 1000 via an air circuit 4170 to a patient interface 3000 (see, for example, FIGS. 1A-1C).
[0102] 5.3 Patient Interface 3A , a non-invasive patient interface 3000 in accordance with one aspect of the present technology includes the following functional aspects: a seal-forming structure 3100, a plenum chamber 3200, a positioning and stabilizing structure 3300, a vent 3400, a form of connection port 3600 for connection to an air circuit 4170, and a forehead support 3700. In some forms, the functional aspects may be provided by one or more physical components. In some forms, a single physical component may provide one or more functional aspects. In use, the seal-forming structure 3100 is positioned to surround the entrance to the patient's airways to facilitate the delivery of air at positive pressure to the airways.
[0103] If the patient interface cannot comfortably deliver a minimum level of positive pressure to the airway, the patient interface may be unsuitable for respiratory pressure therapy.
[0104] A patient interface 3000 in accordance with one form of the present technology is constructed and arranged to provide an air supply at a positive pressure of at least 6 cmH2O relative to ambient.
[0105] A patient interface 3000 in accordance with one form of the present technology is constructed and arranged to provide an air supply at a positive pressure of at least 10 cmH2O relative to ambient.
[0106] A patient interface 3000 in accordance with one form of the present technology is constructed and arranged to provide an air supply at a positive pressure of at least 20 cmH2O relative to ambient.
[0107] 5.3.1 Seal formation structure In one form of the present technology, the seal-forming structure 3100 provides a target seal-forming area and may further provide a cushioning function. The target seal-forming area is the area where a seal may occur in the seal-forming structure 3100. The area where a seal actually occurs (i.e., the actual sealing surface) may vary from patient to patient in a given treatment session and from day to day, depending on a range of factors (e.g., placement of the patient interface on the face, tension in the positioning and stabilizing structure, and the shape of the patient's face).
[0108] In one form, the target seal-forming area is located on an exterior surface of the seal-forming structure 3100 .
[0109] In certain forms of the present technology, the seal-forming structure 3100 is constructed from a biocompatible material (eg, silicone rubber).
[0110] A seal-forming structure 3100 according to the present technology may be constructed from a soft, flexible and resilient material (eg, silicone).
[0111] In certain forms of the present technology, a system is provided that includes more than one seal-forming structure 3100. Each seal-forming structure 3100 is configured to accommodate a different size and / or shape range. For example, the system may include one form of seal-forming structure 3100 that is suitable for large head sizes but not small head sizes, and another that is suitable for small head sizes but not large head sizes.
[0112] 5.3.1.1 Sealing mechanism In one form, the seal-forming structure includes a sealing flange that employs a pressure-assisted sealing mechanism. In use, the sealing flange can readily respond to positive system pressure within the plenum chamber 3200 by acting on its underside to form a tight sealing engagement with the surface. The pressure-assisted mechanism can work in conjunction with elastic tension in the positioning and stabilizing structure.
[0113] In one form, the seal-forming structure 3100 includes a sealing flange and a support flange. The sealing flange includes a relatively thin member having a thickness of less than about 1 mm (e.g., about 0.25 mm to about 0.45 mm) that extends around the peripheral length of the plenum chamber 3200. The support flange may be relatively thicker than the sealing flange. The support flange is disposed between the sealing flange and the peripheral edge of the plenum chamber 3200 and extends around at least a portion of the peripheral length. The support flange is or includes a spring-like element that functions to support the sealing flange against buckling during use.
[0114] In one form, the seal-forming structure may include a compressive or gasket sealing portion that is constructed and arranged to be in compression in use due to, for example, elastic tension in the positioning and stabilizing structure.
[0115] In one form, the seal-forming structure includes a tensioning portion that, in use, is held taut by, for example, an adjacent region of the sealing flange.
[0116] In one form, the seal-forming structure includes an area having a sticky or adhesive surface.
[0117] In certain forms of the present technology, the seal-forming structure may include one or more of a pressure-assisted sealing flange, a compression sealing portion, a gasket sealing portion, a tension portion, and a portion having an adhesive or adhesive surface.
[0118] 5.3.1.2 Nasal bridge or nasal ridge area In one form, the non-invasive patient interface 3000 includes a seal-forming structure that, in use, forms a seal on the nasal bridge or nasal ridge region of the patient's face.
[0119] In one form, the seal-forming structure includes a saddle-shaped region constructed to form a seal over the nasal bridge or nasal ridge region of the patient's face in use.
[0120] 5.3.1.3 Upper lip area In one form, the non-invasive patient interface 3000 includes a seal-forming structure that, in use, forms a seal over the upper lip region (ie, upper lip) of the patient's face.
[0121] In one form, the seal-forming structure includes a saddle-shaped region constructed to form a seal over the upper lip region of the patient's face in use.
[0122] 5.3.1.4 Jaw area In one form, the non-invasive patient interface 3000 includes a seal-forming structure that, in use, forms a seal over the chin area of the patient's face.
[0123] In one form, the seal-forming structure includes a saddle-shaped region constructed to form a seal over the chin region of the patient's face in use.
[0124] 5.3.1.5 Frontal area In one form, the seal-forming structure forms a seal on the forehead region of the patient's face when in use, and in such a form, the plenum chamber may cover the eyes when in use.
[0125] 5.3.1.6 Nasal pillow In one form, the seal-forming structure of the non-invasive patient interface 3000 includes a pair of nasal puffs or nasal pillows, each constructed and arranged to form a seal with a respective nostril of the patient's nose.
[0126] Nasal pillows according to one aspect of the present technology include a truncated cone. At least a portion of the truncated cone forms a seal over the underside of the patient's nose, the stem, and a flexible region on the underside of the truncated cone, connecting the truncated cone to the stem. Additionally, the structure to which the nasal pillows of the present technology are connected includes a flexible region adjacent to the base of the stem. The flexible region can function to facilitate a universal joint structure. The universal joint structure accommodates both the displacement and angle of the truncated cone and the relative movement of the structure to which the nasal pillows are connected. For example, the truncated cone can be displaced axially toward the structure to which the stem is connected.
[0127] 5.3.2 Plenum chamber The plenum chamber 3200 has edges shaped to complement the surface contours of an average human face in the area where a seal is formed in use. In use, the peripheral edges of the plenum chamber 3200 are positioned in close proximity to the adjacent surface of the face. Actual contact with the face is provided by the seal-forming structure 3100. The seal-forming structure 3100 may extend around the entire edge of the plenum chamber 3200 in use. In some forms, the plenum chamber 3200 and the seal-forming structure 3100 are formed from a single, homogenous piece of material.
[0128] In some forms of the present technology, the plenum chamber 3200 does not cover the patient's eye when in use. In other words, the eye is outside the pressurized space defined by the plenum chamber. Such forms may improve treatment compliance, often resulting in less intrusiveness and / or greater wearer comfort.
[0129] In certain forms of the present technology, the plenum chamber 3200 is constructed from a transparent material (e.g., clear polycarbonate). The use of a transparent material may reduce the intrusiveness of the patient interface and may help improve compliance with treatment. The use of a transparent material may help the clinician see the placement and function of the patient interface.
[0130] In certain forms of the present technology, the plenum chamber 3200 is constructed from a translucent material, which can make the patient interface less intrusive and help improve compliance with treatment.
[0131] 5.3.3 Positioning and stabilizing structures The seal-forming structure 3100 of the patient interface 3000 of the present technology may be held in a sealed position by the positioning and stabilising structure 3300 in use.
[0132] In one form, the positioning and stabilizing structure 3300 provides at least enough holding force to overcome the effect of the positive pressure in the plenum chamber 3200 to lift off the face.
[0133] In one form, the positioning and stabilizing structure 3300 provides a holding force sufficient to overcome the attractive force on the patient interface 3000.
[0134] In one form, the positioning and stabilizing structure 3300 provides a holding force as a safety margin to eliminate the possibility of destructive action on the patient interface 3000 (e.g., due to tube drag or inadvertent interference with the patient interface).
[0135] In one form of the present technology, there is provided a positioning and stabilizing structure 3300 configured to be worn by a patient while sleeping. In one example, the positioning and stabilizing structure 3300 has a low profile or cross-sectional thickness to reduce the perceived or actual bulk of the device. In one example, the positioning and stabilizing structure 3300 includes at least one strap having a rectangular cross-section. In one example, the positioning and stabilizing structure 3300 includes at least one flat strap.
[0136] In one form of the present technology, a positioning and stabilizing structure 3300 is provided that is configured so that it is not excessively large or bulky in size that would interfere with a patient sleeping in a supine sleeping position with the posterior region of the patient's head resting on a pillow.
[0137] In one form of the present technology, a positioning and stabilizing structure 3300 is provided that is configured so that it is not excessively large or bulky in size that would interfere with a patient sleeping in a lateral sleeping position with the side region of the patient's head resting on a pillow.
[0138] In one form of the present technology, the positioning and stabilizing structure 3300 comprises a decoupling site located between an anterior section of the positioning and stabilizing structure 3300 and a posterior section of the positioning and stabilizing structure 3300. The decoupling site does not resist compression and can be a flexible or flimsy strap, for example. The decoupling site is constructed and positioned such that when a patient lies down with their head on a pillow, the presence of the decoupling site prevents forces from being transmitted along the positioning and stabilizing structure 3300 to the posterior section, disrupting the seal.
[0139] In one form of the present technology, the positioning and stabilizing structure 3300 includes a strap constructed from a laminate of a fabric patient-contacting layer, a foam material inner layer, and a fabric outer layer. In one form, the foam material is porous to allow moisture (e.g., sweat) to pass through the strap. In one form, the fabric outer layer includes loop material that engages with portions of hook material.
[0140] In certain forms of the present technology, the positioning and stabilizing structure 3300 includes an extensible (e.g., elastically extensible) strap. For example, the strap can be configured to be tensioned in use to direct a force that urges the seal-forming structure into contact with a portion of the patient's face. In one example, the strap can be configured as a tie.
[0141] In one form of the present technology, the positioning and stabilizing structure includes a first tie constructed and arranged such that, in use, at least a portion of its lower edge passes over and moves to a superior-auricular point on the patient's head and covers a portion of the parietal bone without covering the occipital bone.
[0142] In one form of the present technology, suitable for a nasal-only or full-face mask, the positioning and stabilizing structure includes a second tie constructed and arranged such that, in use, at least a portion of its upper edge passes below the inferior ear base point on the underside of the patient's head and covers or rests below the occipital bone of the patient's head.
[0143] In one form of the present technology suitable for a nasal-only or full-face mask, the positioning and stabilizing structure includes a third tie constructed and arranged to interconnect the first tie and the second tie in a manner that reduces the tendency of the first tie and the second tie to move apart.
[0144] In certain forms of the present technology, the positioning and stabilizing structure 3300 includes straps that are bendable, e.g., non-rigid. An advantage of this embodiment is that the straps are more comfortable when the patient lies down to sleep.
[0145] In a particular form of the present technology, the positioning and stabilizing structure 3300 includes straps configured to be breathable to allow water vapor to pass therethrough.
[0146] In certain forms of the present technology, a system is provided that includes more than one positioning and stabilizing structure 3300. Each positioning and stabilizing structure is configured to provide a holding force to accommodate a different size and / or shape range. For example, the system may include one form of positioning and stabilizing structure 3300 that is suitable for large sized heads but not small sized heads, and another form of positioning and stabilizing structure 3300 that is suitable for small sized heads but not large sized heads.
[0147] 5.3.4 Ventilation In one form, the patient interface 3000 includes a vent 3400 constructed and arranged to allow the expulsion of exhaled gases (eg, carbon dioxide).
[0148] In certain forms, the vent 3400 is configured to allow continuous vent flow from the interior of the plenum chamber 3200 to atmosphere when the pressure within the plenum chamber is positive relative to atmosphere. The vent 3400 is configured such that the magnitude of the vent flow is sufficient to reduce rebreathing of exhaled CO2 by the patient while maintaining therapeutic pressure within the plenum chamber in use.
[0149] Ventilation section 3400 in one form according to the present technology includes a plurality of holes (eg, about 20 to about 80 holes, or about 40 to about 60 holes, or about 45 to about 55 holes).
[0150] The vent 3400 may be located within the plenum chamber 3200. Alternatively, the vent 3400 is located within a decoupling structure (e.g., a swivel).
[0151] Woven Vent Assembly 4A-4K is configured to provide a gas ventilation flow for expelling a patient's exhaled breath according to one embodiment of the present technology. In the illustrated example, the ventilation assembly 4400 includes a diffusing member (e.g., a layer of woven material 4600) along the ventilation flow path. The ventilation flow path is constructed and arranged to diffuse the exhaust ventilation flow and reduce noise generation.
[0152] Vents containing woven fabric are extremely quiet and highly diffusive. However, woven fabric vents can experience significant reductions in airflow when exposed to high humidity or moisture. For example, partial or complete blockage of airflow can occur due to moisture retention or condensation in the woven fabric fibers. This blockage can occur if the woven fabric vent is not dried properly after washing and / or if the woven fabric vent is exposed to high humidity in a cold environment. When blockage occurs, it can take an unacceptably long time for the woven fabric vent to recover and return to its initial airflow. When woven fabric vents are used under these conditions, insufficient CO2 ventilation can lead to increased CO2 accumulation in the patient interface. For these reasons, woven fabric vents are not widely used in CPAP therapy.
[0153] Aspects of the present technology relate to a woven vent assembly constructed and arranged to address this moisture retention problem and allow sufficient airflow when the woven fabric becomes blocked due to wetting with moisture or humidity. Thus, the woven vent assembly according to aspects of the present technology allows for the use of woven fabric as a safe and reliable ventilation component for CPAP therapy.
[0154] In the illustrated example, the vent assembly 4400 takes the form of a vent insert or cartridge and is configured to be inserted into an opening in the patient interface 3000 or air delivery conduit (eg, air circuit 4170).
[0155] For example, the vent assembly 4400 shown in FIGS. 4A-4D is structured to be inserted into the opening 6050 of the air delivery conduit 6000. In use, the vent assembly 4400 is constructed and arranged to allow gas flow from the interior or pressurized space of the air delivery conduit 6000 to the exterior of the air delivery conduit 6000 (e.g., to atmosphere). The vent assembly 4400 may be removably or permanently secured within the opening 6050 in any suitable manner (e.g., by a press-fit, snap-fit, or interference-fit assembly) or permanently secured (e.g., the vent assembly may include a groove around its periphery, the groove adapted to position the vent assembly against a correspondingly sized rim of the opening of the air delivery conduit, adhesively) or the like. In another example, one or more portions of the vent assembly 4400 may be one-piece molded with the air delivery conduit 6000 (e.g., by overmolding or insert molding).
[0156] In another example, a vent assembly 4400 may be provided to the patient interface 3000 (e.g., to the plenum chamber 3200 or the connection port 3600) to allow gas flow from the interior of the patient interface (e.g., the plenum chamber) to the exterior of the patient interface (e.g., the atmosphere).
[0157] As shown in Figures 4E-4H, vent assembly 4400 includes a base 4700, a layer of woven material 4600 supported by base 4700, a cover 4500 that maintains woven material 4600 within base 4700, and a membrane 4800 constructed and arranged to regulate the flow of air through vent assembly 4400 to allow sufficient flushing of gases during use.
[0158] The base 4700 includes a base wall 4705. The base wall 4705 has at least one first orifice 4710 extending therethrough to allow gas release to the atmosphere or surrounding atmosphere, and at least one second orifice 4720 to allow gas release to the atmosphere. The base wall 4705 includes an inner surface 4730 adapted to be oriented toward the interior of the air delivery conduit 6000 (i.e., the pressurizable volume) in use, and an outer surface 4740 adapted to be oriented toward the atmosphere in use. A flange or shoulder 4750 is provided along the periphery of the base wall 4705 to support and align the woven material 4600 on the outer surface 4740 of the base 4700. A retention structure 4760 is provided on the inner surface 4730 of the base 4700 to hold the membrane 4800 adjacent to the inner surface 4730.
[0159] In one example, base 4700 can be constructed (e.g., molded) from a relatively rigid material (e.g., a thermoplastic polymer, (e.g., polycarbonate)). In one example, base 4700 can have a thickness of approximately 1-3 mm (e.g., 2 mm), although other suitable thicknesses are possible.
[0160] In the illustrated example, the woven material 4600 includes at least one orifice 4610 extending therethrough. The woven material 4600 is configured to be supported on an outer surface 4740 of the base 4700, which is held within a flange or shoulder 4750 along the periphery of the base 4700. As shown, the woven material 4600 is positioned to cover a first orifice 4710 of the base 4700 (such that flow exiting the first orifice 4710 flows into the woven material 4600). Furthermore, the orifice 4610 of the woven material 4600 is positioned to be aligned with a second orifice 4720 of the base 4700 (such that the second orifice 4720 is not covered by the woven material 4600 and flow exiting the second orifice 4720 does not flow into the woven material 4600).
[0161] In one example, the woven material 4600 can be constructed of a porous material to allow gas to pass therethrough and dissipate any plumes or other flow formations exiting the first orifice 4710 (e.g., a nonwoven fibrous material, a woven fibrous material). In one example, the woven material 4600 can include a diffusing material that can be similar to or identical to a filter material or filter media. In one example, the thickness of the woven material 4600 can be approximately 0.1-0.5 mm (e.g., 0.25 mm), although other suitable thicknesses are possible. In the illustrated example, the woven material 4600 includes a single layer, but it should be understood that the woven material 4600 can include two or more layers (e.g., stacks of similar or different diffusing materials).
[0162] The cover 4500 includes a main wall 4510 and a side wall 4520 that forms the perimeter of the vent assembly 4400. The main wall 4510 includes a mesh configuration (e.g., one or more cross bars) that forms slots or exit orifices 4530 through the cover 4500. The mesh configuration allows flow within the mesh configuration while retaining the woven material 4600 within the base 4700 and allowing for minimal contact (e.g., preventing contamination).
[0163] The cover 4500 is engaged with the base 4700 until the main wall 4510 abuts a flange or shoulder 4750 along the periphery of the base 4700. The flange or shoulder 4750 supports and spaces the cover 4500 and its main wall 4510 from the outer surface 4740 of the base 4700, thereby containing and retaining the woven material 4600 between the cover 4500 and the base 4700 (i.e., the cover 4500 and the base 4700 form a casing or cartridge for the woven material 4600). The side wall 4520 of the cover 4500 extends downwardly along the periphery of the base 4700. The cover 4500 can be removably or permanently secured to the base 4700 in any suitable manner (e.g., a press-fit assembly, a snap-fit or interference fit assembly, adhesive). In the illustrated example, the sidewall 4520 also interfaces with the opening 6050 in the air delivery conduit 6000 (eg, press-fit assembly, snap-fit or interference-fit assembly, adhesive).
[0164] In examples, the cover 4500 may be removably secured to the base, for example, to allow for cleaning and / or replacement of the fabric material 4600. Alternatively, instead of replacing the individual fabric materials 4600, the entire vent assembly 4400 may be replaced.
[0165] In another example, vent assembly 4400 may be provided without cover 4500, and woven material 4600 may be secured to base 4700 in other suitable manners (e.g., by gluing or overmolding the woven material to the base). In this example, more of woven material 4600 may be exposed to promote drying. Such an arrangement also reduces the overall size (e.g., height) of the vent assembly due to the elimination of components (e.g., a more discreet appearance).
[0166] In one example, cover 4500 can be constructed (e.g., molded) from a relatively rigid material (e.g., a thermoplastic polymer, (e.g., polycarbonate)). In one example, cover 4500 can have a height of about 2-5 mm (e.g., about 3.5 mm), although other suitable heights are possible.
[0167] The membrane 4800 includes a flap portion 4810. The flap portion 4810 is movably connected (e.g., hingedly connected by a hinge portion) to a retaining portion 4820, thereby allowing the flap portion 4810 to pivot relative to the retaining portion 4820. The retaining portion 4820 is constructed and arranged to engage within a slot 4765 in a retaining structure 4760 of the base 4700, thereby securing the membrane 4800 to the base 4700. The retaining portion 4820 may be removably or permanently secured to the retaining structure 4760 of the base in any suitable manner (e.g., a press-fit assembly, a snap-fit or interference fit assembly, adhesive).
[0168] The flap portion 4810 of the membrane 4800 includes an orifice 4815 extending therethrough. The membrane 4800 is supported by a retention structure 4760 adjacent the inner surface 4730 of the base 4700. The flap portion 4810 is freely movable toward and away from the base of the inner surface 4730 of the base (e.g., in response to the presence of pressurized gas and / or occlusion of the woven material 4600). The orifice 4815 in the flap portion 4810 is positioned to align with the first orifice 4710 in the base 4710, such that the first orifice 4710 cannot be completely covered or blocked by the membrane 4800, thereby permitting flow through the first orifice 4710. Additionally, because the flap portion 4810 is positioned to overlap the second orifice 4720 of the base 4710, the second orifice 4720 may be selectively covered or closed by the membrane 4800 to restrict flow through the second orifice 4720.
[0169] In an example, membrane 4800 may be constructed of a relatively flexible, elastic material (e.g., silicone or other thermoplastic elastomer). In one example, membrane 4800 may have a thickness of approximately 0.25 to 0.75 mm (e.g., 0.45 mm), although other suitable thicknesses are possible.
[0170] The assembled vent assembly 4400 has a low profile and does not protrude significantly into the interior of the air delivery conduit 6000. In examples, the vent assembly 4400 may be about 2-5 mm (e.g., about 3.5 mm) high, about 5-15 mm (e.g., 10 mm) wide, and about 10-30 mm (e.g., 20 mm) long, although other suitable dimensions are possible.
[0171] In the illustrated example, the vent assembly 4400 and the corresponding opening 6050 in the air delivery conduit 6000 include a stadium shape (i.e., a rectangle with semicircular sides). However, it should be understood that the vent assembly and the corresponding opening in the air delivery conduit may have other suitable shapes (e.g., circular and non-circular).
[0172] Vent assembly 4400 is constructed and arranged to provide: (1) a primary vent flowpath V1 that extends through woven material 4600 to diffuse exhaust vent flow in a noise-reducing manner, and (2) a secondary vent flowpath V2 that bypasses woven material 4600 to allow adequate gas flushing (in the event that woven material 4600 becomes blocked due to moisture or humidity). Membrane 4800 is constructed and arranged to regulate vent flow along primary vent flowpath V1 and secondary vent flowpath V2.
[0173] As described below, the vent assembly 4400 is constructed and arranged to provide sufficient ventilation flow under a variety of scenarios during respiratory therapy (e.g., when there is no or low air pressure in the air delivery conduit 6000, when there is air pressure in the air delivery conduit 6000, and when there is air pressure in the air delivery conduit 6000 but the woven material 4600 is occluded). The vent assembly 4400 is constructed and arranged to operate under adverse conditions and to enable the use of woven materials or similar porous materials as safe and reliable ventilation components for respiratory therapy. In an example, the ventilation flow may be continuous during respiratory therapy.
[0174] As shown in FIG. 4I , when there is no or low air pressure in the air delivery conduit 6000 (e.g., when the RPT device is not operating or the air delivery conduit is blocked during use) and the woven material 4600 is not blocked, the membrane 4800 may be in a static or non-activated position, allowing air to pass through both the primary and secondary ventilation flow paths V1 and V2. That is, pressurized gas is not delivered to the air delivery conduit 6000 or is not large enough to allow the membrane 4800 to collapse or deflect downwardly away from the inner surface 4730 of the base 4700 and the first and second orifices 4710 and 4720. As a result, air may pass through primary ventilation flow path V1. Primary ventilation flow path V1 extends through the first orifice 4710, through the woven material 4600, and through the cover 4500. Additionally, air may pass through secondary ventilation flow path V2. Secondary ventilation flowpath V2 extends through the second orifice 4720, through the orifice 4610 in the woven material 4600, and through the cover 4500. When the membrane 4800 is in the resting or non-activated position, a majority of the woven material 4600 is exposed through the first orifice 4710, providing a low impedance airway for the patient to inhale ambient air and exhale through the primary ventilation flowpath V1. Secondary ventilation flowpath V2 also provides a low impedance airway for the patient to inhale and exhale ambient air.
[0175] 4J , when there is air pressure in the air delivery conduit 6000 (e.g., when the RPT device is operating) and the fabric material 4600 is not occluded, an increase in pressure within the pressurized space of the air delivery conduit 6000 may urge or move the membrane 4800 to an activated position, thereby allowing air to travel only through the primary ventilation flow path V1. That is, the air pressure in the air delivery conduit 6000 is sufficient to force and maintain engagement between the membrane 4800 and the inner surface 4730 of the base 4700. As a result, the orifice 4815 in the flap portion 4810 may be positioned to align with the first orifice 4710 in the base 4700, allowing air to pass through the primary ventilation flow path V1. Primary ventilator flow path V1 extends through orifice 4815 in flap portion 4810, through first orifice 4710 in base 4700, through fabric material 4600, and through cover 4500. Additionally, flap portion 4810 is positioned to cover or block second orifice 4720 in base 4710, such that air flow through secondary ventilator flow path V2 is restricted or blocked by membrane 4800. When membrane 4800 is in the activated position, air flow is restricted to primary ventilator flow path V1, such that any flow through the layer of fabric material 4600 is directed to the atmosphere, diffusing the exhaust ventilator flow and reducing noise generation.
[0176] Additionally, the orifice 4815 in the flap portion 4810 is appropriately sized to regulate flow along the primary ventilation flow path V1. That is, the orifice 4815 in the flap portion 4810 forms an exhaust flow inlet along the primary ventilation flow path V1, and the size of the orifice 4815 (e.g., the cross-sectional area of the orifice 4815) can be adjusted to provide a desired flow curve within a therapeutic pressure range (e.g., a substantially constant flow rate over a therapeutic pressure range of 4-20 cmH2O).
[0177] As shown in FIG. 4K , when there is air pressure in the air delivery conduit 6000 (e.g., when the RPT device is operating) and the woven material 4600 is blocked due to moisture or humidity, the membrane 4800 does not fully activate, allowing air to pass through secondary air flow path V2 while primary air flow path V1 remains blocked. That is, the membrane 4800 and base 4700 are configured and arranged such that the blockage of the woven material 4600 changes the flow and forces acting on the membrane 4800, allowing the membrane 4800 to move away from the inner surface 4730 of the base 4700 and the first and second orifices 4710 and 4720. As a result, air may move through secondary air flow path V2. Secondary air flow path V2 extends through the second orifice 4720, through the orifice 4610 in the woven material 4600, and through the cover 4500. This restricts air flow to a secondary airflow path V2 that bypasses the fabric material 4600, thereby providing sufficient airflow when the fabric material 4600 is occluded.
[0178] The second orifice 4720 in the base 4700 is appropriately sized to regulate flow along the secondary ventilation flow path V2. That is, the second orifice 4720 in the base 4700 forms an exhaust flow inlet along the secondary ventilation flow path V2, and the size of the second orifice 4720 (e.g., the cross-sectional area of the orifice 4720) may be adjusted to provide a desired flow curve within a therapeutic pressure range (e.g., a substantially constant flow rate over a therapeutic pressure range of 4-20 cmH2O). For example, the second orifice 4720 may be adjusted to provide sufficient airflow (i.e., a low impedance airway) to avoid CO2 buildup in the patient interface.
[0179] Additionally, the secondary ventilation flow path V2 is left open until the fabric material 4600 along the primary ventilation flow path V1 is sufficiently dry or unblocked to allow sufficient exhaust ventilation flow.
[0180] In an example, the membrane 4800 may be constructed and arranged to respond to the impedance of air flow through the woven material 4600 (i.e., to the extent of wetness or dryness of the woven material 4600). For example, as the woven material 4600 dries, the membrane may gradually move toward the activation position, thereby gradually decreasing air flow through the secondary air flowpath V2. This is because the drying of the woven material 4600 allows for a gradually increasing air flow through the primary air flowpath V1. In another example, as the woven material 4600 becomes wetter (e.g., due to humidity), the membrane may gradually move away from the activation position, thereby gradually increasing air flow through the secondary air flowpath V2 due to the wetness of the woven material 4600, thereby gradually decreasing air flow through the primary air flowpath V1. Thus, the membrane can be constructed and arranged to gradually deflect proximally to and away from the activation position due to the dry state of the fabric material, thereby dividing or apportioning the ventilation flow between the primary ventilation flow path V1 and the secondary ventilation flow path V2 at the overall therapeutic pressure.
[0181] As discussed above, aspects of the vent assembly 4400 may be adjusted to provide a desired flow curve within a therapeutic pressure range. In examples, the ventilation characteristics of each of the ventilation components may be adjusted based on, for example, ventilation needs, audio needs, therapy needs, etc. Such an arrangement allows for greater customization of the vent assembly to the patient.
[0182] For example, for membrane 4800, the thickness, length, material, and shape of the membrane may be adjusted to deform in a desired manner, and the shape, size, and number of orifices 4815 through membrane 4800 may be adjusted to regulate flow. For base 4700, the shape, size, and number of at least one first orifice 4710 and the shape, size, and number of at least one second orifice 4720 may be adjusted for flow regulation. For fabric 4600, the thickness and material of fabric 4600 may be adjusted for flow regulation. For cover 4500, the shape, size, and number of orifices 4530 through cover 4500 may be adjusted for flow regulation.
[0183] 5A-5G show a woven vent assembly 4400 in accordance with another example of the present technology. In this example, the vent assembly 4400 further includes an activator 4900. The activator 4900 is constructed and arranged to deflect the membrane 4800 away from the activated position when the woven material 4600 is exposed to water (i.e., when the woven material becomes wet and the air flow therethrough is significantly reduced).
[0184] Similar to the examples described above, vent assembly 4400 in Figures 5A-5G includes a base 4700, a layer of woven material 4600 supported by base 4700, a cover 4500 that maintains woven material 4600 within base 4700, and a membrane 4800 constructed and arranged to regulate air flow through vent assembly 4400 to ensure adequate gas flushing during use. Additionally, vent assembly 4400 in Figures 5A-5G includes activator 4900. Activator 4900 is positioned within recess 4770 in inner surface 4730 of base 4700, thereby holding activator 4900 adjacent to membrane 4800.
[0185] In an example, the activator 4900 comprises an expanding polymer material (e-polymer) structured to rapidly expand when exposed to water. Such expansion is used to engage and deflect the membrane 4800. The higher the expansion percentage of the material, the smaller the thickness of material required to deflect the membrane 4800. It should be understood that any material capable of undergoing a process of penetration and rapid expansion upon exposure to water can be used as the activator. In another example, natural fibers can be used as the activator.
[0186] Similar to the above example, as shown in FIG. 5E, when there is no air pressure in the air delivery conduit 6000 or the pressure in the air delivery conduit 6000 is low (e.g., the RPT device is not operating or the air delivery conduit is blocked during use) and the woven material 4600 is not blocked, the membrane 4800 may assume a static or non-activated position, allowing air to pass through both the primary ventilation flow path V1 and the secondary ventilation flow path V2.
[0187] 5F , when there is air pressure in air delivery conduit 6000 (e.g., when the RPT device is operating) and woven material 4600 is not occluded, the increased pressure within the pressurized space of air delivery conduit 6000 may urge or move membrane 4800 to the activated position, thereby allowing air to pass only through primary airflow path V1. When woven material 4600 and activator 4900 are dry, activator 4900 is in a contracted or unexpanded configuration such that activator 4900 remains submerged or recessed in recess 4770 and does not affect the deflection of membrane 4800 from the activated position. Thus, the flap portion 4810 is positioned to cover or close the second orifice 4720 so that air flow is restricted to the primary ventilation flow path V1, thereby directing all of the flow in the layer of woven material 4600 to diffuse the exhaust ventilation flow, thereby reducing noise generation.
[0188] 5G , when air pressure is present in the air delivery conduit 6000 (e.g., when the RPT device is in operation) and the woven material 4600 becomes occluded due to moisture or humidity, such moisture or humidity causes the activator 4900 to expand to its expanded configuration, extending from the recess 4770 to engage and urge the membrane 4800 away from the inner surface 4730 of the base 4700 and the first and second orifices 4710 and 4720. That is, the activator 4900 may be activated upon exposure to water, deflecting the membrane 4800 and thereby permitting air to pass through the secondary air flow path V2 while the primary air flow path V1 is occluded. This restricts air flow to the secondary air flow path V2, bypassing the woven material 4600, thereby providing sufficient air flow while the woven material 4600 is occluded.
[0189] Additionally, secondary vent flow path V2 remains open until the fabric material 4600 along primary vent flow path V1 is sufficiently dry or unblocked to allow sufficient exhaust vent flow, for example, since activator 4900 dries along with fabric material 4600, activator 4900 remains activated until fabric material 4600 is sufficiently dry or unblocked.
[0190] In an example, the membrane 4800 may be constructed and arranged to gradually deflect toward and away from the activation position due to the dryness of the activator 4900 and thus the dryness of the textile material 4600, such that the air flow between the primary and secondary air flow paths V1 and V2 is divided or apportioned at an overall treatment pressure. For example, as the activator 4900 becomes more wet (e.g., due to moisture or humidity), the activator 4900 may gradually expand, gradually moving the membrane 4800 away from the activation position, such that the air flow in the primary air flow path V1 gradually decreases and the air flow in the secondary air flow path V2 gradually increases due to the wetness of the textile material 4600. Similarly, as the activator 4900 dries, it may gradually shrink, causing the membrane 4800 to gradually move toward the activated position, gradually increasing the air flow in the primary air flow path V1 as the fabric material 4600 dries, while gradually decreasing the air flow in the secondary air flow path V2.
[0191] 6A-6K show a woven vent assembly 5400 including an activator 5900 in accordance with another example of the present technology. In this example, the vent assembly 5400 is provided without a cover, thereby facilitating exposure of the woven material 5600 (e.g., to promote drying). Such an arrangement also reduces the overall size (e.g., height) of the vent assembly due to the elimination of components (e.g., a more discreet appearance).
[0192] As with the previous examples, the vent assembly 5400 takes the form of a vent insert or cartridge and is structured to be inserted into an opening in the patient interface or air delivery conduit. The patient interface is then removably or permanently secured, for example, within an opening 6050 in the air delivery conduit 6000, as shown in Figures 6A-6D. In another example, one or more portions of the vent assembly 5400 may be one piece molded with the air delivery conduit 6000 (e.g., by overmolding or insert molding).
[0193] As shown in Figures 6E-6H, vent assembly 5400 includes a base 5700, a layer of woven material 5600 supported by base 5700, a membrane 5800 constructed and arranged to regulate air flow through vent assembly 5400 to provide sufficient gas flushing during use, and an activator 5900 to deflect membrane 5800.
[0194] The base 5700 includes a base wall 5705. The base wall 5705 has at least one first orifice 5710 extending therethrough to allow gas release to the atmosphere. The base wall 5705 also includes a plurality of second orifices 5720 to allow gas release to the atmosphere. The base wall 5705 includes an inner surface 5730 adapted to be oriented toward the interior of the air delivery conduit 6000 (i.e., the pressurizable volume) in use, and an outer surface 5740 adapted to be oriented toward the atmosphere in use. In the illustrated example, the plurality of second orifices 5720 extend along the outer surface 5740 from a circular protrusion 5742 and extend along the inner surface 5730 to a sloped or angled protrusion 5732. Retention structure 5760 is provided on inner surface 5730 of base 5700 to retain membrane 5800 adjacent inner surface 5730. Also, opening 5770 is provided in base 5700 to retain activator 5900 adjacent membrane 5800. In the illustrated example, the periphery of base 5700 forms an interface with opening 6050 in air delivery conduit 6000 (e.g., press-fit assembly, snap-fit or interference fit assembly, adhesive).
[0195] As with the above example, it should be appreciated that the shape, size and number of the second orifices 5720 can be adjusted for flow regulation.
[0196] In the illustrated example, the woven material 5600 includes at least one orifice 5610 extending through the woven material 5600. The woven material 5600 is configured to be supported and held on the outer surface 5740 of the base 5700. The woven material 5600 can be secured to the base 5700 in any suitable manner (e.g., the woven material is glued or overmolded to the base). As shown, the woven material 5600 is positioned to cover the first orifice 5710 of the base 5700, and the orifice 5610 of the woven material 5600 is positioned to align with the circular protrusion 5742 along the outer surface 5740, such that the plurality of second orifices 5720 are not covered by the woven material 5600.
[0197] The membrane 5800 includes a flap portion 5810. The flap portion 5810 is movably connected (e.g., hingedly connected by a hinge portion) to a retaining portion 5820, thereby allowing the flap portion 5810 to pivot relative to the retaining portion 5820. In the illustrated example, the retaining portion 5820 includes a hole 5822 and the retaining structure 5760 includes a post 5762 that is constructed and arranged to engage the hole 5822 and secure the membrane 5800 to the base 5700. However, the retaining portion 5820 may be removably or permanently secured to the retaining structure 5760 of the base in any suitable manner (e.g., a press-fit assembly, a snap-fit or interference fit assembly, adhesive).
[0198] The membrane 5800 is supported by a retention structure 5760 adjacent the inner surface 5730 of the base 5700. In the illustrated example, the flap portion 5810 includes a length sufficient to overlap with the plurality of second orifices 5720, thereby allowing the second orifices 5720 to be selectively covered or closed by the membrane 5800 in use.
[0199] Activator 5900 is disposed within opening 5770 in base 5700 to hold activator 5900 adjacent membrane 5800. As in the above example, activator 5900 may comprise an expanding polymer material (e-polymer) or other suitable material capable of rapid expansion when exposed to water.
[0200] In the illustrated example, the ventilation assembly 5400 and the corresponding opening 6050 in the air delivery conduit 6000 include a stadium shape, but it should be understood that the ventilation assembly and the corresponding opening in the air delivery conduit may have other suitable shapes (e.g., circular and non-circular).
[0201] Similar to the above example, as shown in FIG. 6I, when there is no air pressure in the air delivery conduit 6000 or the pressure in the air delivery conduit 6000 is low (e.g., the RPT device is not operating or the air delivery conduit is blocked during use) and the woven material 5600 is not blocked, the membrane 5800 assumes a static or non-activated position, allowing air to pass through both the primary ventilation flow path V1 and the secondary ventilation flow path V2.
[0202] 6J , when air pressure is present in air delivery conduit 6000 (e.g., when the RPT device is operating) and woven material 5600 is not occluded, an increase in pressure within the pressurized space of air delivery conduit 6000 may bias or move membrane 5800 to the actuated position, thereby allowing air to move only through primary airflow path V1. When woven material 5600 and activator 5900 are dry, activator 5900 is in a contracted or unexpanded configuration such that activator 5900 remains submerged or recessed in opening 5770 and has no effect on the deflection of membrane 5800 from the actuated position. Thus, the flap portion 5810 is positioned to cover or block the plurality of second orifices 5720, thereby restricting air flow to the primary ventilation flow path V1, so that all flow through the layer of woven material 5600 is directed to diffuse the exhaust ventilation flow, reducing noise generation.
[0203] 6K, when there is air pressure in the air delivery conduit 6000 (e.g., when the RPT device is operating) and the woven material 5600 is blocked due to moisture or humidity, the moisture or humidity causes the activator to expand to its expanded configuration, causing the activator 5900 to extend from the opening 5770 and engage the membrane 5800, forcing the membrane 5800 away from the inner surface 5730 of the base 5700 and the first orifice 5710 and the plurality of second orifices 5720. That is, when exposed to water, the activator 5900 may be activated to deflect the membrane 4500, allowing air to pass through the secondary air flow path V2 when the primary air flow path V1 is blocked. As a result, air flow is restricted to the secondary air flow path V2, which bypasses the woven material 5600, thereby providing sufficient air flow when the woven material 5600 is blocked.
[0204] Similar to the above example, secondary ventilation flowpath V2 remains open until the fabric material 5600 along primary ventilation flowpath V1 is sufficiently dry or unblocked, thereby allowing sufficient exhaust ventilation flow. Additionally, membrane 5800 may be constructed and arranged to gradually deflect toward and away from the activated position due to the dryness of activator 5900 and thus the dryness of fabric material 5600, thereby dividing or apportioning the ventilation flow between primary ventilation flowpath V1 and secondary ventilation flowpath V2 at an overall therapeutic pressure.
[0205] It should be understood that activation of secondary vent flow path V2 may be accomplished in other manners. For example, another example vent assembly 5400 shown in Figures 7A-7C includes an electromagnetic activator 6900 constructed and arranged to deflect membrane 5800.
[0206] In this example, the activator 6900 includes a sensor 6910 disposed along the inner surface 5730 of the base 5700. As shown, the sensor 6910 includes a track circuit 6915. The track circuit 6915 is constructed and arranged to detect moisture (e.g., moisture between the track circuits as shown in FIG. 7C ). When moisture is detected, the sensor 6910 activates an electronic switch or control signal to activate the activator 6900. For example, the activator 6900 includes a moving member (e.g., a plunger arrangement) constructed and arranged to engage the membrane 5800 and urge the membrane 5800 away from the inner surface 5730 of the base 5700 and the first and plurality of second orifices 5710 and 5720. The switch may be set to activate when a certain level of moisture / humidity is present in the vent assembly. Additionally, the switch may be set to remain activated for a predetermined period of time, for example, to ensure a dry state of the fabric material 5600 before deactivating. In an example, such a vent configuration using an electromagnetic activator 6900 may be used as an active vent (e.g., controlled vent flow characteristics) by controlling the flow through the primary vent flow path V1 and the secondary vent flow path V2.
[0207] In another example, the vent assembly may only include a sensor configured to detect moisture / wetness in the vent assembly and then provide a signal to the RPT device, which may then alert the patient that the vent is wet and / or update its operation accordingly (e.g., update the delivery pressure to ensure safe use of the patient interface during periods of moist vent).
[0208] 8A-8E show a vent assembly 7400 in accordance with another example of the present technology. In this example, the vent assembly 7400 includes a vent component 7900 that includes an expansive polymer material (e-polymer) structured to rapidly expand when exposed to moisture, such expansion causing a vent orifice 7925 to open through the vent component 7900 and activate a secondary vent flow path V2.
[0209] As shown in Figures 8A-8C, the vent assembly 7400 includes a base 7700, a layer of woven material 7600 supported by the base 7700, and a vent component 7900 constructed and arranged to regulate vent flow through a secondary vent flow path V2 to provide sufficient gas flushing during use.
[0210] The base 7700 includes a base wall 7705. The base wall 7705 has at least one first orifice 7710 extending therethrough to allow gas release to the atmosphere and a second orifice 7720 structured to support the vent component 7900.
[0211] In the illustrated example, the woven material 7600 is positioned to cover a first orifice 7710 of the base 7700, and the woven material 7600 includes an orifice 7610 that is aligned with a second orifice 7720 such that the second orifice 7720 is not covered by the woven material 7600. In this example, the vent assembly 7400 is provided without a cover, and the woven material 7600 may be secured to the base 7700 in any suitable manner (e.g., the woven material is glued or overmolded to the base).
[0212] In examples, the e-polymer vent component 7900 takes the form of a grommet and is structured to be inserted into the second orifice 7720 of the base 7700. For example, the vent component 7900 may include a groove 7950 around its periphery that is adapted to position the vent component 7900 against an edge or rim of the second orifice 7720 of the base 7700. The vent component 7900 and the base 7700 are positioned to provide sufficient clearance to allow the vent component 7900 to expand relative to the base 7700. However, in other suitable aspects, the vent assembly 7400 may be removably or permanently secured internally to the base.
[0213] Additionally, the e-polymer vent component 7900 includes a plurality of vent orifices 7925 that are constructed and arranged to regulate gas flow from the interior of the air delivery conduit 6000 to the exterior (e.g., atmosphere) of the air delivery conduit 6000. In particular, the e-polymer vent component 7900 is structured to expand and contract due to the presence of moisture / humidity, such expansion / contraction causing expansion and contraction of the vent orifices 7925 to regulate flow along the secondary vent flow path V2.
[0214] It should be appreciated that the shape, size and number of the secondary orifices 7925 may be adjustable to further regulate the flow.
[0215] 8D , when the woven material 7600 and e-polymer vent component 7900 are dry, the orifices 7925 of the e-polymer vent component 7900 may be substantially closed or constricted, thereby allowing little to no flow through the orifices 7925. Thus, air flow is restricted to the primary vent flow path V1, directing all of the flow through the layer of woven material 7600, diffusing the exhaust vent flow and reducing noise generation.
[0216] 8E, if the woven material 7600 is occluded due to moisture or humidity, such moisture or humidity may cause the e-polymer vent component 7900 to expand to an expanded configuration, opening or expanding the orifices 7925 and allowing flow through the orifices 7925. This allows air to flow along secondary vent flow path V2 that bypasses the woven material 7600 to provide sufficient vent flow with the woven material 7600 occluded. The e-polymer vent component 7900 remains in an activated state until the woven material 7600 is sufficiently dry or unoccluded.
[0217] In an example, the e-polymer vent component 7900 may be constructed and arranged to gradually expand and contract due to the wetness of the e-polymer vent component 7900 and thus the wetness of the woven material 7600, thereby dividing or apportioning the air flow between the primary air flow path V1 and the secondary air flow path V2 at an overall treatment pressure. For example, as the wetness of the e-polymer vent component 7900 increases (e.g., due to moisture or humidity), the e-polymer vent component 7900 may gradually expand, gradually opening the orifice 7925. Thus, as the air flow in the primary air flow path V1 gradually decreases due to the wetness of the woven material 7600, the air flow in the secondary air flow path V2 gradually increases. Similarly, as the e-polymer vent component 7900 dries, the e-polymer vent component 7900 may gradually contract, gradually closing the orifice 7925. Thus, as the air flow in the primary air flow path V1 gradually increases due to the drying of the fabric material 7600, the air flow in the secondary air flow path V2 gradually decreases.
[0218] 9A-9F show a woven vent assembly 8400 in accordance with another example of the present technology. In this example, the vent assembly 8400 includes a vent member 8500 (e.g., including a layer of woven material 8510 having a plurality of vent holes 8530 extending therethrough) and a diffusion member 8600 (e.g., including a layer of woven material 8610) along an air flow path constructed and arranged to diffuse the exhaust vent flow and reduce noise generation. Because the vent member 8500 and the diffusion member 8600 both include woven material, the vent assembly 8400 may include a thinner, more compact, and smaller configuration.
[0219] In examples, the vent assembly 8400 may take the form of a vent insert or vent module and is structured to be inserted into an opening in a patient interface or air delivery conduit (e.g., into a frame or shell of the patient interface that forms at least a portion of a plenum chamber).
[0220] The vent assembly 8400 may be removably or permanently secured within the opening in any suitable manner (e.g., by a press-fit, snap-fit, or interference-fit assembly), or adhesively secured (e.g., the vent assembly 8400 may include a groove around its periphery that is adapted to position the vent assembly 8400 against a correspondingly sized rim of the opening in the frame).
[0221] In another example, one or more portions of the ventilation assembly 8400 may include a portion of the patient interface or air delivery conduit (e.g., the frame of the patient interface) or may be formed as a single piece with the patient interface or air delivery conduit (e.g., the frame of the patient interface) (e.g., by overmolding or insert molding).
[0222] In the illustrated example, the vent assembly 8400 (and the corresponding opening in the frame) comprises a stadium shape (i.e., a rectangle with semicircular sides), however, it should be understood that the vent assembly (and the corresponding opening in the frame) may have other suitable shapes (e.g., circular and non-circular).
[0223] In use, the vent assembly 8400 is constructed and arranged to allow gas flow between a pressurized interior of the patient interface or air delivery conduit (e.g., a plenum chamber) and an exterior of the patient interface or air delivery conduit (e.g., atmosphere).
[0224] As shown in the examples of Figures 9A-9F, ventilation assembly 8400 includes a base or frame 8700, a ventilation member 8500 (e.g., including a layer of woven material 8510 having a plurality of ventilation holes 8530 extending therethrough) supported by base 8700, a diffusion member 8600 (e.g., including a layer of woven material 8610), and a support structure 8800 that supports diffusion member 8600 offset or spaced apart from ventilation member 8500.
[0225] The base 8700 includes an outer wall 8710 that defines an opening 8720 therein. As noted above, in any suitable manner, the base 8700 may be removably or permanently secured within an opening in a patient interface or air delivery conduit to secure the vent assembly 8400 to the patient interface or air delivery conduit. Alternatively, as noted above, the base 8700 and its opening 8720 may comprise part of the patient interface or air delivery conduit or may be formed one piece with the patient interface or air delivery conduit, for example by overmolding or insert molding.
[0226] The vent member 8500 is supported by an outer wall 8710 of the base 8700 along the front side of the base 8700. As shown, the vent member 8500 may be positioned to cover an opening 8720 in the base 8700, thereby allowing a vent flow of exhaled gases from the patient through the opening 8720 and through a plurality of vent holes 8530 in the vent member 8500.
[0227] In examples, the woven material 8510 comprises a sheet of woven material having a thickness of approximately 0.10 mm to 0.30 mm (e.g., 0.19 mm). However, it should be understood that other suitable thicknesses are possible. In examples, the diameter of each of the plurality of vent holes 8530 is approximately 0.18 mm to 0.20 mm. In examples, the diameter of each of the plurality of vent holes 8530 is no less than approximately 0.18 mm (i.e., greater than approximately 0.18 mm), for example, to avoid blockage by moisture. In examples, the plurality of vent holes 8530 may be laser cut through the woven material 8510.
[0228] In an example, the woven material 8510 may be attached to the base 8700, and then the vent holes 8530 may be laser cut through the woven material 8510 while attached to the base 8700. In another example, the vent holes 8530 may be laser cut through the woven material 8510, and then the woven material 8510 along with the vent holes 8530 may be attached to the base 8700.
[0229] The support structure 8800 includes an outer wall 8810 that defines an opening 8820 therein, and a plurality of support members 8830 that protrude from a rear side of the outer wall 8810. In the illustrated example, the support members 8830 are disposed on the outer wall 8810 along the major and minor axes of the support structure 8800, although it should be understood that in other suitable manners the support members 8830 may be disposed around the periphery of the outer wall 8810.
[0230] The diffusion member 8600 is supported by an outer wall 8810 of the support structure 8800 along the front side of the support structure 8800. In the illustrated example, the diffusion member 8600 includes a layer of woven material 8610 positioned to cover an opening 8820 in the support structure 8600. Additionally, the diffusion member 8600 forms a cover or exterior of the vent assembly 8400. In examples, the woven material of the diffusion member 8600 on the exterior of the vent assembly 8400 facilitates cleaning of the vent assembly 8400. Additionally, such a woven exterior may provide aesthetic appeal (particularly when used in conjunction with a woven patient orifice or a woven air delivery conduit).
[0231] The support structure 8800 and the diffusion member 8600 supported thereon are mounted to the front side of the base 8700 and the vent member 8500 supported thereon. As shown, the support member 8830 is positioned to engage the vent member 8500 along its periphery, such that the vent member 8500 is sandwiched between the support member 8830 and the outer wall 8710 of the base 8700. The support member 8830 is further positioned to support the outer wall 8810 and the diffusion member 8600 on the outer wall 8810, spaced apart from the front side of the base 8700 and the vent member 8500. This arrangement defines a side opening 8450 along the periphery of the vent assembly, which may allow at least a portion of the flow exiting the vent 8530 to bypass the diffusion member 8600 and flow through the side opening 8450. With such an arrangement, the diffusion member 8600 is also offset from the ventilation member 8500 by a gap 8475, which allows for continuous air flow therein while resisting any moisture or dust that may clog the diffusion member 8600. In an example, the height of the gap 8475 may be approximately 1-2 mm (e.g., 1.5 mm). However, it should be understood that the gap 8475 may be any other suitable size, and such size may vary with the air flow rate and ventilation area.
[0232] In one example, the diffusion member 8600 may be constructed of a porous material (e.g., a woven material 8610, such as a nonwoven or woven fibrous material) that allows gas to pass therethrough and dissipates any plumes or other flow formations exiting the plurality of vent holes 8530. In an example, the diffusion member 8600 may comprise a woven continuous loop (UBL) material having a thickness of about 0.10 mm to 0.30 mm (e.g., 0.20 mm). However, it should be understood that other suitable woven materials and thicknesses are possible.
[0233] In examples, the base 8700 and support structure 8800 may comprise a relatively rigid or relatively soft structure. Because the ventilation member 8500 and the diffusion member 8600 both comprise a flexible woven material, the base 8700 and support structure 8800 (as well as the ventilation member 8500 and the diffusion member 8600) may be able to be curved (to follow the contours of the patient interface or air delivery conduit (e.g., the soft, flexible structure of the base 8700)), may be able to flex or bend to follow the contours, or the base 8700 and support structure 8800 may have a rigid structure that is molded or otherwise formed to follow the contours.
[0234] 9E, when there is pressure in the patient interface or air delivery conduit (e.g., when the RPT device is operating) and the diffusing member 8600 is not obstructed, air may be directed through a primary ventilation flow path V1 that extends through the multiple vent holes 8530 and the diffusing member 8600 to atmosphere to diffuse the exhaust ventilation flow and reduce noise generation. In addition, air may travel through a secondary ventilation flow path V2 that extends through the multiple vent holes 8530 and the side opening 8450 to atmosphere. Such primary ventilation flow path V1 and secondary ventilation flow path V2 provide ventilation paths that allow sufficient gas flushing to avoid CO2 buildup in the patient interface or air delivery conduit.
[0235] 9F, if there is pressure in the patient interface or air delivery conduit (e.g., when an RPT device is operating) and the diffusing member 8600 is blocked due to moisture or humidity, air may travel through the secondary ventilation flow path V2, which extends to atmosphere through the multiple vent holes 8530 and side openings 8450. The secondary ventilation flow path V2 bypasses the diffusing member 8600, thereby providing sufficient ventilation flow when the diffusing member 8600 is blocked. Furthermore, because the secondary ventilation flow path V2 is always open, exhaust ventilation flow is ensured until enough diffusing member 8600 is sufficiently dry or unblocked along the primary ventilation flow path V1.
[0236] 10A-10F show a woven vent assembly 9400 in accordance with another example of the present technology. Vent assembly 9400 is similar to vent assembly 8400 described above, but differs in the arrangement for supporting vent member 9500 and diffusion member 9600.
[0237] 10A-10F, the vent assembly 9400 includes a frame 9700, a vent member 9500 (e.g., including a layer of woven material 9510 having a plurality of vent holes 9530 extending therethrough) supported along a rear side of the frame 9700, and a diffusion member 9600 (e.g., including a layer of woven material 9610) supported along a front side of the frame 9700. In this example, the frame 9700 supports the diffusion member 9600 in an offset or spaced-apart manner from the vent member 9500.
[0238] The frame 9700 includes a rear wall 9710 forming an opening 9720 therein, a front wall 9740 forming an opening 9750 therein, and a plurality of support members 9730 that support and space the front wall 9740 from the rear wall 9710. In the illustrated example, the support members 9730 are disposed along the major and minor axes of the frame 9700, although it should be understood that in other suitable embodiments, the support members 9730 may be disposed along the periphery of the frame 9700. Additionally, the rear wall 9710, the front wall 9740, and the support members 9730 form side openings 9450 along the periphery of the vent assembly, such that at least a portion of the flow exiting the vent 9530 may bypass the diffusion member 9600 and flow through the side openings 9450.
[0239] The ventilation member 9500 is supported by a rear wall 9710 of the frame 9700 along the rear side of the frame 9700, and the diffusion member 9600 is supported by a front wall 9740 of the frame 9700 along the front side of the frame 9700. Thus, in the support structure provided by the frame 9700, the diffusion member 9600 is spaced apart from the ventilation member 9500, thereby forming a gap 9475 that resists any moisture or dust that may cause clogging of the diffusion member 9600, as described above.
[0240] Similar to the vent assembly 8400 described above, the frame 9700 may comprise a relatively rigid or relatively flexible structure. Because the vent member 9500 and the diffusion member 9600 both comprise a flexible woven material, the frame 9700 (and the vent member 9500 and the diffusion member 9600) may be curved to follow the contours of the patient interface, or the air delivery conduit (e.g., the soft, flexible structure of the frame 9700) may flex or bend to follow the contours, or the frame 9700 may have a rigid structure molded or otherwise formed to follow the contours.
[0241] 10E, when there is pressure in the patient interface or air delivery conduit (e.g., when the RPT device is operating) and the diffusing member 9600 is not obstructed, noise generation may be reduced by diffusing the exhaust ventilation flow by moving air to atmosphere through a primary ventilation flow path V1 extending through the multiple vent holes 9530 and the diffusing member 9600. In addition, air may move to atmosphere through a secondary ventilation flow path V2 extending through the multiple vent holes 9530 and the side opening 9450. Such primary ventilation flow path V1 and secondary ventilation flow path V2 provide ventilation paths that allow sufficient gas flushing to avoid CO2 buildup in the patient interface or air delivery conduit.
[0242] 10F, if there is pressure in the patient interface or air delivery conduit (e.g., when an RPT device is operating) and the diffusing member 9600 is blocked due to moisture or humidity, air may be able to be routed to atmosphere through a secondary ventilation flow path V2 extending through the multiple vent holes 9530 and side openings 9450. The secondary ventilation flow path V2 bypasses the diffusing member 9600, thereby providing sufficient ventilation flow when the diffusing member 9600 is blocked. Furthermore, because the secondary ventilation flow path V2 is always open, sufficient exhaust ventilation flow is ensured until the diffusing member 9600 along the primary ventilation flow path V1 is sufficiently dry or unblocked.
[0243] In each of the above examples, the total vent flow through the vent assembly may ideally include the sum of the primary vent flow through primary vent flow path V1, the secondary vent flow through secondary vent flow path V2, and any leakage in the vent assembly (e.g., approximately 0.1-0.2 L / min). Thus, at a given pressure, a decrease in primary vent flow must be offset by an increase in secondary vent flow. In the example, the change in vent flow velocity in the primary and secondary vent flow paths may depend on the rate of moisture accumulation and the rate at which moisture dries in the vent assembly. The crossover of vent flow between the primary and secondary vent flow paths may depend on the design and may be adjusted as described above.
[0244] 11A-11F are graphs illustrating some exemplary ventilation flow possibilities.
[0245] In the example of FIG. 11A, the vent assembly may be configured to provide a gradual decrease in primary vent flow and a gradual increase in secondary vent flow across the therapeutic pressure range.
[0246] In the example of FIG. 11B, the vent assembly may be configured so that the secondary vent remains closed until a particular therapeutic pressure is reached (e.g., 8 cmH2O), after which the secondary vent flow gradually increases as the primary vent flow continues to gradually decrease.
[0247] In the example of FIG. 11C, the vent assembly may be configured such that the secondary vent flow gradually increases as the primary vent flow gradually decreases until a certain therapeutic pressure is reached (e.g., 10 cmH2O), such pressure being sufficient to remove the obstruction in the primary vent, after which the secondary vent flow gradually decreases as the primary vent flow gradually increases.
[0248] In the example of Figure 1 ID, the vent assembly may be configured such that secondary venting is activated after the primary vent becomes wet (e.g., due to moisture or humidity). In this example, when the primary vent becomes wet, the primary vent flow is reduced by approximately 50% from the original dry flow, and secondary venting is activated to increase the overall vent flow after the vent assembly is exposed to moisture. By adjusting the increase allowed by such secondary venting, sufficient gas flushing is ensured during use.
[0249] In the example of FIG. 11E, the vent assembly may be configured such that when the primary vent is wet (e.g., due to moisture or humidity), the secondary vent remains closed until a certain level of water saturation or a certain level of blockage is reached in the primary vent. The secondary vent is then activated to increase the overall vent flow. Similar to the example of FIG. 11D, when the primary vent becomes wet, the primary vent flow is reduced to approximately 50% of the original dry flow. In this example, the secondary vent is activated at approximately 8 cmH2O, although it should be understood that activation may occur at lower or higher pressures depending on, for example, the level of water saturation or blockage, as described above. Also, in examples, activation of the secondary vent may be performed electronically via an electromechanical system (e.g., see electromagnetic activator 6900, described above). Adjusting this increase in overall vent flow enabled by the secondary vent may ensure sufficient gas flushing during use.
[0250] In the example of FIG. 11F, the vent assembly can be configured so that secondary venting is activated after the primary vent becomes wet (e.g., due to moisture or humidity). In this example, the primary vent flow drops by about 50% from the original dry flow due to its own moisture at low pressures (e.g., below about 10 cmH2O (e.g., 4-10 cmH2O)), and secondary venting is activated to increase the overall vent flow. At higher pressures (e.g., above about 10 cmH2O (e.g., 10-20 cmH2O)), the pressure during venting is sufficient to remove moisture or blockages in the primary vent, after which the primary vent flow can increase and the secondary vent flow can gradually decrease or remain substantially constant (as it dries due to air flow over the components). Over time, the overall vent flow can return to the original dry flow rate. In examples, if the textile material contains small holes between fabrics or denser weaves, a higher pressure may be required to remove moisture or blockages in the primary vent. Similarly, if the textile material contains larger holes between fabrics or less dense weaves, a lower pressure may be required to remove moisture or blockages in the primary vent.
[0251] In each of the above examples, the diffusion member (e.g., a woven material) may include one or more coatings (e.g., a hydrophobic coating and / or a hydrophilic coating). In an example, a hydrophobic coating may be provided on one side of the woven material (e.g., the patient side) to trap moisture, and a hydrophilic coating may be provided on the other side of the woven material (e.g., the atmosphere side) to stop moisture migration. However, it should be understood that other suitable coating arrangements are possible.
[0252] 5.3.5 Decoupling Structures (Singular or Plural) In one form, the patient interface 3000 includes at least one decoupling structure (eg, a swivel or a bulb).
[0253] 5.3.6 Connection Port The connection port 3600 allows connection to the air circuit 4170 .
[0254] 5.3.7 Forehead support In one form, the patient interface 3000 includes a forehead support 3700 .
[0255] 5.3.8 Anti-asphyxiation valve In one form, the patient interface 3000 includes an anti-asphyxiation valve.
[0256] 5.3.9 Ports In one form of the present technology, the patient interface 3000 includes one or more ports that allow access to the volume within the plenum chamber 3200. In one form, this allows a clinician to provide supplemental oxygen. In one form, this allows a property of the gas (e.g., pressure) within the plenum chamber 3200 to be directly measured.
[0257] 5.4 Air Circuit An air circuit 4170, according to one aspect of the present technology, is a conduit or tube constructed and arranged such that, in use, air flow travels between two components (e.g., the RPT device 4000 and the patient interface 3000).
[0258] In particular, the air circuit 4170 may be fluidly connected to the patient interface and the outlet of the pneumatic block of the RPT device 4000. The air circuit may be referred to as an air delivery tube. In some cases, there may be separate limbs of the circuit for inhalation and exhalation. In other cases, a single limb is used.
[0259] In some forms, the air circuit 4170 may include one or more heating elements configured to heat the air in the air circuit (e.g., to maintain or increase the air temperature). The heating elements may take the form of a heated wire circuit and may include one or more transducers (e.g., temperature sensors). In one form, the heated wire circuit may be spirally wound around the axis of the air circuit 4170. The heating elements may be in communication with a controller (e.g., a central controller). One example of an air circuit 4170 including a heated wire circuit is described in U.S. Patent Application No. 8,733,349, which is incorporated herein by reference in its entirety.
[0260] 5.4.1 Oxygen delivery In one form of the present technology, supplemental oxygen can be delivered to one or more points in the pneumatic pathway (eg, upstream of the pneumatic block), the air circuit 4170 and / or the patient interface 3000.
[0261] 5.5 Glossary For purposes of this disclosure, in certain aspects of the technology, one or more of the following definitions may apply. In other aspects of the technology, other definitions may apply.
[0262] 5.5.1 General Air: In certain forms of the present technology, air may refer to atmospheric air, while in other forms of the present technology, air may refer to a combination of other breathable gases (e.g., oxygen-rich atmospheric air).
[0263] Atmosphere: In certain forms of the present technology, the term "atmosphere" should be taken to mean (i) that which is external to the treatment system or patient, and (ii) that which immediately surrounds the treatment system or patient.
[0264] For example, the ambient humidity for a humidifier may be the humidity of the air immediately surrounding the humidifier (e.g., the humidity inside the room where the patient is sleeping). Such ambient humidity may differ from the humidity outside the room where the patient is sleeping.
[0265] In another example, the ambient pressure may be the pressure immediately surrounding or external to the body.
[0266] In certain embodiments, ambient (e.g., acoustic) noise can be considered the background noise level in the room the patient is in, other than noise emanating from, for example, the RPT device or from the mask or patient interface. Ambient noise can originate from sources outside the room.
[0267] Automatic Positive Airway Pressure (APAP) Therapy: CPAP therapy that is capable of automatically adjusting therapeutic pressure between minimum and maximum limits, for example, between breaths, depending on the presence or absence of signs of an SDB episode.
[0268] Continuous Positive Airway Pressure (CPAP) Therapy: Respiratory pressure therapy in which the therapeutic pressure is approximately constant throughout the patient's respiratory cycle. In some forms, the pressure at the entrance to the airways increases slightly during exhalation and decreases slightly during inhalation. In some forms, the pressure varies during different respiratory cycles of the patient (e.g., increased in response to the detection of an indication of partial upper airway obstruction and decreased in the absence of notification of partial upper airway obstruction).
[0269] Flow Rate: The instantaneous amount (or mass) of air delivered per unit time. Flow rate can refer to an instantaneous quantity. In some cases, reference to flow rate refers to a scalar quantity (i.e., a quantity that has only magnitude). In other cases, reference to flow rate refers to a vector quantity (i.e., a quantity that has both magnitude and direction). Flow rate may be given the symbol Q. "Flow rate" may also be simply called "flow."
[0270] In the example of a patient's breathing, the flow rate may be nominally positive for the inspiratory portion of the patient's breathing cycle, and therefore negative for the expiratory portion of the patient's breathing cycle. Total flow rate Qt is the flow rate of air exiting the RPT device. Vent flow rate Qv is the flow rate of air exiting the vent to allow for the outflow of exhaled gases. Leakage flow rate Ql is the flow rate of leakage from the patient interface system or elsewhere. Respiratory flow rate Qr is the flow rate of air received into the patient's respiratory system.
[0271] Humidifier: The word "humidifier" is construed to mean a humidifying device constructed, arranged, or configured with a physical structure capable of providing a therapeutically beneficial amount of water (H2O) vapor to an air stream to improve the medical respiratory condition of a patient.
[0272] Leakage: The term "leakage" refers to unintended airflow. In one example, a leak can occur due to an imperfect seal between the mask and the patient's face. In another example, a leak can occur at the swivel elbow to the perimeter.
[0273] Noise Conduction (Acoustic): In this document, conducted noise refers to noise that is carried to the patient by the pneumatic pathway (e.g., the air circuit and patient interface and the air therein). In one form, conducted noise can be quantified by measuring the sound pressure level at the end of the air circuit.
[0274] Noise Emission (Acoustic): In this document, radiated noise refers to noise carried by the ambient air to the patient. In one form, radiated noise can be quantified by measuring the sound power / pressure level of the target in accordance with ISO 3744.
[0275] Ventilation noise (acoustic): In this document, ventilation noise refers to the noise generated by airflow through any ventilation (eg, vents in the patient interface).
[0276] Patient: A person with or without a respiratory disease.
[0277] Pressure: Force per unit area. Pressure can be expressed in a variety of units (e.g., cmH2O, gf / cm 2 , and hectopascals). 1cmH2O is 1g-f / cm 2 which is approximately 0.98 hectopascals. In this specification, pressures are given in units of cmH2O unless otherwise specified.
[0278] The pressure in the patient interface is designated by the symbol Pm, and the therapeutic pressure, which represents the target value that the mask pressure Pm should achieve at this time, is designated by the symbol Pt.
[0279] Respiratory Pressure Therapy (RPT): The application to the airway entrance of an air supply at therapeutic pressure, typically positive pressure relative to atmosphere.
[0280] Ventilator: A mechanical device that provides pressure support to a patient while they perform some or all of the work of breathing.
[0281] 5.5.1.1 Materials Silicone or silicone elastomer: Synthetic rubber. References to silicone herein refer to liquid silicone rubber (LSR) or compression molded silicone rubber (CMSR). One commercially available form of LSR is SILASTIC (in a family of products sold under this registered trademark) manufactured by Dow Corning. Another LSR manufacturer is Wacker. Unless otherwise specified, exemplary forms of LSR have a Shore A (or Type A) indentation hardness of about 35 to about 45, as measured by ASTM D2240.
[0282] Polycarbonate: A thermoplastic polymer of bisphenol A carbonate.
[0283] 5.5.1.2 Mechanical properties Elasticity: The ability of a material to absorb energy during elastic deformation and to release the energy when unloaded.
[0284] Elastic: Releases substantially all of the energy upon unloading. Examples include certain silicone and thermoplastic elastomers.
[0285] Hardness: The ability of a material to resist deformation (e.g., as described by Young's modulus or the indentation hardness scale measured on a standardized sample size). "Soft" materials may include silicone or thermoplastic elastomers (TPEs) and may easily deform under finger pressure, for example. "Hard" materials may include polycarbonate, polypropylene, steel or aluminum, and do not easily deform under finger pressure, for example.
[0286] Stiffness (or rigidity) of a structure or component: The ability of a structure or component to resist deformation when subjected to a load. The load can be a force or a moment (e.g., compression, extension, bending, or torsion). A structure or component may offer different resistance in different directions.
[0287] Floppy structure or component: A structure or component that changes shape (e.g., flexes) within a relatively short period of time (e.g., 1 second) when forced to support its own weight.
[0288] Rigid structure or component: A structure or component that does not substantially change shape when subjected to loads typically encountered in use. An example of such an application would be setting up and maintaining a patient interface in a sealed manner against a patient airway entrance under a pressure load of, for example, approximately 20-30 cmH2O.
[0289] As one example, an I-beam may have a different bending stiffness (resistance to bending load) in a first direction compared to a second, orthogonal direction. In another example, a structure or component may be floppy in a first direction and rigid in a second direction.
[0290] 5.5.2 Respiratory cycle Apnea: According to some definitions, apnea is said to occur when flow below a predetermined threshold continues for a duration of, for example, 10 seconds. Obstructive apnea is said to occur when some airway obstruction does not allow airflow despite patient effort. Central apnea is said to refer to a condition in which apnea is detected due to reduced or absent respiratory effort despite a patent airway. Mixed apnea is said to refer to a condition in which reduced or absent respiratory effort occurs simultaneously with airway obstruction.
[0291] Respiratory rate: The patient's spontaneous breathing rate, usually measured in breaths per minute.
[0292] Duty cycle: The ratio of inspiration time Ti to total breathing time Ttot.
[0293] Exercise (Respiration): Respiratory effort is said to refer to the movement made by the spontaneous breathing of a person trying to breathe.
[0294] Expiratory portion of the respiratory cycle: the period from the start of expiratory flow to the start of inspiratory flow.
[0295] Flow limitation: Flow limitation is understood to be a condition in a patient's breathing where an increase in patient effort does not result in a corresponding increase in flow rate. If flow limitation occurs during the inspiratory portion of the respiratory cycle, the flow limitation can be referred to as inspiratory flow limitation. If flow limitation occurs during the expiratory portion of the respiratory cycle, the flow limitation can be referred to as expiratory flow limitation.
[0296] Flow-limited inspiration waveform types: (i) Flattening: An upswing followed by a relatively flat area, followed by a downswing. (ii) M-shaped: has two local peaks, one at the rise and one at the fall, with a relatively flat region between these two peaks. (iii) Chair-like: A single local peak occurs at the rising part, followed by a relatively flat region. (iv) Inverted chair: A relatively flat region is followed by a single local peak, which occurs on the trailing edge.
[0297] Hypopnea: By some definitions, hypopnea refers to a reduction in flow, rather than an interruption of flow. In one form, hypopnea is said to occur when flow is reduced below a threshold rate for a sustained period of time. When hypopnea is detected due to a decrease in respiratory effort, central hypopnea is said to occur. In one form, hypopnea may be considered when any of the following occur in adults: (i) A 30% decrease in patient respiration for at least 10 seconds plus an associated 4% desaturation, or (ii) A reduction in patient respiration (less than 50%) lasting at least 10 seconds and associated desaturation of at least 3% or arousal occurs.
[0298] Hyperventilation: An increase in flow to a level higher than normal.
[0299] Inspiratory portion of the respiratory cycle: The period from the start of the inspiratory flow to the start of the expiratory flow is taken as the inspiratory portion of the respiratory cycle.
[0300] Patency (Airway): The degree to which the airway is open or the extent to which it is open. Airway patency is an opening. Airway patency can be quantified, for example, with a value of 1 indicating open and a value of 0 indicating closed (obstructed).
[0301] Positive end-expiratory pressure (PEEP): The pressure above atmosphere in the lungs that exists at the end of expiration.
[0302] Peak flow (Qpeak): The maximum value of flow during the inspiratory portion of the respiratory flow waveform.
[0303] Respiratory airflow, airflow, patient airflow, respiratory airflow (Qr): These terms may be understood to refer to the RPT device's estimate of respiratory airflow, and are used in contrast to "true respiratory flow" or "true respiratory airflow," which is the patient's actual respiratory flow, usually expressed in liters / minute.
[0304] Tidal volume (Vt): The volume of air inhaled or exhaled during normal breathing without extra effort. In principle, the inhaled volume Vi (volume of air inhaled) is equal to the exhaled volume Ve (volume of air exhaled), so a single tidal volume Vt can be defined as equal to either volume. In practice, the tidal volume Vt is estimated as some combination (e.g., the average of the inhaled volume Vi and the exhaled volume Ve).
[0305] (Inspiration) Time (Ti): The duration of the inspiratory portion of the respiratory flow waveform.
[0306] (Expiratory) Time (Te): The duration of the expiratory portion of the respiratory flow waveform.
[0307] (Total) Time (Ttot): The total duration between the start of one inspiratory portion of the respiratory flow waveform and the start of the next inspiratory portion of the respiratory flow waveform.
[0308] Typical Recent Ventilation: The ventilation value around which recent values of ventilationVent over a given time scale tend to cluster (i.e., the degree to which recent values of ventilation tend to be centered).
[0309] Upper Airway Obstruction (UAO): Includes both partial and total upper airway obstruction. May be associated with a state of flow limitation in which flow may increase or decrease slightly with increasing pressure differential across the upper airway (Starling resistor behavior).
[0310] Vent: A measure of the rate of gas exchange performed by a patient's respiratory system. Measurements of ventilation may include either or both inspiratory and expiratory flow per unit time. When expressed as volume per minute, this quantity is often referred to as "minute ventilation." Minute ventilation is sometimes given simply as volume and is understood as volume per minute.
[0311] 5.5.3 Ventilation Adaptive servo-ventilator (ASV): A servo-ventilator that does not have a fixed target ventilation but is variable. The variable target ventilation can be learned from some characteristic of the patient (e.g., the patient's breathing characteristics).
[0312] Backup Rate: A ventilator parameter that establishes the minimum respiratory rate (typically in breaths per minute) that will be delivered to the patient by the ventilator (when not triggered by spontaneous breathing efforts).
[0313] Cycle: The end of the inspiratory phase of a ventilator. When a ventilator delivers breaths to a spontaneously breathing patient, at the end of the inspiratory portion of the breathing cycle, the ventilator is said to be cycled to stop breath delivery.
[0314] Expiratory Positive Airway Pressure (EPAP): The base pressure to which varying pressures are added during a breath to produce the desired mask pressure that the ventilator attempts to achieve at a given moment.
[0315] End Expiratory Pressure (EEP): The desired mask pressure that the ventilator attempts to achieve at the end of the expiratory portion of the breath. If the pressure waveform template Π(Φ) has a value of zero at the end of expiration (i.e., Π(Φ)=0 when Φ=1), then EEP is equal to EPAP.
[0316] Inspiratory Positive Airway Pressure (IPAP): The maximum desired mask pressure that the ventilator attempts to achieve during the inspiratory portion of the breath.
[0317] Pressure Support: A number indicating the increase in pressure during ventilator inspiration compared to the corresponding ventilator expiration, and refers primarily to the pressure difference between the maximum inspiratory pressure and the base pressure (e.g., PS = IPAP - EPAP). In some contexts, pressure support refers to the difference the ventilator attempts to achieve (rather than the difference it actually achieves).
[0318] Servo-ventilator: A ventilator that has both patient ventilation and target ventilation, and adjusts the level of pressure support to bring the patient ventilation closer to the target ventilation.
[0319] Spontaneous / Timed (S / T): A mode of a ventilator or other device that attempts to detect the onset of a breath in a spontaneously breathing patient. However, if the device fails to detect a breath within a predetermined period of time, the device automatically begins breath delivery.
[0320] Swing: A term equivalent to pressure assistance.
[0321] Triggered: When a ventilator delivers a breath of air to a spontaneously breathing patient, the ventilator is said to be triggered to deliver a breath when the patient himself initiates the breathing portion of the breathing cycle.
[0322] 5.5.4 Anatomy 5.5.4.1 Facial Anatomy Ala: The outer wall or "wing" of each nostril (plural: alar).
[0323] Wing angle:
[0324] Alare: The outermost point on the ala of the nose.
[0325] Alar curvature (or alar crest) point: The most posterior point on the curved baseline of each alar, found in the crease formed by the union of the alar and cheek.
[0326] Pinna: the entire visible part of the ear.
[0327] (Nasal) skeleton: The nasal skeleton includes the nasal bones, the frontal process of the maxilla, and the nasal portion of the frontal bone.
[0328] (Nasal) cartilaginous rami: The cartilaginous rami of the nose include the septal cartilage, lateral cartilage, greater cartilage, and lesser cartilage.
[0329] Columella: The piece of skin that separates the nostrils and extends from the tip of the nose to the upper lip.
[0330] Columella angle: the angle between a line drawn through the midpoint of the nostril and a line drawn perpendicular to the Frankfurt horizontal and intersecting the subnasal point.
[0331] Frankfort horizontal plane: A line extending from the most inferior point of the orbital rim to the left auricular point, which is the deepest point of the auricle from the superior side of the notch to the tragus.
[0332] Glabellar: Located in the soft tissue, the most prominent point in the midsagittal direction of the forehead.
[0333] Lateral nasal cartilage: a generally triangular plate of cartilage whose upper margin is attached to the nasal bone and the frontal process of the maxilla, and whose lower margin is connected to the greater alar cartilage.
[0334] Lip, lower side (lower lip: labrale inferius):
[0335] Lip, upper side (upper lip: labrale superius):
[0336] Greater alar cartilage: a cartilaginous plate located beneath the lateral nasal cartilage. It curves around the anterior part of the nostril. Its posterior end is connected to the frontal process of the maxilla by a tough fibrous membrane containing three or four alar cartilages.
[0337] Nostrils (nares): Generally ellipsoidal alar openings that form the entrance to the nasal cavity. The singular form of nostrils is naris (nose hole). These nostrils are separated by the nasal septum.
[0338] Nasolabial fold or nasolabial crease: a fold or groove of skin that runs from each side of the nose to the corners of the mouth, separating the cheek from the upper lip.
[0339] Nasolabial angle: the angle between the bridge of the nose and the upper lip, intersecting with the subnasal point.
[0340] Inferior ear point: lowest point of attachment of the pinna to the facial skin.
[0341] Superior auricular point: the highest point of attachment of the pinna to the facial skin.
[0342] Nasal tip: The most prominent point or tip of the nose, which can be seen in a lateral view of the rest of the head.
[0343] Philtrum: midline groove extending from the lower border of the nasal septum to the top of the lip in the upper lip area.
[0344] Pogonion: The most anterior midpoint of the jaw, located on the soft tissue.
[0345] Nasal ridge: The nasal ridge is the midline prominence of the nose, extending from the serion to the apex.
[0346] Sagittal plane: A vertical plane running from anterior (front) to posterior (rear). The midsagittal plane is the sagittal plane that divides the body into right and left halves.
[0347] Cerion: Located on the soft tissue, it is the most concave point on the area of the frontonasal suture.
[0348] Septal cartilage (nose): The nasal septum cartilage is part of the septum, which divides the anterior part of the nasal cavity.
[0349] Nasal alar nasal basin: the point on the lower periphery of the alar base where it joins with the skin of the upper (top) lip.
[0350] Subnasal point: Located on the soft tissue, the point where the columella joins the upper lip in the midsagittal plane.
[0351] Supramenton: The most concave point in the midline of the lower lip between the lower lip midpoint and the soft tissue pogonion.
[0352] 5.5.4.2 Skull anatomy Frontal bone: The frontal bone contains the squama frontalis, a large vertical portion that corresponds to the area known as the forehead.
[0353] Mandible: The mandible forms the lower jaw. The mental protuberance is a bony protuberance in the jaw, forming the chin.
[0354] Maxilla: The maxilla forms the upper jaw and is located below the mandible and below the orbit. The frontal process of the maxilla projects upward by the sides of the nose and forms part of its lateral border.
[0355] Nasal bones: The nasal bones are two small, rectangular bones that vary in size and shape from person to person. They lie side by side in the middle and upper parts of the face, and their junction forms the "bridge" of the nose.
[0356] Nasion: the intersection of the frontal bone and the two nasal bones, a concave area directly between the eyes and the upper side of the bridge of the nose.
[0357] Occipital bone: The occipital bone is located at the back and underside of the skull. It contains the foramen magnum, an oval hole through which the intracranial cavity connects with the vertebral canal. The curved plate posterior to the foramen magnum is the squama occipitalis.
[0358] Orbit: bony cavity in the skull that contains the eyeball.
[0359] Parietal bones: The parietal bones are bones that, when joined together, form the top and sides of the skull.
[0360] Temporal bone: The temporal bone is located on the base and sides of the skull and supports parts of the face known as the temples.
[0361] Cheekbones: The two cheekbones in the face are located in the upper and lateral parts of the face and form the cheek ridges.
[0362] 5.5.4.3 Respiratory system anatomy Diaphragm: A sheet of muscle that runs over the lower rib cage. The diaphragm separates the thoracic cavity, which contains the heart, lungs, and ribs, from the abdominal cavity. When the diaphragm contracts, it increases the volume of the thoracic cavity and draws air into the lungs.
[0363] Larynx: The larynx or voice box that houses the vocal cords and connects the lower part of the pharynx (hypopharynx) to the trachea.
[0364] Lung: respiratory organ in humans. The conductive zone of the lung includes the trachea, bronchi, bronchi, and terminal bronchioles. The respiratory zone includes the respiratory bronchioles, alveolar ducts, and alveoli.
[0365] Nasal Cavity: The nasal cavity (or nasal fossa) is a large, air-filled space in the center of the face above and behind the nose. The nasal cavity is divided into two by a vertical fin called the nasal septum. On the sides of the nasal cavity are three horizontal extensions called nasal conchae (singular "concha") or turbinates. The nasal cavity is anteriorly connected to the nose, and posteriorly to the choanae, which open into the nasopharynx.
[0366] Pharynx: The part of the throat located immediately below (inferior to) the nasal cavity and above the esophagus and larynx. The pharynx is traditionally divided into three parts: the nasopharynx (upper pharynx) (nasal part of the pharynx), the oropharynx (mid pharynx) (oral part of the pharynx), and the hypopharynx (low pharynx).
[0367] 5.5.5 Patient Interface Anti-asphyxiation valve (AAV): A component or subassembly of a mask system that vents to atmosphere in a fail-safe manner to reduce the risk of excessive CO2 rebreathing by the patient.
[0368] Elbow: An elbow is an example of a structure that directs the axis of airflow moving therethrough to change direction through an angle. In one form, the angle may be approximately 90 degrees. In another form, the angle may be greater than or less than 90 degrees. The elbow may have a generally circular cross section. In another form, the elbow may have an oval or rectangular cross section. In certain forms, the elbow may be rotatable relative to the mating component, for example, approximately 360 degrees. In certain forms, the elbow may be detachable from the mating component, for example, via a snap connection. In certain forms, the elbow may be assembled to the mating component via a one-time snap during manufacturing, but cannot be removed by the patient.
[0369] Frame: Frame is taken to mean the mask structure that supports the tensile load between two or more points that connect the headgear. A mask frame can be a non-airtight load-bearing structure in the mask. However, some forms of mask frames may be airtight.
[0370] Headgear: Headgear is taken to mean a form of positioning and stabilizing structure designed for use on the head. For example, the headgear may include a collection of one or more posts, ties, and stiffeners configured to position and hold the patient interface in place on the patient's face for delivery of respiratory therapy. Some ties are formed from a soft, flexible, elastic material (e.g., a layered composite of foam and fabric).
[0371] Membrane: Membrane is taken to mean a typically thin-walled element, preferably substantially non-resistant to bending and resistant to stretching.
[0372] Plenum Chamber: Mask plenum chamber is taken to mean a part of a patient interface having walls that at least partially enclose a volume of space, the air in the volume being pressurized to exceed atmospheric pressure in use. The shell may form part of the wall of the mask plenum chamber.
[0373] Seal: When used as a noun ("seal"), it can refer to a structure, and when used as a verb ("to seal"), it can refer to an effect. Two elements can be constructed and / or arranged to "seal" or achieve a "sealing" effect between them without the need for a separate "sealing" element itself.
[0374] Shell: A shell is taken to mean a curved, relatively thin structure that has bending, tensile, and compressive stiffness. For example, the curved structural wall of a mask may be a shell. In some forms, the shell may be faceted. In some forms, the shell may be airtight. In some forms, the shell may not be airtight.
[0375] Stiffener: A stiffener is taken to mean a structural component designed to increase the bending resistance of another component in at least one direction.
[0376] Strut: A strut is taken to mean a structural component designed to increase the compressive resistance of another component in at least one direction.
[0377] Swivel (noun): A subassembly of components configured to rotate, preferably independently, about a common axis, preferably under low torque. In one form, the swivel may be configured to rotate through an angle of at least 360 degrees. In another form, the swivel may be configured to rotate through an angle less than 360 degrees. When used in the context of an air delivery conduit, the subassembly of components preferably includes a mating cylindrical conduit. In use, there is little leakage of air flow from the swivel.
[0378] Tie (noun): A structure designed to resist tension.
[0379] Venting: (noun): A structure that allows airflow into the ambient atmosphere inside a mask or conduit, allowing clinically effective flushing of exhaled gases. For example, for clinically effective flushing, flow rates of about 10 liters / minute to about 100 liters / minute may be used depending on mask design and treatment pressure.
[0380] 5.5.6 Structural shape Products of the present technology may include one or more three-dimensional mechanical structures (e.g., a mask cushion or impeller). The three-dimensional structures may be bounded by two-dimensional surfaces. These surfaces may be distinguished using labels to describe the orientation, location, function, or some other characteristic of the associated surfaces. For example, the structure may include one or more of a front surface, a back surface, an interior surface, and an exterior surface. In another example, the seal-forming structure may include a face-contacting (e.g., outer) surface and a separate non-face-contacting (e.g., lower or interior) surface. In another example, the structure may include a first surface and a second surface.
[0381] To facilitate the description of the shape and surface of a three-dimensional structure, we first consider a cross section at a point p through the surface of the structure. See Figures 3B-3F. Figures 3B-3F show an example cross section at point p on the surface and an example of the resulting planar curve. Figures 3B-3F also show the outward normal vector at p. The outward normal vector at p points away from the surface. In some examples, the surface is described from the perspective of a fictitious little person standing upright on the surface.
[0382] 5.5.6.1 Curvature in one dimension The curvature of a plane curve at p can be described as having a sign (eg, positive, negative) and a magnitude (eg, 1 / radius of the circle tangent to the curve at p).
[0383] Positive curvature: If the curve at p bends toward the outward normal, the curvature at that point is taken to have a positive value (if our fictitious little person were to walk away from point p, they would have to walk uphill). See Figure 3B (relatively large positive curvature compared to Figure 3C) and Figure 3C (relatively small positive curvature compared to Figure 3B). Such curves are often called concave.
[0384] Zero curvature: If the curve at p is a straight line, the curvature is taken as zero (if this imaginary little person walks away from point p, they can walk on a horizontal plane that is neither pointing up nor pointing down). See Figure 3D.
[0385] Negative curvature: If the curve at p bends away from the outward normal, the curvature at that point and in that direction is taken to have a negative value (if this fictitious little person were to walk away from point p, they would have to walk downhill). See Figure 3E (relatively small negative curvature compared to Figure 3F) and Figure 3F (relatively large negative curvature compared to Figure 3E). Such curves are often called convex.
[0386] 5.5.6.2 Two-dimensional surface curvature A description of a shape at a given point on a two-dimensional surface according to the present technology may include multiple perpendicular cross sections. The multiple cross sections may cut the surface in a plane containing the outward normal (the "normal plane"), and each cross section may be taken in a different direction. Each cross section results in a plane curve with a corresponding curvature. The different curvatures at the point may have the same or different signs. Each curvature at the point has a (e.g., relatively small) magnitude. The plane curves in Figures 3B-3F may be examples of such multiple cross sections at a particular point.
[0387] Principal curvature and direction: The directions of the normal plane in which the curvature of a curve reaches its maximum and minimum values are called the principal directions. In the example of Figures 3B-3F, the maximum curvature occurs in Figure 3B and the minimum occurs in Figure 3F, so Figures 3B and 3F are cross sections in the principal directions. The principal curvature at p is the curvature in the principal direction.
[0388] Surface region: A set of connected points on a surface. This set of points within a region may have similar properties (e.g., curvature or sign).
[0389] Saddle region: A region where the principal curvatures at each point have opposite signs (i.e., one positive sign and the other negative sign) (depending on the direction a hypothetical person who may be walking uphill or downhill is facing).
[0390] Dome area: an area where the principal curvatures at each point have the same sign: either both positive ("concave dome") or both negative ("convex dome")
[0391] Cylindrical region: A region in which one principal curvature is zero (or, for example, zero within manufacturing tolerances) and the other principal curvature is non-zero.
[0392] Planar region: A region of a surface where both principal curvatures are zero (or are zero within a manufacturing tolerance, for example).
[0393] Surface Edge: The boundary or limit of a surface or area.
[0394] Path: In certain forms of the present technology, a "path" is taken to mean a path in the mathematical-topological sense (e.g., a continuous space curve from f(0) to f(1) on a surface). In certain forms of the present technology, a "path" may be described as a route or course that includes, for example, a set of points on a surface. (A hypothetical person's path is a place they walk on a surface, similar to a path in a garden.)
[0395] Path Length: In certain forms of the present technology, "path length" is taken to refer to the distance along the surface from f(0) to f(1) (i.e., the distance along a path on the surface). There may be more than one path between two points on the surface, and such paths may have different path lengths. (The path length of a fictional person is the distance walked along the path on the surface.)
[0396] Straight-line distance: Straight-line distance is the distance between two points on a surface, but does not take the surface into account. On a planar area, there is a distance on the surface edge that has the same path length as the straight-line distance between two points on the surface. On a non-planar surface, there cannot be a path that has the same path length as the straight-line distance between two points. (For a fictional person, straight-line distance corresponds to the distance as the crow flies.)
[0397] 5.5.6.3 Space curve Space Curve: Unlike a plane curve, a space curve does not necessarily exist within any particular plane. A space curve may be closed, i.e., it has no endpoint. A space curve may be considered a one-dimensional piece of three-dimensional space. A fictional character walking on a strand of DNA helix walks along a space curve. A typical human left ear contains a left-handed helix (see Figure 3Q). A typical human right ear contains a right-handed helix (see Figure 3R). Figure 3S shows a right-handed helix. The edge of a structure (e.g., the edge of a membrane or impeller) may trace a space curve. In general, a space curve can be described by the curvature and twist at each point on the space curve. Torsion is a measure of the way the curve emanates from the plane. Twist has a sign and a magnitude. The twist at a point on a space curve can be characterized with respect to the tangent, normal, and binormal vectors at that point.
[0398] Tangent unit vector (or unit tangent vector): For each point on a curve, the vector at that point specifies the direction and magnitude from that point. A tangent unit vector is a unit vector that points in the same direction as the curve at that point. If a fictional character were flying along the curve and fell off their vehicle at a particular point, the direction of the tangent vector would be the direction they would be traveling.
[0399] Unit normal vector: As the fictional character moves along the curve, this tangent vector itself changes. The unit vector that points in the same direction as the tangent vector is changing is called the unit principal normal vector. It is perpendicular to the tangent vector.
[0400] Binormal unit vector: The binormal unit vector is perpendicular to both the tangent vector and the principal normal vector. Its direction can be determined by the right-hand rule (see, for example, Figure 3P) or the left-hand rule (Figure 3O).
[0401] Oscillating plane: A plane containing a unit tangent vector and a unit principal normal vector. See Figures 3O and 3P.
[0402] Torsion of a Space Curve: The torsion at a point on a space curve is the magnitude of the rate of change of the binormal unit vector at that point. It measures the degree of deviation of the curve from the tangential plane. A space curve that lies within a plane has zero torsion. If the space curve deviates from the tangential plane by a relatively small amount, the magnitude of torsion of the space curve is relatively small (e.g., a gently sloping spiral path). If the space curve deviates from the tangential plane by a relatively large amount, the magnitude of torsion of the space curve is relatively large (e.g., a steeply sloping spiral path). Referring to Figure 3S, because T2 > T1, the magnitude of torsion near the top coil of the spiral in Figure 3S is greater than the magnitude of torsion of the bottom coil of the spiral in Figure 3S.
[0403] Referring to the right-hand rule in Figure 3P, a space curve that bends toward the right-hand binormal can be considered to have a positive right-hand twist (e.g., a right-hand spiral as shown in Figure 3S). A space curve that bends away from the right-hand binormal can be considered to have a negative right-hand twist (e.g., a left-hand spiral).
[0404] Similarly, with reference to the left-hand rule (see Figure 3O), a space curve oriented in a left-handed binormal direction can be considered as having a positive left-handed twist (e.g., a left-handed spiral). Thus, a positive left-handed direction corresponds to a negative right-handed direction. See Figure 3T.
[0405] 5.5.6.4 Holes A surface may have one-dimensional holes (e.g., holes bounded by a planar or space curve). In the case of a thin structure (e.g., a membrane) that contains holes, the structure may be described as having one-dimensional holes. See, for example, how the one-dimensional holes in the surface of the structure shown in Figure 3I are bounded by a planar curve.
[0406] A structure can have a two-dimensional hole (e.g., a hole bounded by a surface). For example, an inflatable tire has a two-dimensional hole bounded by the tire's inner surface. In another example, a bladder with a cavity for air or gel can have a two-dimensional hole. See, for example, the cushion in FIG. 3L and the exemplary cross-section of FIG. 3L in FIGS. 3M and 3N, where the inner surface bounding the two-dimensional hole is shown. In yet another example, a conduit can include a one-dimensional hole (e.g., at its inlet or its outlet) and can include a two-dimensional hole bounded by the inner surface of the conduit. See also the two-dimensional hole through the structure shown in FIG. 3K and bounded by a surface as shown.
[0407] 5.6 Other Notes Unless otherwise clearly indicated from the context and unless a range of values is provided, it is understood that each intervening value, to the tenth of the unit of the lower limit, between the upper and lower limits of the range, and for any other stated or intervening value in the stated range, is encompassed by the technology. The upper and lower limits of these intervening ranges, independently included in the intervening range, are also encompassed by the technology if they specifically exceed the limits in the stated range. If the stated range includes one or both of these limits, then ranges exceeding either or both of these stated limits are also encompassed by the technology.
[0408] Furthermore, when a value or values are embodied herein as part of the present technology, unless otherwise specified, it is understood that such values may be approximated and may be used to any appropriate significant figures to the extent practical technical practice permits or requires.
[0409] Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this technology belongs. Although any methods and materials similar or equivalent to those described herein can be used in the practice or testing of this technology, a limited number of exemplary methods and materials are described herein.
[0410] Although particular materials are described as being suitable for use in the construction of components, obvious alternative materials having similar properties may be substituted. Furthermore, unless stated to the contrary, any and all components described herein are understood to be manufacturable and therefore may be manufactured collectively or separately.
[0411] Please note that as used herein and in the appended claims, the singular forms "a," "an," and "the" include their plural equivalents unless the context clearly dictates otherwise.
[0412] All publications mentioned herein are incorporated by reference to disclose and describe the methods and / or materials that are the subject of these publications. The publications mentioned herein are provided solely for their disclosure prior to the filing date of this application. Nothing herein should be construed as an admission that the present technology does not antedate such publications by virtue of prior patents. Furthermore, the dates of publications mentioned may differ from the actual publication dates, which may require independent confirmation.
[0413] The terms "comprises" and "comprising" should be construed as referring to elements, components, or steps in a non-exclusive sense, indicating that a described element, component, or step may be present in, utilized with, or combined with other elements, components, or steps not specifically described.
[0414] The headings used in the detailed description are for the convenience of the reader and should not be used to limit the content found in the disclosure or claims as a whole. These headings should not be used in interpreting the scope of the claims or the claim limitations.
[0415] Although the technology herein has been described with reference to specific embodiments, it should be understood that these embodiments are merely illustrative of the principles and applications of the technology. In some cases, terms and symbols may indicate specific details unnecessary for the practice of the technology. For example, although the terms "first" and "second" (etc.) are used, unless otherwise specified, these terms are not intended to indicate any order but are used to distinguish between separate elements. Furthermore, although the process steps in the method may be described or illustrated in an ordered manner, such an order is not required. Those skilled in the art will recognize that such an order can be changed and / or aspects can be performed simultaneously or even synchronously.
[0416] It is therefore to be understood that numerous modifications may be made in the illustrative embodiments and that other arrangements may be devised without departing from the spirit and scope of the present technology. [Explanation of symbols]
[0417] patient 1000 Bedmate: 1100 Patient Interface 3000 Seal forming structure 3100 Plenum Chamber 3200 Positioning and stabilizing structure 3300 Ventilation section 3400 Connection port 3600 Forehead support part 3700 RPT Device 4000 Air Circuit 4170 Ventilation Assembly 4400 Cover 4500 Main wall 4510 side wall 4520 Orifice 4530 Textile material 4600 Orifice 4610 Base 4700 Base wall 4705 First Orifice 4710 Second Orifice 4720 Inner surface 4730 Exterior 4740 Shoulder 4750 Retaining structure 4760 Slot 4765 Recess 4770 Membrane 4800 Flap part 4810 Orifice 4815 Holding part 4820 Activator 4900 Humidifier 5000 Ventilation Assembly 5400 Textile material 5600 Orifice 5610 Base 5700 Base wall 5705 First Orifice 5710 Second Orifice 5720 Inner surface 5730 Protrusion 5732 Exterior 5740 Protrusion 5742 Retaining structure 5760 Post 5762 Opening 5770 Membrane 5800 Flap part 5810 Holding part 5820 Hole 5822 Activator 5900 Air Delivery Conduit 6000 Opening 6050 Base 6700 Inner surface 6730 Activator 6900 Sensor 6910 Orbital circuit 6915 Ventilation Assembly 7400 Textile material 7600 Orifice 7610 Base 7700 Base wall 7705 First Orifice 7710 Second Orifice 7720 Ventilated Components 7900 Second Orifice 7925 Groove 7950 Ventilation Assembly 8400 Side opening 8450 Gap 8475 Ventilation material 8500 Textile material 8510 Ventilation hole 8530 Diffusion material 8600 textile material 8610 Base 8700 Exterior wall 8710 Opening 8720 Support structure 8800 Exterior wall 8810 Opening 8820 Support member 8830 Ventilation Assembly 9400 Side opening 9450 Gap 9475 Ventilation material 9500 Textile material 9510 Ventilation hole 9530 Diffusion material 9600 Textile material 9610 Frame 9700 Rear wall 9710 Opening 9720 Support member 9730 Front wall 9740 Opening 9750
Claims
1. 1. A patient interface configured to deliver a supply of gas at positive pressure to an entrance to a patient's airway for respiratory therapy, the patient interface comprising: a plenum chamber pressurizable to a treatment pressure above ambient air pressure; a seal-forming structure configured to form a seal with an area of the patient's face surrounding an entrance to the patient's airway; a vent assembly configured to provide a vent gas flow such that gases exhaled by a patient are continuously released from the plenum chamber to the ambient air; It is equipped with The vent assembly comprises: a base comprising at least one first orifice extending therethrough to allow gas from the plenum chamber to be released to the atmosphere along a primary ventilation flow path, and at least one second orifice extending therethrough to allow gas from the plenum chamber to be released to the atmosphere along a secondary ventilation flow path; a diffusing member disposed on the base, the diffusing member constructed and arranged such that at least one of the first orifices is covered by the diffusing member, thereby directing air flow through the diffusing member along the primary air flow path, and such that at least one of the second orifices is not covered by the diffusing member, thereby directing air flow around the diffusing member along the secondary air flow path; and a membrane disposed on the base, the membrane constructed and arranged to distribute the ventilation gas flow along the primary ventilation flow path and the secondary ventilation flow path throughout respiratory treatment; an activator constructed and arranged to deflect the membrane to distribute the vent gas flow along the primary vent flowpath and the secondary vent flowpath; It is equipped with 10. A patient interface comprising: a vent assembly configured to: detect moisture in the vent assembly; and activate the activator when a certain level of moisture / humidity is present in the vent assembly.
2. 10. The patient interface of claim 1, wherein the sensor includes circuit tracks constructed and arranged to detect moisture and activate the activator.
3. 3. A patient interface according to claim 1 or 2, wherein the sensor is configured to transmit a control signal to activate the activator.
4. 4. The patient interface of claim 3, wherein the sensor is configured to send the control signal when a certain level of moisture / humidity is present in the vent assembly.
5. 5. A patient interface according to claim 3 or 4, wherein the control signal is configured to be transmitted for a predetermined period of time.
6. 6. A patient interface according to any one of claims 1 to 5, wherein the activator is configured to control airflow characteristics by controlling flow through the primary and secondary airflow paths.
7. 7. A patient interface according to any preceding claim, wherein the activator includes a displacement member configured to engage the membrane and deflect the membrane.
8. 8. A patient interface according to claim 7, wherein the displacement member comprises a plunger arrangement.
9. 9. A patient interface according to any one of claims 1 to 8, wherein the sensor is configured to provide a signal to an RPT device whereby the RPT device can alert the patient and / or update its operation.
10. 10. A patient interface according to any preceding claim, wherein the membrane includes a flap portion that is pivotable relative to the base.
11. the membrane is movable to an actuation position to cover and close the at least one second orifice due to pressure in the plenum chamber such that the ventilation gas flow is restricted to the primary ventilation flow path; and 11. A patient interface according to any one of claims 1 to 10, wherein the membrane is movable to expose and open at least one second orifice such that when the primary ventilation flowpath is obstructed, the ventilation gas flow is restricted to the secondary ventilation flowpath.
12. 12. A patient interface according to any preceding claim, wherein the diffusion member comprises a woven material.
13. 13. A patient interface according to any one of claims 1 to 12, wherein the diffusion member includes at least one orifice positioned to be aligned with at least one second orifice in the base.
14. 14. A patient interface according to any one of claims 1 to 13, wherein the secondary ventilation flow path bypasses the diffusing member so as to be able to provide ventilation gas flow in the event that the diffusing member becomes obstructed due to moisture or humidity.
15. 1. A CPAP system for providing a patient with positive pressure gas for respiratory therapy, comprising: The CPAP system comprises: an RPT device configured to deliver a gas flow at a therapeutic pressure; A patient interface according to any one of claims 1 to 14; an air delivery conduit configured to pass a flow of gas at the therapeutic pressure from the RPT device to the patient interface; A CPAP system comprising:
16. 1. A vent assembly configured to provide a vent gas flow for releasing gas from a pressurized volume to atmosphere, comprising: The vent assembly comprises: a base including at least one first orifice extending therethrough to allow gas from the pressurized volume to be released to the atmosphere along a primary vent flow path, and at least one second orifice extending therethrough to allow gas from the pressurized volume to be released to the atmosphere along a secondary vent flow path; a diffusing member constructed and arranged such that at least one of the first orifices is covered by the diffusing member, thereby directing air flow through the diffusing member along the primary air flow path, and such that at least one of the second orifices is not covered by the diffusing member, thereby directing air flow around the diffusing member along the secondary air flow path; a membrane disposed on the base, the membrane constructed and arranged to distribute gas vent flow along the primary vent flowpath and the secondary vent flowpath; an activator constructed and arranged to deflect the membrane to distribute the gas vent flow along the primary vent flowpath and the secondary vent flowpath; Including, 10. A vent assembly, comprising: a sensor configured to detect moisture in the vent assembly and to activate the activator when a certain level of moisture / humidity is present in the vent assembly.
17. 17. The vent assembly of claim 16, wherein the sensor includes a circuit track constructed and arranged to detect moisture and activate the activator.
18. 18. A vent assembly according to claim 16 or claim 17, wherein the sensor is configured to send a control signal to activate the activator.
19. 20. The vent assembly of claim 18, wherein the sensor is configured to send the control signal when a certain level of moisture / humidity is present in the vent assembly.
20. 20. A vent assembly according to claim 18 or claim 19, wherein the control signal is arranged to be transmitted for a predetermined period of time.
21. 21. A vent assembly according to any one of claims 16 to 20, wherein the activator is configured to control vent flow characteristics by controlling flow through the primary and secondary vent flow paths.
22. 22. A vent assembly according to any one of claims 16 to 21, wherein the activator comprises a displacement member configured to engage the membrane to deflect the membrane.
23. 23. A vent assembly according to claim 22, wherein the displacement member comprises a plunger arrangement.
24. 24. A venting assembly according to any one of claims 16 to 23, wherein the sensor is configured to provide a signal to an RPT device, whereby the RPT device can alert the patient and / or update its operation.
25. 25. A vent assembly according to any one of claims 16 to 24, wherein the membrane includes a pivotable flap portion.
26. the membrane is movable to an actuation position to cover and close the at least one second orifice due to pressure within the pressurized volume such that the vent gas flow is restricted to the primary vent flow path; and 26. A vent assembly as described in any one of claims 16 to 25, wherein the membrane is movable to uncover and open at least one second orifice so that the vent gas flow is restricted to the secondary vent flow path when the primary vent flow path is blocked.
27. 27. A vent assembly according to any one of claims 16 to 26, wherein the diffusing member comprises a woven material.
28. 28. A vent assembly according to claim 16 or claim 27, wherein the diffusing member includes at least one orifice positioned to be aligned with at least one of the second orifices.
29. 29. A vent assembly as described in any one of claims 16 to 28, wherein the secondary ventilation flow path bypasses the diffusing member so as to be able to provide ventilation gas flow in the event that the diffusing member becomes blocked due to moisture or humidity.
30. 30. A patient interface for delivering a supply of gas at positive pressure to an entrance to a patient's airway, the patient interface comprising a vent assembly according to any one of claims 16 to 29.
31. 30. An air delivery conduit for passing a gas flow between two components, the air delivery conduit comprising a vent assembly according to any one of claims 16 to 29.
Citation Information
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