High Nasal Gas Flow During Anaesthesia to Extend the Apnoeic Window
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Solution Overview
Problem
Patients undergoing medical procedures, particularly anesthesia, experience diminished respiratory function, leading to risks of hypoxia and hypercapnia due to inadequate oxygen supply and CO2 removal, which can result in apnoea and complications during intubation and post-operative care.
Innovation Solution
A method and apparatus utilizing high gas flow therapy to promote gas exchange through oxygenation and CO2 removal, employing a gas flow generator, humidifier, and patient interface to deliver high gas flow rates during various stages of medical procedures, including pre-oxygenation, apnoeic phases, and post-procedure recovery.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Quantity of substance
If traditional low gas flow methods are used for oxygenation during anesthesia, then the equipment complexity is low, but the patient's oxygenation is insufficient and CO2 removal is inadequate
Solution Approach 1:
The patent changes the flow rate parameter of the gas delivery system from traditional low flow (5-15 L/min) to high flow (30-150 L/min). This parameter change enables sufficient oxygenation and CO2 removal during anesthesia and apnoeic phases without requiring complex additional equipment, as the high flow itself provides the necessary gas exchange capability
Solution Approach 2:
The system performs preliminary oxygenation before the apnoeic phase by delivering high flow oxygen to saturate the patient's blood and fill the functional residual capacity. This preliminary action extends the safe apnoeic window by creating an oxygen reservoir that maintains oxygenation during periods when spontaneous breathing is suppressed
2Duration of action of moving object
If high gas flow rates are used to extend the apnoeic window, then oxygenation is improved, but the risk of barotrauma and airway damage increases
Solution Approach 1:
The system dynamically adjusts the gas flow rate based on the patient's respiratory phase and clinical needs. During spontaneous breathing, the flow is synchronized to provide high flow during inspiration and reduce during expiration. During apnoeic phases, high flow is maintained to extend the window. This dynamic adjustment prevents sustained high pressure that could cause barotrauma while achieving the goal of extending apnoeic duration
Solution Approach 2:
The system employs periodic high flow delivery synchronized with the patient's respiratory cycle when spontaneous breathing is present, and continuous high flow during apnoeic phases. This periodic action pattern allows the system to achieve extended apnoeic windows through pre-oxygenation and CO2 removal while minimizing continuous high pressure exposure that could lead to barotrauma
3Ease of operation
If high gas flow is delivered through nasal interfaces, then patient comfort is improved, but the device complexity increases
Solution Approach 1:
The patient interface is segmented into separate nasal prongs that can be independently positioned in each nostril. This segmentation allows the high flow to be distributed across two separate entry points rather than one, reducing the flow demand at each individual prong and minimizing nasal trauma while maintaining patient comfort and ease of use
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
Enhances respiratory support by maintaining adequate oxygenation and CO2 removal, extending the apnoeic window, and reducing complications such as hypoxia and atelectasis, facilitating safer and more efficient intubation and recovery.
Implementation Method 1
In certain embodiments, the high gas flow is humidified
Data Source
AI summary
Several methods of supporting respiratory function of a patient before, during and/or after a medical procedure are disclosed. In certain arrangements, supporting respiratory function while a patient is under general anaesthesia can include providing a high gas flow a high gas flow that is greater than 15 L/min while the patient is under general anaesthesia. In certain arrangements, a method of providing ventilation while a patient is under general anaesthesia involves providing only a gas flow delivered through a nasal interface that is greater than 15 L/min while the patient is under general anaesthesia.