Ventilating apparatus and method enabling a patient to talk with or without a trachostomy tube check valve

Abstract

A method of operating a ventilator assembly having inhalation and exhalation passages communicating with one another, and a respiration assembly that can perform repetitive respiratory cycles. The method includes (a) connecting the conduit with an open end of an endotracheal tube positioned within the trachea so that the open end leads into the airway below the vocal cords, (b) repetitively cycling the respiration assembly so that during the inhalation phase, gas in the inhalation passage flows through the endotracheal tube and into the airway, and during the exhalation phase, an exhalation valve is maintained relatively closed and the exhaled gases flow pass the vocal cords and out of the mouth thereby facilitating the patient's ability to speak, and (c) monitoring ring the pressure within at least one of the passages during both phases for determining the pressure within the patient for use in operating the ventilator assembly.

1 - 11 . (canceled) 
     
     
         12 . A patient ventilator assembly for connection with an endotracheal tube constructed and arranged to be installed through a patient's trachea below the patient's vocal cords so that an exterior open end of the tube is exterior of the patient and an interior open end of the tube communicates with the patient's airway and lungs, the ventilator assembly comprising:
 a conduit for connection with the exterior open end of the endotracheal tube and providing inhalation and exhalation passages communicating with one another;   proportionally controlled inhalation and exhalation valves in the inhalation and exhalation passages, respectively; and   a controller for controlling the proportionally controlled inhalation valve and the proportionally controlled exhalation valve so as to provide repetitive respiratory cycles, each including an inhalation phase and an exhalation phase, wherein during the inhalation phase the proportionally controlled inhalation valve is relatively open and the proportionally controlled exhalation valve is relatively closed and a flow of gas is allowed to pass through the inhalation passage and the tube into the patient's airway and lungs, the controller controlling the proportionally controlled exhalation valve for use in two exhalation phase modes, the two modes including:   (1) a first mode wherein the proportionally controlled exhalation valve is relatively open during the exhalation phase, allowing the gas in the patient's airway and lungs after the preceding inhalation phase to pass through the relatively open proportionally controlled exhalation valve and through an outlet of the ventilator assembly, and   (2) a second mode wherein the proportionally controlled exhalation valve is maintained relatively closed so the patient causes the gas in the patient's airway and lungs after the preceding inhalation phase to flow past the patient's vocal cords and out of the patient's mouth, thus facilitating the patient's ability to talk.   
     
     
         13 . A patient ventilator assembly as defined in  claim 12 , wherein the controller comprises an exhalation controller module that controls the exhalation valve and an inhalation controller module that controls the inhalation valve. 
     
     
         14 . A patient ventilator assembly as defined in  claim 12 , wherein the controller comprises a first algorithm for controlling the inhalation valve and a second algorithm for controlling the exhalation valve. 
     
     
         15 . A patient ventilator assembly according to  claim 12 , wherein the exhalation valve is completely closed during the exhalation phase. 
     
     
         16 . A patent ventilator assembly according to  claim 12 , wherein the exhalation valve is completely closed during the inhalation phase. 
     
     
         17 . A patient ventilator assembly according to  claim 12 , wherein the exhalation valve is controlled by the controller to be closed sufficiently during the inhalation phase to enable a desired pressure to build within the conduit. 
     
     
         18 . A patient ventilator assembly according to  claim 12 , wherein the exhalation valve is controlled by the controller to be closed sufficiently during the exhalation phase to maintain a desired pressure in the conduit. 
     
     
         19 . A patient ventilating apparatus as defined in  claim 12 , wherein the ventilator assembly includes at least one pressure monitor communicating with the passages for purposes of determining the existing pressure conditions in the patient's airway and lungs, the pressure monitor operatively connected with the controller for operating the inhalation and exhalation valves. 
     
     
         20 . A patient ventilating apparatus as defined in  claim 19 , wherein the at least one pressure monitor is capable of detecting occlusions in the conduit and disconnections of the conduit. 
     
     
         21 . A patient ventilating apparatus as defined in  claim 12 , wherein the endotracheal tube is devoid of a check valve so that communication between the passages and the patient's airway and lungs while the exhalation valve is in the first mode thereof is through the exterior tube end in both directions. 
     
     
         22 . A patient ventilating apparatus as defined in  claim 12 , wherein the inhalation and exhalation valves form part of a respiration assembly. 
     
     
         23 . A patient ventilating apparatus comprising:
 an endotracheal tube constructed and arranged to be installed into a patient's trachea below the patient's vocal cords so that an exterior open end thereof is exterior of the patient and an interior open end thereof communicates with the patient's airway and lungs;   a conduit connected with the exterior open end of the tube and providing inhalation and exhalation passages communicating with one another;   a respiration assembly constructed and arranged to provide repetitive respiratory cycles, each including (a) an inhalation phase during which a proportionally controlled inhalation valve in the inhalation passage is relatively open and a proportionally controlled exhalation valve in the exhalation passage is relatively closed, and wherein a flow of gas is allowed to pass through the inhalation passage and the endotracheal tube into the patient's airway and lungs and (b) an exhalation phase during which the proportionally controlled inhalation valve is relatively closed and the proportionally controlled exhalation valve is maintained relatively closed causing the gas in the patient's airway and lungs after the preceding inhalation phase to flow past the patient's vocal cords and out of the patient's mouth, thus facilitating the patient's ability to talk;   a check valve operatively coupled to the endotracheal tube, the check valve improving the patient's ability to speak, the check valve being operable to trap pressure within the patient's lungs at the end of the inhalation phase when both the proportionally controlled inhalation and exhalation valves are relatively closed so as to allow pressure in the passages at the end of each inhalation phase to substantially equalize with the pressure within the patient's airway and lungs during the exhalation phase;   a controller that controls operation of the proportionally controlled inhalation valve and the proportionally controlled exhalation valve; and   at least one pressure monitor for monitoring the pressure in the inhalation and exhalation passages during both inhalation and exhalation phases, the pressure monitor being operatively connected with the controller to provide input signals to the controller that are used in controlling the proportionally controlled inhalation valve and the proportionally controlled exhalation valve.   
     
     
         24 . The patient ventilating apparatus of  claim 23 , wherein during the inhalation phase, the flow of gas is allowed to pass through the exhalation valve. 
     
     
         25 . A patient ventilator assembly for connection with an endotracheal tube constructed and arranged to be installed through a patient's trachea below the patient's vocal cords so that an exterior open end of the tube is exterior of the patient and an interior open end of the tube communicates with the patient's airway and lungs, the ventilator assembly comprising:
 a conduit for connection with the exterior open end of the endotracheal tube and providing an inhalation passage and an exhalation passage communicating with one another,   a proportionally controlled inhalation valve operatively coupled to the inhalation passage;   a proportionally controlled exhalation valve operatively coupled to the exhalation passage; and   a controller for controlling the proportionally controlled inhalation valve and the proportionally controlled exhalation valve so as to provide repetitive respiratory cycles, each including an inhalation phase and an exhalation phase, wherein during the inhalation phase the proportionally controlled inhalation valve is relatively open and the proportionally controlled exhalation valve is relatively closed and a flow of gas is allowed to pass through the inhalation passage and the tube into the patient's airway and lungs, the controller controlling the proportionally controlled exhalation valve for use in two exhalation phase modes, the two modes including:   (1) a first mode wherein the proportionally controlled exhalation valve is relatively open during the exhalation phase, allowing the gas in the patient's airway and lungs after the preceding inhalation phase to pass through the relatively open proportionally controlled exhalation valve and through an outlet of the ventilator assembly, and   (2) a second mode wherein the proportionally controlled exhalation valve is maintained relatively closed so the patient causes the gas in the patient's airway and lungs after the preceding inhalation phase to flow past the patient's vocal cords and out of the patient's mouth, thus facilitating the patient's ability to talk wherein the conduit is devoid of a check valve.   
     
     
         26 . A method as defined in claim  1 , comprising an act of maintaining a desired pressure in the conduit by controlling the relative opening and closing of at least one of the proportionally controlled inhalation and exhalation valves. 
     
     
         27 . A patient ventilator assembly according to  claim 12 , wherein the relative opening and closing of at least one of the proportionally controlled inhalation and exhalation valves is controlled by the controller to maintain a desired pressure in the conduit.