System for performing remote ischemic conditioning

Abstract

A system for performing remote ischemic conditioning includes an inflatable cuff configured to encircle a limb of a subject and a controller removably attached to the cuff. The controller includes a pump; a manifold in fluid communication with the pump; a connector in fluid communication with the manifold and in removable fluid communication with the inflatable cuff; a pressure sensor; and a control circuit configured to implement a remote ischemic conditioning treatment protocol.

What is claimed is: 
     
       1. A device for remote ischemic conditioning comprising:
 an inflatable cuff configured to encircle a limb of a subject; 
 a controller removably attached to the cuff, wherein the controller comprises:
 a manifold configured to provide fluid communication between the controller and the cuff; 
 an outlet in fluid communication with the manifold and in removable fluid communication with the inflatable cuff; and 
 a control circuit configured to implement a remote ischemic conditioning treatment protocol; and 
 
 a controller attachment section joined to the cuff, the controller attachment section having a bottom surface that substantially conforms to an outer surface of the cuff, wherein the controller is removably attached to the cuff by selective attachment to the controller attachment section disposed on the cuff, the controller attachment section further comprising:
 an upper surface for supporting the controller in an attached state; 
 an upstanding wall surrounding the upper surface; 
 a tab mounted at one end of the upper surface and including a projecting edge spaced from the upper surface, the projecting edge facing outwardly toward the upstanding wall; and 
 bosses disposed on the upstanding wall on the opposite side of the controller attachment section from the tab; 
 
 wherein the controller further comprises a slot that is disposed between a body of the controller and an outer band, and wherein the device is arranged such that when the controller is attached to the controller attachment section, an upper portion of the tab is pushed inwardly away from the upstanding wall so that the tab passes through the slot, and the bosses extend into corresponding recesses provided in the controller body. 
 
     
     
       2. The device of  claim 1 , wherein the controller attachment section further includes a conduit that provides sealed, fluid communication between the controller and inflatable cuff. 
     
     
       3. The device of  claim 1 , wherein cuff pressure is controllable by selectively opening a valve of the controller in response to a command from control circuitry of the control circuit. 
     
     
       4. The device of  claim 3 , wherein the controller attachment section provides fluid communication between the controller and a bladder of the cuff via a structure that includes a conduit that has a female section constructed and arranged to mate with the controller outlet and a male section that is constructed and arranged to mate with a valve of the bladder of the cuff. 
     
     
       5. The device of  claim 1 , wherein:
 an axial direction of the cuff is substantially parallel to an axis of the limb when the cuff is in a fitted state; 
 the controller attachment section is operatively attached to the cuff by at least one attachment joint oriented substantially parallel to the axial direction of the cuff; and 
 the controller attachment section provides fluid communication between the controller and the cuff. 
 
     
     
       6. The device of  claim 1 , wherein the controller comprises a slow continuous relief valve that continually releases gas from the cuff at a flow rate lower than a flow rate of the gas being introduced into the cuff. 
     
     
       7. The device of  claim 1 , wherein the controller further comprises at least one valve configured to open in response to an overpressure event, or in response to an error command from the control circuit. 
     
     
       8. The device of  claim 7 , wherein the valve opens in response to a command from the controller when a specified condition is detected. 
     
     
       9. The device of  claim 1 , wherein the control circuit maintains a cuff pressure between pre-selected pressure limits during an ischemic duration of the remote ischemic conditioning treatment protocol. 
     
     
       10. A device for remote ischemic conditioning comprising:
 an inflatable cuff configured to encircle a limb of a subject; 
 a controller removably attached to the cuff, wherein the controller comprises:
 a manifold configured to provide fluid communication between the controller and the cuff; 
 an outlet in fluid communication with the manifold and in removable fluid communication with the inflatable cuff; and 
 a control circuit configured to implement a remote ischemic conditioning treatment protocol; and 
 
 a controller attachment section joined to the cuff, the controller attachment section having a bottom surface that substantially conforms to an outer surface of the cuff, wherein the controller is removably attached to the cuff by selective attachment to the controller attachment section disposed on the cuff; 
 wherein cuff pressure is controllable by selectively opening a valve of the controller in response to a command from control circuitry of the control circuit; 
 wherein the controller attachment section provides fluid communication between the controller and a bladder of the cuff via a structure that includes a conduit that has a female section constructed and arranged to mate with the controller outlet and a male section that is constructed and arranged to mate with a valve of the bladder of the cuff; and 
 wherein the controller outlet has an outer dimension at an end spaced from the controller, and the female section of the conduit has an upper opening that is configured to receive the end of the controller outlet, a cross-sectional size of the upper opening of the female section being greater than the outer dimension of the controller outlet and greater than an inner dimension of the male section. 
 
     
     
       11. The device of  claim 10 , further comprising an O-ring seal disposed within the upper opening of the female section, the O-ring seal surrounding and sealing the controller outlet when disposed within the female section. 
     
     
       12. The device of  claim 11 , wherein a mouth of the upper opening of the female section includes a retaining structure that has an upper surface that forms an acute angle with respect to a direction of elongation of the controller outlet. 
     
     
       13. A device for remote ischemic conditioning comprising:
 an inflatable cuff configured to encircle a limb of a subject;   a controller removably attached to the cuff, wherein the controller comprises:
 an outlet in removable fluid communication with the inflatable cuff; and 
 a control circuit configured to implement a remote ischemic conditioning treatment protocol; 
   wherein cuff pressure is controllable by selectively opening a valve of the controller in response to a command from control circuitry of the control circuit;   wherein fluid communication between the controller and a bladder of the cuff is provided via a structure that includes a conduit that has a female section constructed and arranged to mate with the controller outlet and a male section that is constructed and arranged to mate with a valve of the bladder of the cuff; and   wherein the controller outlet has an outer dimension at an end spaced from the controller, and the female section of the conduit has an upper opening that is configured to receive the end of the controller outlet, a cross-sectional size of the upper opening of the female section being greater than the outer dimension of the controller outlet.    
     
     
       14. The device of claim 13, wherein the inflatable cuff comprises:
 at least two flexible sections spaced apart in a longitudinal direction of the cuff and an intermediate section disposed between the two flexible sections, the intermediate section having a greater rigidity than the two flexible sections; and   a plurality of reinforcing structures disposed on at least one of the two flexible sections and being elongated in an axial direction substantially perpendicular to the longitudinal direction of the cuff, wherein when the cuff is inflated, the reinforcing structures distribute pressure applied by the cuff in the axial direction.    
     
     
       15. The device of claim 14, wherein the plurality of reinforcing structures are spaced apart in a longitudinal direction, and are generally parallel to one another to permit the cuff to bend around an encircled limb while providing increased rigidity in the direction generally perpendicular to the longitudinal direction.  
     
     
       16. The device of claim 14, wherein the reinforcing structures are curved.  
     
     
       17. The device of claim 14, wherein the reinforcing structures are generally linear.  
     
     
       18. The device of claim 14, wherein the reinforcing structures are integrally formed with the flexible sections.  
     
     
       19. The device of claim 18, wherein the reinforcing structures comprise portions of the flexible sections which are uncompressed.  
     
     
       20. The device of claim 14, wherein the reinforcing structures are formed by providing alternating areas of compressed foam and uncompressed foam.  
     
     
       21. The device of claim 14, wherein the reinforcing structures are formed separately from the flexible sections and are attached to at least one of the two flexible sections after formation of the flexible sections.  
     
     
       22. The device of claim 14, wherein the reinforcing structures extend substantially across a width of the cuff.  
     
     
       23. The device of claim 22, wherein the reinforcing structures distribute pressure applied by the cuff across the width of the cuff in the axial direction.  
     
     
       24. The device of claim 14, wherein the reinforcing structures assist in preventing kinks in the cuff assembly.  
     
     
       25. The device of claim 14, further compromising: an outer layer; an inner layer; and an inflatable bladder disposed between the inner layer and the outer layer.  
     
     
       26. The device of claim 25, wherein the reinforcing structures are formed on the outer layer.  
     
     
       27. The device of claim 25, further comprising at least one non-slip structure disposed on an exterior face of the inner layer and configured to face the limb of the subject.  
     
     
       28. The device of claim 27, wherein the non-slip structure comprises a strip formed of silicone.  
     
     
       29. The device of claim 25, wherein the inner layer is formed of a soft, non-irritating material.  
     
     
       30. The device of claim 25, wherein the inner layer is configured to provide moisture absorption, wicking, and/or breathability to the cuff.  
     
     
       31. The device of claim 30, wherein the inner layer comprises a cloth material.  
     
     
       32. The device of claim 31, wherein the cloth material comprises a felt.  
     
     
       33. The device of claim 25, wherein a fluid inlet to the bladder extends from the bladder through the intermediate section of the outer layer.  
     
     
       34. The device of claim 14, further comprising a fastener to couple together ends of the two flexible sections about the limb of the subject.  
     
     
       35. The device of claim 34, wherein the fastener comprises a hook and loop fastener.  
     
     
       36. The device of claim 14, wherein the intermediate section comprises:
 a substantially planar upper surface;   an attachment device configured to removably attach the controller to the upper surface; and   the conduit.    
     
     
       37. The device of claim 36, wherein the intermediate section comprises a curved inner surface extending in the longitudinal direction of the cuff.  
     
     
       38. The device of claim 14, further comprising a controller attachment section disposed on the intermediate section, the controller attachment section being configured to permit removable attachment of the controller.  
     
     
       39. The device of claim 38, wherein the controller attachment section is joined to the intermediate section by two attachment joints that are aligned in a direction generally perpendicular to the longitudinal direction of the cuff.  
     
     
       40. A device for remote ischemic conditioning comprising:
 an inflatable cuff configured to encircle a limb of a subject;   a controller removably attached to the cuff; and   a controller attachment section joined to the cuff, the controller attachment section having a bottom surface that substantially conforms to an outer surface of the cuff, wherein the controller is removably attached to the cuff by selective attachment to the controller attachment section disposed on the cuff, the controller attachment section further comprising:
 an upper surface for supporting the controller in an attached state; an upstanding wall surrounding the upper surface; and 
 a tab mounted at one end of the upper surface and including a projecting edge spaced from the upper surface, the projecting edge facing outwardly toward the upstanding wall; 
   wherein the controller further comprises a slot that is disposed between a body of the controller and an outer band, and wherein the device is arranged such that when the controller is attached to the controller attachment section, an upper portion of the tab is pushed inwardly away from the outstanding wall so that the tab passes through the slot.