Patent Publication Number: US-7713219-B2

Title: Combined air pulsator and movable pedestal

Description:
FIELD OF THE INVENTION 
   The invention relates to a portable medical device operable with a vest to apply repetitive compression forces to the body of a person to aid blood circulation, loosen and eliminate mucus from the lungs and trachea and relieve muscular and nerve tensions. 
   BACKGROUND OF THE INVENTION 
   Clearance of mucus from the respiratory tract in healthy individuals is accomplished primarily by the body&#39;s normal mucociliary action and cough. Under normal conditions these mechanisms are very efficient. Impairment of the normal mucociliary transport system or hypersecretion of respiratory mucus results in an accumulation of mucus and debris in the lungs and can cause severe medical complications such as hypoxemia, hypercapnia, chronic bronchitis and pneumonia. These complications can result in a diminished quality of life or even become a cause of death. Abnormal respiratory mucus clearance is a manifestation of many medical conditions such as pertussis, cystic fibrosis, atelectasis, bronchiectasis, cavitating lung disease, vitamin A deficiency, chronic obstructive pulmonary disease, asthma, and immobile cilia syndrome. Exposure to cigarette smoke, air pollutants and viral infections also adversely affect mucociliary function. Post surgical patients, paralyzed persons, and newborns with respiratory distress syndrome also exhibit reduced mucociliary transport. 
   Chest physiotherapy has had a long history of clinical efficacy and is typically a part of standard medical regimens to enhance respiratory mucus transport. Chest physiotherapy can include mechanical manipulation of the chest, postural drainage with vibration, directed cough, active cycle of breathing and autogenic drainage. External manipulation of the chest and respiratory behavioral training are accepted practices. The various methods of chest physiotherapy to enhance mucus clearance are frequently combined for optimal efficacy and are prescriptively individualized for each patient by the attending physician. 
   Cystic fibrosis (CF) is the most common inherited life-threatening genetic disease among Caucasians. The genetic defect disrupts chloride transfer in and out of cells, causing the normal mucus from the exocrine glands to become very thick and sticky, eventually blocking ducts of the glands in the pancreas, lungs and liver. Disruption of the pancreatic glands prevents secretion of important digestive enzymes and causes intestinal problems that can lead to malnutrition. In addition, the thick mucus accumulates in the lung&#39;s respiratory tracts, causing chronic infections, scarring, and decreased vital capacity. Normal coughing is not sufficient to dislodge these mucus deposits. CF usually appears during the first 10 years of life, often in infancy. Until recently, children with CF were not expected to live into their teens. However, with advances in digestive enzyme supplementation, anti-inflammatory therapy, chest physical therapy, and antibiotics, the median life expectancy has increased to 30 years with some patients living into their 50s and beyond. CF is inherited through a recessive gene, meaning that if both parents carry the gene, there is a 25 percent chance that an offspring will have the disease, a 50 percent chance they will be a carrier and a 25 percent chance they will be genetically unaffected. Some individuals who inherit mutated genes from both parents do not develop the disease. The normal progression of CF includes gastrointestinal problems, failure to thrive, repeated and multiple lung infections, and death due to respiratory insufficiency. While some patients experience grave gastrointestinal symptoms, the majority of CF patients (90 percent) ultimately succumb to respiratory problems. 
   Virtually all patients with CF require respiratory therapy as a daily part of their care regimen. The buildup of thick, sticky mucus in the lungs clogs airways and traps bacteria, providing an ideal environment for respiratory infections and chronic inflammation. This inflammation causes permanent scarring of the lung tissue, reducing the capacity of the lungs to absorb oxygen and, ultimately, sustain life. Respiratory therapy must be performed, even when the patient is feeling well, to prevent infections and maintain vital capacity. Traditionally, care providers perform Chest Physical Therapy (CPT) one to four times per day. CPT consists of a patient lying in one of twelve positions while a caregiver “claps” or pounds on the chest and back over each lobe of the lung. To treat all areas of the lung in all twelve positions requires pounding for half to three-quarters of an hour along with inhalation therapy. CPT clears the mucus by shaking loose airway secretions through chest percussions and draining the loosened mucus toward the mouth. Active coughing is required to ultimately remove the loosened mucus. CPT requires the assistance of a caregiver, often a family member but a nurse or respiratory therapist if one is not available. It is a physically exhausting process for both the CF patient and the caregiver. Patient and caregiver non-compliance with prescribed protocols is a well-recognized problem that renders this method ineffective. CPT effectiveness is also highly technique sensitive and degrades as the giver becomes tired. The requirement that a second person be available to perform the therapy severely limits the independence of the CF patient. 
   Artificial respiration devices for applying and relieving pressure on the chest of a person have been used to assist in lung breathing functions, and loosening and eliminating mucus from the lungs of CF persons. Subjecting the person&#39;s chest and lungs to pressure pulses or vibrations decreases the viscosity of lung and air passage mucus, thereby enhancing fluid mobility and removal from the lungs. An example of a body pulsating method and device disclosed by C. N. Hansen in U.S. Pat. No. 6,547,749, incorporated herein by reference, has a case accommodating an air pressure and pulse generator. A handle pivotally mounted on the case is used as a hand grip to facilitate transport of the generator. The case including the generator must be carried by a person to different locations to provide treatment to individuals in need of respiratory therapy. These devices use vests having air-accommodating bladders that surround the chests of persons. An example of a vest used with a body pulsating device is disclosed by C. N. Hansen and L. J. Helgeson in U.S. Pat. No. 6,676,614. The vest is used with an air pressure and pulse generator. Mechanical mechanisms, such as solenoid or motor-operated air valves, bellows and pistons are disclosed in the prior art to supply air under pressure to diaphragms and bladders in regular pattern or pulses. Manually operated controls are used to adjust the pressure of the air and air pulse frequency for each patient treatment and during the treatment. The bladder worn around the thorax of the CF person repeatedly compresses and releases the thorax at frequencies as high as 25 cycles per second. Each compression produces a rush of air through the lobes of the lungs that shears the secretions from the sides of the airways and propels them toward the mouth where they can be removed by normal coughing. Examples of chest compression medical devices are disclosed in the following U.S. patents. 
   W J Warwick and L G. Hansen in U.S. Pat. Nos. 4,838,263 and 5,056,505 disclose a chest compression apparatus having a chest vest surrounding a person&#39;s chest. A motor-driven rotary valve located in a housing located on a table allows air to flow into the vest and vent air therefrom to apply pressurized pulses to the person&#39;s chest. An alternative pulse pumping system has a pair of bellows connected to a crankshaft with rods operated with a dc electric motor. The speed of the motor is regulated with a controller to control the frequency of the pressure pulses applied to the vest. The patient controls the pressure of the air in the vest by opening and closing the end of an air vent tube. The apparatus must be carried by a person to different locations to provide treatment to persons in need of respiratory therapy. 
   M Gelfand in U.S. Pat. No. 5,769,800 discloses a vest design for a cardiopulmonary resuscitation system having a pneumatic control unit equipped with wheels to allow the control unit to be moved along a support surface. 
   N. P. Van Brunt and D J Gagne in U.S. Pat. Nos. 5,769,797 and 6,036,662 disclose an oscillatory chest compression device having an air pulse generator including a wall with an air chamber and a diaphragm mounted on the wall and exposed to the air chamber. A rod pivotally connected to the diaphragm and rotatably connected to a crankshaft transmits force to the diaphragm during rotation of the crankshaft. An electric motor drives the crankshaft at selected controlled speeds to regulate the frequency of the air pulses generated by the moving diaphragm. A blower delivers air to the air chamber to maintain the pressure of the air in the chamber. Controls for the motors that move the diaphragm and rotate the blower are responsive to the air pressure pulses and pressure of the air in the air chamber. These controls have air pulse and air pressure responsive feedback systems that regulate the operating speeds of the motors to control the pulse frequency and air pressure in the vest. The air pulse generator is a mobile unit having a handle and a pair of wheels. 
   SUMMARY OF THE INVENTION 
   The invention is a medical device used to deliver high-frequency chest wall oscillations to promote airway clearance and improve bronchial drainage in humans. The primary components of the device include an air-pulse generator, an air inflatable vest, and a flexible hose coupling the generator to the vest for transmitting air pressure and pressure pulses from the generator to the vest. The air-pulse generator is mounted on a pedestal having wheels that allow the generator to be moved to different locations to provide therapy treatments to a number of persons. The pedestal includes a linear lift that allows the elevation or height of the air-pulse generator to be adjusted to accommodate different locations and persons. The air-pulse generator includes a housing supporting generator controls for convenient use. The housing has a top handle used to manually transport the air-pulse generator. The housing is supported on and secured to a frame assembly joined to the top of the pedestal. The frame assembly has parallel horizontal members connected to a platform engaging the bottom of the housing of the air-pulse generator. Upright members joined to the horizontal members are fastened to opposite sides of the housing of the air-pulse generator. U-shaped handles joined to and extended outwardly from the upright members provide handles to facilitate movement of the pedestal and air-pulse generator. 

   
     DESCRIPTION OF DRAWING 
       FIG. 1  is a perspective view of the combined air pulsator and movable pedestal of our invention; 
       FIG. 2  is a front elevational view thereof; 
       FIG. 3  is a side elevational view of the right side thereof; 
       FIG. 4  is a side elevational view of the left side thereof; 
       FIG. 5  is a top plan view thereof; 
       FIG. 6  is a bottom plan view thereof; and 
       FIG. 7  is a rear elevational view thereof. 
   

   DESCRIPTION OF INVENTION 
   A portable human body pulsating apparatus  10 , shown in  FIGS. 1 and 4 , comprises an air-pulse generator  11  having a housing  12 . A movable pedestal  29  supports generator  11  and housing  12  on a surface, such as a floor. Pedestal  29  allows respiratory therapists and patient careperson to transport the entire human body pulsating apparatus to different locations accommodating a number of persons in need of respiratory therapy and to storage locations. 
   Human body pulsating apparatus  10  is used with a vest (not shown) to apply repetitive pressure pulse to a person&#39;s thorax to provide secretion and mucous clearance therapy. An example of a respiratory vest is disclosed by C N. Hansen and L H Helgeson in U.S. Pat. No. 6,676,614 incorporated herein by reference. Respiratory mucous clearance is applicable to many medical conditions, such as pertussis, cystic fibrosis, atelectasis, bronchiectasis, cavitating lung disease, vitamin A deficiency, chronic obstructive pulmonary disease, asthma, and immobile cilia syndrome. Post surgical patients, paralyzed persons, and newborns with respiratory distress syndrome have reduced mucociliary transport. Apparatus  10  provides high frequency chest wall oscillations or pulses to enhance mucus and airway clearance in a person with reduced mucociliary transport. High frequency pressure pulses subject to the thorax in addition to providing respiratory therapy to a person&#39;s lungs and trachea, also stimulates the heart and blood flow in arteries and veins in the chest cavity. Muscular and nerve tensions are also relieved by the repetitive pressure pulses imparted to the front, sides, and back portions of the thorax. The lower part of the thoracic cage comprises the abdominal cavity which reaches upward as high as the lower tip of the sternum so as to afford considerable protection to the large and easily injured abdominal organs, such as the liver, spleen, stomach, and kidneys. The abdominal cavity is only subjected to very little high frequency pressure pulses. 
   Housing  12  is a generally rectangular member having front and back walls  13  and  14  and side walls  26  and  27  joined to a top wall  16 . An arched member  17  having a horizontal handle  18  extended over top wall  16  is joined to opposite portions of top wall  16  whereby handle  18  can be used to manually carry air-pulse generator  11  and facilitate mounting air-pulse generator  11  on pedestal  29 . A control panel  19  mounted on top wall  16  has time coated keys  21  and frequency control keys  22  located on opposite sides of a visual control screen  23 . An air pressure control knob  24  is located on the left side of panel  19 . Control keys  21  and  22 , screen  23  and air pressure control knob  24  are in locations that are readily accessible by the respiratory therapists and user of apparatus  10 . The operating elements and functions and controls of air-pulse generator  11  are disclosed by C. N. Hansen, P. E. Cross and L. T. Helgeson in U.S. application Ser. No. 11/089,862 and incorporated herein by reference. An alternative air pulse generators are disclosed by C. N. Hansen in U.S. Pat. Nos. 6,488,641 and 6,547,749 incorporated herein by reference. 
   Person care homes, assisted living facilities and clinics can accommodate a number of persons in different rooms or locations that require respiratory therapy or high frequency chest wall oscillations as medical treatments. The portable pulsating apparatus  10  can be manually moved to required locations and connect with a flexible hose to a vest located around a person&#39;s thorax or other body members. The vest can be a single person garment designed to comfortably fit the person. 
   Pedestal  29 , shown in  FIGS. 1 to 7 , has an upright gas operated piston and cylinder assembly  31  mounted on a base  32  having outwardly extended legs  33 ,  34 ,  35 ,  36  and  37 . Other types of linear expandable and contractible devices can be used to change the location of generator  11 . Caster wheels  38  are pivotally mounted on the outer ends of legs  33 - 37  to facilitate movement of body pulsating apparatus  10  along a support surface. One or more wheels  38  are provided with releasable brakes to hold apparatus  10  is a fixed location. An example of a pedestal is disclosed in U.S. Pat. No. 5,366,275. The piston and cylinder assembly  31  is linearly extendable to elevate air-pulse generator  11  to a height convenient to the respiratory therapist or user. A gas control valve having a foot operated ring lever  39  is used to regulate the linear extension of piston and cylinder assembly  31  and resultant elevation of generator  11 . Generator  11  can be located in positions between its up and down positions. Lever  39  and gas control valve are operative associated with the lower end of piston and cylinder assembly  31 . 
   As shown in  FIGS. 5 and 6 , a frame assembly  41  having parallel horizontal members  42  and  43  and a platform  44  mounts housing  12  on top of upright piston and cylinder assembly  31 . The upper member of piston and cylinder assembly  31  is secured to the middle of platform  44 . The opposite ends  46  and  47  of platform  44  are turned down over horizontal members  42  and  43  and secured thereto with fasteners  48  and  49 . Upright inverted U-shaped arms  51  and  52  joined to opposite ends of horizontal members  42  and  43  are located adjacent opposite side walls  26  and  27  of housing  12 . As shown in  FIGS. 3 and 4 , fasteners  53  and  54  secure arms  51  and  52  to opposite side walls  26  and  27  of housing  12 . U-shaped handles  56  and  57  are joined to and extend outwardly from arms  51  and  52  provide hand grips to facilitate manual movement of the air-pulse generator  11  and pedestal  29  on a floor or carpet. As shown in  FIGS. 1 and 3 , an electrical female receptacle  58  mounted on side wall  27  faces the area surrounded by arm  51  so that arm  51  protects the male plug (not shown) that fits into receptacle  58  to provide electric power to air-pulse generator  11 . As shown in  FIG. 4 , a tubular air outlet sleeve  59  is mounted on side wall  26  of housing  12 . The hose leading to the vest telescopes into sleeve  59  to allow air and air pressure pulses to travel in the hose to the vest to apply pressure pulses to a person&#39;s body. 
   The advantages and details of structures and functions of the preferred embodiments have been disclosed. They are exemplary and other equivalents are feasible. Therefore, changes in shape, size, elements, and arrangement of pedestal and generator structures can be made by a person skilled in the area within the scope of the invention.