US 6,776,155 B2Grant
Nasal ventilation as a treatment for stroke
Issue Date:2004-08-17
•2 Claims
Abstract
A new treatment and apparatus for acute and chronic treatment is described here which incorporates nasal ventilation, with or without concomitant drug therapy, using continuous positive airway pressure (CPAP) or bi-level pressure treatment or variants thereof, including devices which automatically set their pressures based on physiologic data inputs.
Metadata
Assignee
- ResMed Limited
Inventors
- Peter Craig Farrell
- Gary William Pace
Application Information
Application Number:US 09/996,769
Filing Date:2001-11-30
Priority Date:1997-05-16
Art Unit:7
Classifications
IPC:
A61M 1500A61M 1600
Field of Search:
1282041812820421128204231282042512820426
Patent Drawings
This patent does not have any drawings.
Description
Cross Reference to Related Applications
[0002] This application is a divisional of U.S. application Ser. No. 09/079,848, filed May 15, 1998 now U.S. Pat. No. 6,336,454 which claims priority from U.S. Provisional Application No. 60/046,745, filed May 16, 1997, the specifications of which are incorporated herein by reference.
Field of the Invention
[0003] The present invention relates to a method of treatment and apparatus for stroke patients.
Background of the Invention
[0004] Stroke, or brain attack as it is commonly called, can be caused by either vascular hemorrhage or vascular blockage with the latter accounting for about 80% of the events which lead to a stroke. Stroke is associated with considerable morbidity in terms of long-term neurological deficit and the risk of subsequent stroke as well as mortality post stroke is considerable in stroke patients. Treatment in the acute phase typically entails the invasive administration of clot dissolving drugs within the first three hours of the stroke as well as stabilization of cardiovascular function and vital signs. Post stroke therapy can include intensive and costly rehabilitation depending on the degree of neurological deficit.
[0005] Continuous positive airway pressure (hereinafter CPAP) has been identified as a method of treatment for sleep disorders, and in particular, sleep apnea. The application of CPAP for sleep disorders was first introduced in U.S. Pat. No. 4,944,310. This patent described the application of continuous positive airway pressure being applied to the patient, through the patient's nares, to treat sleep disorders, including obstructive sleep apnea. It has been found that the application of pressure which exceeds atmospheric pressure, typically 4 to 15 centimeters of H2O is useful in treating sleep disorders. However, prior to this invention, the application of CPAP as a method for treating stroke patients has never been known.
[0006] There exists a need for a method of treatment for stroke patients which is non-invasive, and does not include the use of drugs.
[0007] There also exists a need for the treatment of stroke patients which is inexpensive and does not require a medical facility or hospital.
Summary of the Invention
[0008] A new treatment and apparatus for acute and chronic treatment of stroke patients is described here which incorporates nasal ventilation, with or without concomitant drug therapy, using continuous positive airway pressure (CPAP) or bi-level pressure treatment or variants thereof, including devices which automatically set their pressures based on physiologic data inputs.
Detailed Description of the Preferred Embodiment
[0009] Nasal CPAP treatment has been traditionally used for the management of patients with obstructive sleep apnea where CPAP acts as a pneumatic splint to maintain upper airway patency and therefore ensures free flow of air while the patient sleeps. The current invention describes the use of positive pressure ventilation, which may include CPAP, bi-level pressure, or variants thereof, for stroke patients. The use of CPAP treats stroke patients by improving arterial blood oxygen levels and reducing arterial carbon dioxide levels as well as improving auto-regulation of, for example, blood pressure, cardiac output and ventilation. Improvements in morbidity, such as rate and degree of recovery of vital signs and patient stabilization in the acute phase, is an expected benefit. Also, an improvement in neurological deficits in the short and/or long term is an expected benefit.
[0010] It is understood that while the invention has been described above in conjunction with the preferred method and preferred embodiment, the description and examples are intended to illustrate but not limit the scope of the invention, which is defined by the scope of the following claims.
Claims
We claim:
1. A method for the treatment of a patient who is suffering from an incident of stroke comprising the steps of:
providing a device for the delivery of positive pressure airway treatment at a pressure which exceeds atmospheric pressure, the device comprising (a) an airflow generator; (b) an interface adapted to fit a patient; and (c) a conduit for the flow of air from said generator to said interface; and
delivering treatment with said device to said patient during an acute phase of an incident of stroke in said patient to improve the patient's blood oxygen level, the acute phase being defined as the first three hours from onset of the incident of stroke.
2. The method of claim 1 wherein the airflow generator is configured and arranged to deliver a bi-level positive pressure airway treatment.
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- Fisher & Paykel HEalthcare; HC200 Series Nasal CPAP Blower & Heated Humidifier.Applicant
- Pierre Medical; Morphee Plus apparaeil de traitment des apnees du sommmeil manuel d'utillsation.Applicant
- Weinmann:Hamburg; Somnotron nCPAP-Gerat WM 23000, 11/91.Applicant
- Puritan Bennett; 515a Part of Our Blueprint for the Future; 03/90.Applicant
- Puritan Bennett; Companion 320 I/E Bi-Level Respiratory System; 4/93.Applicant
- ResMed; Sullivan VPAP II & II ST.Applicant
- ResMed; The Sullivan V Family of CPAP Systems; 1996.Applicant
- ResMed; The AutoSet Portable II; 1997.Applicant
- ResMed; Sullivan Nasal CPAP System.Applicant
- ResMed; The Sullivan IIID; 1995.Applicant
- ResMed; The Sullivan Comfort; 1996.Applicant
- DeVilbiss a Division of Sunrise Medical; Expand your Horizons With The Horizons; 1995.Applicant
- Healthdyne Technologies; Home Health Care Dealer; The Journal of Home Medical Equipment and Services/Supplier; Nov. and Dec. 1997.Applicant
- Healthdyne International; Tranquility Quest, The Compact CPAP for Greater patient comfort.Applicant
- AirStep; Medical Products . . . Stand the Test of Time.Applicant
- MAP Medical Progress for Physician und Patient; The Gentle Therapy for Sleep-Related Breathing Disorders.Applicant
- Taema; Ventilation CP 90, 5/95.Applicant
- DPAP; Breath, by breath, by breath.Applicant
- Lifecare; Smallest. Quietest. Smartest.Applicant
- Lifecare; Quiet CPAP System for Maximum Compliance; 1991.Applicant
- Lifecare; Software Nasal Mask, Custom Nasal Masks; 1991.Applicant
- Nidek Medical; Silenzio.Applicant
- Weinmann; Just to Feel Well, Sensitive Sleep Apnea Therapy with Somnotron 3 and Somno-Mask System.Applicant
- Respironics Inc.; Aria CPAP System; 1993.Applicant
- Respironics Inc.; SleepEasy III A New Dawn in Patient Compliance.Applicant
- Respironics Inc.; Muliple Choice REMstar Choice Nasal CPAP System, 1993.Applicant
- Maxil nCPAP and Moritz II Bi-Level Brochure.Applicant
- Derwent: Flowmeter for fluids-has turbine transducer and volumetric sensor for simultaneous calibration, 1995.Applicant
- Mark Kantrowitz, Erik Horskotte and Cliff Joslyn; “Answers to Frequently Asked Questions about Fuzzy Logic and Fuzzy Expert Systems” Version 1.24 last Modified Feb. 20, 1996.Applicant
- Pressman et al., “Transient Ischemic Attacks and Minor Stroke During Sleep—Relationship to Obstruction Sleep Apnea Syndrome,” pp. 2361-2365, Dec., 1995, STROKE vol. 26 No. 12.Applicant
- Pressman et al., “Transient Ischemic Attacks and Minor Stroke During Sleep—Relationship to Obstruction Sleep Apnea Syndrome,” Stroke, vol. 26, No. 12, Dec. 1995, pp. 2361-2365.Applicant
- Puritan/Bennett Companion, 320 I/E Bi-Level Respiratory System Clinical Manual (for part # 799959 Rev.).Applicant
- Nachtmann et al., “Cheyne-Stokes Respiration in Ischemic Stroke,” Neurology 45, pp. 820-821.Applicant
- Bassetti et al., “Sleep Apnea in Patients With Transient Ischemic Attack and Stroke, a Prospective Study of 59 Patients,” Neurology 47, pp. 1167-1173.Applicant
- Krachman et al., Comparison of Oxygen Therapy With Nasal CPAP on Cheyne-Stoked Respiration During Sleep in Congestive Heart Failure, Chest, V. 116, No. 16, pp. 1550-1565.Applicant
- Good et al., “Stroke and Sleep Apnea,” Neurology Network Commentary vol. 1, pp. 269-275.Applicant
- Good et al., “Sleep-Disordered Breathing and poor Functional Outcome After Stroke,” Stroke vol. 27, No. 2, pp. 252-259.Applicant
- Dyken et al., Investigating the Relationship Between Stroke and Obstructive Sleep Apnea, Stroke vol. 27, No. 3, pp. 401-407.Applicant