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GROUP 06

DEVELOPMENT OF A CONTINUOUS POSITIVE AIRWAY PRESSURE DEVICE
Project advisor: Dr Hans Gray Group members: Wimalarathna H.G.D.B.S. 060558U Thotamuna T.K.M.N. 060494T Weerasinghe B.K.S. 060523J
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CONTENTS
INTRODUCTION 2 LITERATURE SURVEY 3
PROJECT BACKGROUND EXISTING DEVICES KEY COMPONENT
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INTRODUCTION
v Continuous positive airway pressure (CPAP) treatment commonly used to treat breathing disorders.

v Existing device costs nearly two million rupees.
§ It is not affordable for many of the hospitals. § Hard to deal with technical issues.

v Available device is designed for ICU’s wall air and oxygen supply.
§ Have to be kept in the NICU. § Difficult to use in an ambulance.

v v

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OBJECTIVES
v Construct a low-cost CPAP machine with following features
§ Mix oxygen and air to a given ratio as determined by a physician § Pressure 3-7 water cm, §O2 CPAP 21-100% O2 §Air § Ability to set the flow rate of the mixture up to a limit of 15 ℓ/min § § Supply the mixture at a predetermined pressure (3-7 water centimetres) § § The device should be portable enough to be carried in an ambulance § 4 §

METHODOLOGY
v Conduct a survey on problems related with ventilation, existing devices and identify the drawbacks v Collect the possible solutions and identify the best or feasible frame for the device v Analyze the flow and pressure variations using suitable method v Design the device v Construct the device with appropriate materials and suitable manufacturing process v Test the device in laboratory conditions
v v
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WHAT IS CPAP

“Breathing Against A Threshold of Resistance”

“Oxygen Therapy In It’s Most Efficient Form”

v 1971 - Term CPAP introduced, used to treat HMD in neonates (Hyaline Membrane Disease). v CPAP is a device that helps to breathe and does not breathe machine for the patient. v v

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CPAP TREATMENT
DISEASES

Respiratory Distress Syndrome (RDS) Premature infant cannot get enough air into their lungs (respiratory distress) due to lack of surfactant.

Obstructive Sleep Apnea (OSA) Airway of the some people, becomes blocked or collapse, while they are sleeping.

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RESPIRATORY DISTRESS SYNDROME

Figure 1 v Premature infants have lack of surfactant v Surfactant helps keeps lungs open when Figure 2 breathing va soap-like coating that prevents the interior of the alveoli from sticking together v v
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CPAP and Partial Pressure
v CPAP is a treatment, not a cure and it is a oxygen therapy. v Deliver constant flow of air into patient airway. v The CPAP machine creates enough pressure in your airway to hold the tissue open, so your airway does not collapse. v 7cm H2O CPAP increases the partial pressure of the alveolar air by approximately 1%. v This increase in partial pressure ‘forces’ more oxygen into the blood. v   partial pressure of oxygen is 760 X 21% = 159mm Hg

v

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Important Aim Of CPAP
• Increased Functional Residual Capacity (FRC)

Volume of gas remaining in lungs at end-expiration

• Volume of gas remaining in lungs at end-expiration • Reduced work of breathing • CPAP distends alveoli preventing collapse on expiration • Greater surface area improves gas exchange

v
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TREE OF VENTILATORS

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INTERFACES WITH CPAP

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ADVANTAGES AND DISADVANTAGES OF VARIOUS INTERFACES
Interface Endotracheal Tube Head box Mask or CPAP mask Nasal Prongs Advantages Stable, good control & ventilator access Easy application Easiest application Disadvantages Invasive, airway resistance Leak, high flow, access difficult Oral care difficult , leaks, erosion of the boundary

Easy, low resistance, easy Septal erosion, nasal feeding, non-invasive obstruction Non-invasive , easy feeding Leaks, pressure necrosis

Nasotracheal tube

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CPAP DEVICES-Bubble CPAP devices
Advantages: ♣Simple and low costly method ♣Chest vibration generated due to bubble CPAP improves gas exchange in the lungs Disadvantages: ♣Can not be used in an ambulance ♣Fluctuation of pressure ♣Stagnant CO2 due to the expanding alveoli caused by labored breathing

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CPAP DEVICES-Infant flow CPAP system

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FEATURES OF INFANT FLOW CPAP SYSTEM
♣ Detection of supply gases failure: If the differential pressure between the two inlet gases falls outside the limit of 2 bar or one gas fails completely an alarm will sound and the gas at the higher pressure only will be delivered to the patient ♣ Electronic over pressure valve: at 11cm H2O a solenoid control valve will instantaneously vent to ambient and alarm. After 3 seconds the Infant FlowTM Driver will attempt to restore flow to the patient circuit ♣ System safety pressure pop off valve: It activates at peak control pressure and it prevents the circuit and humidifier from over pressure. The patient is not subjected to these pressures.
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Introduction to CPAP system
q A CPAP system basically consist of four main units

 

1. Flow generation unit
 Blower based  ICU compressed system

2. Pressure controlling unit
 Bubble CPAP  Electronic pressure control system  Blower speed controlling

3. Air-Oxygen mixing unit (FiO2 blender)
 Manual flow control FiO2 blenders  Electronically controlled blenders  Mechanical gas blenders

4. Humidifier

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Bubble CPAP system

the expiratory circuit is submerged in a water container and the depth from the water surface to the tube tip represent the pressure in the circuit cheap, readily available Not suitable for the portable devices The pressure in the patient airway is slightly different from the measured value
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Pressure controlling in blower based CPAP systems

Constant pressure is achieved by varying the blower speed Pressure signal is fed to a microcontroller and the microcontroller compares it with the set value and manipulated signal is fed to the blower control unit
[Steven Boedewick. US 2004/0226562 A1] 19

Electronic pressure control system

1-nasal prong 2-pressure sensor(s) 3-variable flow control valve 4-controller

Microcontroller receives the pressure signal and it compares signal with the set value Constant pressure is achieved by varying the flow using proportional flow control valve
[Alex Stenzer et al. 1994] 20

Manual flow control FiO2 Blenders

o Required oxygen concentration is accomplished by manually controlling the oxygen and air flow rate Table is used to find out the flow rates according to the required oxygen percentage
[KSE CPAP manual] 21

Electronic FiO2 blenders

Valve arrangement

Blender control block diagram

Oxygen sensor sense the oxygen concentration and fed to the microcontroller The position of the valve is controlled by a stepper motor Valve position detector sends a feed back signal to the microcontroller 
[Ruiz-Vela et al. 1996] 22

Mechanical gas blenders

diaphragm housing module equalize the pressures of gases prior entering to the proportional module   proportional module mixes the tow gasses at given ratio
[Air-oxygen blender PM 5200 series. Service manual] 23

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