A connector for resuscitating an infant or neonate is disclosed. The pressure is varied between Peak Inspiratory Pressure (PIP) and Peak End Expiratory Pressure (PEEP) by the occlusion of the PEEP outlet. The PEEP outlet may either allow variable PEEP, by adjustment, or substantially flow independent fixed PEEP using a novel umbrella valve (308). A duck billed valve (305) is included for suctioning of surfactant delivery during resuscitation. The connector (134) is adapted to one handed use.

Breathing assistance apparatus

The apparatus provides for the determination of the instantaneous phase in the respiratory cycle, subject's average respiration rate and the provision of ventilatory assistance. A microprocessor (16) receives an airflow signal from a pressure transducer (18) coupled to a port (17) at a mask (11). The microprocessor (16) controls a servo (19), that in turn controls the fan motor (20) and thus the pressure of air delivered by the blower (10). The blower (10) is coupled to a subject's mask (11) by a conduit (12). The invention seeks to address the following goals: while the subject is awake and making substantial efforts the delivered assistance should be closely matched in phase with the subject's efforts; the machine should automatically adjust the degree of assistance to maintain at least a specified minimum ventilation without relying on the integrity of the subject's chemoreflexes; and it should continue to work correctly in the presence of large leaks.

Assisted ventilation to match patient respiratory need

A medical ventilator system and method that triggers, cycles, or both based on patient effort, which is determined from cross-correlating patient flow and patient pressure. The medical ventilator is also controlled such that sensitivity to a patient initiated trigger increases as the expiratory phase of the breathing cycle progresses. The present invention also provides adaptive adjustment of cycling criteria to optimize the cycling operation.

Medical ventilator triggering and cycling method and mechanism

The invention relates to continuous positive airway pressure (CPAP) respiratory therapy apparatus for treatment of apnea, hypopnea and other sleep disorders, and particularly to a control for the CPAP apparatus. A blower is connected through a hose and a mask, such as a nasal mask or a nasal cannula, to the patient's respiratory airway. An air flow sensor and an air pressure sensor are located at the blower end of the hose. Optionally, a vent valve also may be located at the blower end of the hose. The sensor outputs are used to estimate the air pressure at the mask and the air flow sensor output is used to determine the gross air flow to the hose, the patient air flow and the occurrence of patient snoring. The air flow sensor output also is used to generate a square wave breathing signal. The breathing signal may be used by a microprocessor to control the optional vent valve to establish different levels in the applied pressure during inspiration and expiration. The applied CPAP pressure may be increased in response to the detection of apnea and hypopnea events. The microprocessor detects and ignores mask leaks, open mouth breathing and exhale puff breathing.

Control for cpap apparatus

A processor-based system for analyzing physiologic data and medical care is provided wherein the patient data is analyzed to construct images that are representative of a patient's condition. The processor provides a self-modulating analysis, which is responsive to the occurrence of additional data items to increase the information contained in the images. Identifications of modes of physiologic failure by the analysis of the generated images provides for earlier recognition and intervention and improved protocolization of testing and treatment.

Patient safety processor

The invention relates to continuous positive airway pressure (CPAP) respiratory therapy apparatus (10) for treatment of apnea, hypopnea and other sleep disorders, and particularly to a standby control for automatically operating an air blower (12) in CPAP apparatus (10). A blower (12) is connected through a hose (14) and a mask (11), such as a nasal mask or a nasal cannula, to the patient's respiratory airway. Initially, the blower (12) is in a standby mode in which it is either turned off or, preferably, operated at a low speed. When a patient starts breathing through the mask (11), the blower (12) is automatically switched to an operating mode. In the operating mode, the blower (12) may be controlled to initially supply a low air pressure to the mask (11) which either is increased after a sufficient time delay to allow the patient to fall asleep or is increased in response to the detection of a respiratory event such as apnea or hypopnea. If patient breathing through the mask (11) ceases because the mask (11) has been removed or otherwise is no longer sufficiently sealed to the patient's airway, the blower (12) is automatically returned to the low pressure standby mode. If the patient does not begin breathing through the mask (11) within a predetermined time, the blower (12) is stopped. An optional recorder measures the total time that the patient is breathing through the mask (11) or the total time that the blower (12) is in the operating mode to provide the prescribing physician or technician with patient compliance information.

Standby Control for CPAP Apparatus

Enhancers in higher eukaryotes and upstream activating sequences (UASs) in yeast have been shown to recruit components of the RNA polymerase II (Pol II) transcription machinery. At least a fraction of Pol II recruited to enhancers in higher eukaryotes initiates transcription and generates enhancer RNA (eRNA). In contrast, UASs in yeast do not recruit transcription factor TFIIH, which is required for transcription initiation. For both yeast and mammalian systems, it was shown that Pol II is transferred from enhancers/UASs to promoters. We propose that there are two modes of Pol II recruitment to enhancers in higher eukaryotes. Pol II complexes that generate eRNAs are recruited via TFIID, similar to mechanisms operating at promoters. This may involve the binding of TFIID to acetylated nucleosomes flanking the enhancer. The resulting eRNA, together with enhancer-bound transcription factors and co-regulators, contributes to the second mode of Pol II recruitment through the formation of a transcription initiation domain. Transient contacts with target genes, governed by proteins and RNA, lead to the transfer of Pol II from enhancers to TFIID-bound promoters.

/pdf/enhancer-mediated-formation-of-nuclear-transcription-dsogq1fu.pdf

Stephen M. Jones

Papers

Control for cpap apparatus

Standby Control for CPAP Apparatus

Enhancer-Mediated Formation of Nuclear Transcription Initiation Domains