DE102005063661B3 - Modular device for humidifying breathing gas - Google Patents

Abstract

Device for humidifying breathing gas, consisting of at least one device for introducing water or water vapor and a connection to a breathing gas supply, the breathing gas supply (1) having a display device (5) and operating elements (6) and the breathing gas supply (1) also having a delivery device (7) for the respiratory gas, an electric drive (8) for the delivery device (7) and a controller (9) for the electric drive (8), the humidification being effected by water nebulisation excited by means of ultrasound, the Ultrasonic nebulization generates an aerosol through vibrations of a piezoelectric crystal, characterized in that a water supply is positioned on a metal plate with small holes, so that the water is directly on the metal plate, the size of the holes being chosen so that there is no water due to capillary forces flows out.

Description

The invention relates to a device for humidifying respiratory gas.

Such devices contain a device that acts as a water dispenser, which is typically designed either as a fillable tank to provide a water supply, or represents a continuous source, or contain an element that itself gains water and makes it available, for example by condensing moisture from the air or by chemical synthesis, whereby a reservoir can be present in addition to this water extraction element, but does not have to be. In addition, other elements are not necessarily, but typically present, such as a device for heating the water or the breathing gas, for example in the form of a heater, an element closing off the water supply, for example a cover, a connection for connecting to a breathing gas hose or a connection to the Connection to a breathing gas supply.

A typical use of such breathing air humidifiers is in connection with breathing air supplies that are used as part of a CPAP (Continuous Positive Airway Pressure) therapy. Applications in so-called bilevel, APAP ventilation and home ventilation are also possible. Such respiratory air humidifiers are also used in the clinic for intensive ventilation. To prevent the airways from drying out, it has proven to be expedient to humidify the breathing air, particularly during longer ventilation phases. Such humidification of the breathing air can also be implemented in other applications.

The known humidifiers are typically constructed in such a way that the respective humidifier is assigned to a specific ventilator and a specific breathing mask with a breathing tube. This hinders universal usability and in particular the ability to configure an overall system depending on the respective application requirements. In addition, the known respiratory gas humidifiers cannot yet meet all the requirements that are made, for example, of simple and at the same time thorough cleaning capability.

U.S. 2003/0 196 660 A1 discloses a nebulizer which can be connected to a breathing circuit and which can generate an aerosol by oscillating a piezoelectric crystal at a specific frequency.

WO 02/036269 A1 discloses another example of such a nebulizer.

The object of the present invention is therefore to construct a device of the type mentioned in the introduction in such a way that humidification of breathing gas is achieved in line with requirements and economically.

According to the invention, this object is achieved by the features according to claim 1 . Preferred configurations emerge from the dependent claims.

In one exemplary embodiment, the typical respiratory gas humidifier is constructed in a modular manner from individual functional elements. The respiratory gas humidifier is provided with a water supply, a water supply and a hose connection. The hose connection is designed in the form of a socket, for example, and is used to connect a ventilation hose. The respiratory gas humidifier is supplied with respiratory gas via a supply connection. The breathing gas is provided by a breathing gas supply. The supply connection can also be used to couple the respiratory gas humidifier to the respiratory gas supply. A flow space extends above the water supply. The water supply can be closed by a cover and can be connected to the supply connection and the hose connection. The water supply can be arranged in the area of the cover.

The exchange modules are provided in particular in order to be able to adapt individual functional elements to the individual needs of the user. It is also possible to meet later changes in the requirements for the device with little effort by replacing the relevant part. The device changes with the requirements of the user and can therefore be used by him over a long period of time. Due to the modular structure, the device can be adapted to individual needs.

The water supply can be chosen in different sizes depending on water needs and space available, taking into account the presence, type and power of water heating or elements to ensure Protection against tipping of the water can be added as required. If higher pressure of the breathing gas is required, which causes too much noise with a simple air flow, the air flow, for example integrated in the cover of the water supply, can be exchanged for a model with noise insulation. Different connection elements adapt different hoses and additional connections, such as measuring and control lines.

A measuring line for pressure, flow, humidity or similar applications can be arranged next to the breathing gas hose and/or inside the breathing gas hose. The breathing gas hose is connected to a hose coupling of a breathing mask via an exhalation element, for example. As an alternative to the breathing mask, all known interfaces can be used on the patient side, for example tubes, cannulas or similar components.

Due to the modular design of the components that can be separated from one another, it is possible to design them independently of one another in such a way that optimized individual properties are provided in each case. For example, it is possible to optimize the properties with regard to optimized cleanability. The respiratory gas humidifier can also be configured in such a way that it is suitable for very high ventilation pressures. In addition, it is also possible to make the cover and the water supply universal and to make the supply connection and the hose connection in the area of their ends facing away from the cover adapted to certain breathing hoses or respirators. The hose connection and the supply connection can hereby be used as adapter pieces which in fact couple together individual devices that can be selected at will via a breathing gas humidifier that is universally designed apart from the adapter pieces.

The supply connection and the hose connection can extend in the form of a tube, at least in some areas, along a main flow axis. The supply connection and the hose connection are then preferably arranged on a raised base relative to a base plane of the cover, which base delimits the flow space in certain areas. This achieves increased leakage protection and avoids overfilling the water tank.

In the area of the hose connection, there is a connection which is arranged essentially coaxially with the cylindrical outer wall of the hose connection and is intended for connection to a measuring line which runs here, for example, inside the breathing gas hose.

In an advantageous embodiment, the modular system contains modular, exchangeable elements for the water supply and corresponding standardized closure systems for a simple, secure connection that is easy to handle.

Another modularly replaceable component is a device for introducing water or water vapor into the breathing gas. In particular, this can be done in the area of the air duct or in the air duct on or via a water surface, a water nozzle, a water nebulizer, a membrane that is preferably only water-permeable on one side, a Peltier element that generates condensation water, or a fuel cell.

Another modularly exchangeable component is a device for heating the water or the breathing gas that has already been humidified or is still to be humidified.

Additional elements can be added as required, for example in order to achieve a needs-based, optimized control of the respiratory gas provided and its parameters via measured or entered data. Sensors on the user, environmental sensors, sensors on the device and its elements, as well as data read in, for example via long-distance connections, such as telemetry, are recorded, displayed, stored, processed and used for control processes, in a preferred embodiment in the form of a closed control loop, the includes the respective changes in current values triggered by control processes in its control behavior. Automatic warning signals can also be generated, for example if the water supply is too low, cleaning is required or if other limit values are threatened.

Additional elements can also be used for additional or sole water production, such as fuel cells or Peltier elements, the advantage of which is that the water production is a side effect of another device function running at the same time, for example electricity generation or heating. There may also be devices that use moisture from the ambient air in other ways make bar and insert, for example, through a semi-permeable membrane for water in the stream of breathing gas.

Additional components can also serve to simplify handling. Filling aids, handles, additional fastenings for different types of stands, cleaning aids, etc. can be made available so that the user - especially when traveling - has all useful tools at hand. Thanks to the modular structure, the device can be used with and without such elements. Furthermore, the power supply can be designed flexibly either by a power generator or by elements that allow access to alternative power sources, for example according to other standards, by inserting appropriate elements such as accumulator or battery components, fuel cells, transformers or converters if necessary. In particular, the idea is to enable the humidifier to be operated with all conceivable/common voltages, for example 6, 12, 14, 24, 48, 110, 220, 240 volts, direct and/or alternating current.

A particularly efficient form of humidification can be brought about by ultrasonic nebulization, while the water supply remains separated by a filter barrier, thus ensuring the greatest possible purity of the humidified breathing gas. This module can also be supplemented and/or exchanged in a modular manner.

The entire range of humidification of breathing air from the ventilation of newborns to intensive care ventilation (up to 120 l/min or up to 120 mbar) can be made possible thanks to the variable modular design. This is made possible, among other things, by the adaptability to all commercially available ventilators.

A compact device construction is supported by the fact that extension elements for a pressure measuring line are arranged both in the area of the supply connection and in the area of the hose connection.

A simple component geometry, in particular to support injection molding production, is achieved in that the extension elements of the pressure measuring line extend at least in regions along a main flow axis of the supply connection and the hose connection.

A load-bearing connection of the components to one another can be provided, for example, in that the supply connection and the hose connection are positively connected to one another by at least one pin and at least one depression.

In one embodiment, the supply connection is provided with a connection adapter that is used to connect to the respiratory gas supply. The connection adapter is provided with a locking device which snaps into a corresponding counter-element of the respiratory gas supply when the respiratory gas humidifier and the respiratory gas supply are pushed together. The locking device has an actuating element which, when pressed manually, releases the locking state, so that the respiratory gas humidifier can be separated again from the respiratory gas supply in a simple manner.

A lateral boundary of the respiratory gas humidifier can have a contour that is adapted to a contour of the respiratory gas supply. As a result, a very compact overall structure is possible when the respiratory gas humidifier and the respiratory gas supply are joined together. In addition, the breathing gas humidifier can have an electrical connection that can be coupled with a counter-connection of the breathing gas supply. To fix the respiratory gas humidifier to the respiratory gas supply, a locking element is preferably provided, which can be designed in the form of a click closure. A connection of this type can also be used to couple the ventilation hose to the respiratory gas humidifier. A flow space extends above the water supply. These modules are interchangeable and can be connected to one another using the interfaces described.

In order to prevent water from escaping unintentionally and to prevent excessive filling, the supply connection and the hose connection are arranged on a raised base of the cover.

A particularly functional geometric design is provided in that both the supply connection and the hose connection have an essentially angular design.

Manual handling when assembling and separating the individual module elements is made easier by the fact that at least one extension part for the pressure measuring line is arranged inside the cover.

A construction that is particularly easy to assemble can be achieved in that the extension part is designed as a plate-shaped connecting element.

A simplified geometry of the individual elements can be achieved in that the extension part has socket-like connection parts connected to a hose.

In order to support favorable flow guidance, it is provided that the supply connection and the hose connection extend cylindrically at least in regions in the direction of the main flow axis.

Very simple handling when filling the respiratory gas humidifier can be provided by the cover having a water supply.

When in use, the device is arranged in such a way that the respiratory gas supply is connected to the respiratory gas hose via the hose connection and to the respiratory gas supply via the supply connection.

Simple manual handling is also supported by the fact that the respiratory gas humidifier has a releasable lock in the area of its extension that can be used for the respiratory gas supply.

It is also provided that the hose connection can be connected to the breathing gas hose via a releasable lock.

A high mechanical load capacity is achieved in that the cover has a recess for attaching the hose connection.

In particular, it is contemplated that the hose connection engages in the recess with a holding piece and is sealed off from the recess by a sealing ring.

In addition, the mechanical resilience can be increased in that the cover has a recess for fastening the supply connection.

With regard to this constructive realization, it also proves to be advantageous that the supply connection engages in the recess with a holding piece and is sealed off from the recess by a sealing ring.

The formation of spray water inside the respiratory gas humidifier can be avoided by arranging a baffle plate in the area where the supply connection opens into the cover.

According to one embodiment it is provided that the baffle plate is designed as part of the supply connection.

Alternatively, it is also possible for the baffle plate to be designed as part of the cover.

Improved positioning safety by providing a form fit can be achieved in that the supply connection and the hose connection can be connected to one another in a form fit by at least one positioning pin.

A simple assembly is supported by the fact that the positioning pin is firmly inserted in a recess of one of the connections and engages in the other of the recesses with play.

Simple handling is achieved by the fact that all modules can be connected to one another using pegs or tongue and groove mechanisms. So they can simply be plugged into each other.

A long period of humidification without maintenance is achieved because the water supply modules can hold up to 5000 ml of liquid or because there is a continuous flow of water.

A low energy requirement of the device is achieved by partially using the waste heat from the respective ventilator to heat the water.

To avoid condensation, a module contains a heated air inlet and insulation.

The relative increase in humidity is mainly dependent on the air and water temperature.

The following table shows the saturation of the breathing air with water, whereby the saturation depends on the temperature. Temperature [°C] water vapor pressure [mmHg] water vapor pressure [kPa] 20 17.5 2.33 21 18.7 2.49 22 19, 8 2, 64 23 21:1 2.81 24 22:4 2.99 25 23, 8 3, 17 26 25, 2 3.36 27 26.7 3.56 28 28.3 3.77 29 30, 0 4, 00 30 31:8 4.24 31 33.7 4.49 32 35.7 4.76 33 37.7 5, 03 34 39, 9 5, 32 35 42.2 5, 63 36 44, 6 5, 95 37 47, 0 6, 27

With an additional module, the device is operated on demand. A sensor system records the ambient humidity and the ambient temperature and regulates the humidification performance if there are changes. The user can continue to freely regulate the degree of humidification and the temperature of the air. The device only implements the patient's settings within reasonable limits. For example, a minimum humidification of the breathing air is always provided and excessive condensation, especially in the hose, is avoided.

With an additional module for demand-controlled regulation of the respiratory gas humidifier, the respiratory gas humidifier performance is regulated via biofeedback from the patient. A sensor system records the patient's current need for humidification and regulates the performance of the respiratory gas humidifier accordingly. As a measurement parameter, you can choose between: expiratory and/or inspiratory humidity, expiratory and/or inspiratory air temperature, a measurement of the surface moisture on the mucous membranes of the upper respiratory tract or a combination of all. At the same time, the loss Flow can be registered via a possibly existing mouth expiration or also the loss flow via nose/mouth leakage and the respiratory gas humidifier output can be regulated accordingly.

The measurement data is preferably evaluated using fuzzy logic and/or neural networks.

The aforementioned modules are preferably combined in order to ensure ideal, needs-based humidification and heating of the respiratory gas at all times. The humidification performance can be fixed or regulated as required. This can be done in stages or continuously.

The moisture content and the temperature of the respiratory gas are either ideally controlled in an automatic mode and/or fixed by the user and/or are defined within selectable limits. The automatic function is part of a comparator, which also implements user input. The device adjusts to the selected and/or required values. A sensor system detects the ambient humidity and/or the ambient temperature and/or the composition of the ambient air and/or the brightness and/or climatic parameters and/or the flow of breathing gas and/or the pressure of the breathing gas and/or any leaks that may be present the current humidification requirement of the patient and/or the expiratory and/or inspiratory humidity and/or the expiratory and/or inspiratory air temperature and/or the moisture on the mucous membranes of the upper respiratory tract and/or a change in the measured variables over time and/or a Change in the measured variables and regulates the degree of humidification and the temperature of the humidified respiratory gas if there is a change.

The measurement data is preferably evaluated by means of fuzzy logic and/or neural networks and/or by suitable algorithms using a comparator. This compares the actual with the target state. If the actual and target status differ for at least one measured parameter, the comparator sends a corresponding signal to the controller. This regulates the power until the actual corresponds to the target state.

Suitable optical, electronic, mechanical, magnetic sensors can be used as sensors.

Alternatively, you can choose between wired or telemetric transmission of the measurement data from the patient to the respiratory gas humidifier.

Another modularly replaceable component is a power supply device. The respiratory gas humidifier is typically operated together with a ventilator. If the user wants a mobile unit, an energy supply with solar cells, accumulators, batteries, preferably rechargeable accumulators, fuel cells or miniaturized internal combustion engines is possible.

In the case of mobile use in particular, it is important that the stored water cannot tip over. Modular, replaceable components are located in the water supply area and enable tilting protection, for example because the water is held in a porous component. Ideally, there is no more free volume of liquid.

A simple filling is realized by the fact that a funnel folds up from the water supply for filling.

As an additional module, the fill level in the respiratory gas humidifier can be detected by a sensor system. Thus, if required, further water can be supplied to the respiratory gas humidifier in a targeted manner, for example by a pump or an electrically actuated valve. The resulting advantages: There is always very little water in the respiratory gas humidifier, so there is hardly any tilting problem. In addition, there are constant conditions for humidification.

In another exemplary embodiment, the water fill level or the amount of water stored is recorded by means of scales that are arranged in the area of the humidifier.

• - Schwimmer, der einen Schalter, Reed-Kontakt etc. betätigt. Der Schwimmer kann auch direkt auf das Zuführventil wirken.
• - Messung der elektrischen Leitfähigkeit des Wassers: Sinkt der Wasserstand unter zwei Elektroden im Atemgasbefeuchter, so kann kein Strom mehr zwischen den Elektroden Fließen
• - Optische Sensoren, z.B. Reflektionen an der Wasseroberfläche)
• - Weitere Module ermöglichen die Kommunikation bzw. Information der Anwender beispielsweise über aktuelle Betriebszustände. Bei einem auszuwählenden Modul wird die aktuelle Feuchte und Wärme des Atemgases und/oder die eingestellten Werte für diese Parameter, als prozentualer oder absoluter Wert, angezeigt. Mit einem weiteren Modul kann der Anwender eine Anzeige der Nutzungsdauer, eine Speicherung der Werte für die Nutzungsdauer und eine Einstellung der Nutzungsdauer adaptieren. Ein optionaler Reinigungsindikator, der mit dem Modul „Nutzungsdauer“ gekoppelt sein kann, zeigt dem Benutzer die empfohlenen Reinigungs und/oder Wartungstermine an.
• - Die Kommunikation kann durch ein weiteres Modul um eine Spracherkennung und/oder Sprachausgabe erweitert werden. Der Befeuchter kann somit z.B. bettlägrigen Patienten eine Fernsteuerung über eine Spracherkennung ermögliche und mögliche Fehlerfälle und/oder aktuelle Zustände/Daten über die Sprachausgabe kommunizieren. Weitere Module ermöglichen die Kommunikation mit intelligenter Technik und/oder die Versendung und/oder das Empfangen und/oder das Anzeigen von Nachrichten. So kann der Befeuchter über oder telemetrische und/oder kabelgebundene (Display, Anzeigen, SMS, Email, infrarot, bluetooth^®) Informationsweitergabe aktuelle Zustände versenden/anzeigen. Die Anzeige kann z.B. in Form von organischen lichtemittierenden Dioden (OLEDs) erfolgen. Gleichzeitig ermöglicht die Kommunikation auch eine Ferneinstellung, Fernwartung und/oder Fernabfrage von Befeuchter-Parametern. Ist z.B. nur noch wenig Wasser im Vorratsbehälter sendet der Befeuchter rechtzeitig eine Nachricht.

Possible embodiments of the sensors:

• - Swimmer operating a switch, reed contact, etc. The float can also act directly on the supply valve.
• - Measurement of the electrical conductivity of the water: If the water level falls below two electrodes in the respiratory gas humidifier, current can no longer flow between the electrodes
• - Optical sensors, e.g. reflections on the water surface)
• - Other modules enable communication and information for users, for example about current operating states. With a module to be selected, the current humidity and heat of the breathing gas and/or the set values for these parameters are displayed as a percentage or absolute value. With a further module, the user can adapt a display of the useful life, a storage of the values for the useful life and a setting of the useful life. An optional cleaning indicator, which may be coupled to the "Lifetime" module, provides the user with recommended cleaning and/or maintenance dates.
• - The communication can be expanded by another module to include speech recognition and/or speech output. The humidifier can thus, for example, enable bedridden patients to be remotely controlled via voice recognition and communicate possible faults and/or current statuses/data via voice output. Other modules enable communication with intelligent technology and/or sending and/or receiving and/or displaying messages. The humidifier can send/display current statuses via or telemetric and/or wired (display, displays, SMS, e-mail, infrared, bluetooth ^® ) information transfer. The display can be in the form of organic light-emitting diodes (OLEDs), for example. At the same time, the communication also enables remote setting, remote maintenance and/or remote querying of humidifier parameters. If, for example, there is only a little water left in the reservoir, the humidifier sends a message in good time.

The modules enable comprehensive monitoring of temperature and humidity, as well as important and informative functional values. In addition, automatic warning signals are generated and displayed or sent in the event of errors or deviations.

The design of the configured device can largely be freely selected. Interchangeable covers, panels and upper shells are available for the device. These are different in shape, color and design and can preferably be based on the design of the respiratory gas supply used in each case. Alternatively, the customer's wishes can be met by providing a selection of different shapes, colours, designs and materials (in particular also individually adapted). The user can replace the covers/upper shells himself, since the mechanism is simple and self-explanatory. Depending on the component, tongue and groove, rubber-mounted connectors or similar components are used.

The user can choose different modules for the water supply according to his needs. In the area of domestic use, a continuous source of water can be realized, for example, by connecting the humidifier to the domestic water supply. Here it is also possible to directly select a hot water inflow. This means that heating is no longer required.

A module that supplies the humidifier with sterile water improves handling and reduces the cleaning effort. The water does not fill the humidifier. The sterile water supply, for example a plastic bottle, is replaced as soon as it is empty. This option is suitable for bedridden patients, for example, so caregivers have to spend very little time maintaining the technology and can devote their full attention to the patient.

Heat losses can be avoided by insulating the walls of the water supply. The heating of the water is more effective, faster and more energy-saving. As a result, an increased degree of humidification can be achieved with the same energy supply.

A longer humidification period for patients with increased moisture requirements, for example through mouth breathing, can be achieved by modules that allow condensation of air humidity.

In one embodiment, the use of a Peltier element forces the air humidity to condense as a result of a local drop in temperature. In an area of the Peltier element where the temperatures are low, the condensate is collected and fed to the water supply. Alternatively, the Peltier element can directly cool the chamber. At the same time, the warm side of the element to preheat the air before it passes through the humidifier and absorbs water.

A longer duration of humidification in patients with increased moisture requirements, for example through mouth breathing, can also be achieved through the use of modules that provide hygroscopic materials. In one embodiment, the breathing tube is provided with a cover for this purpose, through which the moist exhaled air of the patient flows. The wall between the breathing tube and the outer cover is made of a moisture-wicking material. Coating the partition wall with HME-capable materials increases moisture absorption. The ventilation air, coming from the respiratory gas source, sweeps along this moist wall and absorbs the moisture and conveys it to the patient. An alternative module has a hygroscopic material inside the mask. In a further adaptable variant, a silica gel is used. The silica gel removes a large part of the moisture from the exhaled air. The silica gel is heated at periodic intervals. As a result of the heating, the moisture is released again and fed to the water supply via a hose.

A module specially designed for the mobile use of a ventilator with respiratory gas humidifier aims to have practically no elemental water to carry with you and also not to be dependent on electricity, especially heavy batteries, for energy.

In one embodiment of this module, water is produced from elemental oxygen and hydrogen in a fuel cell. The resulting energy is used to operate the device, the respiratory gas humidifier and, if necessary, the heating.

The control algorithm is preferably set in such a way that the vaporization is carried out shortly before inhalation by recognizing the breathing phases. The pause between expiration and inspiration can serve as a trigger. As a result, the breathing gas is only humidified when the patient needs humidified breathing gas—physiologically sensible. The water supply lasts longer.

In another module, the water is bound in a gel, which results in protection against tipping or leakage, because the gel cannot flow, or only slowly, if the respiratory gas humidifier is tilted. The gel can be heated like water and releases the moisture to the air passing over it, analogous to a water surface. In addition, a gel is preferred that stores heat longer than water, which reduces the energy consumption.

The water supply can also be designed in the form of a bird bath using an alternative module that can be selected. In this case, only the water quantity currently to be humidified and/or heated is taken from the water supply. The water supply lasts longer and less energy is used to heat the water, for example by means of radiation. In a preferred embodiment of this module, water is supplied to the humidifier space depending on the breathing phase. The control algorithm is preferably set in such a way that the evaporation and/or heating of the water is carried out shortly before inhalation by recognizing the breathing phases. The pause between expiration and inspiration can serve as a trigger here. As a result, the breathing gas is only humidified when the patient needs humidified breathing gas—physiologically sensible.

A flow in the respiratory gas humidifier that is independent of the water level is ensured by the water level compensation module. The water supply is always kept in the optimum position in relation to the air flow by means of a spring. The spring gradually pushes the water supply upwards as the amount of water stored decreases. Regardless of the amount of water, the top edge of the water is always the same height. This ensures that the degree of humidification is kept constant. In addition, the sound development remains constant and does not change as the water level decreases and becomes louder.

The water supply is filled depending on the selected water supply module. For the continuous water supply, for example via a connection of the humidifier to the domestic water line, the water supply is self-filling, for example via valves, negative pressure, float switches or the like.

The humidification of the breathing air often takes place in different ways in the individual modules for storing the water. In principle, however, it is intended as part of the exchange The ability of the modules to use different principles of humidification in order to be able to offer the optimum/desired solution here as well.

In the case of membrane humidifiers, the air and water sides are separated from one another by a semi-permeable membrane such as a GoreTex or Nafion membrane. The membrane allows water to pass in the direction of the humidification space. In this way, a large water-air contact surface can be achieved, with optimum flow control and low noise emissions at the same time.

The water supply can preferably be implemented in the area of the breathing tube. Particularly preferably, there are contact points between the semipermeable membrane and respiratory gas in the area of the breathing tube in several areas, preferably three-dimensionally oriented in their arrangement with respect to one another. Ideally, a widely branched, fine capillary network is formed that provides a very large contact surface between water and breathing gas. With an additional module, the heating can be arranged in the area of the breathing tube at the same time. The heater and the membrane are preferably designed in such a way that the heated areas of the membrane allow increased passage of water through the membrane as a result of the heating. The heating can also be regulated very precisely as required. This avoids condensation of water vapor in the area of the membrane that faces the ventilation air. In addition, regulation can take place in such a way that the breathing gas is humidified to a greater or lesser extent in accordance with the breathing phases.

In modules that work on the principle of a drip humidifier, the water supply is located above the water outlet. The opening of the water outlet to the humidification space is designed in such a way that water does not drip out due to the surface tension of the water. Briefly heating the water outlet reduces the viscosity of the water, the surface tension decreases, and heated water drips out of the tank. When the opening cools down, the critical surface tension is reached again and no more water drips. A very dynamic and needs-based regulation of the amount of water withdrawn can be achieved by timing the supply of water to the humidification chamber in accordance with the breathing phases. Water is preferably supplied to the humidification space shortly before inhalation.

Alternatively, the drip humidifier can also be designed in such a way that a heatable metal plate has small holes. The water supply is positioned on this plate. The water is thus directly on the metal plate. The size of the holes is selected so that no water flows out due to capillary forces. If the plate is now heated, the water viscosity changes and water escapes. By regulating the energy supply, the water supply to the humidification space can be regulated.

In another embodiment of the drip humidifier, several parallel tubes, for example, are filled with water. These tubes can extend along the breathing tube. The tubes have fine holes/openings. The openings can be opened/closed in a controlled manner. As with the drip humidifier, water only comes out here when the tubes and/or the openings are heated. Alternatively, the openings in both modules, which work according to the principle of a drip humidifier, are opened or closed electronically, mechanically, pneumatically or magnetically.

The heater can also heat the water indirectly. Alternatively, another module offers the option of directing heated air into the humidification space. Instead of the water, the air that is fed into the respiratory gas humidifier is heated. This allows more moisture to be absorbed when the water temperature is low.

Another module for heating the water is a thin, electrically conductive layer that is arranged in the area of the water supply.

The thin layer can preferably line the entire water supply. This creates a particularly large heat transfer surface. The current-conducting layer can, for example, be vapour-deposited and consist of all suitable materials that have good heat transfer properties, in particular gold, silver, copper and similar metals. The interface to the water is preferably electrically isolated.

All non-electrically conductive materials with good thermal conductivity are suitable for insulation. The insulating layer is typically very thin, preferably in the range of a few μm and nm thick, and can be vapor-deposited, for example. The conductive layer is not only used to heat the water sers. In particular, consideration is given to determining the current water temperature and also determining the water level via the electrically conductive layer.

For example, in phases when there is no heating, the temperature of the water can be determined in order to then adjust the heating output accordingly. The fill level of the water can also be determined in phases in which there is no heating.

The heating output can thus be adjusted to the decreasing water level.

For example, the warm "exhaust air" from the electronics can be used as an energy source for heating the air. It is also possible to use a heating mandrel as used in hair dryers. Both sources are preferably used simultaneously. The breathing gas is continuously preheated by the warm exhaust air from the electronic components and is also regulated to the desired temperature by suitable devices. The heating of the breathing air can be controlled by breathing phases.

Another module provides the structure of an injection humidifier based on the principle of an inkjet printer (piezo or bubble jet). The fine outlet openings are preferably arranged in an elastomer part, so that, for example, limescale deposits can be removed by deforming the elastomer part. The injection can take place diffusely in a humidification space and/or in the ventilator on the motor, blower or fan wheel.

An alternative module provides a pump, which preferably applies the smallest amounts of water directly to the fan impeller or an upstream atomizing element. Due to the high speed of rotation and the small, pulsed amount released, the water is immediately atomized and entrained with the air flow. The modules described enable rapid atomization that can be precisely controlled in terms of time.

With an additional module, the breathing air and/or the humidified breathing air can be heated to the desired temperature by at least one heating grid located in the airway. These modules are preferably used together with non-continuous humidification of the breathing gas. In particular, consideration is given to controlling the humidification in such a way that the patient is provided with a higher humidity and/or temperature in phases of inspiration than in phases of expiration. As a result, water and energy are used as needed and at the same time sparingly.

According to another embodiment, the water is pumped into the respiratory gas humidifier area by a circulating pump and runs back into the tank via one or more walls, lattice structures or similar devices. The best possible wetting of the walls with water is achieved by a distribution system, for example a plurality of nozzles or trough-shaped distribution channels. The breathing air flows over the walls and absorbs the moisture.

Conceivable embodiments of the pump: gear pump, piston pump, pump with turbine wheel, pump with pulsating elements, for example membranes. Valves for specifying the conveying direction, hose pumps, elements extending along the hose, impeller, eccentric worm, side channel or centrifugal pumps can be used.

According to a further embodiment, a partition with an opening can be arranged above the tank. If the opening is arranged at a distance from the outer wall of the tank, the dividing wall protects the respiratory gas humidifier from tilting.

In general, it is conceivable for the entire humidification area, including the partition wall, to be in the form of a removable cover for the respiratory gas humidifier, thereby making it easy to clean.

Optionally, the water can be heated by a flow heater for better respiratory gas humidifier performance.

The humidifier principle is explained in more detail below.

In the sense of a bypass, only a portion of the respiratory gas is humidified by a module. Preferably, this module can be supplemented by a control unit, with the setting / control of the mixing ratio between humidified and non-humidified breathing gas at relatively con constant heating power, the humidity and temperature provided to the patient can be regulated. The advantage of this module is the very fast control, which can be adjusted several times, especially breath by breath.

It is preferably considered to control the humidification in such a way that the patient is provided with a higher humidity and/or temperature in phases of inspiration than in phases of expiration. It is also possible, for example, to moisten differently within a breathing phase at the beginning and at the end of inspiration.

It is preferably considered to control the moistening in such a way that the patient is provided with less moisture in phases of beginning and ending inspiration than in phases of middle expiration. This results in less moisture in the dead space and the condensation in the hose can be effectively reduced.

It is particularly preferred to control the humidification in such a way that the humidification and temperature control of the respiratory air that is required in each case is made available to the patient as a function of the respiratory phase and/or as a function of events. This can be synchronized with the detection of the respiratory phases and/or the detection of events that affect the patient's breathing, for example apnea, coughing, swallowing, by the ventilator.

With the "remoistening" module, various components such as the mask and/or hose are equipped as water and/or heat storage. The inside of the mask and/or the tube and/or the humidifier is lined with a suitable water-storing material (HME heat moisture exchanger), which binds the moisture in the exhaled air and releases it back into the inhaled air with the next inhalation. A respiratory gas humidifier can also be integrated into the mask.

The HME principle described above is expanded in a supplementary module. The HME component is significantly larger here and designed in such a way that at least the humidity and temperature remain largely constant within the matrix and essentially correspond to the values of the exhaled air. This is ensured by the large surface area of the matrix, which is interspersed with fine, hollow capillaries. The oxygen and carbon dioxide exchange takes place within the capillaries by diffusion. This module is elastic and can be moved mechanically, resulting in ventilation. Alternatively, a standard breathing gas source can be connected.

In the following, the air inlet is explained in more detail, which is provided with a return anti-tilt device (bulkheads to prevent backflow, anti-tilt device). Water is held back by walls in the bottom area of the water storage tank when the water tank is tilted. Several walls can, for example, be constructed concentrically with one another. In addition, the height of the walls towards the supply connection or the ventilation connection can increase, so that the necessary tilting angle for water to flow back into the device increases with each wall. The resulting chambers can also be connected through very small openings, so that the backflow is also stretched over time. The central area can be designed in such a way that the air hits the water surface through holes, preferably designed as nozzles, with the aim of increasing the performance of the respiratory gas humidifier.

As a kind of very fast and effective way of heating the water, a module using radiation for heating is provided. Radiation types of different energy ranges and wavelengths are conceivable, for example infrared radiation, UV radiation, microwave radiation. Types of radiation that simultaneously have a disinfecting and a heating effect are preferably used. The radiation can particularly preferably act on small amounts of water, so that the water evaporates almost completely as a result of the action of the radiation. In this way, heating and/or disinfection and/or humidification of the ventilation air can be achieved at the same time.

The actual heating device can be designed as a simple metal plate without an electrical supply. The energy for heating the heating device is then supplied without contact by eddy current, induction.

The water is fed from the water supply through a heatable pipe and then fed in small portions to an evaporation chamber. The advantage here is the low heating capacity required with high thermal dynamics, since only a small amount of water is heated at a time. By suitable arrangement Using a non-return valve, for example based on the principle of a coffee machine, the water can also be pumped to a higher level.

An alternative module that makes it possible to use the heat for only a small amount of water is the floating heating plate. The heating plate swims just under the water surface and mainly heats the part of the water above the heating plate. The portion of the water that is also in contact with the breathing gas in the humidification space is heated in particular. In a module that is preferably to be used, the floating heating plate can also contain and/or activate a sensor. The sensor reacts when the water supply is running low and sends a signal to a refill device and/or activates the refill to a desired water level. At this point, too, the sensor integrated into the heating plate ensures that water refilling is switched off.

A supplement to the energy saving can be provided by a heat accumulator. By heating the respiratory gas humidifier container, for example during hot sterilization, cooking or rinsing in the dishwasher, a latent heat accumulator permanently installed in the area of the water supply is "charged" with thermal energy, for example by microbeads of a heat-accumulating material in the wall of the water supply. During use of the respiratory gas humidifier, the heat is given off again and used to heat up the water.

Another energy saving is provided by a module that enables the water supply to be heated using the waste heat from the device. The waste heat from the device is used to heat the water. For example, the heat sink of the power supply unit is both a heat sink and a water heater. In addition, the heat sink could be tempered with a heater to guarantee an adjustable water temperature regardless of the device load. The water supply is advantageously positioned on the device transformer of the ventilator.

1. a) Druckvernebler: Ein durch Druck erzeugter Luftstrom vernebelt Flüssigkeit über eine Düse. Beim kontinuierlichen Einsatz eines Druckverneblers geht mehr als die Hälfte der erzeugten Menge eines Aerosols während der Ausatmung des Patienten verloren. Durch Einsatz eines Unterbrechers kann die Verneblung auf insbesondere den Bereich der Inspiration, bevorzugt die mittlere Inspiration, beschränkt werden. Dadurch wird Substanz eingespart. Die von einem Düsenvernebler erzeugte Bandbreite von Partikeln und die pro Zeit vernebelte Menge eines Aerosols ist abhängig von der Dimension der Düse und dem von der Atemgasquelle erzeugten Druck, bez. Fluss. Deshalb sind Atemgasquelle und Verneb-lereinrichtung gerätespezifisch aufeinander abzustimmen.
2. b) Ultraschallvernebler: Durch Schwingungen eines z.B. piezoelektrischen Kristalles wird eine Aerosol erzeugt. Ultraschallvernebler produzieren Aerosole, deren Durchmesser von der elektrisch erzeugten Schwingungsfrequenz abhängig ist. Insbesondere ist dieses Modul derart konstruiert, dass insbesondere im Bereich der Inspiration, bevorzugt zur mittleren Inspiration Aerosole, dem Atemgasstrom zugegeben werden.
3. c) Dosieraerosol: Der zur Vernebelung benötigte Druck wird durch Verdampfen erzeugt. Bei Dosieraerosolen gelangten bisher Treibgase zum Einsatz, die nach Entweichen in die Umwelt nur langsam abgebaut wurden und die Ozonschicht schädigten. Mit dem hier bereitgestellten Modul und der Ankopplung an eine Atemgasquelle ist es möglich komplett auf Treibgase zu verzichten. Die Substanz wird fein dosiert nur in den Atemphasen, insbesondere im Bereich der Inspiration, bevorzugt zur mittleren Inspiration, dem Atemgasstrom zugegeben die ermöglichen, dass der Patient die größtmögliche Substanzmenge inhaliert.
4. d) Pulververnebler: Das als feines Pulver vorliegende Medikament wird mit dem inspiratorischen Fluss dem Patienten appliziert. Die Trockenpulver-Inhalation setzt voraus, dass der Patient einen Inhalationsstrom von 25-60 l/min erzeugen kann. Dies ist bei Kleinkindern und bei Erwachsenen mit schwerster Luftwegsobstruktion nicht immer der Fall. Das hier bereitgestellte Modul mit der Ankopplung an eine Atemgasquelle ermöglicht es, die Substanz fein dosiert nur in denjenigen Atemphasen, insbesondere im Bereich der Inspiration, bevorzugt zur mittleren Inspiration, dem Atemgasstrom zuzugeben die es ermöglichen, dass der Patient die größtmögliche Substanzmenge inhaliert.
5. e) Vorschaltkammer In der Vorschaltkammer schlagen sich die schnellsten und größten, d.h. die für die Deposition in den unteren Luftwegen nicht geeigneten Aerosolpartikel, nieder. Zudem muss beim Gebrauch einer Vorschaltkammer der Patient nicht synchron mit der Aktivierung das Dosieraerosol einatmen, sondern er kann die Substanz während einiger ruhiger Atemzüge inhalieren. Dadurch wird die Ablagerung der Substanz in den oberen Atemwegen verringert und in den unteren Atemwegen verbessert.

Modules for generating aerosols can also be used for the humidifier. These modules are intended for a direct supply of substances such as medicines, fragrances, etc. into the airways. The advantage of these supplementary modules is that the patient can easily, quickly and safely convert their existing device for administering respiratory gas and humidification of the respiratory gas and does not have to buy a second device, which would only be required for the generation of aerosols. Specifically, the following modules are considered.

1. a) Pressure nebulizer: An air flow generated by pressure nebulizes liquid through a nozzle. With the continuous use of a pressure nebulizer, more than half of the generated amount of an aerosol is lost during exhalation by the patient. By using an interrupter, the nebulization can be limited to the area of inspiration in particular, preferably the middle inspiration. This saves substance. The range of particles generated by a jet nebulizer and the amount of an aerosol nebulized per time depends on the dimension of the nozzle and the pressure generated by the breathing gas source, or flow. Therefore, the breathing gas source and the nebulizer device must be matched to each other on a device-specific basis.
2. b) Ultrasonic nebulizer: An aerosol is generated by vibrations of a piezoelectric crystal, for example. Ultrasonic nebulizers produce aerosols whose diameter depends on the electrically generated oscillation frequency. In particular, this module is constructed in such a way that aerosols are added to the respiratory gas flow, particularly in the area of inspiration, preferably for the middle inspiration.
3. c) Metered dose aerosol: The pressure required for nebulization is generated by evaporation. In the case of dosing aerosols, propellant gases were previously used, which only slowly decomposed after escaping into the environment and damaged the ozone layer. With the module provided here and the connection to a breathing gas source, it is possible to do without propellant gases completely. The substance is finely dosed only in the respiratory phases, especially in the inspiration area, preferably for the middle inspiration, added to the respiratory gas flow, which allows the patient to inhale the largest possible amount of substance.
4. d) Powder nebuliser: The medication, which is in the form of a fine powder, is applied to the patient with the inspiratory flow. Dry powder inhalation requires the patient to be able to generate an inhalation flow of 25-60 l/min. This is not always the case in young children and in adults with the most severe airway obstruction. The module provided here with the connection to a breathing gas source makes it possible to finely dose the substance only in those breathing phases, in particular in the area of inspiration, preferably mid-inspiration, to the flow of respiratory gas that allow the patient to inhale the greatest possible amount of substance.
5. e) Pre-chamber The fastest and largest aerosol particles, ie those not suitable for deposition in the lower airways, settle in the pre-chamber. In addition, when using an upstream chamber, the patient does not have to breathe in the metered-dose aerosol synchronously with activation, but can inhale the substance during a few quiet breaths. This reduces the deposition of the substance in the upper airways and improves it in the lower airways.

The efficiency of the aerosol therapy is improved by reducing the adhesion of the substances to the surface of the devices. For example, surfaces are used in the modules that reduce the adhesion of substances to the surface of the equipment, e.g. reduce the electrostatic charge of plastic.

Ideally, aerosols used to treat lung diseases have a diameter of between 0.1-10 pm. Larger diameter droplets do not reach the lower airways, smaller particles contain only small amounts of a drug and are also largely exhaled.

The choice of a specific aerosol form must be made individually. It depends on various factors, not the least of which is the patient's preferences. For infants and small children, for patients who have difficulty operating a metered dose inhaler, modes of aerosol generation that are independent of cooperation are used.

Not only technical aspects are decisive for the compliance of the aerosol therapy, but also the preference of the patient for a certain nebulizer system.

Regardless of the choice of aerosol administration method, it is clear that certain substances can only be nebulized by certain aerosol generating devices. The appropriate module must be selected according to these requirements.

Devices are provided with additional modules for the storage of accessories, which provide the patient with a needs-based, practical and simple aid for facilitating the daily use of the devices according to the invention.

In particular, elements required for therapy, such as hoses, masks and medicines, are kept. In addition, clocks, alarm clocks and entertainment electronics are either integrated or adapted.

Another module for the alarm clock includes a wake-up function that takes the patient's sleep phases into account. By analyzing the sleep phases, those phases are preferably identified for waking up when the patient is not in a deep sleep.

An additional module for a time measurement enables the calculation of the useful life and the duration of sleep. From this, the typical demand for water and energy can be determined by comparing it with other device data and environmental data, which enables appropriate planning and needs-based storage.

The duration of the ventilation, humidification and administration of medication can be set via a timer function.

The storage can preferably take place in or on a drawer, a shelf or on a stand.

The mask is preferably stored in such a way that it is possible for the patient to easily and quickly grasp and put on the mask with one hand. The hose is stored in an orderly and space-saving manner, making it easy to grab and unroll. Plug-in, clamping or latching devices are preferably used for this purpose. The attachment is preferably in the area of the device or on the bed or on a bedside table or a shelf.

A retractor mechanism is also provided for the hose and cord of the power supply.

• 1: Eine perspektivische Darstellung eines Atemluftbefeuchters, der mit einer Luftversorgung verbindbar ist,
• 2 eine perspektivische Darstellung einer Atemmaske mit Atemgasschlauch,
• 3 eine perspektivische Darstellung eines Atemluftbefeuchters mit Wassertank und Deckel sowie einem Versorgungsanschluss zur Verbindung mit einer Atemgasversorgung und einem Schlauchanschluss zur Verbindung mit einem Atemgasschlauch,
• 4 eine Draufsicht auf den Atemluftbefeuchter gemäß 3,
• 5 ein Längsschnitt gemäß Schnittlinie V-V in 4,
• 6 eine teilweise geschnittene Darstellung gemäß Schnittlinie VI-VI in 5,
• 7 eine Konstruktion eines Atemluftbefeuchters mit im Wesentlichen ebener Deckelfläche,
• 8 eine Draufsicht auf den Atemluftbefeuchter gemäß 7,
• 9 einen Vertikalschnitt gemäß Schnittlinie IX-IX in 8,
• 10 ein Querschnitt gemäß Schnittlinie X-X in 9,
• 11 eine perspektivische Darstellung des Atemluftbefeuchters gemäß 3 in einem teilweise auseinandergenommenen Zustand,
• 12 eine perspektivische Darstellung des Atemluftbefeuchters gemäß Blickrichtung XII in 7,
• 13 eine gegenüber der Darstellung in 9 um 180° gedrehte und im Bereich der Verbindung des Schlauchanschlusses sowie des Versorgungsanschlusses modifizierte Darstellung,
• 14 eine vergrößerte Darstellung der Einzelheit XIV in 13,
• 15 eine schematische Darstellung der Module, aus denen ein bedarfsgerechter Befeuchter zusammengestellt werden kann,
• 16 eine schematische Darstellung der möglichen Steuer- und Regelvorgänge,
• 17 ein weiteres Ausführungsbeispiel für das Zusammenwirken von Beatmungsgerät und Befeuchter,
• 18 ein weiteres Modul des Befeuchters, das an ein Beatmungsgerät adaptiert,
• 19 eine Abwandlung zur Darstellung in 18,
• 20 eine weitere Abwandlung zur Darstellung in 18,
• 21 eine nochmals variierte Abwandlung zur Darstellung in 18,
• 22 ein Modul, das mit wasserdurchlässigen Membranen arbeitet, mit einem Wasservorrat in einem Tank,
• 23 eine Abwandlung zu 22, bei der sich der Wasservorrat im Beatmungsschlauch befindet, durch die Membran getrennt von Luftstrom,
• 24 ein Modul: Vorrichtung zur Befüllung des Wasservorrates im Beatmungsschlauch
• 25 ein Modul: „Tintenstrahldrucker“ mit elastischer Düse, bei dem Wasser in den Luftweg gebracht/zerstäubt wird,
• 26 ein Modul: „Wasserzerstäubung“ am Lüfterrad mit Heizgitter im Luftweg,
• 27 ein Modul: „Peltier-Element“ zur Erwärmung des Wasservorrates und/oder Sammeln von kondensierendem Wasser,
• 28 ein Modul: „Brennstoffzelle“ zur Energieversorgung, Wassererzeugung und Erwärmung,
• 29 ein Modul: „Induktiv Heizen“, bei dem der Wasservorrat induktiv geheizt wird,
• 30 ein Modul: „Schwimmende Heizplatte“, bei dem nur die über der Heizplatte befindliche Wassermenge erhitzt wird. Zusätzlich signalisiert die absinkende Platte einen geringen Wasservorrat,
• 31 ein Modul: „Nutzung der Geräteabwärme“, bei dem der Wasservorrat über die Geräteabwärme aufgeheizt wird,
• 32 ein Modul: „Umwälzung/Durchlauferhitzer“, bei dem Wasser dem Vorrat entnommen, erhitzt und über eine große Oberfläche geleitet wird und
• 33 ein Modul: „Verkipp-Sicherung“.

In the drawing, exemplary embodiments of the invention are shown schematically. Show it:

• 1 : A perspective view of a respiratory humidifier that can be connected to an air supply,
• 2 a perspective view of a breathing mask with breathing gas hose,
• 3 a perspective view of a respiratory air humidifier with a water tank and cover and a supply connection for connection to a respiratory gas supply and a hose connection for connection to a respiratory gas hose,
• 4 a top view of the humidifier according to FIG 3 ,
• 5 a longitudinal section according to section line VV in 4 ,
• 6 a partially sectioned representation according to section line VI-VI in 5 ,
• 7 a construction of a respiratory air humidifier with a substantially flat top surface,
• 8th a top view of the humidifier according to FIG 7 ,
• 9 a vertical section along section line IX-IX in 8th ,
• 10 a cross-section along section line XX in 9 ,
• 11 a perspective view of the respiratory humidifier according to FIG 3 in a partially disassembled condition,
• 12 a perspective view of the respiratory humidifier according to viewing direction XII in 7 ,
• 13 one opposite the representation in 9 Rotated by 180° and modified in the area of the connection of the hose connection and the supply connection,
• 14 an enlarged view of the detail XIV in 13 ,
• 15 a schematic representation of the modules from which a needs-based humidifier can be assembled,
• 16 a schematic representation of the possible control and regulation processes,
• 17 Another example of how the ventilator and humidifier work together
• 18 another module of the humidifier that adapts to a ventilator,
• 19 a modification to the representation in 18 ,
• 20 another modification to the representation in 18 ,
• 21 a further variation of the representation in 18 ,
• 22 a module that works with water-permeable membranes, with a water supply in a tank,
• 23 a modification to 22 , in which the water supply is in the breathing tube, separated from the air flow by the membrane,
• 24 a module: Device for filling the water supply in the breathing tube
• 25 a module: "inkjet printer" with elastic nozzle, where water is brought into the airway / atomized,
• 26 a module: "water atomization" on the fan wheel with heating grid in the air path,
• 27 a module: "Peltier element" for heating the water supply and/or collecting condensing water,
• 28 a module: "fuel cell" for energy supply, water production and heating,
• 29 a module: "Inductive heating", in which the water supply is heated inductively,
• 30 a module: “Floating heating plate”, in which only the amount of water above the heating plate is heated. In addition, the sinking plate signals a low water supply,
• 31 a module: "Use of waste heat from the device", in which the water supply is heated using the waste heat from the device,
• 32 a module: “circulation/instantaneous water heater”, in which water is taken from the supply, heated and passed over a large surface and
• 33 a module: "Tilt protection".

The interaction of the modules and the advantages of the modular structure will now be described using several exemplary embodiments. A sleep apnea patient is prescribed CPAP therapy by their doctor to prevent nocturnal breathing pauses. After the start of therapy, the patient notices dehydration of the respiratory tract, after which infections form. The doctor prescribes a humidifier for him. The patient chooses the retrofittable, modular breathing gas humidifier according to the invention since his CPAP device does not have a breathing gas humidifier. The respiratory gas humidifier consists of the basic modules that are required for the effective humidification of respiratory gas when operating together with a CPAP device: water tank, lid that closes the water tank, filler neck for water in the lid, especially with a rubber stopper as a closure, supply connection and breathing hose connection.

The perspective view in 1 shows a breathing gas supply (1) which can be connected to a supply connection (3) of a breathing gas humidifier (4) via a connecting element (2). The connecting element (2) is designed in the manner of a socket and can accommodate the supply connection (3), which is likewise socket-shaped in some areas, or be surrounded by it in some areas.

The breathing gas supply (1) has a display device (5) and operating elements (6). The breathing gas supply (1) is also equipped with a delivery device (7) for the breathing gas, an electric drive (8) for the delivery device (7) and a controller (9) for the electric drive (8).

The respiratory gas humidifier (4) is provided with a water tank (10), a filling opening (12) that can be sealed by a closure element (11) and a hose connection (13). The hose connection (13) is designed in the shape of a socket and is used to connect a ventilation hose. To fix the respiratory gas humidifier (4) to the respiratory gas supply (1), a locking element (14) is provided, which can be designed in the form of a click closure. A connection of this type can also be used to couple the ventilation tube to the respiratory gas humidifier (4). A flow space (15) extends above the water tank (10).

From the presentation in 1 It can be seen that a lateral boundary (16) of the respiratory gas humidifier (4) is designed as an exchangeable panel and has a contour here that is adapted to a contour of the respiratory gas supply (1) in the area of a front side. As a result, a very compact overall structure is possible when the respiratory gas humidifier (4) and the respiratory gas supply (1) are joined together. Beyond that is off 1 recognizable that the breathing gas humidifier (4) has an optional electrical connection (17) which can be coupled together with a mating connection (18) of the breathing gas supply (1). As a result, both elements are joined together easily and securely.

1 also illustrates that the water tank (10) is connected to the supply connection (3) and the hose connection (13) by a cover (19). The filling opening (12) is arranged in the area of the cover (19).

2 shows the breathing gas hose (20) for connection to the hose connector (13). In the illustrated embodiment, an optional pressure measuring line (21) runs next to the breathing gas hose (20), but in particular it is also contemplated to arrange the optional pressure measuring line (21) inside the breathing gas hose (20). The breathing gas hose (20) is connected to a hose coupling (23) of a breathing mask (24) via an exhalation element (22). The breathing mask (24) essentially consists of a mask body (25) and a hood (26).

3 shows a compared to the embodiment in FIG 1 modified respiratory gas humidifier (4) in a further perspective view. It can be seen that the supply connection (3) and the hose connection (13) extend at least in regions in the form of a tube along a main flow axis (27). The supply connection (3) and the hose connection (13) are in relation to a ground plane (28) of the cover (19) is arranged on a raised base (29) which delimits the flow space (15) in certain areas. This achieves increased leak protection and prevents the water tank (10) from being overfilled.

Out of 3 it can also be seen that in the area of the hose connection (13) there is an optional pressure connection (30) which is arranged essentially coaxially to the cylindrical outer wall of the hose connection (13) and is intended for connection to the optional pressure measuring line (21), which in this embodiment is inside of the breathing gas hose (20).

The humidifier according to the invention in this exemplary embodiment is suitable for ventilation pressures of up to 18 mbar in the CPAP basic module variant. It is a cold air humidifier, without heating the water. At the specialist retailer, the respiratory gas humidifier according to the invention is equipped with the supply connection module that allows it to be connected to the patient's CPAP device.

From the presentation in 4 it can be seen that the main flow axis (27) has a lateral offset relative to a device center line (31) of the respiratory gas humidifier (4). It can also be seen that the optional electrical connection (17) is implemented as a coaxial line arrangement in the exemplary embodiment shown. In principle, however, it is also conceivable to use, for example, two contact pins arranged next to one another.

At the in 4 In the embodiment shown, the supply connection (3) is provided with a connection adapter (32) which is used to connect to the respiratory gas supply (1). The connection adapter (32) is provided with a catch (33) which engages in a corresponding counter-element of the respiratory gas supply (1) when the respiratory gas humidifier (4) and the respiratory gas supply (1) are pushed together. The lock (33) has an actuating element (34) which, when pressed manually, releases the locked state, so that the breathing gas humidifier (4) can be separated again from the breathing gas supply (1) in a simple manner.

After some time, the patient notices that the degree of humidification is not sufficient, in addition, he finds the cold damp air uncomfortable and he attributes his frequent colds to it. The doctor prescribes a heated humidifier. According to the state of the art, the patient would now have to buy a new device. However, the respiratory gas humidifier according to the invention is easily upgraded as needed by adding modules.

6 illustrates the structure of the respiratory gas humidifier in a vertical section. From this it can be seen that inside the water tank (10) there is a heating element (52) connected to the electrical connection (17), which can be realized, for example, as a heating rod which is directly surrounded by the liquid stored in the water tank (10). Flow guide elements (53) are arranged inside the supply connection (3), which contribute to an even flow and prevent turbulence in the flowing respiratory gas.

After a while, the patient's state of health deteriorates. The normal CPAP device is no longer sufficient to ventilate the patient as needed because a chronic obstructive lung disease was diagnosed. The doctor prescribes a bilevel ventilator that is able to ventilate the patient's lungs through two different pressure levels between inspiration and expiration. The lower pressure value is 6 mbar and the upper pressure value is 30 mbar. Since this bilevel device is from a different manufacturer than the CPAP device and the ventilation pressure has also been significantly increased, the respiratory gas humidifier is no longer suitable. According to the state of the art, a completely new respiratory gas humidifier would have to be purchased. However, the humidifier according to the invention is adapted to the new bilevel device by means of three supplementary modules. Due to the higher pressure, a different cover with a different closure for the filling opening is required, since these modules of the CPAP variant were only designed for pressures of up to 18 mbar. A new supply port module is required to connect the humidifier to the bilevel machine since it had a different air outlet port than the CPAP machine. In addition, the new device regulates based on measured pressure and/or flow values of the breathing gas, which is why a measuring line has to reach through the humidifier. In addition, a larger water tank is used because the higher pressure and longer ventilation required a larger water supply.

5 shows the structure of the respiratory gas humidifier (4) according to FIG 4 in a vertical section. It can be seen that the hose connection (13) partially surrounds the pressure connection (30) coaxially. The pressure connection (30) has an insertion cone (35) which is provided for the sealed connection to the pressure measuring line (21). Starting from the insertion cone (35), the pressure connection (30) extends essentially along the main flow axis (27) and then bends in the direction of the water tank (10). In the region of its extension facing the cover (19), the hose connection (13) has a holding connector (36) which engages in a recess (37) in the cover (19). The mounting socket (36) has a sealing ring (38) which is provided for sealing relative to the recess (37).

A connecting element (39) is arranged inside the cover (19) and below the recess (37).

To provide a sealed coupling of the connecting element (39) with the hose connection (13), a hollow connecting pin (40) extends in the direction of the connecting element (39) as an extension of the pressure connection (30) and has an insertion cone (41) which is a hollow connection cone (42) of the connecting element (39) is adapted. When the hose connector (13) is inserted into the recess (37) of the cover (19), the respiratory gas hose (20) is connected to the respiratory gas humidifier (4) and the pressure connection for the pressure measuring line (21) is provided in one operation.

The supply connection (3) has a similar design to the hose connection (13). Inside the supply connection (3), a pressure connection (43) initially runs essentially along the main flow axis (27), which in the area of its extension facing the hose connection (31) bends in the direction of a hollow connecting pin (44). The connecting pin (44) has an insertion cone (45) which is adapted to a connecting cone (46) of the connecting element (39). The connecting pin (44) is partially surrounded by a support piece (47) of the supply connection (2), which can be inserted into a recess (48) in the cover (19) and is sealed off from the cover (19) by a sealing ring. With regard to the supply connection (3), both a connection to the respiratory gas humidifier (4) and the provision of the pressure connection can thus be carried out in one operation.

As an alternative to a plate-shaped construction of the connecting element (39), it is also possible, for example, to design the connecting cones (42, 46) as end pieces of pipe segments and to connect the pipe segments to one another using a hose that is attached separately. As a result, an additional work step is required during assembly, but considerably simplified molds can be used in the case of production by injection molding.

The water tank (10) is coupled to the cover (19) via a connection (50), which can be realized, for example, as a thread or a bayonet lock. A seal (51) seals the water tank (10) relative to the cover (19).

7 shows the perspective view of a compared to the embodiment in 6 modified respiratory gas humidifier (4). The supply connection (3) and the hose connection (13) are not arranged on a base (29) here, but together with the closure element (11) in the base plane (28). Otherwise, the structural design essentially corresponds to the embodiments already explained.

8th illustrates a plan view of the respiratory gas humidifier (4) according to FIG 7 and 9 shows a vertical section. In the embodiment according to 9 the supply connection (3) and the hose connection (13) have a structural realization that is modified compared to the previously described embodiments. This structural realization can also be used in a respiratory gas humidifier (4) which is provided with a base (29) in the area of the cover (19) for elevated positioning of the supply connection (3) and the hose connection (13).

The pressure connection (30) of the hose connection (13) extends essentially completely along the main flow axis (27) and exits the hose connection (13) again in the region of a boundary facing the supply connection (3). In the area of this limitation, a recess (54) is arranged, in which a pin (55) of the supply connection (3) engages, in the area of which Pressure connection (43) of the supply port (3) ends. According to an alternative embodiment, it is also possible to arrange the recess in the area of the supply connection (3) and a pin-like projection in the area of the hose connection (13). The positive locking provided prevents the supply connection (3) and the hose connection (13) from twisting relative to one another.

A continuation element (56) for the pressure connection (43) is arranged in the area of the connection adapter (32) in order to provide a continuous pressure connection to the respiratory gas supply (1).

10 shows a cross section for the embodiment according to FIG 9 . In particular, the guiding of the holding piece (47) in the recess (48) of the cover (19) and the sealing using the sealing ring (49) can be seen again.

11 shows again the embodiment according to FIG 3 after removing the supply connection (3) and the hose connection (13) from the cover (19). The interior of the respiratory gas humidifier (4) can be viewed through the recesses (37, 48) and the connecting element (39) can be seen.

12 shows a further perspective representation of the embodiment of the respiratory gas humidifier (4) accordingly 7 . With reference to 7 located in 12 a viewing direction diagonally from behind. In the area of the connection adapter (32), the continuation element (57) for the pressure line can be seen through the selected viewing direction.

In order to avoid the formation of splashing water in the area of the water tank (10), it is advantageous not to allow the breathing gas to flow directly onto the amount of liquid contained in the water tank (10), but to use a baffle plate in the area where the supply connection (3) opens into the cover (19). to be arranged, which extends substantially transversely to the direction of flow. The baffle plate can be attached to the supply connection (3) via spacer elements, but it is also possible to form the baffle plate as part of the cover (19). In particular, the intention is to implement the baffle plate and the cover (19) as a single component by injection molding.

13 shows a structural realization modified in the area of the connection of the pin (55) with the depression (54). Compared to the representation in 9 it can be seen that the seal (56) along the spigot (55) is positioned somewhat further in the direction of the hose connection (13) and is thus arranged in the direction of the main flow axis (27) in a central region of the spigot (55). In addition, the hose connection (13) is provided with a projection (58) surrounding the pin (55) in a circle, which leads to an improved form fit between the supply connection (3) and the hose connection (13) in an assembled state.

An additional form fit between the supply connection (3) and the hose connection (13) is achieved by one or more positioning pins (59). The positioning pin (59) is arranged in the area of the mutually facing boundary surfaces of the supply connection (3) and the hose connection (13). Simple production is supported by the fact that the positioning pin (59) is designed as a separate component and is inserted into recesses (60, 61) in the supply connection (3) and the hose connection (13).

From the enlarged view in 14 it can be seen that the positioning pin (59) is firmly inserted into the recess (60) and engages in the recess (61) with play. This assists in assembling and separating the connections (3, 13). Typically, the positioning pin (59) is firmly connected to that one of the connections (3, 13) which also carries the pin (55). In the illustrated embodiment, this is the supply connection (3).

15 shows schematic examples for the selection within the modules and for the variety of combinations. The actual number of different modules can be expanded practically without limit. There are many possible combinations. In particular, the abbreviations in 15 the following meanings. E. Supply connection curved connector with measuring channel curved connector without measuring channel curved connector without measuring channel straight connector with terminal curved connector without measuring channel with sealing cap curved connector with measuring channel curved connector without measuring channel curved connector without measuring channel straight connector with terminal straight connector with measuring channel D. Water supply 0.5 liters 0.7 liters 0.9 liters 2 liters ... C. Heater heater hotplate radiation device waste heat ... B. Energy battery pack mains power fuel cell ... K. Hoses 25 cm hose, male / female 25 cm tubing male/female with 0.8 micron diaphragm 25 cm hose male/male 25 cm tubing, male/male with 0.8 micron membrane 25 cm dual-extruded coaxially mounted hose, male/female 25 cm dual extruded coaxially mounted tubing, male/female with 0.8 micron diaphragm 25 cm dual-extruded coaxially mounted hose, male/male 25 cm dual-extruded coaxially mounted hose, male/male Internal hose, male Internal tube, male, with 0.8 micron membrane Internal hose, female Internal hose, female, with 0.8 micron membrane Internal 25 cm dual-extruded, coaxially mounted hose, male internal 25 cm dual-extruded coaxially mounted tubing, male, with 0.8 micron membrane 25 cm hose male/male ... I. Connection to breathing mask Conventional adult breathing mask Flexible joint breathing mask for adults Ball joint breathing mask for adults ... II. Hygroscopic Heat and Moisture Exchangers (HME) HME filter between contra-angle and patient-side connector HME/HEPA filter between contra-angle and patient-side connector HME filter in the hose HME filter in mask ... X. Upper shells Side cover CPAP-Basic blue Side cover CPAP-Basic black ...

The table above shows examples for the selection within the modules and for the variety of combinations

The customer can select the desired modules from a catalog similar to the one shown above.

15 In addition to the various modules shown, also illustrates the interaction with a patient (62) and the interaction with an environment (63).

16 illustrates the already explained interaction between the respiratory air humidifier (4), the respiratory gas supply (1), the environment (63) and the patient (62). A comparator (64) for data evaluation and a controller (65) for controlling the respiratory gas humidifier (4) are shown.

At the in 17 illustrated embodiment, the respiratory gas supply (1) and the respiratory gas humidifier (4) are assembled in a modular manner. The breathing gas supply (1) is provided with a filter (66) and a blower (67). A liquid reservoir (68) is arranged in the area of the respiratory gas humidifier (4), for which a minimum and a maximum filling level is provided. An evaporation element (69), which can be made of a porous or capillary material, for example, is arranged so as to dip into the liquid reservoir (68). It is also possible to arrange a large number of outlet openings (70) in the area of the evaporation element (69).

18 shows an embodiment in which the respiratory gas humidifier (4) is arranged above the respiratory gas supply (1) and in which a lateral boundary of the respiratory gas humidifier has a contour that is adapted to a contour of the respiratory gas supply (1). The respiratory gas humidifier (4) has its own control elements (71) and its own display (72).

According to the embodiment in FIG 19 the breathing gas humidifier (4) is positioned below and next to the breathing gas supply (1) in some areas.

According to the embodiment in FIG 20 the respiratory gas humidifier (4) can be inserted into a slot in the respiratory gas supply (1).

21 shows an embodiment in which the respiratory gas humidifier (4) is positioned next to and above the respiratory gas supply (1) in some areas.

22 shows an embodiment in which the respiratory gas humidifier (4) is equipped with a waterproof but vapor-permeable membrane (73). The membrane (73) limits a transition from the water tank (10) to an air flow (74). As a result, the already explained large contact area in the transition area from water to air is realized.

According to the embodiment in FIG 23 a membrane (73) is also used, which is also designed as part of the breathing gas hose. The breathing gas tube (20) is preferably provided with a stretchable, flexible outer sleeve (75). The heating element (52) is preferably arranged between the outer shell (75) and the membrane (73). From the membrane (73) and the outer shell (75) a storage space (76) is limited, which accommodates a water supply. The storage space (76) can be divided by partitions (77) in a longitudinal direction of the breathing gas tube (20). An adapter (78) connects the breathing gas hose (20) to components close to the patient.

24 shows a filling device (79) for filling the storage space (76) which is arranged in the area of the breathing gas hose (20). The filling device (79) has a funnel (80) which surrounds a centering element (81) and together with the centering element (51) delimits an essentially annular filling gap. The water reaches the area of the storage space (76) through the filling gap.

24 also illustrates once again in a perspective view that the membrane (73) and the reservoir (76) essentially concentrically surround a flow path (82).

25 shows an embodiment in which, as a modification to the embodiment in 22 the moisture is directed into the area of the air flow (74) via an elastic nozzle (83). The nozzle (83) protrudes into an air duct (84). The nozzle (83) is connected to the water tank (10) via a droplet generator (85). The droplet generator (85) can be controlled via exciter connections (86).

According to the embodiment in FIG 26 A nozzle (87) opens into the air duct (84) and is connected to the water tank (10) via the droplet generator (85). The drop generator (85) has a drop control (88) here. A fan wheel (90) driven by a fan motor (89) is arranged in the area of the air duct (84). According to one embodiment, the drops emerging from the nozzle (87) reach the area of the fan wheel (90) directly and are distributed by it. Alternatively, it is also possible to arrange an upstream atomizer wheel (91) in the area of this fan wheel (90) in order to prevent moisture from penetrating into the area of the fan motor (89). An electrically controllable heating grid (92) can be used to control the temperature of the air flow within the air duct (84).

According to the embodiment in FIG 27 a Peltier element (93) is used, which is connected to a voltage supply (94). The Peltier element (93) has a cold side (95) with condensation from the air and a warm side (96) with heat emission into the air. Both the cold side (95) and the warm side (96) are subjected to an air flow (97). In the vertical direction below the Peltier element (93) there is a collecting trough (98) for condensate that forms.

According to the embodiment in FIG 28 a fuel cell (99) connected to an oxygen tank (100) and a hydrogen tank (101) is used. The fuel cell (3) has an electrical connection (102) for supplying energy. Water formed by the fuel cell (99) is collected in the area of a collecting device (103). The electrical connection (102) serves to supply energy to at least one connected electrical consumer, for example the respiratory gas humidifier (4) and/or the respiratory gas supply (1).

29 illustrates a module designed as a heating element (52), which is arranged below the water tank (10). In this embodiment, the water tank (10) has an electrically conductive one floor (104). The heating element (52) consists of an electromagnet (105) whose coil (106) is connected to an AC voltage (107). The electromagnet (105) is separated from the water tank (10) by a housing wall (108).

30 illustrates an embodiment with a floating heating plate (109) as the heating device (52). The heating plate (109) floats on a water supply (110) inside the water tank (10). The heating plate (109) is supplied with energy by an electrical connection (111). The air flow (97) sweeps over a surface of the water supply (110). The heating plate (109) is designed in such a way that, taking into account its specific weight, it is slightly immersed in the water supply (110), so that a thin film of water forms on a surface of the heating plate (109) facing away from the water supply (110), which allows for evaporation is provided.

31 illustrates the use of waste heat from a power pack or transformer (112). The water tank (10) is arranged on a heat sink (113) of the power pack (112). The power pack (112) is preferably separated from the heat sink (113) and the water tank (110) by the housing wall (108).

According to the embodiment in FIG 32 are within an interior (114) of the water tank (10), which is arranged above the water supply (110), a plurality of partitions (115) are arranged, which are preferably arranged inclined to the horizontal. Water is removed from the water supply (110) using a pump (116) and heated via the heating element (52). The heated water is supplied to the interior space (114) in a vertical direction from above and gradually runs along the partitions (115) arranged one above the other in the direction of the water reservoir (110). The partitions (115) thus provide large-scale evaporation surfaces. The interior (114) is provided with an air inlet (117) and an air outlet (118).

33 shows one opposite 32 modified embodiment. The air inlet (6) is lower and the air outlet (7) higher. In this way, relative to the water flowing vertically from top to bottom, an air flow is achieved in the countercurrent principle, which again increases the moisture absorption of the air.

Claims (11)

Device for humidifying breathing gas, consisting of at least one device for introducing water or water vapor and a connection to a breathing gas supply, the breathing gas supply (1) having a display device (5) and operating elements (6) and the breathing gas supply (1) also having a delivery device (7) for the breathing gas, an electric drive (8) for the delivery device (7) and a controller (9) for the electric drive (8), with humidification being effected by water nebulization excited by means of ultrasound, with the Ultrasonic nebulization generates an aerosol through vibrations of a piezoelectric crystal, characterized in that a water supply is positioned on a metal plate with small holes, so that the water is directly on the metal plate, the size of the holes being chosen so that no water is present due to capillary forces flows out. device after claim 1 , characterized in that the ultrasonic nebulization generates aerosols that are added to the breathing gas flow in the area of inspiration. device after claim 1 or 2 , characterized in that only a portion of the respiratory gas is humidified by a bypass. Device according to at least one of the preceding claims, characterized in that the moistening is controlled in such a way that the patient is provided with a higher level of moisture in phases of inspiration than in phases of expiration. Device according to at least one of the preceding claims, characterized in that the water supply is arranged above the water outlet and the opening of the water outlet to the humidification space is designed in such a way that no water drips out due to the surface tension of the water. Device according to at least one of the preceding claims, characterized in that the water supply to the humidification space can be regulated by regulating the energy supply. Device according to at least one of the preceding claims, characterized in that the water reservoir is separated from the ultrasonic nebulization area by filters. Device according to at least one of the preceding claims, characterized in that the duration of ventilation, humidification and administration of medication can be set via a timer function. Device according to at least one of the preceding claims, characterized in that aerosols used to treat lung diseases have a diameter of between 0.1-10 µm. Device according to at least one of the preceding claims, characterized in that the device enables remote control via voice recognition and communicates possible faults and/or current statuses/data via voice output. Device according to at least one of the preceding claims, characterized in that a module enables communication and also enables remote setting, remote maintenance and/or remote querying of humidifier parameters.

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