Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
  • A61M16/0096—High frequency jet ventilation
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
  • A61M16/10—Preparation of respiratory gases or vapours
  • A61M16/105—Filters
  • A61M16/106—Filters in a path
  • A61M16/1065—Filters in a path in the expiratory path
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
  • A61M16/10—Preparation of respiratory gases or vapours
  • A61M16/105—Filters
  • A61M16/106—Filters in a path
  • A61M16/107—Filters in a path in the inspiratory path
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
  • A61M16/20—Valves specially adapted to medical respiratory devices
  • A61M16/208—Non-controlled one-way valves, e.g. exhalation, check, pop-off non-rebreathing valves
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
  • A61M16/10—Preparation of respiratory gases or vapours
  • A61M16/14—Preparation of respiratory gases or vapours by mixing different fluids, one of them being in a liquid phase
  • A61M16/16—Devices to humidify the respiration air
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M2205/00—General characteristics of the apparatus
  • A61M2205/42—Reducing noise

Definitions

• the invention relates to a device for generating a pulsating gas column for superponABLE Hochfrequenzj etbe- breathing.
• the invention further relates to the use of the device according to the invention in an open or semi-open respiratory system, in particular using a bronchoscope or laryngoscope, wherein the respiratory gas flow provided by a respirator via at least one jet nozzle with additionally aspirated ambient air as a retrograde current via an exspiration into the patient , is introducible.
• high continuous alveolar distension pressure is built up by using a high gas flow in the ventilation system.
• the breathing gas is usually administered by jet technique.
• jet is meant the directional administration of a high velocity compressed gas through a nozzle. If the ventilation system is open, so-called Venturi effects occur at the end of the nozzle, which, according to the principle of the water jet pump, increase the volume of breathing gas. In doing so, air that surrounds the jet is dragged along so that the volume of gas that reaches the lungs can be much larger than the amount of gas delivered by the ventilator. The additional gas volume sucked in from the environment is called "entrainment".
• An integrated into the system oscillator puts the gas flow in pulsating oscillations with a frequency of typically 1-15 hertz.
• a respirator in which a venturi is located downstream of a jet nozzle to produce a pulsating gas column has become known from DE 3329485 AI.
• the respiratory gas is emitted, for example, by means of a T-connector, to the T-bar of which a respiratory gas transverse flow is connected.
• a device is known in which transversely to the beam of the T-connector a plurality of tubes with a smaller clear cross-section than the clear cross-section of the transversely to the T-bar subsequent tubular part of the T-connector are arranged, which in the direction extend extending transversely to the T-bar tubular part of the T ⁇ connector, wherein at least two tubes are acted upon by pulsating compressed gas of different frequency.
• a disadvantage of this type of jet ventilation is that due to the jet nozzles relatively high shear forces arise, so there is a risk of traumatizing the lungs.
• the aim is to achieve lower shear forces than under conventional ventilation, as well as the same blood gas values with low inspiratory 0 2 concentration (FIO 2 ) and at. to achieve lower ventilation pressure.
• the invention aims to ensure a rapid expiration at the end of inspiration without systemic delay.
• the invention provides a device of the aforementioned type, which has a first connection for a low-frequency breathing gas flow provided by a respirator, a first jet nozzle connected to the first connection, a first venturi body arranged downstream of the first jet nozzle, a second A port for a high-frequency breathing gas flow provided by a respirator, a second jet nozzle communicating with the second port, and a second venturi disposed downstream of the second jet nozzle, the first venturi body and the second venturi body communicating with a common port for a breathing tube.
• the ventilator safety functions requiring a separate pressure measurement of the two flows can be used.
• a measurement of the residual pressure in the expiratory phase is implemented, wherein the measured values are supplied to a risk analysis and if necessary an alarm signal is generated. If the low-frequency and the high-frequency breathing gas flow were connected to one another and expelled through a common jet nozzle, such an alarm function could not be realized.
• the separately generated vibrating gas columns can be connected, so that only a single outlet must be connected to the expiratory limb of a standard tube system.
• first and the second jet nozzles each open into a suction chamber in communication with the ambient air in order to entrain ambient air with the jet stream.
• the entrained at the outlet of the jet stream from a nozzle opening ambient air contributes significantly to ventilation.
• the total amount of breathing gas from expanded gas and the absorbed respiratory gas together provide the necessary amount of gas for gas exchange.
• the suction chamber associated with the first jet nozzle communicate with the ambient air via a first inspiration opening and the suction chamber associated with the second jet nozzle via a second inspiration opening.
• a silencer is connected to the first and the second inspiration opening.
• a filter is in each case connected to the first and the second inspiration opening.
• the expiration can take place via the above-mentioned inspiratory openings.
• the expired air then flows into the device via the connection for the breathing tube and is conducted there via the first and the second venturi body to the inspiration openings.
• the expiration takes place via a separate outlet of the device.
• the device according to the invention is preferably further developed in such a way that an expiration opening is provided which communicates with the connection for the breathing tube.
• the respiratory air is not guided via the first or second venturi body, but rather from the connection for the respiration tube via at least one separate, ie at least partially, section from the one for inspiration. tion provided gas path different line section to the expiration.
• a filter and possibly a silencer is connected to the expiration opening.
• At least one adjustable flap determining the flow cross-section is arranged in the gas path connecting the connection for the breathing tube and the expiration opening.
• the at least one adjustable flap can be designed so that it is spring-loaded in the opening direction.
• the flap is thus formed in the manner of a non-return valve, wherein the expiratory flow acts in opening direction and the Inspirationsström in the closing direction on the flap.
• the at least one flap is designed such that it does not completely occlude the gas path provided for inspiration or expiration, neither in the closed nor in the open state. Rather, it is desirable if the respective gas path, for example, only 90% closed.
• a preferred embodiment provides that the at least one flap cooperates with an adjustable stop, which determines a minimum flow cross section of the expired air.
• an adjustable flap can be arranged at each discharge point.
• the adjustable flaps are advantageously arranged such that the jet stream coming from the first jet nozzle and the jet flow coming from the second jet nozzle act on the respective adjustable flap in the closing direction.
• FIG. 1 shows a respiratory system in which the device according to the invention is used
• FIG. 2 shows a cross section through the device according to the invention in a first embodiment
• FIG. 3 shows a cross section through the device according to the invention in a second embodiment.
• the respirator 1 shows a respirator, for example a TwinStream TM Multi Mode Respirator of Carl Reiner GmbH.
• the respirator 1 comprises a low-frequency jet ventilation unit and a high-frequency jet ventilation unit, the low-frequency respiratory gas flow provided by the respirator 1 being delivered via the line 2 and the high-frequency respiratory gas flow via the line 3.
• the combination of the low-frequency and the high-frequency respiratory gas flow results in a special ventilation pattern, the ventilation being referred to as super-imposed high-frequency jet ventilation.
• the provided via the lines 2 and 3 breathing gas flow is introduced at high pressure (0.1-3.5 bar) via jet nozzles separately from each other in the device referred to as "jet modifier" 4.
• the gas stream formed in the jet modifier 4 is in the form of a pulsating gas column via the expiratory tube 5 against a bias flow (breathing gas cross-flow) pressed and therefore introduced the Biasflow in the respiratory passages 6 of the patient.
• the bias flow is generated by the respirator 1 and provided via the inspiratory tube 7.
• the Biasflow 8 water vapor is added by means of the gas conditioning unit.
• jet ventilation can be characterized by a simultaneous volumetric flow into the lungs (inspiration) as well as from the lungs (expiration).
• the high kinetic energy generated by the chopping of the jet stream leads to more frequent collisions between the gas molecules in the alveoli and consequently promotes the diffusion of the 0 2 molecules into the blood through the alveolar arm. Due to the continuous gas flow to the outside, the CC> 2 elimination is ensured at the same time.
• the bias flow is introduced via the gas conditioning unit 8 into the leg 9 of a Y-piece 10 of a standard hose system.
• a measuring adapter can be installed at the end of the expiratory limb 11, the jet modifier 4 is coupled in as an active expiration valve.
• the function of the jet modifier 4 is to convert the hard jet jet from the lines 2 and 3 into a well-tolerated flow pattern.
• the bias flow escapes unhindered over the jet modifier 4 which is seated at the end of the expiratory limb 10.
• a countercurrent flow is applied into the expiratory limb 10 by the jet modifier 4 and the result is increased a volume shift and to a adequate pressure build-up in the tube, whereby the respiratory conditioned bias flow is forced into the lungs.
• the ventilation pressure can be measured by means of a probe, not shown, and the measured values can be made available to the ventilator 1 for monitoring purposes via a signal line 12.
• Fig. 2 only the jet modifier 4 is shown in detail.
• the Horbuchse for the provided by the ventilator 1 low-frequency breathing gas flow and the high-frequency breathing gas flow is denoted by 13.
• the low-frequency respiratory gas flow is discharged via the opening 14 on the inner circumference of the bush 13 and fed to the first jet nozzle 15.
• the first jet nozzle 15 opens into a suction chamber 16, which communicates with the environment via a radial line and a first inspiration opening 17.
• a first venturi or venturi 18 immediately adjoins the suction chamber 16, to which in turn the first inspiratory conduit 19 connects.
• the high-frequency respiratory gas flow is discharged via the radial bore 20 which opens out on the inner circumference of the bushing 13 and fed to the second jet nozzle 21.
• the second jet nozzle 21 opens into a suction chamber 22, which communicates with the environment via a radial line and a second inspiration opening 23.
• a second venturi body or a second venturi tube 24 immediately adjoins the suction chamber 22, to which the second inspiratory line 25 in turn connects.
• the expiration line 26, which communicates with the environment via the expiration opening 27, opens into the second inspiratory line 25.
• a flap 29 pivotally mounted about the pivot axis 28 is arranged.
• the second inspiratory line 25 opens into the first inspiratory conduit 19.
• a flap 31 mounted pivotably about the pivot axis 30 is arranged.
• the flaps 29 and 31 are respectively spring-loaded in the direction of opening, wherein the open position of the flaps designates that position in which the gas path connecting the expiration opening 27 and the connection 32 for the breathing tube is maximally opened.
• the pivoting movement of the flaps 29 and 31 in the closing direction is limited by a stop, not shown, so that the flaps 29 and 31 can not be completely closed.
• the stop is preferably adjustable, so that the exhalation resistance can be adjusted.
• the respiratory gas flow is in each case directed via the venturi body 18 or 22 against the flap 29 or 31 and moves the flap depending on the applied pressure during the inspiration phase in the closing direction, so that a flow cross section for the gas to be inspired is increased.
• the high-frequency current and the low-frequency current are superimposed in the first inspiratory line 19 and discharged into the expiratory tube 5 via the port 32 in the inspiratory phase.
• a quantity of gas passes from the expiratory tube 5 back into the jet modifier 4, where it via the first inspiratory line 19, the open flap 31, the second inspiratory line 25, the flap 29, the expiratory line 26 and the expiratory opening 27 in the Environment is delivered.
• a filter 33 is connected to the expiratory opening 27 (FIG. 1). Furthermore, a muffler 34 is connected to minimize the noise. A filter 33 and a muffler are also connected to the inspiratory ports 17 and 23.
• the reference symbols used in FIG. 2 have been retained as far as they are concerned. Components that are used in the embodiment of FIG. 2 are used. The embodiment according to FIG. 3 differs from the embodiment according to FIG. 2 in that the separate expiration opening 27 is dispensed with.
• the expiratory air thus passes via the connection 32 into the jet modifier 4, where it is forwarded via the inspiratory line 19 and is divided into two partial flows, each via the venturi tube 15 or 15, respectively. 24 and the suction chambers 16 and 22, respectively, to the inspiration openings 17 and 23, respectively.
• the jet modifier according to FIG. 3 functions the same as the jet modifier according to FIG. 2.
• the embodiment of FIG. 3 allows a particularly compact design.

Landscapes

• Health & Medical Sciences (AREA)
• Pulmonology (AREA)
• Heart & Thoracic Surgery (AREA)
• Engineering & Computer Science (AREA)
• Anesthesiology (AREA)
• Biomedical Technology (AREA)
• Emergency Medicine (AREA)
• Hematology (AREA)
• Life Sciences & Earth Sciences (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• Respiratory Apparatuses And Protective Means (AREA)
• Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)

Applications Claiming Priority (2)

Publications (1)

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ID=49949299

Family Applications (1)

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• 2013
  • 2013-07-17 WO PCT/AT2013/000121 patent/WO2014012127A2/de active Application Filing
  • 2013-07-17 EP EP13750625.9A patent/EP2874685A2/de not_active Withdrawn
  • 2013-07-17 CN CN201380048281.1A patent/CN104812431B/zh not_active Expired - Fee Related
  • 2013-07-17 JP JP2015521909A patent/JP2015521952A/ja active Pending

Non-Patent Citations (2)

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