EP4701700A1 - Vorrichtung zur atemgasversorgung - Google Patents
Vorrichtung zur atemgasversorgungInfo
- Publication number
- EP4701700A1 EP4701700A1 EP24719546.4A EP24719546A EP4701700A1 EP 4701700 A1 EP4701700 A1 EP 4701700A1 EP 24719546 A EP24719546 A EP 24719546A EP 4701700 A1 EP4701700 A1 EP 4701700A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- valve
- designed
- gas
- pressure
- flow
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Pending
Links
Classifications
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- 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. ventilators; Tracheal tubes
- A61M16/0051—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes with alarm devices
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- A—HUMAN NECESSITIES
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- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
- A61M16/0057—Pumps therefor
- A61M16/0066—Blowers or centrifugal pumps
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- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
- A61M16/01—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes specially adapted for anaesthetising
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- A—HUMAN NECESSITIES
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- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
- A61M16/021—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes operated by electrical means
- A61M16/022—Control means therefor
- A61M16/024—Control means therefor including calculation means, e.g. using a processor
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- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
- A61M16/08—Bellows; Connecting tubes ; Water traps; Patient circuits
- A61M16/0883—Circuit type
- A61M16/0891—Closed circuit, e.g. for anaesthesia
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- A61M16/105—Filters
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- A61M16/0087—Environmental safety or protection means, e.g. preventing explosion
- A61M16/009—Removing used or expired gases or anaesthetic vapours
- A61M16/0093—Removing used or expired gases or anaesthetic vapours by adsorption, absorption or filtration
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- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; 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
- A61M16/209—Relief valves
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- A—HUMAN NECESSITIES
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- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
- A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
- A61M2016/0027—Accessories therefor, e.g. sensors, vibrators, negative pressure pressure meter
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- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
- A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
- A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
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- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
- A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
- A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
- A61M2016/0033—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical
- A61M2016/0039—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical in the inspiratory circuit
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- 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. ventilators; Tracheal tubes
- A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
- A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
- A61M2016/0033—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical
- A61M2016/0042—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical in the expiratory circuit
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- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
- A61M16/10—Preparation of respiratory gases or vapours
- A61M16/1005—Preparation of respiratory gases or vapours with O2 features or with parameter measurement
- A61M2016/102—Measuring a parameter of the content of the delivered gas
- A61M2016/1025—Measuring a parameter of the content of the delivered gas the O2 concentration
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- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
- A61M16/10—Preparation of respiratory gases or vapours
- A61M16/1005—Preparation of respiratory gases or vapours with O2 features or with parameter measurement
- A61M2016/102—Measuring a parameter of the content of the delivered gas
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- A—HUMAN NECESSITIES
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- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
- A61M16/10—Preparation of respiratory gases or vapours
- A61M16/1005—Preparation of respiratory gases or vapours with O2 features or with parameter measurement
- A61M2016/102—Measuring a parameter of the content of the delivered gas
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- A61M2202/00—Special media to be introduced, removed or treated
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- A61M2202/00—Special media to be introduced, removed or treated
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- A61M2205/50—General characteristics of the apparatus with microprocessors or computers
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- A61M2205/00—General characteristics of the apparatus
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Definitions
- the invention relates to a device for anesthesia and/or ventilation.
- Anesthesia workstations are usually designed in such a way that the respiratory gases are fed into a circuit and used gases such as oxygen (O2) are supplied and carbon dioxide (CO2) is removed from the circuit.
- gases such as oxygen (O2)
- CO2 carbon dioxide
- volatile anesthetics can be added and separated in a controlled manner. Due to a respiratory gas source and check valves, the gases flow in a defined direction.
- the inspiration air is fed to the patient via the inspiratory branch of the respiratory gas circuit. After inspiration, the patient's expiration air returns to the circuit system via the expiratory branch. CO2 is then separated from the expiration air, the respiratory gas is mixed with new fresh gases and fed back to the patient.
- the CO2 is usually removed from the respiratory gas mixture using a chemical CO2 absorber.
- the object of the present invention is to provide a device that can be used both for the application of volatile anesthetics and for ventilation or for respiratory support and that is simple, flexible and yet safe to operate. This object is achieved with a device as claimed in claim 1. Further developments and advantageous embodiments are the subject of the subclaims. Further advantages and features emerge from the general description and the description of the exemplary embodiments. It should be noted that the features listed individually in the claims can be combined with one another in any technically reasonable manner and show further embodiments of the invention. The description additionally characterizes and specifies the invention, particularly in connection with the figures.
- the invention relates to a device for supplying respiratory gas with at least one respiratory gas line for conducting a respiratory gas mixture, the respiratory gas line comprising at least one outlet via which the respiratory gas mixture can be discharged at least partially, at least temporarily, the respiratory gas line comprising an inspiratory branch which is designed to conduct respiratory gas to a connection for a patient interface, the respiratory gas line comprising an expiratory branch which is designed to conduct respiratory gas between the connection for a patient interface and the outlet, characterized in that at least one shut-off valve is arranged in the respiratory gas line, which is designed and configured to at least temporarily establish a respiratory gas-conducting connection from the expiratory branch to the inspiratory branch.
- the device is characterized in that the device comprises at least one reservoir for the respiratory gas mixture and at least one blower which is configured to provide conveying energy for the respiratory gas mixture, the reservoir and blower being arranged in or on the inspiratory branch.
- the device is characterized in that the shut-off valve is designed as a check valve and is set up to establish the respiratory gas-conducting connection in a flow direction from the expiratory branch to the inspiratory branch.
- the device is characterized in that the shut-off valve is designed as a lockable check valve and is set up to at least temporarily block the respiratory gas line in both flow directions.
- the device is characterized in that the device comprises a control device and at least one power source.
- the device is characterized in that the shut-off valve is set up to block the respiratory gas line in both flow directions when energized by the at least one power source. In some embodiments, the device is characterized in that the shut-off valve is set up to prevent the respiratory gas-conducting connection from the expiratory branch to the inspiratory branch when energized. In some embodiments, the device is characterized in that the respiratory gas mixture can be completely discharged from the expiratory branch via the outlet when the shut-off valve is energized.
- the device is characterized in that the inspiratory branch and expiratory branch form at least a first circuit without energizing the shut-off valve, in which the respiratory gas mixture can be conducted, wherein the respiratory gas mixture can be at least partially discharged via the outlet.
- the device comprises at least one adjustable pressure control valve.
- the device is characterized in that the pressure control valve is set up to regulate an inspiratory pressure Pinsp and/or an expiratory pressure Pexsp.
- the device is characterized in that the pressure control valve is manually and/or electrically adjustable.
- the device is characterized in that the device comprises an APL valve for regulating the inspiratory pressure Pinsp.
- the device is characterized in that the respiratory gas mixture can be discharged via the outlet when the pressure in the respiratory gas line exceeds the inspiratory pressure Pinsp.
- the device is characterized in that the APL valve is designed as a controllably loaded check valve.
- the device is characterized in that the APL valve comprises a stepper motor via which the APL valve can be adjusted.
- the device is characterized in that the valve position of the APL valve is set and/or maintained when energized.
- the device is characterized in that the valve position of the APL valve remains at the last set value without energization.
- the device is characterized in that the APL valve can be adjusted manually and/or electrically.
- the device is characterized in that the device comprises a pressure control valve for controlling the expiratory pressure Pexsp. In some embodiments, the device is characterized in that the pressure control valve is arranged in the expiratory branch. In some embodiments, the device is characterized in that the pressure control valve is designed to control an end-expiratory expiratory pressure PEEP. In some embodiments, the device is characterized in that the pressure control valve is designed to passively regulate to a preset expiratory pressure Pexsp without energization. In some embodiments, the device is characterized in that the preset expiratory pressure Pexsp of the pressure control valve is 3 hPa to 10 hPa, for example 5 hPa.
- the device is characterized in that the respiratory gas mixture contains fresh gas and/or oxygen O2 and/or volatile anesthetics. In some embodiments, the device is characterized in that the device comprises at least one anesthetic supply line for introducing volatile anesthetics into the breathing gas line. In some embodiments, the device is characterized in that a first pressure is present in the breathing gas line and that a second pressure is present in the anesthetic supply line, the first pressure being lower than the second pressure. In some embodiments, the device is characterized in that the second pressure is at least 100 kPa, preferably at least 180 kPa.
- the device is characterized in that the first pressure is less than 100 kPa, preferably less than 50 kPa, particularly preferably less than 10 kPa. In some embodiments, the device is characterized in that the first pressure is less than 8 kPa, preferably less than 5 kPa, particularly preferably less than 3 kPa. In some embodiments, the device is characterized in that the device can be operated at room temperature. In some embodiments, the device is characterized in that the volatile anesthetics are selected from the group: isoflurane, sevoflurane, desflurane, halothane, enflurane, methoxyflurane.
- the device is characterized in that the volatile anesthetics in the anesthetic supply line can be fed to the breathing gas line in liquid form. In some embodiments, the device is characterized in that the volatile anesthetics evaporate at an evaporation rate of 0 to 2 l/min when introduced into the breathing gas line. In some embodiments, the device is characterized in that the evaporated volatile anesthetics mix with the breathing gas mixture in the breathing gas line. In some embodiments, the device is characterized in that the device comprises at least one safety valve that is set up and designed to block the supply of volatile anesthetics. In some embodiments, the device is characterized in that the safety valve is designed as a switching valve.
- the device is characterized in that the safety valve is electrically P580 and/or manually adjustable. In some embodiments, the device is characterized in that the safety valve is designed as an electrically operated switching valve, wherein the safety valve is designed to block the introduction of volatile anesthetics into the respiratory gas mixture without power supply. In some embodiments, the device is characterized in that the outlet comprises at least one filter. In some embodiments, the device is characterized in that the filter is replaceable. In some embodiments, the device is characterized in that respiratory gas mixture discharged via the outlet passes completely through the filter. In some embodiments, the device is characterized in that the filter is an absorbent and/or comprises an absorbent and is designed and configured to absorb at least volatile anesthetics and/or their metabolites.
- the device is characterized in that the filter comprises activated carbon. In some embodiments, the device is characterized in that a double filter system with a first filter and a second filter is arranged at the outlet, wherein the second filter is arranged behind the first filter in the flow direction. In some embodiments, the device is characterized in that the device comprises at least one sensor that is arranged in or at the outlet. In some embodiments, the device is characterized in that the sensor is designed and configured to detect the concentration of volatile anesthetics and/or their metabolites and to transmit it to the control device.
- the device is characterized in that the concentration of volatile anesthetics and/or their metabolites can be detected in the flow direction at least before and/or after the first filter and can be transmitted to the control device.
- the device is characterized in that the control device is configured to generate an alarm when the concentration of volatile anesthetics and/or their metabolites exceeds a limit value.
- the device is characterized in that the device comprises a separating agent that is configured to separate at least CO2 from the respiratory gas mixture.
- the separating agent is a chemical separating agent and/or a mechanical separating agent.
- the device is characterized in that the chemical separating agent contains at least one CO2-binding absorption agent selected from the group: calcium hydroxide, sodium hydroxide, potassium hydroxide, barium hydroxide, soda lime.
- the device is characterized in that the chemical separating agent can be flowed through by expiratory breathing gas exsp when the inspiratory branch and the expiratory branch form the circuit.
- the device is characterized in that the mechanical separating agent is arranged in the expiratory branch.
- the Device characterized in that the mechanical separating means is adjacent to the connection for a patient interface.
- the device is characterized in that the separating means comprises at least one diffusion filter which is designed as a semipermeable membrane and is permeable at least to CO2 molecules. In some embodiments, the device is characterized in that the diffusion filter is not permeable at least to volatile anesthetics. In some embodiments, the device is characterized in that the separating means is designed as a two-chamber system which comprises at least a first chamber and at least a second chamber, wherein the first chamber and the second chamber are gas-conducting and are separated from one another by the diffusion filter.
- the device is characterized in that the first chamber is designed to receive expiratory breathing gas exsp and that the second chamber is designed to receive a sweep gas, wherein the sweep gas has at least a lower CO2 concentration than the expiratory breathing gas exsp.
- the device is characterized in that the first chamber is designed to guide the expiratory breathing gas exsp in the direction of a main flow, wherein the second chamber is designed to guide the sweep gas in the direction of a sweep gas flow, wherein the flow direction of the main flow is opposite to the flow direction of the sweep gas flow.
- the device is characterized in that the CO2 concentration of the sweep gas when introduced into the second chamber is less than 10%, preferably less than 5%, particularly preferably 0%.
- the device is characterized in that the device comprises at least one sweep gas supply line for providing sweep gas for the mechanical separating agent, wherein the sweep gas supply line comprises at least one valve for metering sweep gas.
- the device is characterized in that the flow rate of the sweep gas is greater than or equal to the flow rate of the expiratory breathing gas exsp.
- the device is characterized in that the flow rate of the sweep gas is 0 to 20 l/min, preferably 0 to 10 l/min.
- the device is characterized in that the flow rate of the sweep gas is set in relation to the minute volume.
- the device is characterized in that the flow rate of the sweep gas is 1.1 to 2 times the minute volume, preferably 1.2 to 1.5 times the minute volume. In some embodiments, the device is characterized in that the device comprises at least one valve for dosing fresh gas and/or oxygen O2. In some embodiments, the device is characterized in that the device comprises at least one valve for dosing volatile anesthetics. In some embodiments, the device is characterized in that the dosing valves are selected from the group: needle valve, proportional valve, switching valve, orifice, throttle valve. In some embodiments, the device is characterized in that the dosing valves are designed as needle valves.
- the device is characterized in that the metering valves each comprise at least one stepper motor, via which the metering valves can be adjusted. In some embodiments, the device is characterized in that the valve position of the metering valves is set and/or maintained when energized. In some embodiments, the device is characterized in that the valve position of the metering valves remains at the last set value without energization and/or falls to an open basic setting. In some embodiments, the device is characterized in that the device comprises at least one sensor for detecting at least one ventilation-specific parameter.
- the device is characterized in that the ventilation-specific parameters comprise at least one of the following parameters: inspiratory patient pressure, inspiratory patient flow, inspiratory tidal volume, inspiratory minute volume, inspiratory respiratory rate, inspiratory O concentration, inspiratory CO concentration, inspiratory NO concentration, inspiratory anesthetic gas concentration; expiratory patient pressure, expiratory patient flow, expiratory tidal volume, expiratory minute volume, expiratory respiratory rate, expiratory O concentration, expiratory CO concentration, expiratory NO concentration, expiratory anesthetic gas concentration; gas temperature, gas humidity, fresh gas flow, leakage.
- the ventilation-specific parameters comprise at least one of the following parameters: inspiratory patient pressure, inspiratory patient flow, inspiratory tidal volume, inspiratory minute volume, inspiratory respiratory rate, inspiratory O concentration, inspiratory CO concentration, inspiratory NO concentration, inspiratory anesthetic gas concentration; expiratory patient pressure, expiratory patient flow, expiratory tidal volume, expiratory minute volume, expiratory respiratory
- the device is characterized in that the device comprises at least one storage unit which is set up and designed to store at least the ventilation-specific parameters recorded during the respiratory gas supply.
- the device is characterized in that the storage unit is set up to store patient parameters, wherein the patient parameters comprise at least one of the following parameters: age, weight, height, body mass index (BMI), previous illnesses.
- the device is characterized in that the flow rate of the sweep gas can be dynamically adapted to the ventilation-specific parameters and/or to the patient parameters.
- the device is characterized in that the respiratory gas line comprises a bypass that branches off from the inspiratory branch and flows into the expiratory branch between the mechanical separating means and the outlet.
- the device is characterized in that the bypass is designed to at least temporarily establish a respiratory gas-conducting connection from the inspiratory branch to the expiratory branch in such a way that a second circuit is formed in which the respiratory gas mixture can be conducted.
- the device is characterized in that the second circuit at least partially corresponds to the first circuit, with the connection for a patient interface only being arranged in the first circuit.
- the device is characterized in that the mechanical separating means is only arranged in the first circuit.
- the bypass comprises at least one bypass shut-off valve.
- the device is characterized in that the bypass shut-off valve is designed as a check valve and is set up to at least temporarily establish the respiratory gas-conducting connection in a flow direction from the inspiratory branch to the expiratory branch. In some embodiments, the device is characterized in that the bypass shut-off valve is designed as a lockable check valve and is set up to at least temporarily block the bypass in both flow directions. In some embodiments, the device is characterized in that the bypass shut-off valve is set up to block the bypass in both flow directions when energized by the at least one power source. In some embodiments, the device is characterized in that the respiratory gas mixture can be conducted at least partially in the second circuit without energizing the shut-off valve and the bypass shut-off valve.
- the device is characterized in that the respiratory gas mixture in the first circuit can be conducted with the main flow and that the respiratory gas mixture in the second circuit can be conducted with a bypass flow.
- the device is characterized in that the main flow is dependent on the breathing phases of a patient to be ventilated.
- the device is characterized in that the bypass flow is independent of the breathing phases of a patient to be ventilated.
- the device is characterized in that at least the bypass flow of the second circuit is conducted through the PEEP valve.
- the device is characterized in that the device can be operated in different working modes.
- the device is characterized in that the device can be operated in automatic working modes in which the fan supplies the conveying energy for the respiratory gas mixture. In some embodiments, the device is characterized in that the device can be operated in manual working modes in which the reservoir supplies the conveying energy for the respiratory gas mixture. In some embodiments, the device is characterized in that the reservoir is designed as a hand bag. In some embodiments, the device is characterized in that the device can be operated in working modes with the application of volatile anesthetics and/or in working modes without the application of volatile anesthetics, wherein the safety valve is designed to allow the introduction of volatile anesthetics into the respiratory gas mixture when energized and to block the introduction of volatile anesthetics into the respiratory gas mixture when energized.
- the device is characterized in that the device can be operated in a working mode that is selected from the group: anesthesia mode with volatile anesthetics; anesthesia mode with intravenously administered anesthetics (TIVA mode); Ventilation mode with anesthetics; ventilation mode without anesthetics, O therapy mode, high-flow O therapy mode (HFOT mode), CPAP mode, bi-level mode, SIMV mode, emergency mode.
- the device is characterized in that the working mode can be set manually and/or automatically by the control unit.
- the device is characterized in that the device can be operated in an emergency mode without a power supply and/or in a power-saving manner.
- the device is characterized in that the emergency mode occurs automatically and/or can be set manually. In some embodiments, the device is characterized in that the emergency mode occurs automatically when the functions of the power source and/or the control device and/or the blower are limited or fail. In some embodiments, the device is characterized in that the respiratory gas mixture can be conducted in the emergency mode at least in the first circuit, wherein the respiratory gas mixture can be at least partially discharged via the outlet. In some embodiments, the device is characterized in that the respiratory gas mixture can be conducted in the second circuit in emergency mode. In some embodiments, the device is characterized in that the delivery energy for the respiratory gas mixture is provided by the reservoir in emergency mode.
- the device is characterized in that the APL valve regulates to the last set inspiratory pressure Pinsp in emergency mode. In some embodiments, the device is characterized in that the pressure control valve passively regulates the expiratory pressure Pexsp in emergency mode. In some embodiments, the device is characterized in that the chemical separating agent and/or the mechanical separating agent is active without power supply. In some embodiments, the device is characterized in that the safety valve is closed in emergency mode, wherein the safety valve can be opened manually. In some embodiments, the device is characterized in that the metering valves are not energized in emergency mode, so that the metering of fresh gas and/or oxygen and/or volatile anesthetics and/or sweep gas is kept at the last set value.
- the device is characterized in that the valve for metering sweep gas in emergency mode sets the sweep gas metering to 1.2 to 2 times the last set minute volume, preferably to 1.5 times.
- the device is characterized in that fresh gas and/or oxygen are supplied to the breathing gas mixture in emergency mode via the metering valves.
- the device is characterized in that the fresh gas and/or oxygen are provided in at least one compressed gas cylinder, with the pressure of the compressed gas cylinders providing the delivery energy for the fresh gas and/or oxygen.
- the device is characterized in that the volatile anesthetics are provided in at least one tank each, with a pressure being present in the tanks.
- the device is characterized in that the pressure in the tanks is at least 100 kPa, preferably at least 180 kPa. In some embodiments, the device is characterized in that the pressure in the tanks provides the conveying energy for the volatile anesthetic.
- the invention relates to a method for introducing at least one volatile anesthetic into a breathing gas mixture, wherein the breathing gas mixture is passed in a breathing gas line under a first pressure, characterized in that the volatile anesthetic is passed in liquid form in an anesthetic supply line under a second pressure to the breathing gas line, wherein the first pressure is lower than the second pressure, wherein the volatile anesthetic is exposed to the first pressure upon entering the breathing gas line and becomes gaseous.
- the device 100 is designed to supply respiratory gas.
- the device 100 has a ventilation function and/or an anesthesia function.
- the device 100 can thus be used as a ventilator or as an anesthesia device.
- the device 100 can also be used as a ventilator and as an anesthesia device.
- a patient can thus be ventilated or assisted in breathing using the device 100 and alternatively or additionally kept under anesthesia.
- a ventilator is understood to mean all devices that support a user or patient in natural breathing and/or take over the ventilation of a user or patient and/or serve for respiratory therapy and/or otherwise influence the breathing of a user or patient.
- ventilation used here includes, within the meaning of the invention, all forms of ventilation, respiratory support or respiratory therapy.
- ventilation sometimes also includes anesthesia, namely always in the case that volatile anesthetics or anesthetic gases are added to the respiratory gas.
- a user or patient can be connected to the device 100 via a patient interface 91.
- a patient interface 91 is understood to be any peripheral device that is designed to interact with an individual.
- the patient interface 91 can be designed as a tracheal tube or tracheostomy cannula.
- the patient interface 91 can also be designed as a breathing mask, nasal mask, nasal cushion mask, nasal cannula or oxygen cannula, full-face or total-face mask.
- the patent interface 91 is preferably designed and constructed in such a way that a leak-free supply and/or discharge of a respiratory gas mixture from the device 100 to the patient and/or from the patient to the device 100 can be carried out.
- P580 The figures show embodiments of the device according to the invention.
- Figure 1 a schematic structure of the device in a first embodiment Figures 1A to 1G the operation of the device in different working modes using the example of the first embodiment, where - Figure 1A shows the device in a first working mode for manual ventilation with application of volatile anesthetics; - Figure 1B shows the device in a second working mode for automatic ventilation with application of volatile anesthetics; - Figure 1C shows the device in a third working mode for manual ventilation without application of volatile anesthetics; - Figure 1D shows the device in a fourth working mode for automatic ventilation without application of volatile anesthetics; - Figure 1E shows the device in a fifth working mode for manual ventilation in a battery and/or error mode; - Figure 1F shows the device in a sixth working mode for a constant flow (HFOT), where volatile anesthetics can optionally be applied; - Figure 1G shows the device in a seventh operating mode, which represents a service mode; Figure 2 shows a schematic example of the structure of the supply lines; Figure 3 shows a a
- Figure 4 shows a schematic structure of the device in a second embodiment
- Figure 5 shows a schematic structure of the mechanical separating means with diffusion filter
- Figure 1 shows a schematic structure of the device 100 in a first embodiment.
- the device 100 according to the invention is designed to supply respiratory gas and comprises at least one respiratory gas line 4 for conducting a respiratory gas mixture 5, wherein the respiratory gas line 4 comprises at least one outlet 14-A, via which the respiratory gas mixture 5 can be discharged at least partially, at least temporarily, wherein the respiratory gas line 4 comprises an inspiratory branch 1, which is designed to conduct respiratory gas to a connection 93 for a patient interface, wherein the respiratory gas line 4 comprises an expiratory branch 2, which is designed to conduct respiratory gas between the connection 93 for a patient interface and the outlet 14-A.
- the device 100 is characterized in that at least one shut-off valve 28 is arranged in the respiratory gas line 4, which is designed and set up to at least temporarily establish a respiratory gas-conducting connection from the expiratory branch 2 to the inspiratory branch 1.
- the device 100 according to the invention can be an anesthesia workstation.
- the device 100 can be set up to ventilate and/or anesthetize a living being.
- the device 100 can be set up to provide and/or direct and/or prepare and/or dispose of a respiratory gas mixture or an anesthetic gas mixture.
- the device P580 100 is set up and designed to mechanically and/or manually ventilate or anesthetize a living being.
- the device 100 comprises at least one respiratory gas line 4 and at least one forwarding system 14.
- the device 100 has at least one blower unit 3.
- the blower unit 3 is set up and designed to generate a respiratory gas flow for ventilating and/or anesthetizing a patient and, if necessary, to convey it towards the patient.
- the blower unit 3 can be used to convey a respiratory gas mixture 5 for ventilation and/or anesthesia.
- the blower unit 3 can thus supply the conveying energy for the respiratory gas mixture 5.
- the respiratory gas mixture 5 can be normal breathing air from the environment or pure oxygen O2 or breathing air enriched with oxygen O2.
- the respiratory gas mixture 5 can also contain at least one anesthetic A.
- the respiratory gas mixture 5 can therefore also be an anesthetic gas in particular.
- the respiratory gas flow can be conveyed from the ambient air and/or from compressed gas cylinders and/or from a central gas system (ZGA) of the hospital (not shown).
- the blower unit 3 is preferably designed as at least one blower 3, which can comprise at least one fan wheel for generating a respiratory gas flow. In some embodiments, several blowers 3 can also be connected in series or in parallel. In alternative embodiments, the device 100 can also have another technical unit instead of the blower, which can generate a respiratory work or a conveying energy for the respiratory gas mixture. In such a case, the blower unit 3 can comprise, for example, at least one driven bellows or at least one piston motor.
- the device 100 can thus also be operated with a piston motor with, for example, several pistons and corresponding valves (not shown).
- the blower unit 3 is designed as at least one blower 3. From now on, the blower unit 3 will sometimes be referred to as just blower 3 for the sake of simplicity - this does not exclude the above-mentioned embodiments with several blowers, technical units, bellows or piston engines.
- the device 100 can comprise at least one electric drive (not shown).
- the device 100 can be supplied with power via at least one power source 103, 104 shown here.
- the device can be supplied with energy via a primary power source 103 and alternatively via at least one secondary power source 104.
- the device 100 can have a mains plug and accumulators and/or capacitors arranged inside the device.
- the device 100 can be connected to the supply network via a mains plug and thus supplied with energy.
- the mains plug and supply network can then serve as the primary power source 103.
- the device can be supplied with energy via the accumulators/capacitors.
- the accumulators/capacitors can then serve as a secondary power source 104.
- the device 100 can thus be operated in mains operation and/or in battery operation.
- the device 100 can comprise at least one display device (not shown).
- the display device can be set up as a monitor, for example as a touchscreen for displaying and/or entering medical data. The arrangement of several monitors is also possible.
- the device 100 comprises at least one control device 101 and at least one storage unit 102.
- the fan 3 is controlled via the control device 101.
- the control device 101 controls the fan 3 according to the configurations stored in the storage unit 102.
- the control device 101 sets a certain speed of the fan wheel or regulates the fan speed to a target value.
- the fan 3 can specify a flow and/or a pressure and/or a volume of respiratory gas.
- the fan 3 can generate a defined flow.
- the fan 3 can generate a pressure-independent flow. Flow and pressure can be specified decoupled from one another, so that the flow can be generated independently of the pressure.
- the device 100 is in particular set up and designed to provide the respiratory gas mixture 5 in the form of a patient flow.
- the patient flow serves to supply the patient with respiratory gas.
- the patient flow can depend on the patient's breathing phases.
- the device 100 is set up and designed to provide a permanent byflow.
- the byflow can exist independently of the patient's breathing phases.
- Patient flow and byflow can be formed parallel to one another in the respiratory gas line 4.
- the device 100 comprises at least one sensor 15, 16, 17, 18, 19, 20, 39.
- the device 100 comprises a plurality of sensors 15, 16, 17, 18, 19, 20, 39 (see below).
- the blower 3 can be controlled adaptively. Adaptive control can be carried out, for example, based on ventilation parameters determined and analyzed during ventilation.
- the storage unit 102 is set up to store ventilation-relevant parameters. These ventilation-relevant parameters can be ventilation-specific parameters 110 recorded during the respiratory gas supply and/or patient parameters 111 stored in the storage unit 102.
- the patient parameters 111 can be determined in advance.
- the patient parameters 111 can also be determined during ventilation.
- the stored patient parameters 111 can be selected from the group: age, gender, weight, height, previous illnesses, body fat percentage, body mass index (BMI), ideal body weight (BWI), state of health, nutritional status, patient metabolism, tidal volume, indirect calorimetry and the like.
- the blower 3 comprises at least one blower outlet 3a.
- the blower 3 discharges the respiratory gas mixture 5 into the at least one respiratory gas line 4 via the blower outlet 3a.
- the respiratory gas mixture 5 is conveyed via the respiratory gas line 4.
- the blower 3 sets a main flow S of the respiratory gas mixture 5, the direction of which is shown in Figure 1 with dashed lines.
- the respiratory gas line 4 comprises an inspiratory branch 1.
- the respiratory gas line 4 can comprise an expiratory branch 2.
- the respiratory gas line 4 can also comprise a reservoir line 13.
- the inspiratory branch 1 can be designed to at least conduct respiratory gas to a connection 93 for a patient interface.
- the expiratory branch 2 can be designed to at least conduct respiratory gas between the connection 93 for the patient interface and at least one outlet 14-A.
- a patient interface can be connected to the connection 93, via which a connection to a patient 90 can be established.
- the reservoir line 13 can be viewed as a component of the inspiratory branch 1.
- the reservoir 12 is pneumatically connected to the respiratory gas line 4 via the reservoir line 13. Gases from the reservoir 12 can be introduced at least one reservoir feed point 213.
- the respiratory gas line 4 can be pneumatically connected to the forwarding system 14 for forwarding the respiratory gas mixture 5.
- the respiratory gas line 4 with its inspiratory branch 1 and its expiratory branch 2 can be formed at least partially in the device.
- the respiratory gas line 4 with its inspiratory branch 1 and its expiratory branch 2 can also be formed at least partially outside the device, for example in a hose system.
- the respiratory gas line 4 comprises the reservoir line 13, the inspiratory branch 1, and the expiratory branch 2, which are pneumatically connected to one another.
- the respiratory gas line 4 is also pneumatically connected to the forwarding system 14.
- the respiratory gas line 4 is pneumatically connected to at least one fresh gas supply line 7 and/or to at least one O2 flush supply line 11 and/or to at least one anesthetic supply line 9 and/or to a nitrogen oxide supply line 44.
- the supply lines 7, 9, 11, 44 generally open into the inspiratory branch 1 of the respiratory gas line 4. Respiratory gases and/or anesthetics are fed into the respiratory gas line 4 via the supply lines 7, 9, 11, 44.
- Non-return valves in the supply lines 7,9,11,44 ensure that the breathing gas mixture 5 cannot be discharged via the supply lines 7,9,11,44.
- the blower 3 is preferably arranged in the inspiratory branch 1.
- the blower 3 is preferably arranged downstream of the expiratory branch 2.
- inspiratory breathing gas 5 is usually insp promoted. Fresh gas and/or oxygen and/or anesthetics can be introduced into the inspiratory branch 1.
- At least the blower 3 can be arranged in the inspiratory branch to specify the respiratory gas flow S. Via the inspiratory branch 1 P580 may cause inspiratory gas 5 insp. via the patient interface to the patient 90.
- expiratory breathing gas 5 is usually exsp
- the patient 90 can expiratory breathing gas 5 exsp. via the patient interface into the expiratory branch 2.
- the expiratory breathing gas 5 can be delivered via the expiratory branch 2 exsp. away from the patient.
- the expiratory breathing gas 5 can be diverted via the expiratory branch 2 exsp. to a device 40 for separating at least CO2.
- the expiratory branch 2 can extend at least from the patient interface to the separating means 40, 60.
- the main flow S of the respiratory gas mixture 5 can run from the blower outlet 3a along the inspiratory branch 1 to a connection 93 for a patient interface. From the connection 93, the respiratory gas mixture 5 can run along the expiratory branch 2 back to the inspiratory branch 1.
- the respiratory gas mixture 5 can run along the expiratory branch 2 to the blower inlet of the blower 3 (not shown in detail here).
- the respiratory gas can thus remain in at least one - essentially - closed first circuit K1.
- Inspiratory branch 1 and expiratory branch 2 can thus form at least the first circuit K1 in which the respiratory gas mixture 5 can be conducted.
- the respiratory gas mixture 5 can be at least partially discharged via the outlet 14-A.
- the respiratory gas mixture 5 can be conducted in the first circuit K1 with the main flow S.
- a permanent byflow can also advantageously flow in the circuit K1.
- the byflow offers the advantage that the blower 3 does not have to be stopped during operation. The blower 3 always rotates at a minimum speed.
- the byflow ensures a permanent flow in the respiratory gas line 4.
- a patient interface 91 can be connected to the connection 93, via which the patient is supplied with the respiratory gas mixture 5.
- the respiratory gas mixture 5 can be supplied to the patient 90 via the inspiratory branch 1.
- the device 100 has at least one interface for coupling a hose system 92.
- the respiratory gas mixture 5 can be supplied to the patient 90 via the hose system 92.
- a patient interface 91 can be connected to the hose system 92.
- the hose system 92 can be a two-hose system and have at least one inspiration hose and at least one expiration hose.
- the patient 90 can be supplied with the breathing gas mixture 5 via the inspiration hose of the hose system 92 and the patient interface 91 and can exhale via the expiration hose of the hose system 92.
- the exhalation gas can thus be returned to the device 100 via the expiration hose and at least one closed circuit can exist.
- the connection 93 can be designed as a Y-piece, via which the inspiration hose and the expiration hose can be connected.
- the hose system 92 can also be a single hose system and have only one inspiration hose.
- the patient 90 can be supplied with the breathing gas mixture 5 via the hose system 92 and the patient interface 91 and can exhale into the environment. This means that an open circuit can exist without an expiratory branch.
- the hose system 92 can also be a two-hose system and have an inspiration hose and an expiration hose without the breathing gas running in a closed circuit.
- a semi-open circuit means that the patient 90 can be supplied with the breathing gas mixture 5 via the inspiration hose of the hose system 92 and the patient interface 91 and can exhale via the expiration hose of the hose system 92, with the expiration gas being released into the environment via the expiration hose.
- the device 100 is set up and designed to form a closed circuit and/or a semi-open circuit and/or an open circuit depending on the use of the hose system and the settings in the device 100. The device 100 can therefore be used flexibly, since the breathing gas line 4 can form a closed circuit and/or a semi-open circuit and/or an open circuit.
- a closed circuit means that the breathing gas mixture 5 is guided in a circuit in the main flow S, whereby oxygen O2 and/or anesthetics and/or other gases or gas components or substances can be added or removed.
- Gas exchange takes place in the patient's lungs. Oxygen (O2) is absorbed into the blood and carbon dioxide (CO2) is separated. The patient thus removes gas or gas components from the circuit and adds new and/or changed gases or gas components to the circuit.
- gases or gas components must generally be permanently removed and/or added from the breathing gas mixture circulated in the circuit.
- oxygen O2 and/or anesthetics and/or other gases can be replenished depending on consumption.
- Carbon dioxide (CO2) and/or other undesirable gas components can be removed from the circuit.
- the gas components can thus be used and/or removed and disposed of in a defined manner.
- the control device 101 and/or a user can regulate/control the proportions of the components of the breathing gas mixture 5.
- fresh gas and/or oxygen O2 and/or anesthetics and/or CO2 are introduced or drained or separated.
- the device 100 can comprise at least one connection PAUX for pneumatic accessories (not shown).
- the device 100 comprises more than one connection, for example two or three or 4 or more.
- the PAUX connections can be set up and designed to connect ventilation and/or anesthesia-related accessories to the device 100. These accessories can be selected from the group: laryngeal mask, tracheal tube, cuff, esophageal catheter, bladder catheter. These accessories can perform their function with the help of a balloon P580, which can be supplied with flow and/or pressure and/or volume via the PAUX connections.
- the PAUX connections can be set up and designed in such a way that the functions of the connected accessories can be checked automatically.
- the device 100 can be designed to supply or remove a flow and/or pressure from the PAUX connections.
- sensors can be connected to the PAUX connections in order to check the functionality of the accessories.
- the device 100 can comprise at least one sensor 19.
- the at least one sensor 19 is arranged in and/or on the breathing gas line 4.
- the sensor 19 can, for example, detect the oxygen concentration and/or the CO2 concentration (capnometry) and/or the concentration of one or more anesthetics and/or the humidity.
- the sensor 19 can therefore be designed as an oxygen sensor and/or CO2 sensor and/or anesthetic gas sensor and/or as a humidity sensor.
- the device 100 can alternatively or additionally also comprise a multi-gas sensor 20.
- the multi-gas sensor 20 is set up and designed to detect different gas components in parallel.
- the device 100 comprises at least one multi-gas sensor 20.
- the sensors 19 and/or the multi-gas sensor 20 are arranged at at least one point on the respiratory gas line 4.
- the sensors 19 and/or the multi-gas sensor 20 detect the gas composition of the respiratory gas mixture 5.
- the sensors 19 and/or the multi-gas sensor 20 can be arranged in the inspiratory branch 1 and/or in the expiratory branch 2 of the respiratory gas line 4.
- at least one multi-gas sensor 20 can be arranged directly in front of the patient at or close to the patient interface.
- the multi-gas sensor 20 can be connected to the Y-piece 93 of the hose system 92.
- the multigas sensor 20 can take a sample gas from the Y-piece 93 in order to be able to measure inspiratory and expiratory values.
- a switching valve can be provided on the multigas sensor 20 in order to be able to measure the concentration of the anesthetic directly at the evaporation point of the anesthetic. This has a safety aspect when the anesthetic has to be changed. However, it can also be used to speed up the regulation of the concentration of the anesthetic. This is advantageous because the total gas volume of the device and lungs is very large (8 - 9 liters) and the anesthetic has to be mixed in.
- the sensors 19 can also be arranged at several points on the breathing gas line 4 in order to monitor the gas composition of the breathing gas mixture 5 in detail.
- CO2 sensors and/or O2 sensors can be arranged before and after the patient and before and after a device for CO2 separation, namely a chemical separating agent 40 and/or a mechanical separating agent 60 (see below). This allows the functioning of the separating agents 40, 60 to be monitored.
- a device for CO2 separation namely a chemical separating agent 40 and/or a mechanical separating agent 60 (see below).
- P580 In an exemplary embodiment according to the figures, at least one oxygen sensor 19 can be arranged directly after the blower 3 and can record the oxygen concentration.
- the control or regulation of the components of the breathing gas mixture 5 is carried out by the control device 101.
- Stored instructions and/or preset therapy conditions and/or user specifications and/or the recorded sensor signals can be taken into account.
- the user specifications can be made manually by a user, such as by medical professionals.
- the user specifications can be made in advance and/or during ventilation/anesthesia.
- the control device 101 takes into account in particular the recorded sensor signals.
- the sensor signals of the at least one CO2 sensor 19 and/or O2 sensor 19 and/or anesthetic gas sensor 19 and/or multi-gas sensor 20 are taken into account.
- the control device 101 can thus be able to adapt the components of the respiratory gas mixture 5 to the respective situation during ventilation or anesthesia.
- the respiratory gas mixture 5 returns to the circuit of the respiratory gas line 4 after it has flowed through the sensors 19 or the multi-gas sensor 20 and has been measured.
- the device can preferably comprise at least one flow sensor 17, 18 and/or at least one pressure sensor 15, 16, 39.
- the device 100 can comprise at least one inspiratory flow sensor 17.
- the at least one inspiratory flow sensor 17 can, for example, be arranged downstream of the blower 3 in the inspiratory branch 1 of the respiratory gas line 4.
- the inspiratory flow sensor 17 is arranged between the blower 3 and the O2 flush supply line 11.
- the inspiratory flow sensor 17 is set up and designed to measure at least one inspiratory flow.
- the device 100 can comprise at least one inspiratory pressure sensor 15.
- the at least one inspiratory pressure sensor 15 can, for example, be arranged downstream of the blower 3 in the inspiratory branch 1 of the respiratory gas line 4.
- the inspiratory pressure sensor 15 is arranged directly in front of the patient 90 or the patient interface.
- the inspiratory pressure sensor 15 is set up and designed to measure at least one inspiratory pressure.
- the device 100 can comprise at least one pressure sensor 39.
- the pressure sensor 39 can, for example, be arranged in or on the reservoir line 13.
- the pressure sensor 39 is arranged adjacent to the reservoir 12 in the reservoir line 13.
- the pressure sensor 39 is set up and designed to measure at least one pressure of the reservoir 12.
- the bag pressure of the reservoir 12 can be detected via the pressure sensor 39.
- the pressure sensor 39 can transmit the detected pressure values to the control device 101 in order to monitor the pressure of the reservoir 12.
- the device 100 can comprise at least one expiratory flow sensor 18.
- the at least one expiratory flow sensor 18 can be arranged, for example, in the expiratory branch 2 of the respiratory gas line 4.
- the expiratory flow sensor 18 is set up and designed to measure at least one expiratory flow.
- the device 100 can comprise at least one expiratory pressure sensor 16.
- the at least one expiratory pressure sensor 16 can be arranged, for example, in the expiratory branch 2 of the respiratory gas line 4.
- the expiratory pressure sensor 16 is arranged directly after the patient 90 or the patient interface.
- the expiratory pressure sensor 16 is set up and designed to measure at least one expiratory pressure.
- the flow sensors 17, 18 and/or pressure sensors 15, 16, 39 and/or sensors 19, 20 are designed as measuring devices and record at least one ventilation-specific parameter 110 selected from the group: inspiratory patient pressure, inspiratory patient flow, inspiratory tidal volume, inspiratory minute volume, inspiratory respiratory rate, inspiratory O2 concentration, inspiratory CO2 concentration, inspiratory N2O concentration, inspiratory anesthetic gas concentration; expiratory patient pressure, expiratory patient flow, expiratory tidal volume, expiratory minute volume, expiratory respiratory rate, expiratory O2 concentration, expiratory CO2 concentration, expiratory N2O concentration, expiratory anesthetic gas concentration; gas temperature, gas humidity, leakage or the like.
- the ventilation-specific parameters 110 to be recorded are not limited to these examples.
- the control device 101 is set up and designed to adaptively regulate the operation of the device 100 depending on the determined and analyzed ventilation parameters.
- measured values and parameters of accessories such as cuff pressure (tube sealing cuff), pressure of a stomach or bladder catheter, pressure of the seal of the laryngeal mask, leakage, resistance, bag pressure or similar can also be recorded and included.
- the control device 101 which is in communication with the measuring devices, can determine the technical ventilation parameters and in particular also adapt them adaptively.
- the technical ventilation parameters also include the supply of fresh gas and/or oxygen O2 and/or anesthetics.
- a possible leak can also be detected and transmitted to the control device 101.
- the device 101 can comprise an alarm device that can trigger an alarm signal when a leak is detected.
- the device 100 can have at least one reservoir 12 and at least one reservoir line 13.
- the reservoir 12 can be designed as a hand bag, for example.
- the reservoir 12 can alternatively or additionally be designed as a breathing bellows.
- the reservoir 12 can store the conveying energy P580 for the breathing gas mixture 5.
- the reservoir 12 can be operated manually by a user in particular. For example, a user can operate the reservoir 12 by squeezing it so that a delivery energy is provided for the breathing gas mixture 5.
- the reservoir 12 is set up and designed, among other things, to provide a volume for the breathing gas mixture 5 for the purpose of pressure monitoring or pressure equalization.
- the reservoir 12 is pneumatically connected to the breathing gas line 4 via the reservoir line 13.
- the reservoir 12 can serve both as a pressure source and as a pressure sink.
- the reservoir 12 can also serve both as a volume source and as a volume sink.
- the reservoir line 13 is set up in such a way that a flow of the breathing gas mixture 5 in the direction of the reservoir 12 is possible.
- the reservoir line 13 is also set up in such a way that a flow of the breathing gas mixture 5 in the direction away from the reservoir 12 is possible.
- inspiration the reservoir 12 can serve as a pressure and/or volume source.
- the reservoir 12 can serve as a pressure and/or volume sink.
- the reservoir 12 comprises, for example, at least the volume of one breath.
- the reservoir 12 comprises at least 250 ml, preferably at least 500 ml, particularly preferably at least 1 liter. In a specific embodiment, the reservoir comprises between 1 liter and 5 liters, for example between 2 liters and 2.5 liters.
- the reservoir 12 is, among other things, set up and designed to provide the blower 3 with a volume for delivery. A large part of the tidal volume delivered to the patient 90 can be delivered from the reservoir 12 to the patient 90 via the blower 3. When the patient 90 breathes, a gas exchange takes place in the lungs, which reduces the volume per breath. Therefore, volume must always be added to the closed circuit in order to at least replace the oxygen being breathed.
- the device 100 can comprise at least one pressure sensor 39.
- the pressure sensor 39 can be set up and designed to detect the pressure of the reservoir 12.
- the pressure sensor 39 is preferably arranged in or on the reservoir line 13.
- the pressure sensor 39 can be set up and designed to detect the pressure of the reservoir 12 and transmit it to the control device 101. The filling state of the reservoir 12 can be detected and monitored via the pressure sensor 39.
- a maximum and/or a minimum pressure of the reservoir 12 can be stored in the control device 101. If the pressure in the reservoir 12 falls below a critical level and/or the pressure rises P580 in the reservoir 12 exceeds a critical level, an action can be triggered. For example, an alarm can be triggered.
- the device 100 can comprise an alarm device that is controlled by the control device 101 (not shown). The alarm can signal to the control device 101 and/or the user, i.e. the medical specialist, that the pressure in the reservoir 12 must be increased or decreased. If the minimum pressure of the reservoir 12 is undershot, pressure can build up in the reservoir 12.
- the fresh gas module 6 and/or the O2 flush 10 can be controlled or operated in such a way that fresh gas and/or oxygen is introduced into the reservoir 12 in order to increase the pressure in the reservoir 12. If the maximum pressure of the reservoir 12 is exceeded, pressure can be released from the reservoir 12.
- the reservoir line 13 is pneumatically connected to the discharge system 14.
- the discharge system can comprise at least one overflow valve 25, via which pressure can be released from the reservoir 12. In this way, overfilling of the reservoir 12 can be prevented.
- the device 100 can comprise at least one discharge system 14, via which excess gases, for example excess respiratory gas mixture 5, can be discharged.
- the discharge system 14 can be set up and designed to discharge at least part of the respiratory gas mixture 5 for the purpose of pressure monitoring or pressure equalization.
- the discharge system 14 can also be set up and designed to regulate the oxygen and/or anesthetic concentration of the respiratory gas mixture 5.
- the discharge system 14 is designed as a gas-carrying line and is pneumatically connected to the respiratory gas line 4.
- the discharge system 14 comprises at least one outlet 14-A.
- the discharge system 14 can comprise one or more lines, all of which open into the same outlet 14-A (see Figure 1). Several lines with several outlets 14-A are also possible (not shown).
- Breathing gas mixture 5 can be conveyed with a flow S3 via the conveying system 14. The direction of the flow S3 always runs from the breathing gas line 4 in the direction of the outlet 14-A.
- the conveying system 14 comprises, for example, three lines, namely the first line 14i, the second line 14ii and the third line 14iii.
- the lines 14i, 14ii, 14iii are each pneumatically connected at least to the breathing gas line 4 and each open into the outlet 14-A.
- the breathing gas mixture 5 can be discharged from the breathing gas line 4 in at least three different ways.
- Several lines and several outlets 14-A are conceivable.
- the device 100 is not limited to the embodiments shown.
- the breathing gas mixture 5 can be discharged into the environment via the outlet 14-A or can remain in the circuit.
- the forwarding system 14 can optionally have a pump (not shown here) that can direct the derived breathing gas mixture 5 from the outlet 14-A back to the fresh gas module 6 via a line (not shown).
- the outlet 14-A can comprise at least one filter 94 (not shown).
- the outlet 14-A can comprise a double filter system.
- filters 94 are also conceivable.
- the filters 94 are preferably arranged interchangeably at the outlet 14-A.
- the diverted respiratory gases can be filtered via the filters 94 at the outlet 14-A, so that substances that are potentially harmful to the environment or health are prevented from escaping unfiltered into the environment.
- the filter 94 can comprise activated carbon, for example.
- Activated carbon can act as an absorbent for volatile anesthetics and/or their metabolites and/or other substances.
- the filters 94 can thus be designed as activated carbon filters with which volatile anesthetics VA and/or their metabolites and/or other substances that are potentially harmful to the environment or health can be filtered out of the diverted respiratory gas mixture 5. Through absorption, the absorbed substances accumulate in the activated carbon until it has to be replaced or cleaned in order to restore the filter properties.
- at least one sensor 95 can be arranged in or at the outlet 14-A (not shown). The sensor 95 is preferably arranged behind the filter 94 in the direction of flow.
- the sensor 95 can be designed as an optical sensor, for example, and can be set up to detect the anesthetic concentration of the derived respiratory gas mixture 5 and/or to transmit it to the control device 101.
- the filter properties of the activated carbon filters can thus be determined in this way.
- a first filter 94i and a second filter 94ii can be arranged in or at the outlet 14-A.
- the first filter 94i and the second filter 94ii can form a double filter system with a magazine function that can effectively prevent anesthetics from escaping.
- two activated carbon filters can be arranged one behind the other.
- Sensors 95 can be arranged in front of and/or behind a first filter 94i.
- sensors can also be arranged in front of and/or behind the second filter 94i.
- the sensors can then record the respective anesthetic concentrations in front of and behind the filters. If the anesthetic gas concentration behind the first filter rises above a predefined limit, the second filter can continue to filter the respiratory gas mixture.
- Such a double filter system with sensor offers the advantage that the first filter only needs to be replaced when it can demonstrably no longer filter anesthetics from the respiratory gas.
- the second filter still ensures effective filtering of the respiratory gas mixture. Costs for disposal and filter material can be saved.
- the transport system 14 can thus be set up and designed to dispose of the anesthetic gas in a controlled manner and/or to reprocess it for reuse.
- the device 100 is set up and designed to be able to guide the respiratory gas mixture 5 in a closed circuit.
- This offers the advantage that the volatile anesthetics VA, which are mostly harmful to the environment and climate, remain in the system and are not released into the environment in an uncontrolled manner.
- the device 100 according to the invention enables economical and thus P580 cost-effective use of anesthetics, since unused anesthetics are not released into the environment but can be recycled. Since the patient's expiratory air 90 remains in the breathing gas line 4 of the closed circuit, it is necessary to remove carbon dioxide (CO2) from the breathing gas mixture 5. Therefore, the device 100 has at least one separating agent 40, 60 for separating CO2 from the breathing gas mixture 5.
- the device comprises the at least one separating agent 40.
- the separating agent 40 can be designed as a chemical CO2 absorber.
- the separating agent 40 can thus contain one or more chemically acting absorbents that bind CO2.
- the separating agent 40 is also referred to herein as chemical separating agent 40.
- the separating agent 60 is also referred to herein as mechanical separating agent 60 (see below).
- Chemical absorbents can be selected from the group: calcium hydroxide, sodium hydroxide, potassium hydroxide, barium hydroxide. For example, a mixture of one or more of these components is used in the form of soda lime, through which the breathing gas mixture 5 is passed after expiration.
- the CO2 is bound and water (H20) is formed.
- the reaction is exothermic, so that temperatures between 60 and 70°C can develop.
- the chemical absorbents sometimes also bind anesthetics, so that the anesthetic concentration should be checked after the separating agent 40 so that the anesthetic can be dosed depending on consumption.
- the CO2 binding of the chemical separating agent 40 is very sensitive and is also active at very low CO2 concentrations in the breathing gas mixture 5. Since water precipitates during the chemical absorption of CO2 in the chemical absorber, the breathing gas mixture 5 is enriched with H2O after it has passed through the chemical separating agent 40. For this reason, the device 100 can comprise a humidity control module 41.
- the humidity control module 41 is set up and designed to regulate the humidity of the respiratory gas mixture 5.
- the humidity control module 41 can, for example, be set up as a cold trap and contain a water reservoir in which excess, precipitated water can be collected and disposed of.
- the device 100 can comprise one or more humidity sensors (not shown). Humidity sensors are particularly advantageous when the device 100 is operated with a chemical separating agent 40.
- the humidity sensors can be set up and designed to determine the humidity of the respiratory gas mixture 5 and to provide feedback to the control device 101 and/or the humidity control module 41.
- the humidity sensors can preferably be arranged in the inspiratory branch 1 and determine the humidity in the inspiratory respiratory gas mixture 5.
- the device 100 can have at least one module 6, 8, 10.
- the modules 6, 8, 10 are each connected to the breathing gas line 4 via at least one supply line 7, 9, 11.
- the supply lines can be connected to the P580 Breathing gas line 4 are pneumatically connected, whereby the supply lines can be permanently open or can be opened and/or closed in a controlled manner via valves.
- the modules 6, 8, 10 can serve as a pressure and/or volume source and the breathing gas line 4 as a pressure and/or volume sink.
- the device 100 can comprise at least one fresh gas module 6 and at least one fresh gas supply line 7. Fresh gas can be added to the breathing gas mixture 5 via the fresh gas supply line 7.
- the fresh gas supply line 7 is pneumatically connected to the breathing gas line 4 for this purpose.
- the fresh gas can be introduced at at least one fresh gas feed point 207.
- Fresh gas in the sense of the invention includes any fluid, breathing gas and/or gas mixture that is suitable and can be used for breathing, ventilation and/or respiratory therapy.
- Fresh gas can, for example, be supplied ambient air or a gas mixture of the ambient air and an additional gas or an additional gas alone.
- the fresh gas can be supplied directly from the ambient air and/or from compressed gas cylinders and/or from a central gas system (CGS) of the hospital.
- Fresh gas can also be oxygen or oxygen-enriched air.
- the fresh gas can also contain at least one anesthetic gas.
- the fresh gas supply line 7 generally flows into the inspiratory branch 1 of the breathing gas line 4.
- the fresh gas can be introduced into the breathing gas line 4 upstream of the blower 3 or downstream of the blower 3.
- An oxygen-containing gas mixture and/or oxygen can be introduced into the breathing gas line 4 via the fresh gas module 6 in order to maintain or control the oxygen concentration of the breathing gas mixture 5.
- the breathing gas mixture 5 is supplied in the breathing gas line 4 so that it can be supplied with fresh gas via the fresh gas module 6 and thus enriched with oxygen.
- the control or regulation of the oxygen content of the respiratory gas mixture 5 is carried out by the control device 101.
- the control or regulation of the oxygen content of the respiratory gas mixture 5 can be carried out automatically based on the recorded sensor signals.
- the control or regulation of the oxygen content of the respiratory gas mixture 5 can also be carried out manually by a user such as, for example, by medical specialists. In this way, the medical specialists can supply the patient with fresh gas or oxygen at any time as required during ventilation and/or anesthesia.
- the oxygen introduction can be regulated in such a way that the oxygen concentration of the respiratory gas mixture 5 is generally in a range between 10 and 60%, preferably between 20 and 50%. An oxygen saturation of 40 to 50% can generally be used for permanent ventilation and/or anesthesia.
- P580 In preferred embodiments according to the figures, the fresh gas is introduced into the breathing gas mixture 5 upstream of the blower 3.
- the at least one fresh gas supply line 7 then flows into the breathing gas line 4 upstream of the blower 3.
- the fresh gas can be introduced into the breathing gas line 4 at more than one point, for example at least two points.
- the device 100 can be set up in such a way that the fresh gas module 6 can be connected to the breathing gas line 4 via at least two supply lines 7i, 7ii.
- the fresh gas supply line 7 can be divided into at least two fresh gas supply lines 7i, 7ii, namely, for example, a first fresh gas supply line 7i and a second fresh gas supply line 7ii.
- the first fresh gas supply line 7i and the second fresh gas supply line 7ii can be pneumatically connected to the breathing gas line 4.
- the first fresh gas supply line 7i and the second fresh gas supply line 7ii can preferably open into the breathing gas line 4 at different points.
- the fresh gas supply lines 7i, 7ii can each introduce fresh gas into the breathing gas line at the same time (not shown).
- the fresh gas supply lines 7, 7i, 7ii can be controlled via at least one fresh gas switching valve 32 such that only one of the fresh gas supply lines 7i or 7ii can introduce fresh gas into the breathing gas line.
- the fresh gas switching valves 32 can be used to regulate which of the fresh gas supply lines 7, 7i, 7ii fresh gas is introduced into the breathing gas line 4.
- the fresh gas switching valves 32 can thus be used to regulate the location of the fresh gas feed into the breathing gas line 4.
- the fresh gas switching valves 32 can be switched electronically and/or mechanically.
- the fresh gas switching valves 32 can be switched automatically by the control device 101 and/or manually by the user.
- the fresh gas switching valve 32 can be designed as a monostable or bistable directional valve.
- the fresh gas switching valve 32 is designed as a monostable directional valve.
- the fresh gas switching valve 32 comprises a solenoid and a spring, the interaction of which can be used to switch the valve. Energizing the solenoid actively directs the valve 32 into a first switching position. When de-energized, the solenoid is inactive, so that the spring relaxes and brings the valve into the second switching position. When de-energized, the valve 32 is in its basic position.
- the fresh gas switching valve 32 can then also be connected to the first fresh gas supply line 7i and to the second fresh gas supply line 7ii and, depending on the switching position, supply either the first fresh gas supply line 7i or the second fresh gas supply line 7ii with fresh gas from the fresh gas module 6.
- the first fresh gas supply line 7i and the second fresh gas supply line 7ii open into the breathing gas line 4 at different points.
- the device 100 can thus be set up to regulate the location of the fresh gas introduction into the breathing gas line 4.
- the first fresh gas supply line 7i can open into the breathing gas line 4 upstream of the first check valve 21 in the flow direction.
- the second fresh gas supply line 7ii can open into the breathing gas line 4 downstream of the first check valve 21 in the flow direction.
- the second fresh gas supply line 7ii can open into the breathing gas line 4, in particular between the first check valve 21 and the evaporation element 8a ( Figure 1).
- the device 100 comprises at least two 2/2 fresh gas directional valves instead of the one 2/3 fresh gas directional valve 32.
- the first fresh gas supply line 7i can comprise a first fresh gas directional valve, which can be designed as a 2/2 directional valve with two connections and two switching positions.
- the second fresh gas supply line 7ii can comprise a second fresh gas directional valve, which can also be designed as a 2/2 directional valve with two connections and two switching positions (not shown).
- the 2/2-way valves can then be connected in parallel by the control device 101 in such a way that either the first fresh gas supply line 7i or the second fresh gas supply line 7ii can be opened in order to introduce fresh gas into the breathing gas mixture 5.
- the device 100 can comprise at least one oxygen module 10.
- the oxygen module 10 can be designed as an O2 flush 10 and comprise at least one O2 flush supply line 11. Oxygen O2 or an oxygen-containing gas mixture can be introduced into the breathing gas line 4 via the O2 flush supply line 11.
- the O2 flush supply line 11 is pneumatically connected to the breathing gas line 4 for this purpose.
- the oxygen can be introduced at at least one O2 flush feed point 211.
- the oxygen can be obtained from compressed gas cylinders and/or from a central gas system (ZGA) of the hospital.
- the device 100 is preferably connected to the central gas system (ZGA) and additionally has connections to at least one compressed gas cylinder.
- the oxygen can thus be obtained either from the central gas system (ZGA) or from compressed gas cylinders. In the event of a failure of the central gas supply, the oxygen supply can thus be guaranteed via the compressed gas cylinders for at least a certain period of time.
- the O2 flush 10 can be designed and set up so that a user, for example medical personnel, can quickly fill the breathing gas line 4 (the circuit part) and/or the reservoir 12 with oxygen.
- the O2 flush 10 can be used to: P580 - to refill the breathing gas line 4 and/or the reservoir 12 that has run dry after a leak - to flush anesthetics out of the patient's lungs - to ventilate the patient with pure oxygen for a certain period of time
- the O2 flush of the oxygen module 10 is designed and configured to quickly flood the breathing gas line 4 and/or the reservoir 12 and/or the patient's lungs with oxygen in emergency situations.
- the flow rate of the oxygen or the oxygen-containing gas mixture can be 60 l/min, for example.
- the flow rate is advantageously particularly high so that the breathing gas line 4 and/or the reservoir 12 can be quickly refilled after a leak and/or the anesthetic can be quickly flushed out.
- the breathing gas line 4 and/or the reservoir 12 can run dry due to a leak, either intentionally or unintentionally, for example after changing the hose, changing the filter, replacing the sensor, or improper use of the hose system 92 or the patient interface 91. In such cases, the loss of breathing gas mixture 5 in the breathing gas line 4 and/or the reservoir 12 cannot be replenished quickly enough with the normal fresh gas flow.
- the O2 flush then offers a quick way to refill the breathing gas line 4 and/or the reservoir 12 with a breathable gas.
- patients can be ventilated with undiluted oxygen via the O2 flush, depending on their needs, at least for a short time, for example for a few breaths.
- the patient can be supplied with at least 90% oxygen via the O2 flush, preferably with at least 93% oxygen.
- the oxygen can be fed undiluted into the breathing gas line 4 via the O2 flush of the oxygen module 10; as it comes from the supply (namely the central gas system or the compressed gas cylinder).
- the oxygen introduction via the O2 flush 10 can be regulated in such a way that the oxygen concentration of the breathing gas mixture 5 is up to 100% for at least a defined short period of time. Ventilation with up to 100% oxygen for a short period of time may be necessary during an operation.
- anesthesia when anesthesia is induced, a patient is briefly ventilated with up to 100% oxygen.
- the oxygen introduction via the O2 flush 10 can also be regulated in such a way that the oxygen concentration of the breathing gas mixture 5 is, for example, at least 60% for at least a defined short period of time.
- An oxygen saturation of 60% or more, preferably 80% or more, particularly preferably at least 90%, can be used to flush out anesthetics.
- the rapid removal of anesthetics from the patient's lungs can be achieved by flooding them with pure or highly concentrated oxygen.
- the O2 flush supply line 11 can flow into the inspiratory branch 1 of the breathing gas line 4.
- the oxygen can be introduced upstream before the blower 3 or downstream after the blower 3.
- the oxygen can be introduced into the breathing gas mixture 5 downstream after the blower 3.
- the O2 flush supply line 11 then flows into the breathing gas line 4 downstream after the blower 3. This offers the advantage that the oxygen-enriched breathing gas mixture 5 is not passed through the blower 3, which offers increased safety.
- An oxygen concentration in the blower 3 that is too high can lead to complications such as a short circuit, fire or damage to individual components of the blower 3.
- O2 flush supply lines 11 can be included, which can open into the breathing gas line 4 at different points.
- oxygen can be introduced into the breathing gas line 4 via the O2 flush 10 at more than one point, for example at at least two points.
- the device 100 can be set up in such a way that the O2 flush 10 can be connected to the breathing gas line 4 via at least two O2 flush supply lines 11i, 11ii.
- the O2 flush can be introduced into the breathing gas mixture 5 upstream of the blower 3 and/or downstream of the blower 3.
- the at least one O2 flush supply line 11 then opens into the breathing gas line 4 upstream of the blower 3 and/or downstream of the blower 3.
- the oxygen of the O2 flush 10 can be introduced into the breathing gas line 4 at more than one point, for example at least two points.
- the device 100 can be set up in such a way that the O2 flush 10 can be connected to the breathing gas line 4 via at least two O2 flush supply lines 11i, 11ii.
- the O2 flush supply line 11 can be divided into at least two O2 flush supply lines 11i, 11ii, namely, for example, into a first O2 flush supply line 11i and a second O2 flush supply line 11ii.
- the first O2 flush supply line 11i and the second O2 flush supply line 11ii can be pneumatically connected to the breathing gas line 4.
- the first O2 flush supply line 11i and the second O2 flush supply line 11ii can preferably open into the breathing gas line 4 at different points.
- the O2 flush supply lines 11i, 11ii can each introduce oxygen into the breathing gas line 4 at the same time (not shown).
- the O2 flush supply lines 11, 11i, 11ii can be controlled via at least one O2 flush switching valve 31 such that only one of the O2 flush supply lines 11i or 11ii can introduce oxygen into the breathing gas line 4 at a time.
- the O2 flush switching valves 31 can be used to regulate which of the O2 flush supply lines 11, 11i, 11ii oxygen is fed into the breathing gas line 4.
- the O2 flush switching valves 31 can therefore be used to regulate the location where oxygen is fed into the breathing gas line 4. P580
- the O2 flush switching valve 31 can be designed as a monostable or bistable directional valve.
- the O2 flush switching valve 31, like the fresh gas switching valve 32, is designed as a monostable directional valve with a solenoid and spring. Energizing the solenoid actively directs the valve 31 into a first switching position. When de-energized, the solenoid is inactive, so that the spring relaxes and brings the valve into the second switching position. When de-energized, the valve 31 is in its basic position.
- the O2 flush switching valves 31 can be switched electronically and/or mechanically.
- the O2 flush switching valves 31 can be switched automatically by the control device 101 and/or manually by the user.
- the O2 flush switching valves 31 can be switched manually so that a user (medical specialist) can supply oxygen as needed and can also determine the location of the feed into the breathing gas line 4.
- Figure 1 shows that oxygen is introduced via the first O2 flush supply line 11i when the valve 31 is in its basic position, i.e. without power.
- the second O2 flush supply line 11ii is operated when the valve 32 is energized.
- the O2 flush 10 is connected to the O2 flush supply line 11.
- the O2 flush supply line 11 is connected to the O2 flush switching valve 31.
- the O2 flush switching valve 31 can, for example, be designed as a 2/3-way valve and thus have three connections and two switching positions.
- the O2 flush switching valve 31 can then also be connected to the first O2 flush supply line 11i as well as to the second O2 flush supply line 11ii and, depending on the switching position, supply either the first O2 flush supply line 11i or the second O2 flush supply line 11ii with oxygen from the O2 flush 10.
- the first O2 flush supply line 11i and the second O2 flush supply line 11ii open into the breathing gas line 4 at different points.
- the device 100 can thus be set up to regulate the location of the oxygen introduction into the breathing gas line 4.
- the first O2 flush supply line 11i can open into the breathing gas line 4 after the blower 3 in the flow direction.
- the O2 flush supply line 11 opens into the respiratory gas line 4 as close to the patient as possible.
- the second O2 flush supply line 11ii can open into the respiratory gas line 4 upstream of the blower 3 in the direction of flow.
- the second O2 flush supply line 11ii can open into the respiratory gas line 4 upstream of the first check valve 21 in the direction of flow ( Figure 1).
- the device 100 comprises at least two 2/2-way valves 31 (not shown) instead of the one 2/3-way valve 31.
- the first O2 flush supply line 11i can comprise a first O2 flush switching valve, which can be designed as a 2/2-way valve with two connections and two switching positions.
- the second O2 flush supply line 11ii can comprise a second O2 flush switching valve, which can also be designed as a 2/2-way valve with two connections and two switching positions.
- the two 2/2-way valves can then be connected in parallel by the control device 101 in such a way that either the first O2 flush supply line 11i or the second O2 flush supply line 11ii can be opened in order to introduce oxygen from the O2 flush into the breathing gas mixture 5.
- the device 100 can optionally comprise a separate nitrogen oxide module 43 and at least one nitrogen oxide supply line 44 (not shown).
- Nitrogen oxides for example nitrous oxide N2O, can be used, for example, to enhance anesthesia and/or relieve pain. Nitrous oxide N2O can thus be administered in addition to the at least one volatile anesthetic.
- the nitrogen oxide module 43 can be set up and arranged in the device in parallel and equivalent to the fresh gas module 6 and/or the oxygen module 10.
- the nitrogen oxide module 43 can have a separate nitrogen oxide supply line 44.
- the nitrogen oxide (laughing gas) can also be introduced into the breathing gas line 4 together with the fresh gas and/or the other anesthetics.
- the nitrogen oxide supply line 44 can have a further safety valve to monitor the nitrogen oxide concentration.
- the supply lines in particular the fresh gas supply line 7, the O2 flush supply line 11 and the nitrogen oxide supply line 44, can each comprise at least one element to ensure the functionality and safety of the supply lines 7, 11, 44.
- the elements can be comprised singly or multiple times and can vary in their arrangement.
- the supply lines 7, 11, 44 can be constructed identically or can vary from one another.
- the fresh gas supply lines 7, the O2 flush supply lines 11 and the nitrogen oxide supply lines 44 can in principle be constructed almost identically.
- Figure 2 shows a schematic example of the structure of the supply lines 7, 11, 44, 71.
- the oxygen and/or the oxygen-containing gas mixture and/or the fresh gas and/or the nitrogen oxide can each be obtained from at least one source 89.
- at least two sources 89 are preferably included.
- the oxygen and/or the oxygen-containing gas mixture and/or the fresh gas and/or the nitrogen oxide can each be obtained from at least one compressed gas cylinder 89 and/or from a gas system, for example a central gas system ZGA of a hospital, and can be introduced into the breathing gas line 4 via the supply lines 7, 11, 44.
- Fresh gas, oxygen and nitrogen oxide can in advantageous embodiments be obtained both from a ZGA and from compressed gas cylinders 89.
- the device 100 comprises at least two supply lines 7, 11, 44.
- Oxygen can thus be fed into the breathing gas path 4 via a first supply line 11 from a ZGA and optionally via a second supply line 11 from a compressed gas cylinder 89.
- Fresh gas can accordingly be fed into the breathing gas path 4 via a first supply line 7 from a ZGA and optionally via a second supply line 7 from a compressed gas cylinder 89.
- Nitrogen can accordingly be fed into the breathing gas path 4 via a first supply line 44 from a ZGA and optionally via a second supply line 44 from a compressed gas cylinder 89.
- the control device 101 can control the supply lines 7, 11, 44 in such a way that the respective P580 Feed from the ZGA is prioritized.
- a gas feed from the compressed gas cylinders 89 is only activated when the ZGA fails or is no longer to be or can no longer be used for other reasons.
- the compressed gas cylinders 89 can thus be used, for example, as a reserve for an emergency situation.
- the arrangement of several compressed gas cylinders 89 is also conceivable.
- At least one filter 82 can be arranged in each of the feed lines 7, 11, 44.
- the filters 82 are set up and designed to filter out possible solid particles from the fluid introduced.
- the filters 82 are set up as an optional safety element.
- the filters 82 can preferably be arranged downstream directly after the supply sources 89.
- water separators and/or oil separators can also be arranged in or on the feed lines 7, 11, 44 (not shown).
- At least one sensor 84, 85 can be arranged in or on the feed lines 7, 11, 44.
- the sensors 84, 85 can be set up and designed to detect or control the pressure and/or the volume and/or the flow in the supply lines 7, 11, 44.
- at least one pressure sensor 84 can be arranged in each of the supply lines 7, 11, 44.
- the pressure sensors 84 can detect how much pressure and/or volume is taken from the compressed gas bottles 89.
- the fill level of the compressed gas bottles 89 can be monitored via the pressure sensors 84 and transmitted to the control device 101. If the fill level falls below a critical level, an alarm can be triggered.
- the device can comprise an alarm device that is controlled by the control device 101 (not shown).
- the pressure sensors 84 can preferably be arranged downstream directly after the compressed gas bottles 89 and the filter 82.
- at least one flow sensor 85 can be arranged in each of the supply lines 7, 11, 44.
- the flow sensors 85 can detect the gas flow in the supply lines 7, 11, 44.
- the flow in the supply lines 7, 11, 44 can be monitored via the flow sensors 85 and transmitted to the control device 101.
- the flow sensors 85 can preferably be arranged downstream directly before the junction with the breathing gas line 4. Fine control of the flow can be achieved with the help of the flow sensors 85.
- At least one pressure regulator 80 and/or one stenosis 81 can be arranged in or on the supply lines 7, 11, 44.
- the pressure regulator 80 can be designed as a pressure reducer 80.
- the pressure reducer 80 and/or the stenosis 81 can be set up to regulate the pressure from the supply sources 89 in such a way that the pressure is safely below the smallest specified supply pressure.
- the supply pressures of the central gas supplies and the compressed gas cylinders can vary greatly.
- the metering valves for the gases need a constant pre-pressure, as their characteristic curve depends on it. Therefore, the pressure regulators 80 and/or the stenoses 81 regulate the pressures to a value that is definitely below the smallest specified supply pressure. This means that the metering valves can always work the same. Pressures of up to approximately 20 MPa can exist in the compressed gas cylinders 89.
- the pressure reducers 80 and/or the stenoses 81 are set up and designed to reduce the pressure from the compressed gas cylinders 89 to at least half, preferably at least a quarter, particularly preferably at least a tenth. P580 of the pressure originally prevailing in the compressed gas cylinders 89.
- the pressure reducers 80 and/or the stenosis 81 are set up and designed to regulate the pressure of about 20 MPa, preferably to typically 450 +/-50 kPa.
- the pressure reducers 80 and/or the stenoses 81 can be set up and designed to adjust the pressure such that it is lower than the smallest operating pressure of the device 100.
- At least one valve 83, 86, 87, 88, 31, 32 can be arranged in or on the supply lines 7, 11, 44.
- the supply lines 7, 11, 44 preferably each comprise at least one pressure relief valve 83, preferably at least two pressure relief valves 83.
- the pressure relief valves 83 can be set up and designed as opening pressure valves to discharge the corresponding gas from the supply line 7, 11, 44 if the pressure in the supply lines 7, 11, 44 is too high.
- a first pressure relief valve 83 can be arranged downstream of the pressure regulator 80 and/or the stenosis 81.
- the first pressure relief valve 83 can be set up and designed to release pressure. This offers special protection in the event that the pressure regulator 80 fails and the pressure from the supply source 89 is too high in the supply lines 7, 11, 44.
- At least one second pressure relief valve 83 can be arranged in the supply lines 7, 11, 44.
- the second pressure relief valve 83 can be arranged upstream directly before the introduction into the breathing gas line 4.
- the pressure relief valves 83 offer the advantage of additional security. Excess gas can be discharged into the environment. In some embodiments, the excess gas can also be specifically discharged and reused (not shown).
- Pressure relief valves 83 and stenosis 81 are designed and configured to limit the maximum flows. In particular, pressure relief valve 83 and stenosis 81 can limit the maximum flows in the event of a fault. In the event of a defect in the pressure regulator 80, i.e.
- the pressure relief valve 83 can discharge the excess gas. If the pressure regulator 80 fails, the stenoses 81 can be designed to limit the maximum flow in such a way that the pressure relief valve 83 is protected and the pressure relief valve 83 can discharge the flow.
- the supply lines 7, 11, 44 preferably each comprise at least one non-return valve 86.
- the non-return valve 86 can be designed as a simple non-return valve. In preferred embodiments, the non-return valve is designed as a spring-loaded non-return valve 86.
- the non-return valve 86 is designed to control the flow direction in the supply lines 7, 11, 44 and in particular to prevent a backflow of the gas into the supply sources 89.
- the non-return valve 86 ensures that the supply sources 89 are not contaminated with the breathing gas mixture 5 from the breathing gas line 4.
- the supply lines 7, 11, 44, 71 can also each comprise at least one switching valve 87, 31, 32 and/or at least one metering valve 88, 88i.
- Switching valves 87, 31, 32 and/or metering valves 88, 88i can be designed as bistable valves in preferred embodiments.
- the metering valves 88, 88i can be designed as needle valves, for example.
- the bistable switching valves 87 and/or metering valves 88 are preferably arranged before the junction with the breathing gas line 4 and are designed to control the supply line and/or the supply quantity into the breathing gas line 4.
- the bistable switching valves 87 and/or metering valves 88 can control the flow and/or volume and/or pressure introduced into the breathing gas line 4.
- the flow in particular can be controlled via the bistable switching valves 87 and/or metering valves 88.
- at least one switching valve 87 can be arranged in each of the supply lines 7, 11, 44.
- the at least one switching valve 87 in each of the supply lines 7, 11, 44 can be designed as a bistable valve, for example.
- At least one bistable switching valve 87 can be arranged in the fresh gas supply lines 7.
- at least one bistable switching valve 87 can be arranged in the nitrogen oxide supply lines 44.
- at least one bistable switching valve 87 can be arranged in the O2 flush supply lines 11.
- all supply lines 7, 11, 44 have at least one bistable switching valve 87.
- the bistable switching valves 87 can each be arranged upstream directly after the check valves 86.
- the bistable switching valves 87 can preferably be switched in an open position or in a closed position. An open position allows the gas flow to pass through without restriction. A closed position can hermetically seal the supply line and prevent the gas flow in the supply line.
- the bistable switching valves 87 can be adjusted from an open position to a closed position.
- the position of the bistable switching valves 87 can be controlled by the control device 101.
- the position of the switching valves 87 can be used to regulate which of the lines 7, 11, 44 is open and which is closed.
- the position of the switching valves 87 can therefore be used to regulate the sources from which gas is fed into the breathing gas line 4.
- the position of the switching valves 87 can be used to regulate whether the respective gas is fed into the breathing gas line 4 from the ZGA or from the compressed gas cylinders or not at all.
- the bistable switching valves 87 can be set up so that electricity is required to switch between an open and a closed state and vice versa. The switching energy can be selected to be very low.
- the bistable switching valves 87 then remain open or closed without additional energy being required.
- the bistable switching valves 87 can therefore remain in the specified position without electricity. This offers the advantage that in an emergency situation, such as a power failure or low power availability or a software crash or other technical error, the last selected functions and settings are retained and ventilation is still possible.
- the bistable switching valves 87 can also be set up so that manual switching is possible. This means that the medical staff can still act in an emergency situation.
- the device 100 offers the option of manual ventilation to ensure the safety of the patient. In the event of a power and/or software failure, the device 100 switches without the intervention of the P580 user in a state where the user can still provide emergency care to the patient using manual ventilation. Pressure changes must be possible.
- the bistable switching valves 87 can also be set up and designed in such a way that the closed position is only maintained with the expenditure of energy. Gas can therefore only be introduced into the breathing gas line 4 when the bistable switching valves 87 are de-energized. This offers the advantage that the gas introduction into the breathing gas line 4 is guaranteed in an emergency situation, for example in the event of a power failure. This can ensure that the oxygen and/or fresh gas supply can continue. It can also be guaranteed that the anesthetic gas supply can continue and the anesthesia is maintained.
- the bistable switching valves 87 can also be set up and designed in such a way that the open position is only maintained with the expenditure of energy. Gas can therefore only be introduced into the breathing gas line 4 when the bistable switching valves 87 are supplied with power. This can offer the advantage that the gas entry into the breathing gas line 4 is interrupted in an emergency situation, for example in the event of a power failure, and manual ventilation, for example ventilation with a hand bag, is made possible.
- at least one metering valve 88, 88i can be arranged in each of the supply lines 7, 11, 44, 71.
- the at least one metering valve 88, 88i in each of the supply lines 7, 11, 44, 71 can be designed, for example, as a needle valve 88, 88i.
- the metering valve 88 can also be designed as a proportional valve.
- the dosing can also be carried out by arranging several switching valves with different orifices, so that the flow can be adjusted using different orifice sizes/powers.
- the dosing valve 88 is designed as a needle valve. Needle valves offer the advantage that almost an infinite number of switching positions can be realized. Very precise dosing is possible using needle valves.
- Needle valves offer the advantage of a very large control range, in which both very small flow quantities and very large flow quantities can be precisely adjusted.
- at least one needle valve 88 can be arranged in the fresh gas supply lines 7.
- at least one needle valve 88 can be arranged in the nitrogen oxide supply lines 44.
- at least one needle valve 88 can be arranged in the O2 flush supply lines 11.
- all supply lines 7, 11, 44 each have at least one needle valve 88.
- Needle valves 88 offer the advantage that very fine pressure control is possible with small flows. At the same time, needle valves 88 can allow very large flows.
- the needle valves 88 can be designed and constructed in such a way that the flow can be very small (0-30 l/min) as well as very large (80- P580 120 l/min) as well as at any intermediate level.
- the device is therefore suitable both for ventilation under anesthesia, where smaller flows are required, and for ventilation with large flows, for example high-flow ventilation.
- the device 100 is particularly suitable both for the ventilation/anesthesia of adults who require larger flows, and for the ventilation/anesthesia of children, toddlers, newborns and premature babies who require smaller flows.
- the needle valves 88 can be set up and designed in such a way that a flow of 0 to 100 l/min is introduced into the breathing gas line 4.
- a flow of 0 to 60 l/min is introduced into the breathing gas line 4.
- the device 100 can be operated in different working modes, for which different flow rates can be set.
- the flow rate is generally set automatically via the control device 101.
- the flow rate can be set, for example, via the settings of the needle valves 88 in the supply lines 7, 11, 44.
- the needle valves 88 can be set up and designed such that a flow of 0 to 120 l/min can be generated.
- the needle valves 88 can be set up and designed such that a flow of 0 to 60 l/min can be generated.
- a flow of up to 120 l/min can be generated, for example up to 100 l/min.
- the flow can be passed through the deactivated blower 3 so that the flow can only be generated through the oxygen module 10 and/or the O2 flush supply line 11.
- a flow of less than 60 l/min can be generated, for example less than 30 l/min, preferably less than 20 l/min.
- a flow of 18 l/min is generated in a working mode for total intravenous anesthesia.
- a flow of less than 60 l/min can be generated, for example less than 30 l/min, preferably less than 20 l/min.
- a flow of 18 l/min is generated in an anesthesia mode with volatile anesthetics VA.
- a flow of less than 60 l/min can be generated, for example less than 30 l/min, preferably less than 20 l/min.
- a flow of 15 l/min is generated in a CPAP mode.
- the needle valves 88 can be designed as bistable needle valves with stepper motors. This allows the needle valves 88 to function as metering valves.
- a combination of needle valves with stepper motors offers the advantage that very small and very large flows can be metered. Needle valves with stepper motors have a very good resolution even with very small flows.
- the bistable needle valves 88 with stepper motors can be set up and designed in such a way that they remain in the last set position without the supply of energy.
- the needle valves 88 can then be adjusted using the energy from the accumulators in the event of a power failure in the power grid.
- the needle valves 88 can also be set up and designed in such a way that manual adjustment is possible in the event of a power failure. This means that the medical personnel can also act in emergency situations.
- the supply lines 7, 11, 44 can also each comprise at least the switching valve 31, 32, which were already described above in relation to Figure 1.
- the switching valves 31, 32 are preferably arranged directly in front of the junction of the supply line with the breathing gas line 4.
- the switching valves 31, 32 control at which point in the breathing gas line 4 the corresponding gas is introduced.
- the switching valves 31, 32 are set up and designed to regulate the feed point of the gases (fresh gas, oxygen).
- the device 100 can optionally comprise at least one anesthetic module 8 and at least one anesthetic supply line 9.
- the anesthetic module 8 is set up and designed to provide anesthetics to the system via the anesthetic supply line 9.
- the anesthetic module 8 can be controlled via the control device 101.
- the device 100 can be used for inhalation anesthesia or inhalation anesthesia.
- Volatile anesthetics VA can be used for inhalation anesthesia or inhalation anesthesia.
- the volatile anesthetics VA can be selected from the group: isoflurane, sevoflurane, desflurane, halothane, enflurane, methoxyflurane.
- Particularly preferred volatile anesthetics VA are selected from the group: isoflurane, sevoflurane, desflurane, halothane.
- gaseous anesthetics such as xenon, argon or nitrous oxide N2O (laughing gas) can be used alternatively or additionally.
- laughing gas in particular can be added to the breathing gas mixture 5 to support or positively influence the effect of the volatile anesthetics VA.
- the volatile anesthetics VA are used to create optimal conditions for the patient with regard to at least the following parameters - unconsciousness (patient is asleep / hypnosis) - freedom from pain / pain perception (analgesia) - reduction of muscle tension - dampening of vegetative reflexes and defensive reflexes
- the volatile anesthetics VA are low molecular weight and have a high vapor pressure and a relatively low boiling point.
- the anesthetics VA or the gaseous anesthetics can be mixed with fresh gas beforehand.
- the device 100 can have a mixing chamber (not shown).
- the gaseous anesthetics mixed with fresh gas can then be fed via the anesthetic feed line 9 into the breathing gas line 4, where they mix with the breathing gas mixture 5.
- the volatile anesthetics VA are introduced into the breathing gas line 4 via a liquid metering device.
- the device 100 can have at least one evaporation element 8a.
- the evaporation element 8a can be arranged in or on the breathing gas line 4.
- the evaporation element 8a can be designed as an integral part of the breathing gas line 4.
- the volatile anesthetics VA can then be fed via the anesthetic module 8 and the anesthetic feed line 9 into the evaporation element 8a of the breathing gas line 4.
- the anesthetic module 8 is pneumatically connected to the evaporation element 8a of the respiratory gas line 4 via the anesthetic supply line 9.
- the volatile anesthetics VA introduced in liquid form can evaporate and combine with the respiratory gas mixture 5.
- Liquid dosing of the volatile anesthetics VA can be achieved by cooling the anesthetics VA in a tank and/or pressurizing them.
- a first pressure P1 is present in the respiratory gas line 4 and a second pressure P2 is present at least in the anesthetic supply line 9, the first pressure P1 being lower than the second pressure P2.
- the second pressure P2 is, for example, at least 100 kPa. In preferred embodiments, the second pressure P2 can be at least 180 kPa.
- the volatile anesthetics VA can thus be introduced in liquid form into the evaporation element 8a via the anesthetic module 8 and the anesthetic supply line 9. Only there can the anesthetics VA evaporate and combine with the breathing gas mixture 5.
- the concentration of anesthetics VA is usually selected such that the anesthetic concentration in the breathing gas mixture 5 is, for example, in a range between 0 and 25%.
- the device 100 is set up such that a user, for example medical professionals such as the anesthetist, can set the concentration of the anesthetics VA very precisely and variably. Depending on the anesthetic used and the patient and/or type of operation, the anesthetist can set the concentration of the anesthetics and adapt it to the conditions during the operation.
- the concentration of the individual volatile anesthetics VA in the breathing gas mixture 5 is usually selected as follows: isoflurane 0 to 5%; halothane 0 to 5%; sevoflurane 0 to 8%; desflurane 0 to 18%.
- the volatile anesthetics VA are generally not used together. Higher concentrations are possible and are at the discretion of the user, i.e. in particular at the discretion of the anesthetist.
- the device 100 is set up and designed to allow the setting of all concentrations.
- the liquid dosing of the volatile anesthetics offers the following advantages over gas dosing with a prior mixture with fresh gas: - More precise and therefore more economical dosing of anesthetics is possible -
- the supply of anesthetics is independent of the supply of fresh gas or oxygen -
- the anesthetic concentration is independent of the fresh gas concentration and/or the oxygen concentration -
- the pressure from anesthetic compressed gas cylinders can provide the energy for the anesthetics
- the anesthetic supply line 9 can open into the evaporation element 8a. In the evaporation element 8a, the state of aggregation of the volatile anesthetics VA changes.
- the volatile anesthetics VA When entering the evaporation element 8a of the respiratory gas line 4, the volatile anesthetics VA are exposed to the pressure P1 of the respiratory gas line 4 and thus become gaseous.
- the evaporation element 8a can be arranged in the inspiratory branch 1 of the respiratory gas line 4.
- the anesthetics VA can thus be introduced into the inspiratory branch 1 of the respiratory gas line 4.
- the evaporation element 8a can be arranged upstream of the blower 3 or downstream of the blower 3. In preferred embodiments according to the figures, the evaporation element 8a can be arranged upstream of the blower 3.
- the evaporation element 8a can preferably be arranged downstream of the fresh gas supply lines 7i, 7ii.
- the evaporation element 8a is arranged between the junction of the first fresh gas supply line 7i in the breathing gas line 4 and the blower 3.
- the device 100 is advantageously set up in such a way that at least one permanent flow, the byflow, is formed in the breathing gas line 4.
- the byflow ensures that the breathing gas mixture 5 in the breathing gas line 4 is always in motion.
- the byflow has positive effects on the evaporation rate of the volatile anesthetics VA. P580
- the byflow in the evaporation element 8a can be generated and maintained by the reservoir 12 and/or by the blower 3 and/or by the fresh gas module 6 and/or by the oxygen module 10.
- FIG 3 shows a schematic section of the breathing gas line 4 in which the evaporation element 8a is arranged, which is connected to the anesthetic module 8 via the anesthetic supply line 9. It can be seen from Figure 3 that the evaporation element 8a can be arranged in the breathing gas line 4 between the first check valve 21 and the blower 3. The evaporation element 8a can preferably be arranged upstream directly in front of the blower 3. The evaporation element 8a can preferably be arranged downstream of the fresh gas feed point 207 of the first fresh gas supply line 7i.
- the evaporation element 8a can preferably be arranged downstream of the first check valve 21.
- the check valve 21 can then prevent the breathing gas mixture 5 conveyed in the breathing gas line 4 from flowing against the main flow direction S.
- the anesthetic module 8 can be connected to the evaporation element 8a via the anesthetic supply line 9.
- An anesthetic feed 209 can be made into the breathing gas mixture 5 via the evaporation element 8a.
- Different volatile anesthetics VA can be fed to the breathing gas mixture 5 via the anesthetic module 8. As a rule, only one anesthetic is added to the patient at a time.
- the anesthetic module 8 also makes it possible to exchange the respective anesthetic during the operation.
- At least one volatile anesthetic VA can be introduced into the evaporation element 8a in liquid form via the anesthetic module 8.
- the volatile anesthetic VA can evaporate and mix with the breathing gas mixture 5.
- the anesthetic module 8 and the anesthetic supply line 9 can be cooled and/or kept under pressure.
- the anesthetic module 8 and the anesthetic supply line 9 are preferably kept under the second pressure P2.
- the pressure P2 is preferably at least 180 kPa. At this pressure, the volatile anesthetic VA is in the liquid state as long as the temperature is below 40°C.
- Preferred volatile anesthetics VA are, for example, selected from the group: isoflurane, sevoflurane, desflurane, halothane.
- the anesthetic module 8 can comprise at least one of the following units: pressure supply unit 810, receiving unit 820, selection unit 830, dosing unit 840, safety unit 850, temperature unit 860.
- the anesthetic module 8 is to be understood as a pneumatic unit. All units of the module 8 are (directly or indirectly) pneumatically connected to one another. The connection can be made via the at least one anesthetic supply line 9.
- the anesthetic module 8 and the anesthetic supply line 9 are preferably under the pressure P2 in order to keep the volatile anesthetic VA to be delivered liquid.
- the storage and/or P580 Delivery and/or control of anesthetics from the anesthetics module 8 can be controlled by the control unit 101.
- the anesthetics module 8 can be connected to at least one device for storing volatile anesthetics 800.
- the devices for storing volatile anesthetics can be designed as anesthetic tanks 800.
- the at least one tank 800 is set up and designed to receive and/or store and/or deliver volatile anesthetics VA.
- an individual tank 800 is preferably used for a single volatile anesthetic VA.
- the tanks 800 are set up and designed to receive and/or store and/or deliver a volatile anesthetic VA.
- the tanks 800 are preferably pressurized such that the stored volatile anesthetics are in a liquid state at room temperature.
- the pressure in the tanks 800 can be in a range between 100 kPa and 500 kPa in order to keep the anesthetics liquid.
- the pressure in the tanks 800 is preferably in a range between 150 kPa and 300 kPa.
- the pressure in the tanks 800 is, for example, at least 180 kPa.
- the tanks 800 are thus also set up and designed to absorb and/or maintain and/or release pressure.
- the tanks 800 can be refillable with anesthetics VA.
- the tanks 800 can be set up and designed in such a way that the fill level of the anesthetic can be detected (not shown). The fill level can be detected visually.
- the tanks 800 can be at least partially transparent.
- the tanks 800 can have a viewing window, optionally with a scale, through which the fill level of the tanks 800 can be visually read.
- the fill level can also be detected using sensors.
- the tanks 800 can comprise a floating element that floats on the anesthetic and is, for example, magnetic.
- the field strength can be detected using a magnetic sensor.
- the field strength can be used to determine where the floating element is located.
- the fill level of the anesthetic can then be determined using the position of the floating element.
- the tanks 800 can also have elements that allow for a clear assignment (not shown).
- a code can be stored on or in the tanks 800 that allows for a clear assignment of the individual tank 800 or the anesthetic contained in it.
- the anesthetic module 8 can comprise at least one receiving unit 820.
- the receiving unit 820 comprises at least one receiving bay 821.
- the receiving unit 820 can receive at least one tank 800 via the receiving bays 821.
- the receiving unit 820 preferably comprises more than one receiving bay 821 for receiving several different tanks 800, for example two (see Figure 3) or more (not shown).
- the device 100 can have a special receiving bay 821 for each individual tank 800, i.e. for each anesthetic.
- a P580 receiving bay 821 is designed to accommodate different individual tanks 800 with different anesthetics.
- the receiving bays 821 can have at least one device (not shown here) for recognizing the individual tanks 800. This offers an additional safety aspect, as it can prevent confusion between the different anesthetics.
- the recognition can be done mechanically and/or visually and/or sensorily. In this way, it can be ensured that the correct tank 800 with the correct anesthetic is placed in the designated receiving bay 821.
- the receiving bays 821 can, for example, have tank-specific connection devices for mechanically recognizing the individual tank 800.
- the recognition can alternatively or additionally also be visually coded, for example via color coding of the individual tanks 800 and their respective receiving bay 821.
- the recognition can alternatively or additionally also be sensorily or electrically coded.
- the tanks 800 can have a barcode or the like, for example, and the receiving bays 821 can have a corresponding sensor.
- the receiving unit 820 is set up and designed to receive one or more tanks 800 such that the tanks 800 are under pressure.
- the receiving unit 820 is preferably set up to keep the pressure in the tanks 800 at, for example, at least 180 kPa.
- the receiving unit 820 is set up and designed to supply pressure to the tanks 800 and/or to remove pressure from the tanks 800.
- the receiving unit 820 can be connected to at least one pressure supply unit 810.
- the pressure supply unit 810 is set up and designed to supply the receiving unit 820 and thus the tanks 800 with pressure or to relieve it.
- the pressure supply unit 810 can supply pressure and/or remove pressure.
- the pressure supply unit 810 can be connected to the fresh gas module 6 and/or the oxygen module 10 in order to obtain fresh gas and/or oxygen to provide a pressure.
- the pressure supply unit 810 obtains fresh gas with a regulated pre-pressure in order to provide the pressure.
- the pressure supply unit 810 can preferably comprise a pressure regulator in order to regulate the pressure from the fresh gas module 6 to the pressure level required in the tanks 800.
- the pressure supply unit 810 can also comprise at least one pressure sensor in order to detect the pressure in the respective tanks 800.
- the pressure supply unit 810 can also comprise at least one temperature sensor in order to detect the temperature.
- the device 100 can comprise at least one alarm device (not shown).
- the anesthetic module 8 can interact with the alarm device via the control unit 101.
- the alarm device can issue an alarm if the temperature rises above a value at which it cannot be guaranteed that all volatile anesthetics can still be kept liquid.
- the alarm device can also issue an alarm if the pressure falls below a value at which it cannot be guaranteed that all volatile anesthetics can still be kept liquid.
- the pressure supply unit 810 can preferably have its own reservoir for storing fresh gas (not shown), so that the pressure can be maintained for a certain time even without access to the fresh gas module 6.
- the pressure supply unit 810 can also comprise at least one check valve, so that the fresh gas supply can only run in the direction from the fresh gas module 6 to the pressure supply unit 810 and not vice versa.
- the pressure supply unit 810 can comprise at least one valve for loading 811 and at least one valve for relieving 812 the receiving unit 820 and/or the tanks 800. Pressure can thus be supplied to the receiving unit 820 and/or the tanks 800 via the fresh gas module 6 and the valve 811. Pressure can be released from the receiving unit 820 and/or the tanks 800 via the valve 812.
- the anesthetic module 8 is connected to the outlet 14-A so that the pressure can be released via the valve 812 and the outlet 14-A.
- the pressure supply unit 810 can comprise at least one switching valve 813 in order to select the respective tank 800 to be supplied.
- a plurality of valves 811, 812, 813 is advantageous, which can be controlled by the control device 101 or directly by a user in such a way that the pressure in all tanks 800 in use can be regulated.
- the receiving unit 820 is further set up and designed to receive one or more tanks 800 in such a way that the tanks 800 can receive and/or store and/or release anesthetics.
- the anesthetic can be received in the respective tank 800 inside the receiving bays 821 or outside.
- the tanks 800 can each comprise a filling valve (not shown).
- the intake of anesthetics can take place when the tanks 800 are vented.
- the intake of anesthetics can also take place when the tanks 800 are under pressure.
- the intake unit 820 is also set up and designed to ensure a controlled release of anesthetics from the tanks 800.
- the anesthetic module 8 is set up and designed such that the release of anesthetics from the tanks 800 into the anesthetic supply line 9 can only take place when the respective tank 800 and the anesthetic supply line 9 are loaded. The volatile anesthetic VA is then released in liquid form.
- the valves of the receiving unit 820 and/or the tanks 800 and/or the pressure supply unit 810 are set up and designed in such a way that they allow various functions in interaction, such as: - Tanks 800 are inserted into the receiving bays and are under pressure and deliver volatile anesthetics VA - Tanks 800 are inserted into the receiving bays and are under pressure and do not deliver volatile anesthetics VA P580 - Tanks 800 are inserted into the receiving bays and are under pressure and can be filled with volatile anesthetics VA - Tanks 800 are inserted into the receiving bays and are not under pressure and can be filled with volatile anesthetics VA - Tanks 800 are inserted into the receiving bays and are not under pressure and can be filled with volatile anesthetics VA - Tanks 800 are inserted into the receiving bays and are not under pressure and can be removed
- the receiving unit 820 can be pneumatically connected to the selection unit 830 via the anesthetic supply line 9.
- the selection unit 830 of the anesthetic module 8 is set up and designed to select the respective anesthetic. As a rule, only one volatile anesthetic VA is used at a time in order to avoid undesirable interactions between the volatile anesthetics VA. The selection of the anesthetic is made by the medical specialist. An input can be made to the device 100 for this purpose.
- the selection unit 830 not shown in detail here, comprises at least one selection valve 831.
- the selection valve 831 can be designed as a 2/2-way switching valve, for example.
- the selection unit 830 can comprise several selection valves 831, in particular one for each individual anesthetic.
- the selection valves 831 are preferably designed as bistable 2/2-way switching valves.
- the selection valves 831 can each be set up and designed in such a way that they prevent the path to the dosing unit 840 and/or to the evaporation element 8a in a de-energized state.
- a current supply can switch one of the selection valves 831 in such a way that the path to the dosing unit 840 and/or to the evaporation element 8a is opened.
- it is preferably stored in the control unit 101 that only one selection valve 831 can be opened at a time. This ensures that only one of the anesthetics is fed into the breathing gas line 4 at a time.
- Check valves can be arranged behind the selection valves 831 in order to prevent a backflow of anesthetics (not shown).
- the selection unit 830 can be pneumatically connected to the dosing unit 840 via the anesthetic supply line 9.
- the dosing unit 840 of the anesthetic module 8 is set up and designed to dose the respective selected anesthetic.
- the dosing unit 840 (not shown in detail here) can comprise at least one dosing valve 841 for this purpose.
- the dosing valves 841 are set up and designed to enable dosing of volatile anesthetics.
- the dosing can take place in a liquid or gaseous state of the anesthetics. In preferred embodiments, the dosing takes place in a liquid state of the anesthetics.
- the dosing valves 841 can be set up and designed to apply a flow and/or a volume and/or a pressure.
- the dosing valves 841 can preferably specify a specific flow.
- the dosing valves 841 can preferably be set up and designed to allow continuous dosing.
- the dosing valves 841 can be designed as needle valves in some embodiments.
- the dosing valves 841 can be in P580 in some embodiments designed as needle valves with stepper motors. Needle valves offer the advantage of safe and precise dosing. Position coding is also possible.
- the dosing valves 841 can be designed and configured to dose different anesthetics VA using position coding.
- more than one anesthetic can be dosed into the circuit, for example more than two, for example at least three different volatile anesthetics VA.
- isoflurane and/or sevoflurane and/or desflurane can be dosed into the circuit in a controlled manner using position coding of the dosing valves 841.
- the dosing valves 841 can be configured and configured so that the valve position remains at the last set value without power and/or falls to an open basic setting and/or falls to a closed basic position.
- the metering valves 841 can be set up and designed such that the valve position remains in the last set position without the supply of energy.
- the metering valves 841 can be set up and designed such that they meter the last set flow without the supply of energy. This offers the device 100 a special safety function in the event of a power failure, since the anesthetic supply can then continue to be maintained because, on the one hand, the metering valves 841 remain in their position and, on the other hand, the energy for delivering the anesthetics VA comes from the compressed gas cylinders.
- the metering unit 840 can also comprise at least one flow sensor and/or at least one pressure sensor and/or at least one temperature sensor (not shown). With these sensors, the flow and/or the pressure and/or the temperature can be detected in the metering unit 840 and controlled by the control unit 101.
- the dosing unit 840 can be pneumatically connected to the safety unit 850 via the anesthetic supply line 9.
- the safety unit 850 of the anesthetic module 8 is set up and designed to control the introduction of the anesthetic into the evaporation element 8a.
- the introduction of the anesthetic into the evaporation element 8a can be permitted and/or stopped via the safety unit 850.
- the safety unit 850 can be pneumatically connected to the evaporation element 8a via the supply line 9.
- the safety unit 850 can be pneumatically connected to the outlet 14-A (not shown).
- the safety unit 850 comprises at least one valve 851, 852 for this purpose. In some embodiments, the safety unit 850 can comprise at least two valves 851, 852.
- the valves 851, 852 can, for example, be connected in series.
- the valves 851, 852 can preferably be designed as 2/2-way switching valves and/or as 3/2-way switching valves.
- the valves 851, 852 can preferably be designed as monostable.
- the safety unit 850 comprises a first valve 851 and a second valve 852.
- the valves 851, 852 can be arranged, for example, between the metering valve 841 and the evaporation element 8a in the anesthetic supply line 9.
- the first valve 851 can be designed, for example, as a monostable 2/2-way switching valve and can be set up to allow or close the path to the evaporation element 8a.
- valve 851 is closed without power and open when powered, or vice versa.
- an anesthetic flow into the evaporation element 8a is only possible when the first valve 851 is powered.
- the first valve 851 can thus serve as a safety valve, so that the introduction of anesthetics into the evaporation element 8a can only take place actively. In an emergency situation (power and/or software failure), the valve 851 can thus automatically interrupt the introduction of volatile anesthetics.
- the first valve 851 can preferably also be set up so that it can be switched manually.
- the second valve 852 can, for example, be designed as a monostable 3/2-way switching valve and be set up to allow or close the path to the evaporation element 8a and/or to the outlet 14-A. It can be provided that the valve 852 opens the path to the evaporation element 8a when there is no current and opens the path to the outlet 14-A when there is current, or vice versa.
- an anesthetic flow into the outlet 14-A is only possible when the second valve 852 is energized. Anesthetic can therefore be actively discharged into the outlet 14-A via the second valve 852.
- the safety unit 850 can therefore also be set up and designed to flush out anesthetics VA from the anesthetic supply line 9. This can be particularly advantageous when changing the anesthetic. By flushing out the anesthetic supply line 9, it can be prevented that there is more than one anesthetic in the anesthetic supply line 9 at a time.
- the safety unit 850 can also comprise an inclination sensor (not shown). The spatial orientation of the evaporation element 8a and/or the device 100 as a whole can be determined via the inclination sensor.
- the temperature unit 860 of the anesthetic module 8 is set up and designed to detect and/or regulate the temperature in or on the evaporation element 8a.
- the temperature unit 860 can comprise at least one temperature sensor in order to detect the temperature in or on the evaporation element 8a.
- the temperature unit 860 can comprise at least one heating element 861.
- the at least one heating element 861 can be set up and designed to influence the temperature in the evaporation element 8a.
- the heating elements 861 can heat the evaporation element 8a, preferably to a temperature above room temperature.
- temperatures of up to 40°C can be set to increase the evaporation rate of the anesthetic in the evaporation element 8a.
- the temperature of the evaporation element 8a affects the evaporation rate of the anesthetic. Basically, the higher the temperature, the higher the evaporation rate. The evaporation rate can thus be up to 2 liters per minute. P580 At the start of anesthesia, evaporation rates of up to 2 l/min may be necessary to initiate anesthesia. With saturated fatty tissue, smaller evaporation rates may be necessary to maintain anesthesia. The device 100 can then be set such that the evaporation rate is below 2 l/min, for example below 1 l/min or below 0.5 l/min. With saturated fatty tissue, an evaporation rate of 1 ml/min to 100 ml/min may sometimes be sufficient to maintain anesthesia.
- the evaporation rate can be variably set via the anesthetic module 8.
- the device 100 can comprise a plurality of further functional valves 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, which are described below.
- the terms “first”, “second” etc. sometimes used herein merely serve to distinguish between the various valves and have no technical meaning, in particular no prioritization or the like. From Figure 1 it can be seen that the device 100 can comprise at least one pressure control valve 30 which is arranged in the breathing gas line 4.
- the pressure control valve 30 can be set up to influence or regulate the flow direction of the main flow S.
- the pressure control valve 30 is set up to allow or regulate variable volume flows.
- the pressure control valve 30 can be designed as a bistable switching valve.
- the pressure control valve 30 can be switched in an open position or in a closed position or in at least one middle position.
- An open position allows the gas flow to pass through without restriction.
- a closed position can hermetically seal the supply line and prevent the gas flow in the breathing gas line 4.
- a middle position can allow the gas flow to be restricted.
- the pressure control valve 30 can be designed as a proportional valve.
- the pressure control valve 30 can be designed as a 2/2 proportional directional valve (see figures).
- the pressure control valve 30 is preferably designed to selectively shut off the flow in at least one direction. Due to the arrangement of the pressure control valve 30 in the breathing gas line 4, the flow direction of the breathing gas mixture 5 is not reversible.
- the pressure control valve 30 is preferably designed as an adjustable pressure control valve 30 for regulating an expiratory pressure Pexsp.
- the pressure control valve 30 can be designed as a PEEP valve and can be designed to set or maintain at least the positive end-expiratory pressure (PEEP).
- PEEP positive end-expiratory pressure
- the pressure control valve 30 can prevent the pressure drop during exhalation from reaching the ambient air pressure.
- the pressure control valve 30 represents an adjustable stenosis.
- the pressure control valve 30 can be electrically set to a value and/or passively regulated to a preset value.
- the pressure control valve 30 can be set to a patient-specific PEEP.
- the patient-specific PEEP can be determined and set in advance. In healthy adults, the PEEP is usually between 15 and 20 hPa.
- the PEEP can be preset and/or adjusted during use.
- the operating pressure of the pressure control valve 30 can be electrically adjustable.
- the operating pressure of the pressure control valve 30 is preferably adjustable to a PEEP of 0 to 100 hPa, preferably from 0 to 80 hPa, particularly preferably from 3 to 80 hPa.
- the pressure control valve 30 is set up and designed to assume any switching position within its working range.
- the setting of the pressure control valve 30 can be controlled manually and/or by the control device 101.
- the pressure control valve 30 can be set up so that electricity is only required to change the operating pressure.
- the pressure control valve 30 can thus be set up to remain in its preset position without electricity being required.
- the pressure control valve 30 can be set up so that it falls back to a base state with a defined pressure when de-energized.
- the PEEP valve 30 can, for example, passively regulate in a range between 3 and 10 hPa.
- the PEEP valve 30 can, for example, passively regulate to a PEEP of 5 hPa.
- the device 100 can maintain a PEEP of, for example, 5 hPa even in an emergency situation, for example in the event of a power failure.
- At least the byflow flows permanently through the PEEP valve 30 and seals it. The byflow has a positive effect on the functioning of the PEEP valve 30.
- the device 100 is set up and designed to carry out complex maneuvers to determine the optimal ventilation parameters.
- the PEEP and/or the inspiration pressure can be determined automatically.
- loops over pressures and/or flows and/or volumes can also be used, such as pressure-volume loops (P-V loops).
- the device can thus advantageously be used for ventilation and anesthesia and still perform complex maneuvers such as loops or PEEP finders.
- the device 100 can comprise a series of further valves that serve the safety and/or function of the device.
- the device 100 can comprise valves 21, 22, 23, 24, 25, 26, 27, 28, 29.
- the valves 21, 22, 23, 24, 25, 26, 27, 28, 29 can be designed as check valves, for example.
- Check valves can control and/or restrict and/or prevent the flow of a gas, for example the breathing gas mixture 5, in one direction. Opening the check valve releases the flow. Closing the check valve selectively blocks the flow in at least one direction. Check valves can limit or prevent the gas from flowing back against the direction of flow.
- valves 21, 22, 23, 24, 25, 26, 27, 28, 29 can each be designed as - a simple check valve or as - a lockable check valve with, for example, a magnetic coil or as - a simple, loaded check valve with, for example, a spring or as P580 - Adjustable, loaded check valve with, for example, a solenoid coil and a spring or as - Continuously adjustable, loaded check valve with, for example, a solenoid coil, a spring and a stepper motor.
- Simple check valves only allow flow in one direction.
- valves 21, 22, 23 can be designed as simple check valves, for example. Lockable check valves can allow flow in one direction in the rest position and block flow in one direction.
- Lockable check valves can block flow in both directions in an active position, for example when the solenoid coil is energized.
- Valve 28 can preferably be designed as a lockable check valve. Loaded check valves only allow flow in one direction and are closed in a rest position. Simple, loaded check valves are loaded with a spring, for example, and open at a predefined pressure (working pressure) depending on the spring setting. The working pressure of simple spring-loaded check valves can be constant.
- the valve 27 can preferably be designed as a simple loaded check valve.
- the working pressure in adjustable spring-loaded check valves can be adjustable. The adjustment of the working pressure of loaded check valves and the blocking of lockable check valves can be done automatically and/or manually.
- Adjustable, loaded check valves can, for example, also include a solenoid in addition to the spring, which can at least partially or completely counteract the spring tension.
- the solenoid When the solenoid is energized, the spring tension is reduced or completely removed, so that the flow can be increased or released.
- the spring When de-energized, the spring is active, so that the flow is reduced or closed.
- the valves 24, 25, 26 can, for example, be designed as adjustable, loaded check valves with a spring and solenoid. An additional stepper motor allows the flow to be adjusted continuously.
- the APL valve 29 can be designed, for example, as a continuously adjustable, loaded check valve with a spring, magnetic coil and stepper motor.
- the device 100 can, for example, comprise at least one simple check valve 21, 22.
- the device 100 can have at least a first simple check valve 21 in the inspiratory branch 1 and additionally or alternatively at least a second simple check valve 22 in the expiratory branch 2.
- the first check valve 21 and/or the second check valve 22 can thus be arranged in the respiratory gas line 4.
- the arrangement of several simple check valves in the respiratory gas line 4 can also be sensible and possible in some embodiments (see Figure 4).
- P580 The first check valve 21 can be arranged in the breathing gas line 4 in the direction of flow before the blower 3.
- the first check valve 21 is arranged in the direction of flow before the first fresh gas supply line 7i joins the breathing gas line 4. In the specific embodiment according to Figure 1, the first check valve 21 is arranged in the direction of flow after the second fresh gas supply line 7ii joins the breathing gas line 4. In the specific embodiment according to Figure 1, the first check valve 21 is arranged in the direction of flow before the first O2 flush supply line 11i joins the breathing gas line 4. In the specific embodiment according to Figure 1, the first check valve 21 is arranged in the direction of flow after the second O2 flush supply line 11ii joins the breathing gas line 4. For example, the first check valve 21 is designed as a simple check valve.
- the first check valve 21 is designed as a spring-loaded check valve (not shown).
- the second check valve 22 can be arranged in the expiratory branch 2.
- the second check valve 22 can be arranged in the respiratory gas line 4 in the flow direction after the patient interface.
- the second check valve 22 is designed as a simple check valve.
- the second check valve 22 is designed as a spring-loaded check valve (not shown).
- the check valves 21, 22 can be set up as simple check valves and designed to at least control the flow direction of the main flow S.
- the first check valve 21 can be set up and designed to at least control the flow direction of the main flow S and in particular to prevent a backflow of the respiratory gas mixture 5 into the reservoir 12.
- the second check valve 22 can be set up and designed to at least control the flow direction of the main flow S and in particular to prevent a backflow of the respiratory gas mixture 5 to the patient 90.
- the arrangement of further simple check valves in the respiratory gas line 4 is possible and is shown, for example, in Figure 4 (see below).
- the device 100 can also comprise the valves 23, 24 which are arranged in or on the respiratory gas line 4.
- the device 100 can, according to the specific embodiments according to Figures 1 and 4, comprise at least a first safety valve 23 and/or at least a second safety valve 24.
- the first safety valve 23 and/or the second safety valve 24 can be arranged in the respiratory gas line 4.
- the first safety valve 23 and/or the second safety valve 24 can be arranged in the respiratory gas line 4 after the blower 3.
- the safety valves 23 and 24 in the breathing gas line 4 are located directly after the first O2 flush supply line 11i joins the breathing gas line 4 and thus immediately before the P580 patient interface.
- the first safety valve 23 and/or the second safety valve 24 are thus preferably arranged in the inspiratory branch 1.
- the safety valves 23, 24 are preferably arranged in opposite directions to one another.
- the safety valves 23, 24 can be set up and designed to ensure the safety of the device 100 in an emergency situation.
- An emergency situation can occur, for example, in the event of a power failure, low power availability or a technical defect in the device 100 or parts of the device 100.
- the safety valves 23, 24 can also ensure the safety of the device 100 if the pressure in the breathing gas line 4 is too high and/or too low.
- the safety valves 23, 24 make it possible for the patient to breathe in and/or breathe out independently.
- the safety valves 23, 24 also make it possible for the patient to be ventilated manually, e.g. using a hand bag. Independent breathing and/or manual ventilation can then only take place via the inspiratory branch 1 of the device 100 and the safety valves 23, 24, bypassing the remaining elements of the device 100.
- the first safety valve 23 can be set up as a free-breathing valve or as an inspiratory deficiency valve.
- the first safety valve 23 is preferably designed as a simple check valve.
- the patient can breathe in via the first safety valve 23 if, for example, the blower 3 fails and does not deliver any conveying energy. This means that it is possible for inspiration to take place, for example, via the first safety valve 23. In this case, the inspiration gas can be taken directly from the ambient air.
- the second safety valve 24 can be set up as a static pressure relief valve.
- the second safety valve 24 is preferably designed as a spring-loaded check valve.
- the second safety valve 24 can be an adjustable spring-loaded check valve.
- the second safety valve 24 preferably also has a solenoid coil with which the spring can be actuated.
- the second safety valve 24 can be subjected to a constant pressure so that the safety valve 24 remains closed during normal operation of the device 100.
- the second safety valve 24 can then open when the pressure in the breathing gas line 4 is higher than the working pressure of the safety valve 24 so that pressure and/or volume can escape via the safety valve 24.
- the second safety valve 24 can also be opened electronically, for example by energizing the magnetic coil.
- the second safety valve 24 can thus be designed as a mechanical and/or electrical pressure relief valve. If the pressure in the breathing gas line 4 increases, the second safety valve 24 can open passively and/or actively. The pressure in the breathing gas line 4 can be increased, for example, if the expiratory path is blocked, for example by a hose system 92 blocked by dirt or kinks. P580 The second safety valve 24 thus makes it possible for expiration to take place in emergency situations.
- the expiratory breathing gas 5exsp can then be released directly into the ambient air via the inspiratory branch 1 and the second safety valve 24.
- the device 100 can comprise at least one further, preferably a plurality of, valves 25, 26, 27, 28, 29. In the specific embodiments according to the figures, the device 100 can comprise, for example, five further differently arranged valves 25, 26, 27, 28, 29. For better clarity, the valves 25, 26, 27, 28, 29 are referred to below as overflow valve 25, drain valve 26, inlet valve 27, shut-off valve 28, APL valve 29.
- the device 100 can comprise at least one overflow valve 25. Alternatively or additionally, the device 100 can comprise at least one drain valve 26. Alternatively or additionally, the device 100 can comprise at least one inlet valve 27.
- the device 100 can comprise at least one shut-off valve 28.
- the device 100 can comprise at least one APL valve 29 (airway pressure limiting valve).
- Overflow valve 25, drain valve 26, inlet valve 27, and APL valve 29 are preferably designed as spring-loaded check valves.
- the shut-off valve 28 is preferably designed as a lockable check valve.
- Overflow valve 25, drain valve 26, inlet valve 27, shut-off valve 28, and APL valve 29 can be set with one or with different, adjustable working pressures.
- the working pressures can be set manually and/or automatically.
- the working pressures can be preset or adjusted - manually or automatically - during operation of the device 100.
- the working pressures of the overflow valve 25, drain valve 26, inlet valve 27, shut-off valve 28 and APL valve 29 can be predefined with at least one setting.
- the inlet valve 27 can be set such that the working pressure is above 0 hPa, for example in a range from 0.1 hPa to 10 hPa.
- the working pressure of the inlet valve 27 can preferably be predefined with one setting.
- the working pressure of the inlet valve 27 can also have at least two settings.
- the inlet valve 27 can be set with a relatively low working pressure.
- the working pressure of the inlet valve 27 can be set to 2 hPa.
- the shut-off valve 28 and/or drain valve 26 and/or overflow valve 25 can also be predefined with a setting.
- the working pressures of the shut-off valve 28 and/or drain valve 26 and/or overflow valve 25 can preferably be operated with at least two different working pressures and therefore in at least two settings.
- the working pressures of the shut-off valve 28 and/or drain valve 26 and/or overflow valve 25 can be set such that the working pressure is in a range from 0 hPa to 200 hPa.
- the working pressures of the shut-off valve 28 and/or drain valve 26 and/or P580 Overflow valve 25 can be operated either with at least one relatively high working pressure or with at least one relatively low working pressure.
- the shut-off valve 28 and/or the drain valve 26 and/or the overflow valve 25 can be set to be adjustable between the at least two settings.
- the working pressure can be switched manually and/or automatically at least between a first setting and a second setting.
- the working pressure can be switched between a rather low working pressure and a rather higher working pressure.
- a low working pressure exists at working pressures less than 50 hPa.
- a higher working pressure exists at working pressures greater than 50 hPa.
- the working pressure of the shut-off valve 28 and/or the drain valve 26 and/or the overflow valve 25 can be set to 10 hPa or less in a first setting, preferably to 5 hPa or less, for example 2 hPa or less.
- the working pressure of the shut-off valve 28 and/or the drain valve 26 and/or the overflow valve 25 can be set to 50 hPa or higher, preferably to 100 hPa or higher, in a second setting.
- a setting to a rather low working pressure of, for example, 2 hPa or less causes the corresponding valve in the device to be in a quasi-open position and thus allows gas to pass through.
- a setting to a rather high working pressure of, for example, 100 hPa or higher causes the corresponding valve in the device to be in a quasi-closed position and thus does not allow gas to pass through.
- the working pressure of the APL valve 29 can allow at least one, preferably several, particularly preferably a large number of settings.
- the APL valve 29 can be equipped with a stepper motor that allows a preferably stepless adjustment of the spring tension.
- Overflow valve 25 and/or drain valve 26 and/or APL valve 29 can be arranged in or on the circulation system 14. As a rule, only expiratory respiratory gases 5 are thus removed through the overflow valve 25, the drain valve 26 and the APL valve 29.
- the overflow valve 25 can be arranged, for example, in the first line 14i of the conveying system 14.
- the overflow valve 25 can be arranged between the reservoir 12 and the outlet 14-A.
- the overflow valve 25 can be set up and designed to control the pressure of the reservoir 12.
- the overflow valve 25 is preferably designed as a spring-loaded check valve.
- the overflow valve 25 can be set up and designed to release pressure from the reservoir 12.
- the APL valve 29 can be arranged, for example, in the second line 14ii of the conveying system 14.
- the drain valve 26 can be arranged, for example, in the third line 14iii of the P580 forwarding system 14.
- the discharge valve 26 and APL valve 29 can be arranged, for example, in parallel lines 14ii, 14iii of the forwarding system 14.
- the discharge valve 26 can be set up to forward gases bypassing the APL valve.
- the inlet valve 27 can be arranged in or on the breathing gas line 4. Ambient air can be fed into the breathing gas line 4 via the inlet valve 27.
- the inlet valve 27 can be arranged, for example, downstream of the separating agent 40 on the breathing gas line 4.
- the inlet valve 27 can be arranged, for example, downstream of the humidity control module 41 on the breathing gas line 4.
- the inlet valve 27 can preferably branch off between the chemical separating agent 40 and the humidity control module 41.
- the inlet valve 27 can, for example, optionally feed ambient air into the breathing gas line 4 between the chemical separating agent 40 and the humidity control module 41.
- the ambient air can be fed into the breathing gas line 4 via the inlet valve 27 at an ambient air feed point 227.
- the shut-off valve 28 can be arranged in the breathing gas line 4.
- the shut-off valve 28 can, for example, be arranged downstream after the separating agent 40.
- the shut-off valve 28 can, for example, be arranged downstream before the humidity control module 41.
- the shut-off valve 28 can preferably be arranged between the chemical separating agent 40 and the humidity control module 41.
- the valves 25, 26, 27, 28, 29 are in particular set up and designed to influence the function of the device 100.
- the flow path of the breathing gas mixture 5 can be influenced via different functions and/or settings of the valves 25, 26, 27, 28, 29.
- different functions and/or settings of the valves 25, 26, 27, 28, 29 can be used to regulate whether the breathing gas mixture 5 remains in the circuit and/or is passed on via the forwarding system 14 and/or whether ambient air is introduced into the breathing gas mixture 5.
- the shut-off valve 28 and/or the APL valve 29 and/or the drain valve 26 can be set up and designed to control the path of the breathing gas mixture 5.
- the breathing gas mixture 5 can be guided in a closed circuit or in a semi-open circuit.
- a closed circuit can be useful, for example, if the device 100 is operated in an anesthesia mode with volatile anesthetics VA.
- a semi-open circuit can be useful, for example, if the device 100 is operated in a TIVA mode.
- a semi-open circuit can also be useful if the device 100 is operated in a service mode, for example in a drying mode.
- the device 100 can thus be operated in different working modes via the settings of the valves 25, 26, 27, 28, 29 and optionally also via the settings of the blower 3 and/or the pressure relief valve 30 as well as via the operation of the reservoir 12, as follows. P580.
- the working mode of the device 100 can be set manually and/or automatically specified by the control device 101.
- volatile anesthetics VA can be applied, directed and in particular also specifically drained for disposal or reuse.
- ventilation without volatile anesthetics can also be achieved with the device 100.
- the device 100 can, for example, be operated in a working mode that is selected from the group: anesthesia mode with volatile anesthetics VA; anesthesia mode with intravenously administered anesthetics (TIVA mode); ventilation mode with anesthetics; ventilation mode without anesthetics such as O2 therapy, high-flow O2 therapy (HFOT), CPAP, BiLevel, SIMV (synchronized intermittent mandatory ventilation).
- TIVA mode intravenously administered anesthetics
- ventilation mode without anesthetics such as O2 therapy, high-flow O2 therapy (HFOT), CPAP, BiLevel, SIMV (synchronized intermittent mandatory ventilation).
- all ventilation modes that are usually used in intensive care medicine can be implemented with the device 100.
- the device 100 offers the advantage that lung-protective ventilation can be implemented even under anesthesia.
- pressure-controlled ventilation can be carried out, which means a relatively low load for the lungs. Pressure-controlled ventilation is particularly advantageous for patients with lung damage.
- the control device 101 can regulate the device 100 in such a way that the device 100 can be operated in different working modes. The regulation can be carried out, for example, via the different adjustability of the components blower 3 and/or valves 25, 26, 27, 28, 29 and/or pressure relief valve 30.
- the flow path of the respiratory gas mixture 5 and thus the operation of the device 100 as a whole can be influenced by setting the working pressure levels of the spring-loaded check valves 25, 26, 27, 28, 29.
- the working mode of the device 100 can be set before commissioning or changed during operation. The change from one working mode to the other can be made manually by a user, for example by medical professionals.
- the change from one working mode to the other can also be made automatically by the control device 101 when the conditions under ventilation and/or anesthesia change.
- the device 100 can be operated in an anesthesia mode or a ventilation mode or a combined anesthesia and ventilation mode.
- the working modes can each be operated in different ways, for example as automatic ventilation (machine ventilation), as manual ventilation (hand ventilation) or in error mode.
- Manual ventilation can be or become necessary, among other things, when inducing and/or ending anesthesia, during surgery in the neck or pharynx and/or in emergency situations.
- Machine ventilation can be used, for example, during an operation with volatile anesthetics and/or intravenously administered anesthetics.
- FIGS 1A to 1G show the device 100 of the first embodiment in various circuits and settings for implementing various operating modes. Inactive and/or blocked elements and connections are shown in dashed lines, active and/or free elements and connections are marked with solid lines. With regard to elements, active here means that the elements can act as described and/or have gases flowing through them.
- inactive here means that the elements do not perform their described function and/or have gases flowing through them or only passively.
- active means that gases can be passed through this line and that the path is not, or at least not completely, blocked.
- blocked means that gases cannot be conducted through this line and the line is preferably hermetically sealed.
- the different functional valves, in particular the overflow valve 25, the drain valve 26, the inlet valve 27, the shut-off valve 28 can each be set to relatively high working pressures or to relatively low working pressures in order to implement the different working modes.
- a high working pressure means in the sense of the invention that the respective valve is closed and blocks the gas flow in the line in which it is located.
- a high working pressure can exist, for example, if the corresponding valve is subjected to a working pressure of more than 50 hPa, for example 100 hPa.
- a low working pressure means in the sense of the invention that the respective valve is open and can allow the gas flow in the line in which it is located.
- a low working pressure can be present, for example, if the corresponding valve is subjected to a working pressure of less than 10 hPa, for example 2 hPa or less than 0.5 hPa.
- the working pressure of the APL valve 29 can preferably be adjusted continuously and allow a variety of settings. The APL valve 29 can thus limit and/or prevent the gas flow in the corresponding line.
- the APL valve 29 is preferably designed as an electrically adjustable valve.
- the APL valve 29 is set up to regulate an inspiration pressure Pinsp.
- the APL valve 29 can cause the breathing gas mixture 5 to be discharged via the outlet 14-A if the pressure in the breathing gas line 4 exceeds the inspiration pressure Pinsp.
- the APL valve 29 is set up as a controllably loaded check valve with a stepper motor.
- the APL valve 29 is set up to remain in its last set position without power.
- the APL valve 29 can thus regulate to the last set inspiration pressure Pinsp without power.
- This P580 is particularly advantageous in the event of a power failure, as the APL valve 29 can continue to perform its function.
- the APL valve 29 can be designed as a digital APL valve 29.
- the APL valve 29 can preferably be controlled automatically by the software or by the control device 101.
- the APL valve can alternatively or additionally be operated manually. This gives medical personnel the option of operating the APL valve manually if necessary, e.g. using a haptic encoder (rotary handle), and loading or unloading the APL.
- Figure 1A shows the device 100 in a first operating mode M1 for manual ventilation with the application of volatile anesthetics.
- Figure 1A shows that the blower 3 is inactive in the first operating mode M1.
- An inactive blower 3 means that the blower 3 does not supply any conveying energy.
- the fan wheel of the blower 3 is not driven in the inactive blower.
- the breathing gas mixture 5 can flow through the blower 3 in an inactive state.
- the reservoir 12 supplies the conveying energy for the breathing gas mixture 5.
- the reservoir 12, which can be designed in the form of a hand bag, for example, is operated manually or automatically in the first working mode M1.
- the reservoir 12 can thus supply the breathing energy in the first working mode M1.
- the breathing gas mixture 5 is conveyed into the reservoir line 13.
- the overflow valve 25 is subjected to a high working pressure and blocks the first line 14i.
- the breathing gas mixture 5 can thus be introduced from the reservoir line 13 into the inspiratory branch 1 of the breathing gas line 4.
- the check valve 21 prevents the breathing gas mixture 5 from flowing back into the reservoir line 13.
- the fresh gas module 6 is active.
- the fresh gas switching valve 32 In the first operating mode M1, the fresh gas switching valve 32 is in its basic position, so that fresh gas can be introduced into the breathing gas line 4 via the first fresh gas supply line 7i.
- the first fresh gas supply line 7i In the first operating mode M1, the first fresh gas supply line 7i is active.
- the second fresh gas supply line 7ii In the first operating mode M1, the second fresh gas supply line 7ii is inactive.
- the fresh gas can then be introduced in the flow direction behind the check valve 21.
- the fresh gas feed point 207 can then be arranged between the first check valve 21 and the evaporation element 8a (and thus the anesthetic feed 209).
- the fresh gas can preferably be introduced with a constant flow.
- the fresh gas can then form at least one byflow.
- the anesthetic module 8 In the first working mode M1, the anesthetic module 8 is active.
- volatile anesthetics VA can be introduced into the evaporation element 8a via the anesthetic module 8 and the anesthetic supply line 9 and thus added to the breathing gas mixture 5 as required.
- the breathing gas mixture 5 can be optimally enriched with volatile anesthetics VA via the fresh gas byflow.
- the oxygen module 10 is active.
- An active oxygen module 10 means that oxygen can optionally be introduced via the O2 flush 10.
- the O2 flush switching valve 31 is in its basic position, so that optionally P580 Oxygen can be introduced into the breathing gas line 4 via the first O2 flush supply line 11i.
- the first O2 flush supply line 11i is active.
- the second O2 flush supply line 11ii is inactive.
- the oxygen introduction via the O2 flush 10 can optionally take place after (manual or automatic) activation of the O2 flush 10.
- the oxygen introduction then takes place via the O2 flush 10 and the first O2 flush supply line 11i in the flow direction behind the blower 3 and in front of the safety valves 23,24.
- the O2 flush feed point 211 can then be arranged between the blower 3 and the safety valves 23,24. This offers the advantage that the volatile anesthetics can be quickly washed out by flooding the lungs with oxygen if necessary.
- the O2 flush 10 can also be used to fill the reservoir 12, e.g. after a leak.
- the oxygen then flows from the O2 flush 10 via the feed point 211 into the breathing gas line 4 and from there in the flow direction S through the inspiratory branch 1 and the expiratory branch 2 to the reservoir 12.
- the patient can be manually supplied with inspiratory breathing gas 5 via the inspiratory branch 1. insp and optionally supplied with volatile anesthetics VA.
- the expiratory branch 2 with its elements can also be active and expiratory breathing gas 5 exsp
- the expiratory breathing gas can be 5 exsp be diverted away from the patient via the expiratory branch 2.
- the check valve 22 prevents the expiratory breathing gas 5 from flowing back exsp to the patient.
- the PEEP valve 30 is active and set to an individual PEEP.
- the main flow direction S of the respiratory gas mixture 5 runs via the inspiratory branch 1 towards the patient interface and from the patient interface into the expiratory branch 2.
- the sensors 16,17,18,19,20, 39 are active in the first operating mode M1.
- the valves 26,28,29 are switched in the operating mode M1 such that the respiratory gas mixture 5 in the expiratory branch 2 can take two different paths:
- the respiratory gas mixture 5 or portions of the respiratory gas mixture 5 can be directed in the direction of the main flow S in the circuit and/or diverted from the circuit via the discharge system 14.
- the check valve 28 is subjected to a low working pressure in the first operating mode M1 and releases the respiratory gas line 4.
- the check valve 28 can act as a simple check valve in the first operating mode without the action of the solenoid coil.
- the breathing gas mixture 5 can be guided at least partially in the direction of the main flow S in the circuit in the M1 working mode.
- the breathing gas mixture 5 is then fed back into the inspiratory branch 1 from the expiratory branch 2.
- the breathing gas mixture 5 passes through the separating agent 40 and the humidity control module 41, which are active in the first M1 working mode. CO2 is separated in the separating agent 40 and moisture can be removed from the breathing gas mixture 5 in the humidity module 41.
- Fresh gas and/or oxygen and/or anesthetics can be fed back into the breathing gas mixture 5 in the inspiratory branch 1.
- the settings of the drain valve 26 and the APL valve 29 can influence whether the second line 14ii and the third line 14iii are active and thus conduct gas.
- From Figure 1A P580 shows that in the first working mode M1 the second line 14ii is active and the third line 14iii is blocked.
- the drain valve 26 In the first working mode M1 the drain valve 26 is subjected to a high working pressure and blocks the third line 14iii.
- the APL valve 29 In the first working mode M1 the APL valve 29 is subjected to a working pressure that allows the gas flow of the second line 14ii to be restricted. This allows the breathing gas mixture 5 to be at least partially discharged from the circuit through the second line 14ii of the circulation system 14.
- the APL valve 29 can be set to a patient-specific inspiration pressure Pinsp.
- the patient-specific inspiration pressure Pinsp can be determined and set in advance. In healthy adults the inspiration pressure Pinsp is usually between 20 and 25 hPa.
- the inspiration pressure Pinsp can be preset and can also be adjusted during use.
- the setting of the APL valve 29 can be controlled manually and/or by the control device 101. By diverting a partial gas from the circuit, the APL valve 29 can limit the maximum pressure during inspiration. In addition, diverting a partial gas can ensure that gas exchange takes place. Gas exchange can remove metabolites from the lungs (such as methane or ammonia) from the circuit. Fresh gas and/or oxygen and/or anesthetics can be supplied to the circuit as required.
- the reservoir 12 is actively activated.
- the breathing gas mixture 5 reaches the patient via the Y-piece 93 until the inspiration pressure Pinsp set on the APL valve 29 is reached in the patient. An inspiratory plateau can then be maintained in which no flow flows from or to the patient.
- the activation of the reservoir 12 is stopped.
- the respiratory gas mixture 5 passes from the patient via the Y-piece 93 into the expiratory branch 2, the pressure drops to the PEEP set on the pressure control valve 30. There is then an expiratory plateau in which no flow flows from or to the patient.
- Manual ventilation always works with an excess fresh gas flow. The excess volume can only be released into the circulation system 14 during inspiration.
- the reservoir 12 must then always be disengaged more than just for the patient volume.
- Figure 1B shows the device 100 in a second operating mode M2 for automatic ventilation with the application of volatile anesthetics.
- the blower 3 is active in the second operating mode M2.
- the active blower 3 supplies the conveying energy for the respiratory gas mixture 5.
- the fan wheel of the blower 3 is driven and conveys the respiratory gas mixture 5.
- the blower 3 can generate the required patient flow and a constant byflow in the second operating mode M2.
- the blower 3 can generate a set flow pattern in the second working mode M2.
- the reservoir 12 serves as a storage for part of the breathing gas mixture 5.
- the reservoir 12 does not supply any conveying energy for the breathing gas mixture 5.
- the reservoir 12 can at least partially supply the volume for the blower 3.
- the fresh gas switching valve 32 and the O2 flush switching valve 31 are in the basic position, so that fresh gas can be introduced into the breathing gas line 4 via the first fresh gas supply line 7i and optionally oxygen via the first O2 flush supply line 11i.
- the fresh gas can be introduced in the flow direction behind the check valve 21.
- the fresh gas can preferably be introduced with a constant flow.
- the fresh gas forms a byflow together with the blower flow.
- the anesthetic module 8 is active.
- volatile anesthetics VA can be introduced into the evaporation element 8a via the anesthetic module 8 and the anesthetic supply line 9 and thus added to the respiratory gas mixture 5 as required.
- the respiratory gas mixture 5 can be optimally enriched with volatile anesthetics VA via the byflow.
- the patient can be supplied with inspiratory respiratory gas 5 via the inspiratory branch 1. insp and optionally supplied with volatile anesthetics.
- the expiratory branch 2 can also be active, so that the expiratory breathing gas 5 exsp is diverted away from the patient via the expiratory branch 2.
- the non-return valves 21, 22 prevent the respiratory gas mixture 5 from flowing back against the main flow direction S.
- the PEEP valve 30 is active and set to an individual PEEP.
- the main flow direction S of the respiratory gas mixture 5 runs via the inspiratory branch 1 towards the patient interface and from the patient interface via the expiratory branch 2.
- the respiratory gas mixture 5 is then fed back from the expiratory branch 2 into the inspiratory branch 1 and/or the reservoir 12.
- the respiratory gas mixture 5 mostly flows into the patient until an inspiratory plateau is reached.
- the byflow flows through the expiratory branch 2.
- the blower 3 predominantly pumps the byflow, which flushes the circuit K1. In this phase, the byflow refills the reservoir 12.
- the valves 26, 28, 29 are switched in the second working mode M2 in such a way that the breathing gas mixture 5 essentially runs in the circuit along the main flow direction S:
- the shut-off valve 28 is subjected to a low working pressure in the second working mode M2 and releases the breathing gas line 4.
- the APL valve 29 is subjected to a higher working pressure than the shut-off valve 28 and thus blocks the second line 14ii.
- the drain valve 26 is subjected to a high working pressure and blocks the third line 14iii. This allows the breathing gas mixture 5 to be guided in the direction of the main flow S in the circuit in the second working mode M2.
- the breathing gas mixture 5 is then fed back into the inspiratory branch 1 from the expiratory branch 2.
- the breathing gas mixture 5 passes through the separating agent 40 and the humidity control module 41. CO2 is separated in the separating agent 40 and moisture can be removed from the respiratory gas mixture 5 in the humidity module 41. Fresh gas and/or oxygen and/or anesthetics can be fed back into the respiratory gas mixture 5 in the inspiratory branch 1.
- the overflow valve 25 is subjected to a low working pressure and can release the first line 14i. The respiratory gas mixture 5 or parts of the respiratory gas mixture 5 can thus be fed through the first line 14i of the forwarding system 14 to the outlet 14-A and released into the environment.
- the reservoir 12 is full, i.e.
- the inlet valve 27 can be designed as a volume and/or flow deficiency valve.
- the inlet valve 27 can be set to a low working pressure.
- the inlet valve 27 is preferably set such that outside air can be supplied to the circuit when there is a negative pressure in the breathing gas line 4. In the second working mode M2, a negative pressure can arise in the breathing gas line 4, for example in the event of a (unintentional or intentional) leak.
- a negative pressure in the breathing gas line 4 can open the inlet valve 27 so that ambient air can be supplied to the breathing gas line 4 via the inlet valve 27.
- the inlet valve 27 is set to a working pressure of 2 hPa. This corresponds to the pressure of the filled reservoir 12. If one looks at Figures 1A and 1B, for example, it can be seen that the breathing gas mixture 5 can be guided in an essentially closed circuit and/or in an essentially half-open circuit.
- the interaction of the shut-off valve 28, the drain valve 26 and the APL valve 29 is essential here.
- the interaction of the valves 26, 28, 29 can take place as follows: With a low working pressure of the shut-off valve 28 and a high working pressure of the drain valve 26 and the APL valve 29, the breathing gas mixture 5 can be guided in an essentially closed circuit.
- the closed circuit exists when the working pressure of the shut-off valve 28 is lower than the working pressure of the drain valve 26 and the APL valve 29. Because the respective working pressure of the drain valve 26 and APL valve 29 is higher than the working pressure of the shut-off valve 28, the path to the outlet 14-A is blocked. Because the respective working pressure of the drain valve 26 and APL valve 29 is higher than the working pressure of the shut-off valve 28, the path of the breathing gas line 4 to the separating agent 40 and/or to the humidity control module 41 is open.
- the breathing gas mixture 5 can be guided in a half-open circuit.
- the half-open circuit exists when the working pressure of the shut-off valve 28 is greater P580 is the respective working pressure of the drain valve 26 and APL valve 29.
- the shut-off valve 29 blocks the path to the blower 3.
- the flow direction of the respiratory gas mixture 4 then runs - roughly outlined - from the blower 3 via the inspiratory branch 1 to the patient interface and to the patient 90 and from the patient 90 via the expiratory branch 2 to the outlet 14-A.
- FIG. 1C shows the device 100 in a third operating mode M3 for manual ventilation without application of volatile anesthetics.
- Figure 1D shows the device 100 in a fourth operating mode M4 for automatic ventilation without application of volatile anesthetics.
- the device 100 can be operated in operating modes without application of volatile anesthetics.
- the device 100 is thus also designed and configured to ventilate the patient without volatile anesthetics.
- the device 100 can thus also be used with the application of total intravenous anesthesia (TIVA) and/or with the application of local anesthesia such as spinal anesthesia.
- TIVA total intravenous anesthesia
- anesthetics for example propofol
- TIVA anesthetics
- propofol propofol
- the device 100 offers the advantage that it allows ventilation in combination with total intravenous anesthesia, whereby alternatively or additionally volatile anesthetics VA can also be administered via the airways.
- the device 100 can be operated, for example, in an open and/or semi-open circuit.
- the respiratory gas In operation without inhalation anesthetics VA, the respiratory gas can be discharged into the environment. In operating modes without the addition of inhalation anesthetics VA, the respiratory gas mixture can be completely exchanged for each respiratory phase (inspiration and expiration). This means that the minute volume is always provided anew. For the treatment of an adult, this means that an average of around 6 l/min of respiratory gas mixture is provided and applied.
- Figure 1C shows that the blower 3 is inactive in the third operating mode M3, so that the respiratory gas mixture 5 only flows through the blower 3. In the third operating mode M3, the reservoir 12 supplies the delivery energy for the respiratory gas mixture 5 and thus the breathing energy. In the third operating mode M3, the anesthetic module 8 is generally inactive.
- the respiratory gas mixture 5 is delivered into the reservoir line 13.
- the respiratory gas mixture 5 is introduced from the reservoir line 13 into the inspiratory branch 1 of the respiratory gas line 4.
- the check valve 21 prevents the respiratory gas mixture 5 from flowing back into the reservoir line 5.
- the fresh gas switching valve 32 can preferably be switched in such a way that fresh gas can be introduced into the breathing gas line 4 via the second fresh gas supply line 7ii. The fresh gas introduction can then take place in the flow direction upstream of the first check valve 21.
- the O2 flush switching valve 31 can preferably be switched in such a way that oxygen can optionally be introduced into the breathing gas line 4 via the second O2 flush supply line 11ii.
- the oxygen introduction via the O2 flush 10 can optionally take place after (manual or automatic) actuation of the O2 flush 10.
- the oxygen introduction then takes place via the O2 flush 10 and the second O2 flush supply line 11ii in the direction of flow in front of the blower 3.
- the oxygen introduction via the O2 flush 10 preferably takes place in the third working mode M3 in the direction of flow in front of the first check valve 21.
- fresh gas and/or oxygen can thus be fed into the breathing gas line 4 in front of the first check valve 21 and thus fill the reservoir 12 if required.
- the patient can be manually supplied with inspiratory breathing gas 5 at least via the inspiratory branch 1. insp
- the expiratory branch 2 with its elements can also be active.
- the expiratory breathing gas 5 exsp be diverted away from the patient via the expiratory branch 2.
- the PEEP valve 30 is active and set to an individual PEEP.
- the PEEP valve 30 can regulate to the set PEEP pressure.
- the main flow direction S of the respiratory gas mixture 5 runs via the inspiratory branch 1 towards the patient interface and from the patient interface via the expiratory branch 2.
- volatile anesthetics VA are generally not applied, so that the respiratory gases do not have to be guided in a closed circuit.
- the expiratory respiratory gas 5 can exsp via the expiratory branch 2 and the discharge system 14 into the environment.
- the respiratory gas mixture 5 is guided in a semi-open circuit in the third working mode M3, i.e. inspiration takes place via the inspiratory branch 1 and expiration takes place via the expiratory branch 2, with the expiratory respiratory gas 5exsp being discharged via the discharge system 14 and not fed back to the inspiratory branch 1.
- the shut-off valve 28 can be subjected to a high working pressure in the third working mode M3 and block the connection between the inspiratory branch 1 and the expiratory branch 2 in such a way that the expiratory respiratory gas 5exsp cannot be fed back into the inspiratory branch.
- the separating agent 40 and the humidity control module 41 are not flowed through by respiratory gases in the third working mode M3 and are inactive.
- the drain valve 26 is subjected to a low working pressure and releases the third line 14iii.
- the APL valve 29 is subjected to a higher working pressure than the drain valve 26 and thus blocks the second line 14ii.
- P580 Due to the low working pressure of the discharge valve 26, the expiratory breathing gas 5exsp is discharged via the third line to the outlet 14-A and into the environment, bypassing the APL valve 29.
- the APL valve 29 is inactive, so that the PEEP valve 30 also specifies the inspiration pressure Pinsp.
- the PEEP corresponds to the inspiration pressure Pinsp.
- the PEEP valve 30 regulates the PEEP pressure.
- inspiration the PEEP valve 30 regulates the inspiratory patient pressure.
- the breathing gas mixture 5 is not prepared, but rather the entire gas used is discharged into the environment via the discharge system 14.
- Figure 1D shows that the breathing gas mixture 5 in the fourth working mode M4 is guided in a semi-open circuit, similar to the third working mode M3.
- the flow path of the fourth working mode M4 essentially corresponds to that of the third working mode M3.
- the blower 3 is active in the fourth working mode M4 and supplies the conveying energy for the breathing gas mixture 5.
- the blower 3 can generate the required patient flow and a constant byflow.
- the blower 3 can dynamically generate a set patient flow pattern.
- the reservoir 12 can at least partially supply the volume for the blower 3.
- the fresh gas can preferably be introduced with a constant flow.
- the fresh gas forms a byflow together with the blower flow.
- the active blower 3 generates a negative pressure in front of the blower 3 in the inspiratory branch 1, so that the inlet valve 27 can be activated in the fourth working mode M4. If the fresh gas and/or oxygen feed is too low, ambient air can be fed into the breathing gas line 4 via the inlet valve 27.
- the overflow valve 25 is subjected to a low working pressure and can release the first line 14i.
- the breathing gas mixture 5 can thus be at least partially guided through the first line 14i to the outlet 14-A and released into the environment.
- the overflow valve 25 can be set up and designed to protect the reservoir 12 from overstretching and/or destruction.
- fresh gas can be fed into the breathing gas line 4 via the fresh gas module 6 and/or oxygen via the O2 flush 10 in front of the first check valve 21 and can quickly fill the reservoir 12 if necessary. Overfilling of the reservoir 12 can be effectively prevented by the overflow valve 25.
- Figure 1E shows the device 100 in a fifth operating mode M5 for manual ventilation in an emergency mode.
- the device 100 is set up and designed to be able to be operated safely with the fifth operating mode M5 even in emergency situations.
- An emergency situation can occur, for example, if the primary power source 103 and/or the secondary power sources 104 fail.
- An emergency situation can also occur, for example, if the primary power source 103 P580 and/or the secondary power sources 104 can only provide limited energy. In an emergency situation, the power supply may be reduced or fail completely.
- the device 100 can be operated without power and/or in a power-saving manner.
- the device 100 can be operated without a power source and/or only with the secondary power sources 104.
- An emergency situation can alternatively or additionally occur if critical components of the device 100 such as the control device 101, the software, the hardware or the blower 3 fail in part or in full.
- the device 100 can preferably retain the last selected functions and settings and continue to enable ventilation.
- the fifth operating mode M5 allows medical personnel to continue to act even in emergency situations.
- the device 100 is set up and trained to automatically switch to the fifth operating mode M5 when an emergency situation occurs in order to ensure emergency care. It is also possible to set the fifth operating mode M5 manually. This can be advantageous in order to achieve energy-saving operation.
- the monitor can be switched off in order to save power.
- all actuators can be de-energized.
- the sensors can be inactive.
- the blower 3 can also be set to energy-saving operation.
- the blower can be operated less dynamically.
- the device 100 can be set up and designed to apply volatile anesthetics VA in the fifth operating mode M5, since the fresh gas flow can remain. In preferred embodiments, no volatile anesthetics VA are applied in the fifth operating mode M5.
- the anesthetic module 8 and the evaporation element 8a are inactive, so that the patient can continue to be ventilated with the device 100, but without the application of volatile anesthetics. Anesthesia with intravenous anesthetics is then possible.
- Figure 1E shows that the blower 3 can be inactive in the fifth operating mode M5.
- the reservoir 12 can supply the conveying energy for the respiratory gas mixture 5.
- the respiratory gas mixture 5 can flow through the blower 3 (passively).
- the reservoir 12 When the reservoir 12 is activated, the respiratory gas mixture 5 is conveyed into the reservoir line 13.
- the respiratory gas mixture 5 is introduced from the reservoir line 13 into the inspiratory branch 1 of the respiratory gas line 4.
- the check valve 21 prevents the respiratory gas mixture 5 from flowing back into the reservoir line 5.
- the fresh gas switching valves 32 are in their basic position.
- fresh gas can be fed into the respiratory gas line 4 via the first fresh gas supply line 7i.
- the fresh gas can thus be fed in at the feed point 207 and in the flow direction behind the check valve 21.
- the fresh gas can be fed into the breathing gas line with a constant flow in the M5 working mode, since the switching valve 87 and/or the metering valve 88 of the fresh gas supply line 7 can remain in their last set positions without power. The metering of fresh gas can therefore remain at the last set value.
- the O2 flush 10 can be operated manually so that oxygen can optionally be fed into the breathing gas line 4.
- the O2 flush switching valves 31 are in their basic position. The oxygen can thus be fed in via the first O2 flush supply line 11i. The oxygen can thus be fed in at the feed point 211 and in the direction of flow in front of the safety valves 23,24.
- the patient can thus be supplied with breathing gas and/or fresh gas and/or oxygen in the fifth working mode M5 by activating the reservoir 12 and via the fresh gas module 6 and/or the oxygen module 10.
- Figure 1E shows that the expiratory breathing gas 5exsp is guided in the fifth working mode M5 in a similar way to the first working mode M1.
- the flow path of the fifth working mode M5 essentially corresponds to that of the first working mode M1:
- the valves 26, 28, 29 are switched in the fifth working mode M5 such that the breathing gas mixture 5 in the expiratory branch 2 can take two different paths:
- the breathing gas mixture 5 or portions of the breathing gas mixture 5 can be guided in the direction of the main flow S in the circuit and/or diverted from the circuit via the discharge system 14.
- the breathing gas mixture 5 can be guided in the emergency mode M5 at least in the first circuit K1.
- the breathing gas mixture 5 can be at least partially discharged via the outlet 14-A in the emergency mode M5.
- the shut-off valve 28 is de-energized and thus inactive in the fifth working mode M5.
- the shut-off valve 28 thus acts as a simple check valve and releases the breathing gas line 4 in the direction of the main flow S.
- the expiratory breathing gas 5exsp can thus be at least partially directed in the direction of the main flow S in the circuit.
- the expiratory breathing gas 5exsp passes through the separating agent 40, in which CO2 can be chemically separated.
- the humidity management 41 is inactive when de-energized and is only flowed through.
- fresh gas and/or oxygen can be fed back into the breathing gas mixture 5.
- the third line 14iii of the forwarding system 14 is blocked by the drain valve 26 in the fifth working mode M5.
- the drain valve 26 When de-energized, the drain valve 26 is subjected to a high working pressure.
- the drain valve 26 When de-energized, the drain valve 26 can, for example, have a working pressure of 100 hPa due to the spring tension.
- the second line 14ii of the conduction system 14 can be active in the fifth working mode M5, since the APL valve 29 remains in the last set position when de-energized.
- the APL valve 29 can therefore continue to regulate to the (last set) inspiration pressure Pinsp in the emergency mode M5 when de-energized.
- the expiratory breathing gas 5exsp can be at least partially diverted through the second line 14 ii and the outlet 14-A.
- the gas flow of the second line 14ii can thus be released to a limited extent in the fifth working mode M5 through the APL valve 29.
- Excess breathing gas mixture 5 that cannot be guided in the circuit of the breathing gas line 4 can be diverted during inspiration via the second line 14ii.
- the pressure control valve 30 is de-energized and thus generally no longer adjustable.
- the pressure control valve 30 can passively regulate the expiratory pressure Pexsp.
- the pressure control valve 30 When de-energized, the pressure control valve 30 drops to its passive working pressure. In the fifth operating mode M5, the pressure control valve 30 can passively regulate the PEEP to, for example, 5 hPa. In contrast to the first operating mode M1, the sensors 15, 16, 17, 18, 19, 20, 39 and the humidity control module 41 are de-energized and thus inactive in the fifth operating mode M5. Alternatively or in addition to the operating modes described so far, the device 100 can also be operated in at least one sixth operating mode M6, which can provide a large, essentially constant flow. A constant flow can be used, for example, to carry out high-flow therapy (HFOT). The device 100 can be used to carry out HFOT.
- HFOT high-flow therapy
- humidifiers and/or heating elements can optionally be connected to the device 100 in order to humidify and/or heat the breathing air.
- the sixth operating mode M6 can be used in combination with spinal anesthesia and/or other local anesthesia.
- the sixth operating mode M6 can be operated with awake patients who are to receive respiratory support.
- Figure 1F shows the device 100 in the sixth operating mode M6 for a constant flow (HFOT), where volatile anesthetics VA can optionally be applied.
- the sixth operating mode M6 can be implemented both without adding volatile anesthetics (see Figure 1F) and with an application of volatile anesthetics (not shown).
- the sixth operating mode M6 can also be implemented in a failure mode (not shown).
- Figure 1F shows the device 100 in the sixth operating mode for a constant flow and without applying volatile anesthetics.
- the device 100 is set up and designed to generate a nearly constant flow without generating or specifying a breathing pattern.
- the flow is applied in the sixth operating mode M6 independently of the patient's breathing phases.
- flows of up to 80l/min can be achieved.
- HFOT mode constant flows of 60l/min are usually generated.
- the HFOT can be carried out via an open and/or semi-open circuit.
- P580 The HFOT is preferably implemented via an open circuit without an expiratory branch 2 (see Figure 1F).
- the device 100 can then only have an inspiration tube.
- the patient 90 can be supplied with the breathing gas mixture 5 via the inspiration tube and the patient interface 91 and can exhale into the environment.
- the patient interface 91 is preferably a nasal cannula to implement an HFOT.
- the breathing gas mixture 5 is driven exclusively by the fresh gas module 6.
- the fresh gas switching valves 32 are in their basic position.
- fresh gas can thus be fed into the breathing gas line 4 via the first fresh gas supply line 7i.
- the supply of fresh gas can thus take place at the supply point 207 and in the direction of flow behind the check valve 21.
- the supply of fresh gas can preferably provide the flow for the HFOT.
- the constant fresh gas flow can preferably be guided directly to the patient interface without influence.
- the O2 flush 10 can be operated manually and optionally additional oxygen can be fed into the breathing gas line 4.
- the O2 flush switching valves 31 are in their basic position.
- the supply of oxygen can thus take place via the first O2 flush supply line 11i.
- the supply of oxygen can thus take place at the supply point 211 and in the direction of flow in front of the safety valves 23,24.
- the inspiratory pressure sensor 15 and/or the inspiratory flow sensor 17 and/or the oxygen sensor 19 are preferably active in the sixth working mode M6.
- the second safety valve 024 can be electrically activated in the sixth operating mode M6 and offers additional protection.
- the device 100 is alternatively or additionally designed to provide a constant flow in the sixth operating mode M6 and at the same time to apply volatile anesthetics VA (not shown).
- a constant flow is also generated with an application of volatile anesthetics, without generating or specifying a breathing pattern and independently of the patient's breathing phases.
- the anesthetic module 8 and/or the evaporation element 8a can optionally be activated.
- a constant fresh gas flow is fed in via the fresh gas module 6 and the first fresh gas supply line 7i, which can be enriched with anesthetics VA after being fed into the evaporation element 8a and can be fed directly to the patient interface without further influence.
- the device 100 can then be set up and designed to be connected to a hand bag 35 designed for this purpose, so that the volatile anesthetics are not released into the environment, but can be reused via the hand bag 35 (not shown).
- P580 When applying volatile anesthetics in the sixth operating mode M6, the multigas sensor 20 can also preferably be active. In addition, an O2 flush close to the patient is possible for safety reasons.
- the device 100 is alternatively or additionally set up to provide a constant flow in a fault mode without an application of volatile anesthetics (not shown).
- the fresh gas feed can be continued behind the first check valve 21, since the switching valve 87 and/or the metering valve 88 of the fresh gas supply line 7 can remain in their last set positions without power.
- the sensors 15, 17, 19 can be deactivated.
- no measurements are then taken by the inspiratory flow sensor 17 and/or the O2 sensor 19 and/or the inspiratory pressure sensor 15.
- the anesthetic module 8 can be deactivated manually or automatically so that no more anesthetics are fed in.
- the O2 flush 10 can still be operated manually in the error mode of the sixth operating mode M6 so that oxygen can optionally be fed into the respiratory gas line 4 close to the patient.
- Figure 1G shows the device 100 in a seventh operating mode M7, which represents a service mode.
- the device 100 In the seventh operating mode M7, the device 100 is generally not connected to a patient 90.
- the device 100 can be operated in the seventh operating mode M7, which allows maintenance and/or servicing and/or drying.
- the device 100 can also be operated in a standby mode.
- the device 100 can advantageously be operated in the seventh operating mode M7 to enable drying of the device 100 or at least parts of the device 100. In this way, the moisture condensed by the use of the chemical release agent 40 can be effectively removed from the breathing gas line 4.
- the fresh gas module 6 is inactive.
- the fresh gas module 6 can be inactivated by closing the metering valve 88 and/or the switching valve 87 in the fresh gas supply line 7.
- the blower 3 is active.
- the blower 3 can generate a constant pressure and/or a constant flow and/or a constant volume.
- the blower 3 can generate a negative pressure in the breathing gas line 4 upstream of the blower 3 in the flow direction.
- the inlet valve 27 can open.
- air from the environment can be sucked into the device 100 via the inlet valve 27.
- the ambient air can be fed into the breathing gas line 4 via the inlet valve 27 at the ambient air feed point 227.
- the feed point for ambient air 227 can be located in the flow direction after the separating agent 40.
- the feed point for ambient air 227 can preferably be located in the flow direction after the shut-off valve 28.
- the feed point for ambient air 227 is, for example, in the flow direction before the humidity control module 41.
- the feed point for ambient air 227 is between the shut-off valve 28 and the humidity control module 41.
- the ambient air sucked in is thus passed through the humidity control module 41.
- the humidity control module 41 In the seventh working mode M7, the humidity control module 41 is inactive and the sucked in ambient air can flow through it passively.
- the ambient air can absorb moisture in the humidity control module 41.
- the ambient air then flows through the inspiratory branch 1 and the expiratory branch 2.
- the Y-piece 93 is closed on the patient side in the seventh working mode M7.
- the ambient air can also flow through the first check valve 21, the blower 3, the inspiratory flow sensor 17, the hose system 92, the second check valve 22, the PEEP valve 30, the expiratory flow sensor 18 and/or the drain valve 27, whereby the ambient air can absorb moisture and drain it via the outlet 14-A.
- the drain valve 26 is subjected to a low working pressure and releases the third line 14iii.
- the APL valve 29 is subjected to a higher working pressure than the drain valve 26 and thus blocks the second line 14ii. Due to the low working pressure of the drain valve 26, the moisture-saturated ambient air is discharged via the third line 14iii to the outlet 14-A and into the environment, bypassing the APL valve 29.
- Figure 4 shows a schematic structure of the device in a second exemplary embodiment.
- the exemplary embodiment according to Figure 4 corresponds in its essential structure to that of the exemplary embodiment according to Figure 1, but can at least comprise the at least one mechanical separating means 60.
- the separating means 60 can be designed as a mechanical CO2 absorber 60.
- the CO2 separation can take place mechanically via at least one diffusion filter 61, as described further below for Figure 4.
- the mechanical separating means 60 can be comprised alternatively or in addition to the chemical separating means 40.
- the device 100 preferably comprises either the chemical separating means 40 (see Figure 1) or the mechanical separating means 60 (see Figure 4).
- the mechanical separating means 40 can be arranged in or on the breathing gas line 4.
- the mechanical separating means 40 can be arranged downstream of the patient interface.
- the mechanical separating means 40 is preferably arranged in the expiratory branch 2 of the respiratory gas line 4.
- the mechanical separating means 40 can be arranged downstream of the multi-gas sensor 20.
- the mechanical separating means 40 can be arranged downstream of the expiratory pressure sensor 16.
- P580 The mechanical separating means 40 can be arranged upstream of the forwarding system 14.
- the mechanical separating means 40 can be arranged upstream of the PEEP valve 30.
- the mechanical separating means 40 can be arranged upstream of the junction of the bypass 75 into the expiratory branch 2.
- the mechanical separating means 40 can be arranged upstream of the second safety valve 22. In the specific embodiment according to Figure 3, the mechanical separating means 40 can be arranged between the junction of the bypass 75 into the expiratory branch 2 and the patient interface.
- the device 100 in the embodiment according to Figure 4 can comprise additional elements compared to the embodiment according to Figure 1, which enable or at least positively influence the functioning of the device 100 with the mechanical separating means 60.
- the device 100 in the embodiment according to Figure 4 can also comprise fewer elements compared to the embodiment according to Figure 1.
- the embodiment according to Figure 4 can be designed without a chemical absorber 40.
- the humidity control module 41 therefore no longer has to be included.
- the device 100 can also be equipped with a mechanical separating means 60 and with a humidity control module 41 (not shown).
- the device 100 can comprise at least one sweep gas module 70 and at least one sweep gas supply line 71 for providing, introducing, discharging and controlling sweep gas 64 for the mechanical separating means 60 (see also further below, Figure 5).
- the sweep gas module 70 is set up and designed to provide sweep gas 64 for the separating means 60. Sweep gas 64 can be introduced into and/or discharged from the mechanical separating means 60 in a controlled manner via the sweep gas supply line 71.
- the sweep gas supply line 71 is pneumatically connected to the separating means 60 for this purpose.
- the device 100 can also comprise at least one bypass 75.
- the bypass 75 can be designed as a gas-conducting line and can be pneumatically connected to the breathing gas line 4. At least part of the breathing gas mixture 5 can be conducted via the bypass 75.
- the bypass 75 can allow or enable a bypass flow S1, the direction of which is shown in Figure 4 with a dashed line.
- the bypass flow S1 can exist in addition to the main flow S of the breathing gas mixture 5.
- the bypass 75 is designed to at least temporarily establish a breathing gas-conducting connection from the inspiratory branch 1 to the expiratory branch 2 in such a way that a second circuit K2 is formed in which the breathing gas mixture 5 can be conducted.
- the second circuit K2 can correspond at least partially to the first circuit K1.
- the bypass 75 is arranged such that the connection 93 for a patient interface is not arranged in the second circuit K2.
- the connection 93 for a patient interface is only arranged in the first circuit K1.
- the bypass 75 is arranged such that the mechanical separating means 60 is not arranged in the second circuit K2.
- the mechanical separating means 60 is only arranged in the first circuit K1.
- the breathing gas mixture 5 can be conducted in the first circuit K1 with the main flow S and additionally in the second circuit K2 with the bypass flow S1.
- Bypass flow S1 and main flow S of the breathing gas mixture 5 can run parallel at least in some areas.
- At least one valve 76 can be arranged in the bypass 75.
- the valve 76 can be designed as a check valve.
- the valve 76 can then at least specify the direction of the bypass flow S1.
- the valve 76 can in particular prevent the bypass flow S1 from flowing back into the inspiratory branch 1 of the breathing gas line 4.
- the valve 76 can be designed as a simple check valve or as a loaded check valve (not shown).
- the valve 76 can be designed as a lockable check valve and thus as a bypass shut-off valve 76.
- the bypass shut-off valve 76 can be designed, for example, as a lockable check valve with a solenoid coil.
- the bypass shut-off valve 76 can therefore preferably be operated in at least two settings: In a first setting, for example in a rest position, the bypass shut-off valve 76 can release the flow in one direction and block it in one direction. In this first setting, the bypass shut-off valve 76 can act as a simple check valve. In a second setting, for example in an active position, the bypass shut-off valve 76 can block the flow in both directions.
- the active position of the valve 76 can be established, for example, by energizing the solenoid coil.
- the bypass 75 can branch off in the inspiratory branch 1.
- the bypass 75 can open into the expiratory branch 2.
- the bypass 75 can branch off between the blower 3 and the patient interface 91.
- the bypass 75 can preferably branch off between the blower 3 and the feed point 211 of the first O2 flush supply line 11i.
- the bypass 75 can branch off, for example, between the inspiratory flow sensor 17 and the feed point 211 of the first O2 flush supply line 11i.
- at least one further check valve, namely a third safety valve 77 can advantageously be included.
- the third safety valve 77 can be arranged in the breathing gas line 4 between the branch of the bypass 75 and the feed point 211 of the first O2 flush supply line 11i.
- the third safety valve 77 is designed as a simple check valve.
- the third safety valve 77 is designed as a spring-loaded check valve.
- the bypass 75 can flow back into the respiratory gas line 4 between the patient interface 91 and the blower 3.
- the bypass 75 can thus flow into the expiratory branch 2.
- the bypass 75 can preferably flow back into the respiratory gas line 4 between the separating means 60 and the blower 3.
- the bypass 75 can flow back into the respiratory gas line 4 in particular between the separating means 60 and the anesthetic module 8.
- the bypass 75 can, for example, flow into the expiratory branch 2 after the second safety valve 22. P580 branch 2 of the breathing gas line 4.
- the second safety valve 22 can then prevent the bypass flow S1 from running against the main flow S1 and in the direction of the separating means 60.
- the bypass 75 can branch off from the breathing gas line 4 after the blower 3 and flow back into the breathing gas line 4 at least before the anesthetic module 8.
- the bypass flow S1 can be generated through the bypass 75.
- the bypass flow S1 is not directed to the patient 90.
- the bypass flow S1 is not generated at the inlet of the oxygen module 10.
- the bypass flow S1 is not directed through the separating means 60.
- the second safety valve 22 prevents the bypass flow S1 from flowing in the direction of the separating agent 60.
- the bypass flow S1 runs at least from the blower 3 through the bypass 75 to the anesthetic module 8 and back to the blower 3.
- a second gas circuit can thus be formed through the bypass 75 with the bypass flow S1, which can exist as an alternative or in addition to the gas circuit of the main flow S.
- the bypass flow S1 and the main flow S can run parallel in the respiratory gas line 4 at least in some areas.
- the bypass flow S1 and the main flow S can not run in a common line at least in some areas.
- one or more anesthetics VA are kept under pressure and therefore liquid in the anesthetic module 8 and/or the anesthetic supply line 9 and are injected from there into the respiratory gas line 4.
- the anaesthetics VA evaporate and mix with the breathing gas mixture 5.
- the anaesthetics VA can mix particularly advantageously with the breathing gas mixture 5.
- This type of liquid dosing means that a prior mixing of anaesthetics VA and fresh gas is no longer necessary.
- a mixing chamber separated from the breathing gas line 4 for a separate mixture of fresh gas or breathing gas and anaesthetics VA is no longer necessary.
- FIG. 5 shows a schematic structure of the mechanical separating means 60 with diffusion filter 61.
- the mechanical separating means 60 can in principle be designed as a two-chamber system 65 and comprise at least one first chamber 62 and at least one second chamber 63.
- the first chamber 62 and the second chamber 63 are separated from one another by the at least one diffusion filter 61.
- the mechanical separating means 60 can comprise a plurality of such two-chamber systems 65, which can run parallel to one another.
- the two-chamber systems 65 are designed as gas-conducting tubes.
- the tubes can have a diameter of 0.1 mm to 10 mm, preferably of P580 0.1 mm to 5 mm, particularly preferably from 0.3 to 1 mm.
- the tubes of the two-chamber systems 65 have a diameter of 0.5 mm.
- the mechanical separating means 60 comprises several thousand such tubes (not shown).
- the total diameter of the tubes and thus of the separating means 60 advantageously corresponds to the diameter of the breathing gas line 4.
- the diffusion filter 61 can be designed as a semi-permeable membrane and have pores 65 that are designed in such a way that only molecules that are smaller than a certain size can pass through the membrane.
- the diffusion filter 61 is preferably made of a chemically inert material.
- the diffusion filter 61 is characterized in that it can be cleaned, disinfected and reused.
- the diffusion filter 61 is made of plastic, ceramic, glass, metal or combinations thereof.
- the material of the diffusion filter 61 is selected from the group polysulfone, polyethersulfone, cellulose, cellulose ester, cellulose acetate, cellulose nitrate, regenerated cellulose, silicone, polyamide, polyamideimide, polyamide urea, polycarbonate, ceramic, stainless steel, silver, silicon, zeolite, aluminosilicate, polyacrylonitrile, polyethylene, polypropylene, polytetrafluoroethylene, polyvinylidene fluoride, polyvinyl chloride, polypiperazinamide.
- the breathing gas mixture 5 can be passed in the direction of the main flow S through the first chamber 62 of the two-chamber system 65. Expiratory breathing gas 5 is preferred. exsp through the separating agent 60 to separate CO2. The expiratory breathing gas 5 exsp can be passed through the first chamber 62.
- the separating agent 60 is preferably arranged in the expiratory branch 2. It is particularly advantageous if the separating agent 60 is arranged very close to the patient 90.
- the separating agent 60 can alternatively or additionally be designed to separate nitrous oxide (N2O). The separation of N2O can be carried out in an equivalent manner to the separation of CO2 described here.
- a sweep gas 64 can be passed through the second chamber 63 of the two-chamber system 65.
- the sweep gas 64 is designed to wash out at least CO2 from the respiratory gas mixture 5.
- the sweep gas 64 is passed through the second chamber 63 with a sweep gas flow S2, the direction of which is indicated in Figure 5 with an arrow S2.
- the direction of the sweep gas flow S2 is preferably chosen to be opposite to the direction of the main flow S of the breathing gas mixture 5, which is indicated here with an arrow S.
- the device 100 can comprise the at least one sweep gas module 70 and the at least one sweep gas supply line 71. Sweep gas 64 can be introduced into the separating agent 60 via the sweep gas supply line 71.
- Sweep gas 64 can be introduced in particular into the second chamber 63 of the separating agent 60 via the sweep gas supply line 71. Sweep gas 64 can also be discharged from the second chamber 63 via the sweep gas supply line 71.
- the sweep gas supply line 71 is pneumatically connected to the second chamber 63.
- the sweep gas supply line 71 can supply and/or discharge sweep gas 64 from the separating agent 60.
- the sweep gas 64 can be obtained from compressed gas cylinders. Alternatively or additionally, the sweep gas 64 can also be obtained via the oxygen module 10 and/or the fresh gas module 6.
- the control device 101 and/or the sweep gas module 70 can specify the composition of the sweep gas 64.
- the control device 101 and/or the sweep gas module 70 can specify a flow and/or volume of the sweep gas 64.
- the sweep gas module 70 can be connected to the control device 101 and/or controlled by the control device 101.
- the control device 101 and/or the sweep gas module 70 can also be set up to prevent or terminate the sweep gas flow, so that the device 100 can also be operated without sweep gas 64. This is advantageous, for example, when the device 100 is operated in a semi-open circuit, for example in TIVA mode.
- the separating agent 60 Without a sweep gas flow in the second chamber 63, the separating agent 60 is inactive.
- the breathing gas mixture 5 can then flow through the mechanical separating agent 60 without gas components such as CO2 being separated.
- the sweep gas 64 is set up in such a way that the concentration of CO2 is significantly lower than that of the breathing gas mixture 5.
- the sweep gas 64 is set up in such a way that the CO2 concentration of the sweep gas 64 when introduced into the second chamber 63 is less than 20%, preferably less than 10%, particularly preferably less than 5%.
- the CO2 concentration of the sweep gas 64 when introduced into the second chamber 63 is 0%.
- the sweep gas 64 is also advantageously free of anesthetics VA.
- the sweep gas 64 is also designed such that the concentration of oxygen O2 and/or nitrogen N2 can preferably be at least equal to or higher than that of the expiratory breathing gas mixture 5.
- the O2 concentration of the sweep gas 64 is above 0%, preferably above 20%, particularly preferably above 40% when introduced into the second chamber 63.
- the O2 concentration of the sweep gas 64 can be 6347% when introduced into the second chamber 63.
- the N2 concentration of the sweep gas 64 is above 0%, preferably above 20%, particularly preferably above 40% when introduced into the second chamber 63.
- the N2 concentration of the sweep gas 64 can be 6353% when introduced into the second chamber. Due to a concentration gradient across the diffusion filter 61, the breathing gas mixture 5 can be separated in the mechanical separation medium 60.
- the nature of the diffusion filter 61 allows particularly small molecules to be separated. In particular, molecules that consist of a few atoms, for example fewer than 5 atoms, can be separated.
- CO2 molecules can be separated.
- Oxygen O2 and nitrogen N2 can also pass through the diffusion filter 61.
- Anaesthetics VA that have more than 5 atoms, however, cannot pass through the diffusion filter 61 and remain in the breathing gas mixture 5.
- P580 The initial concentration of the gas components of the sweep gas 64 can be used to control which gas components are filtered out of the breathing gas mixture 5 and which gas components remain in the breathing gas mixture 5.
- the following scenario can be advantageous with regard to carbon dioxide CO2: If a sweep gas 64 is introduced into the second chamber 63 that contains a lower CO2 concentration than the breathing gas mixture 5 in the first chamber 62, CO2 can be filtered out of the breathing gas mixture 5. This allows CO2 to be removed from the breathing gas mixture 5.
- the breathing gas mixture 5 can be suitable for inspiration again.
- the breathing gas mixture 5 can therefore be guided in a closed circuit.
- the following scenarios can be advantageous with regard to oxygen O2 and/or N2: If sweep gas 64 is introduced into the second chamber 63 which contains the same and/or a higher O2 concentration than the breathing gas mixture 5 in the first chamber 62, O2 can remain in the breathing gas mixture 5. If the breathing gas mixture 5 is then used again for inspiration, it contains oxygen in the concentration of the sweep gas 64. If sweep gas 64 is introduced into the second chamber 63 which contains a lower O2 concentration than the breathing gas mixture 5 in the first chamber 62, O2 can be filtered out of the breathing gas mixture 5.
- the retention or removal of N2 and/or N2O from the breathing gas mixture 5 can also be controlled in this way according to the same principle.
- the gas concentrations of the introduced sweep gas 64 can be controlled via the control device 101 and/or via the sweep gas module 70.
- the volume and/or flow of the introduced sweep gas 64 can also be controlled via the control device 101 and/or via the sweep gas module 70.
- the sweep gas flow through the separating agent 60 is constant.
- the sweep gas flow can also be adapted to the ventilation and thus, for example, to the tidal volume or the minute volume.
- the control is preferably carried out automatically by specifications and values stored in the control device 101, but can also be set manually by medical specialists if required.
- the sweep gas flow and/or the sweep gas volume corresponds to the flow and/or the volume of the breathing gas mixture 5.
- the sweep gas 64 is introduced into the separating agent 60 in excess of the breathing gas mixture 5.
- the same amount of sweep gas 64 is introduced into the second chamber 63 per breath as the amount of breathing gas mixture 5 flows into the first chamber 62.
- more sweep gas 64 is introduced into the second chamber 63 per breath than the amount of breathing gas mixture 5 flows into the first chamber 62.
- the ratio of the amount of sweep gas 64 to breathing gas mixture 5 can be at least 1:1, preferably at least 1.2:1, particularly preferably at least 1.4:1.
- the ratio of sweep gas 64 to breathing gas mixture is 51.5:1 or more.
- a ratio of sweep gas 64 to breathing gas mixture 5 of at least 2:1 or at least 5:1 is also conceivable.
- the sweep gas is dosed such that it is 1.2 to 1.5 times the minute volume.
- the ratio of the amount of sweep gas 64 to breathing gas mixture 5 can be variably adjustable and adaptively adapted to the corresponding ventilation situation.
- the sweep gas flow can be adjusted based on the CO2 concentration of the expiratory breathing gas 5 exsp be adjustable.
- the mechanical separating means 60 with the sweep gas module 70 offers the advantage that the CO2 concentration of the breathing gas mixture 5 can be adjusted quickly, in a defined, highly dynamic and cost-effective manner. Since a high CO2 concentration stimulates the patient to breathe spontaneously, the CO2 concentration can, for example, influence the weaning of the patient from mechanical ventilation.
- the sweep gas supply line 71 can be constructed in accordance with the supply lines according to Figure 2.
- the sweep gas supply line 71 can also have more or fewer elements than the supply lines according to Figure 2.
- the sweep gas supply line 71 can comprise at least one valve 88i for dosing sweep gas 64.
- the sweep gas module 70 can be supplied with gas in particular by the fresh gas module 6 and/or the oxygen module 10.
- the sweep gas supply line 71 can comprise at least one bistable switching valve 87 and/or at least one bistable needle valve 88 as well as at least one flow sensor 85, via which the sweep gas introduction into the separating agent 60 is controlled (not shown).
- the advantages of the mechanical release agent 60 compared to a chemical release agent 40 are as follows: - Significant savings in anesthetics VA, as these are not filtered out but remain in the circuit and thus in the breathing gas mixture 5 -
- the mechanical release agent 60 is chemically neutral or inert - There is therefore no heat development and no water formation during CO2 separation - No hazardous chemical waste is therefore produced -
- the mechanical release agent 60 is designed for very long use (up to a year) and the release agent 60 rarely needs to be replaced -
- the release agent 60 can therefore be replaced by a service employee - Due to the less frequent replacement, there is a lower risk of contamination -
- the release agent 60 can optionally be reused after processing -
- the release agent 60 is more cost-effective than chemical release agents
- the bypass 75 can provide a permanent gas flow (byflow) in the breathing gas line 4, at least in sections.
- the bypass 75 can provide a permanent gas flow in the area of the breathing gas line 4 into which the anesthetic supply line 9 opens.
- the bypass 75 can provide a permanent gas flow in the evaporation element 8a. Because a permanent flow (byflow) of the breathing gas mixture 5 prevails in the evaporation element 8a, the anesthetics VA can be introduced and/or mixed into the breathing gas mixture 5 in a particularly advantageous manner via a liquid metering system.
- the advantage of embodiments with at least one bypass 75 is that the byflow is not passed through the entire system. The byflow can be limited to the second circuit K2.
- the bypass 75 ensures that the byflow does not flow to the patient.
- the bypass 75 also ensures that the byflow does not flow through the mechanical separating agent 60.
- the bypass shut-off valve 76 can be used to establish or block the respiratory gas connection of the bypass. Blocking the bypass 75 can be advantageous if the concentration of the anesthetics VA or that of the oxygen in the respiratory gas mixture 5 in the inspiratory branch 1 is to be changed quickly. It must be noted that the efficiency of the diffusion absorber is reduced during this time.
- the device 100 of the second embodiment can be operated in the different operating modes M1, M2, M3, M4, M5, M6, M7 described for Figures 1A-1F.
- the operating modes can be set manually and/or automatically specified by the control device 101. In the second embodiment, too, volatile anesthetics VA can be applied, directed and, in particular, also specifically drained off for disposal or reuse using the device 100.
- ventilation without volatile anesthetics VA can also be carried out using the device 100.
- the working modes in the second embodiment can be implemented, for example, via the settings of the valves 25, 26, 27, 28, 29 and optionally also via the settings of the blower 3 and/or the pressure relief valve 30 as well as via the actuation of the reservoir 12.
- the working modes in the second embodiment can also be influenced in particular via the setting of the bypass shut-off valve 76.
- the working modes M1 to M7 of the second embodiment largely correspond to the working modes of the first embodiment described above. In particular, the bypass and the P580 However, there are differences between the different separating agents 40, 60, which are described below.
- the reservoir 12 also supplies the delivery energy for the respiratory gas mixture 5 and thus the respiratory energy in the second embodiment.
- the inspiratory respiratory gas 5 insp is supplied to the patient via the inspiratory branch 1 and the expiratory breathing gas 5 exsp is carried away from the patient via the expiratory branch 2.
- Fresh gas switching valve 32 and O2 flush switching valve 31 are in their basic positions. The fresh gas introduction can thus take place in the direction of flow behind the non-return valve 21.
- the optional oxygen introduction via the O2 flush 10 can take place in the direction of flow behind the blower 3 and in front of the safety valves 23,24.
- the anesthetic module 8 is active so that volatile anesthetics VA can be introduced into the evaporation element 8a via the anesthetic supply line 9 and added to the breathing gas mixture 5.
- the expiratory breathing gas 5 exsp can be diverted away from the patient via the expiratory branch 2.
- the expiratory breathing gas 5 passes exsp the mechanical separating agent 60.
- the sweep gas module 70 is active in the first operating mode M1 and directs sweep gas into the separating agent 60. This also activates the separating agent 60 and can at least remove CO2 from the expiratory breathing gas 5 exsp
- the expiratory breathing gas 5 exsp can then pass through the active PEEP valve 30, which regulates to an individual exhalation pressure.
- the breathing gas mixture 5 can also take two different paths: On the one hand, the breathing gas mixture 5 can be guided in the direction of the main flow S in the circuit, since the shut-off valve 28 is subjected to a low working pressure and releases the breathing gas line 4. In contrast to the first embodiment, the breathing gas mixture 5 does not have to pass through a chemical CO2 absorber 40 and thus also no humidity control module 41. Since the CO2 has already been separated by the mechanical separating agent 60, the breathing gas mixture 5 can be guided in the circuit and fed back to the patient. However, it is also conceivable that the second embodiment includes a humidity control module 41 in order to remove and/or feed moisture to the circuit (not shown).
- the breathing gas mixture 5 can also be at least partially discharged from the circuit via the APL valve 29 through the forwarding system 14.
- a second circuit with a bypass flow S1 can exist in the second embodiment according to Figure 4.
- the bypass 75 is set up and designed to allow the second circuit if required.
- the bypass shut-off valve 76 In the first working mode M1, the bypass shut-off valve 76 is subjected to a low working pressure or is in a rest position. In the first working mode M1, the bypass shut-off valve 76 can act as a simple check valve without the action of the solenoid coil. In the first working mode M1, the bypass shut-off valve 76 releases the bypass 75 in the direction of the bypass flow S1.
- the bypass 75 offers the advantage that a second circuit is created for the breathing gas mixture 5, which is not directed to the patient. In the second circuit, an almost constant flow can be generated that is independent of the patient's breathing phases. This almost constant flow then also runs through the evaporation element 8a and promotes the liquid dosing of the anesthetics. In addition, by creating the second circuit, the bypass 75 offers the advantage that a lower flow is directed through the separating agent 60 and thus sweep gas 64 can be saved. In the second working mode M2 for mechanical ventilation with the application of volatile anesthetics, the blower 3 also supplies the conveying energy for the breathing gas mixture 5 and thus the breathing energy in the second embodiment.
- the reservoir 12 serves as a storage device for at least part of the breathing gas mixture 5.
- the fresh gas switching valve 32 and the O2 flush switching valve 31 are in the basic position. Fresh gas is introduced into the breathing gas line 4 via the first fresh gas supply line 7i and conveyed to the patient by the blower 3.
- the anesthetic module 8 is active.
- the sweep gas module 70 and thus also the separating agent 60 are also active in working mode M2, so that at least CO2 can be separated and the breathing gas mixture 5 can at least partially remain in the circuit.
- the blower 3 can suck in the breathing gas mixture 5 (enriched with fresh gas and/or anesthetics) from the breathing gas line 4, so that at least a partial negative pressure can arise upstream of the blower 3. This allows breathing gas mixture 5 to be sucked in from the reservoir 12.
- the inlet valve 27 can open and supply ambient air to the breathing gas line 4.
- the feed point for ambient air 227 can be arranged in the breathing gas line 4.
- the feed point for ambient air 227 can also be arranged in the reservoir line 13.
- the feed point for ambient air 227 in the second embodiment according to Figure 4 can be in the reservoir line 13.
- the feed point for ambient air 227 can be between the reservoir 12 and the reservoir feed point 213 in the breathing gas line 4. As a result, ambient air can be fed directly into the breathing gas line 4 via the reservoir line 14.
- the valves 26, 28, 29 are switched in the second working mode M2 in such a way that the breathing gas mixture 5 essentially runs in the circuit along the main flow direction S, but in contrast to the first embodiment, the breathing gas mixture 5 in the second embodiment does not pass through a chemical separating agent 40.
- a humidity control module 41 can optionally be included, but can be dispensed with due to the lack of a chemical absorber 40.
- the bypass shut-off valve 76 of the second embodiment is in its rest position in the second working mode M2. The bypass 75 is thus active and can be flowed through in the direction of the bypass flow S1. In the working mode M2 of the second embodiment, there is thus a second circuit for the breathing gas mixture 5, as in the first working mode M1.
- the third working mode M3 for manual ventilation without application of volatile anesthetics can be very similar in the first and second embodiments.
- the breathing gas mixture 5 can, for example, be guided in the same or similar way. This can be achieved in particular by the bypass 75 and/or the sweep gas module 70 and/or the mechanical separating means 60 of the second embodiment being inactive in the third working mode M3.
- the bypass shut-off valve 76 can be subjected to a high working pressure and/or be in an active position.
- the bypass shut-off valve 76 can act as a shut-off valve under the influence of the solenoid coil.
- the bypass shut-off valve 76 can shut off the bypass 75 in such a way that the bypass 75 is inactive.
- the active bypass shut-off valve 76 blocks the second circuit for the breathing gas mixture 5.
- the sweep gas module 70 can be inactive. An inactive sweep gas module 70 does not feed any sweep gas 64 into the mechanical separating agent 60. Because there is no sweep gas flow in the separating agent 60, the mechanical separating agent 60 is inactive. The separating agent 60 can flow through passively. The expiratory breathing gas mixture 5 exsp can flow through the separating agent 60 in the third working mode M3 without CO2 being separated.
- the fourth operating mode M4 for automatic ventilation without application of volatile anesthetics can also be very similar in the first and second embodiments.
- the breathing gas mixture 5 can, for example, be managed in the same or similar way. This can be achieved in particular by the bypass 75 and/or the sweep gas module 70 and/or the mechanical separating means 60 of the second embodiment being inactive in the fourth operating mode M4.
- the blower 3 is active and the overflow valve 25 is subjected to a low working pressure to activate the first line 14i.
- the shut-off valve 28 is active to stop the circuit and the drain valve 26 is open to activate the third line 14iii.
- the ambient air can be fed directly into the reservoir line 13 through the inlet valve 27 if required.
- the device 100 according to the second embodiment can be operated in the fifth operating mode M5 for manual ventilation in a battery and/or error mode.
- the fifth operating mode M5 can be similar in the first and second embodiments.
- An emergency supply via manual ventilation can be ensured by the reservoir 12 providing the conveying energy for the respiratory gas mixture 5 and fresh gas can be fed into the respiratory gas line 4 with a constant flow via the first fresh gas supply line 7i.
- the fresh gas supply line 7i is open when de-energized.
- the flow path of the respiratory gas basically runs as in the first embodiment from the reservoir 12 via the inspiratory branch 1 to the patient and from the patient via the expiratory branch 2 in the direction of the main flow S in the circuit and/or via the APL valve 29 and the second line 14ii to the outlet 14-A.
- the bypass 75 can be active.
- the bypass shut-off valve 76 can act as a simple check valve without current.
- the respiratory gas mixture 5 can then also be guided with a relatively constant flow in the second circuit.
- the sweep gas module 70 is active without current, so that sweep gas 64 can be introduced into the mechanical separating agent 60 and CO2 can be separated.
- the sweep gas supply line is open.
- the valve 88i for dosing sweep gas 64 can be set to set the sweep gas dosing without power to 1.2 to 2 times the last set minute volume, preferably to 1.5 times.
- the advantage of the second embodiment is that the mechanical CO2 separation does not result in any particular moisture development. In addition, the CO2 separation is ensured by the sweep gas module 70, which is active without power.
- the sixth operating mode M6 for a constant flow (HFOT), with or without the application of volatile anesthetics, can be very similar in the first and second embodiments.
- the breathing gas mixture 5 can, for example, be guided in the same or similar way. This can be achieved in particular by the bypass 75 of the second embodiment being inactive in the sixth operating mode M6.
- the bypass shut-off valve 76 can be subjected to a high operating pressure and/or be in an active position in the sixth operating mode M6. The bypass shut-off valve 76 can thus deactivate or shut off the bypass 75.
- An inactive bypass 75 in the sixth operating mode M6 means that the respiratory gas mixture 5 cannot pass through the bypass 75.
- the respiratory gas mixture 5 is then guided in an open circuit as described above.
- the respiratory gas mixture 5 is guided to the patient via the inspiratory branch 1 so that the patient can be supplied with a constant flow.
- the seventh operating mode M7 can be implemented in the second embodiment in a similar way to the first embodiment.
- the device 100 according to the second embodiment can thus also be operated in a service mode.
- the seventh operating mode M7 is in particular set up and designed to remove condensed moisture from the device 100. Even if the advantageous mode of operation of the mechanical separating agent 60 compared to the chemical separating agent 40 means that less moisture can be produced in the device 100, it is possible to implement the seventh operating mode M7 in order to remove condensed moisture.
- the bypass 75 can be active and flow can also take place. It is also conceivable that the bypass 75 is inactivated by activating the bypass shut-off valve 76.
- the sweep gas module 70 can be inactive and the mechanical separating means 60 can be flowed through passively.
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- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Respiratory Apparatuses And Protective Means (AREA)
Abstract
Description
Claims
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| DE102023110586 | 2023-04-25 | ||
| LU103147A LU103147B1 (de) | 2023-06-12 | 2023-06-12 | Vorrichtung zur Atemgasversorgung |
| PCT/EP2024/060450 WO2024223384A1 (de) | 2023-04-25 | 2024-04-17 | Vorrichtung zur atemgasversorgung |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| EP4701700A1 true EP4701700A1 (de) | 2026-03-04 |
Family
ID=90735067
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| EP24719546.4A Pending EP4701700A1 (de) | 2023-04-25 | 2024-04-17 | Vorrichtung zur atemgasversorgung |
Country Status (5)
| Country | Link |
|---|---|
| EP (1) | EP4701700A1 (de) |
| KR (1) | KR20250175339A (de) |
| CN (1) | CN121057600A (de) |
| DE (1) | DE112024001858A5 (de) |
| WO (1) | WO2024223384A1 (de) |
Family Cites Families (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| DE59305405D1 (de) * | 1992-04-16 | 1997-03-20 | Obermayer Anton | Anästhesiemaschine |
| GB2338902B (en) * | 1999-07-21 | 2000-05-24 | Falah Hasan Ali | Modified micro ventillation anaesthetic circuit |
| DE102004011907B4 (de) * | 2004-03-11 | 2007-03-15 | Fritz Stephan Gmbh | Narkosebeatmungsgerät |
| DE102006032498B3 (de) * | 2006-07-05 | 2007-09-13 | F. Stephan Gmbh | Atemsystem und ein Verfahren zum Betrieb hierzu |
| RU2708784C2 (ru) * | 2016-06-10 | 2019-12-11 | Александр Андреевич Панин | Способ ингаляционного воздействия на организм и аппарат для его осуществления |
| DE102021122598A1 (de) * | 2021-09-01 | 2023-03-16 | Drägerwerk AG & Co. KGaA | Pneumatisches System für ein Anästhesiesystem |
-
2024
- 2024-04-17 EP EP24719546.4A patent/EP4701700A1/de active Pending
- 2024-04-17 CN CN202480027728.5A patent/CN121057600A/zh active Pending
- 2024-04-17 DE DE112024001858.0T patent/DE112024001858A5/de active Pending
- 2024-04-17 WO PCT/EP2024/060450 patent/WO2024223384A1/de not_active Ceased
- 2024-04-17 KR KR1020257039380A patent/KR20250175339A/ko active Pending
Also Published As
| Publication number | Publication date |
|---|---|
| WO2024223384A1 (de) | 2024-10-31 |
| CN121057600A (zh) | 2025-12-02 |
| DE112024001858A5 (de) | 2026-02-12 |
| KR20250175339A (ko) | 2025-12-16 |
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