IT202000027396A1 - FLOW GENERATION EQUIPMENT FOR NON-INVASIVE VENTILATION OR HIGH FLOW OXYGEN THERAPY AND RELATED FLOW MANAGEMENT SYSTEM - Google Patents

Description

DESCRIPTION

Field of application

The present invention relates to a flow generation apparatus for non-invasive ventilation or high-flow oxygen therapy.

The aforesaid device finds useful application in particular, but not exclusively, in the sector of equipment for medical treatments in hospitals, but? clearly adoptable also in the home environment and on the units? emergency furniture.

Known art

? It is known, in the present sector, that a flow of gas composed of variable concentrations of medical oxygen, if conveyed towards the airways of a patient through a special interface, can improve the patient's clinical condition. The presence of a continuous flow of oxygen enriched gas? at the basis of the functioning of the equipment known as CPAP (Continuous Positive Airway Pressure) used both in the home and in the pre- or intra-hospital setting.

CPAP equipment delivers a stream of pressurized gas through a face (or nose) mask and tubing; the pressure of the air eventually enriched with oxygen allows to improve the clinical conditions of the patient.

Such equipment generally comprises a blower, ie a compressor device which increases the air pressure by a few cm of water, a patient connection element and a tube which connects the blower to the latter.

CPAP (Continuous Positive Airway Pressure) equipment provides a constant positive pressure relative to atmospheric pressure. These also include equipment suitable for use on neonates through multiple interfaces that adhere completely or partially to the airways.

In addition to devices that generate continuous pressure (CPAP), are there more equipment available? devices that provide the patient with additional pressure, such as V-PAP or B-PAP (Variable/Bilevel Positive Airway Pressure) and A-PAP (Automatic Positive Airway Pressure) equipment.

CPAP equipment is used in various fields; as home therapy for sleep apnea disorders, but also in the hospital or pre-hospital setting for pathologies such as ARDS (Acute Respiratory Distress Syndrome), pneumonia, acute respiratory failure, post-operative hypoxemia, some cases exacerbations of COPD (Chronic Obstructive Pulmonary Disease), the treatment of chest trauma with pulmonary contusions, pulmonary edema and atelectasis of various origins. Furthermore, they can be used to prevent reintubation in patients just weaned from the mechanical ventilator.

Can acute respiratory failure be caused by various causes. When are you there? damage to the lung parenchyma, for example associated with endoalveolar exudation, interstitial edema, reduction or lack of surfactant substance, the alveoli are more? hardly expandable in the inspiratory phase and more? easily collapsed in the expiratory phase. Alveolar distention can be partially supported with a pressure gradient (CPAP), between the inside of the respiratory tree and the external environment, active for the entire duration of the respiratory cycle.

The pressure gradient prevents alveolar collapse at the end of expiration, maintaining more? high end-expiratory volume and reducing inspiratory effort with the consequent improvement of hypoxemia.

The use of a continuous flow of gas enriched with oxygen is not ? only at the basis of the functioning of CPAP systems, but also of the so-called high flow nasal oxygen therapy (High Flow Nasal Cannula ? HFNC).

The interface that delivers high-flow oxygen therapy? made up of special nasal cannulas which are fed by a gas mixture enriched with Oxygen in variable concentration (even up to 100%) with a modulable flow, generally between 30 and 60 L/min.

The high-flow oxygen therapy has seen a rapid diffusion in recent years thanks to the good tolerability? by patients, simplicity? of use and efficacy in the treatment of multiple pathologies such as pneumonia, heart failure, post-extubation hypoxia.

Both CPAP systems and high-flow oxygen therapy systems require to be supplied with an amount high level of oxygen enriched gas.

To generate an effective flow, different systems are available, such as venturi systems, turbine systems and equipment that requires compressed medical gases. Venturi systems are very popular due to their low cost? and simplicity? of use. However, the flow generators based on Venturi devices adopted today, although advantageous, are difficult to manage as regards the titration of Oxygen (O2) and the measurement of the gas flow supplied to the patient.

The devices and methods adopted today, although advantageous, are still not very precise as regards the titration of Oxygen (O2) and the dosage of the air mixture to the patient.

For this reason, the problem at the basis of the present invention ? that of devising an apparatus capable of overcoming the aforesaid drawbacks, managing at the same time to ensure the maintenance of a sufficient continuous positive pressure.

Another purpose of the present invention ? that of providing equipment suitable for high-flow applications, ie with a mixture flow rate of at least 15 L/min.

Still further purpose? that of providing an apparatus that is simple and comfortable to use by a user.

Finally, further purpose ? that of providing an apparatus which is simple to make.

Summary of the Invention

The solution idea underlying the present invention ? that of providing an equipment capable of efficiently supplying both the flow of a respiratory mixture and the titration of Oxygen, in order to guarantee an adequate FiO2 for the therapy in progress.

The aforementioned technical problem ? resolved by a flow generation apparatus for non-invasive ventilation or high flow oxygen therapy comprising at least one venturi device, suitable for supplying a gas mixture, at least one air inlet into the venturi device comprising at least one choke element suitable for dosing the quantity? of air sucked into the Venturi device, an interface element which completely or partially covers the patient's respiratory tract and comprising an inlet port for the fresh gas mixture, a first duct capable of functionally connecting the Venturi device to the interface, at least a first flowmeter, associated with the Venturi device by means of at least one supply fitting and suitable for dosing the gas mixture.

Advantageously, this apparatus allows it to be used in various ways operational, simply going to act differently on the elements of the equipment.

Preferably, the apparatus according to the invention further comprises an outlet mouth for the excess gases and the patient's exhaled gas and a second duct suitable for evacuating the gases exhaled by the patient from said interface element via the excess gas outlet mouth and the patient?s breath.

Still preferably, the apparatus according to the invention further comprises a positive pressure maintenance valve connected to this outlet.

The inlet can coincide with the outlet mouth, with a Y branch that addresses the flows differently.

Advantageously, the present solution allows a correct dosage of the mixture and a correct titration of Oxygen inside the mixture, maintaining the desired positive pressure.

Further, advantageously, the present solution allows the same apparatus to be applied to different solutions which contemplate a different number of flowmeters without particular structural precautions, but only by means of a simple adjustment.

Preferably, the? At least a first flowmeter ? a high flow oxygen flowmeter able to reach flow rates of at least 15 L/min.

Advantageously, this solution is particularly suitable for all therapies with high flow oxygen and for non-invasive ventilation.

According to a first embodiment, the apparatus, according to the invention, further includes a second flowmeter, comprising a flexible fitting which can be associated with at least one Venturi device; this second flowmeter ? adapted to increase the titration value of Oxygen in said gas mixture.

Advantageously, the first flowmeter will act from source ?driver? for the Venturi device, while the second flowmeter will allow? to increase the titration value of Oxygen in the mixture to be delivered to the patient by using the flexible fitting for connecting the port on the Venturi device.

Preferably, the second flowmeter? a high flow oxygen flowmeter capable of reaching flow rates of at least 15 L/min.

Advantageously, also in this case a solution of this type is particularly suitable for all therapies with high flow oxygen and for non-invasive ventilation.

According to an alternative embodiment ? instead there is a single flowmeter, with the dosage obtained using the choke element.

Therefore the apparatus according to the invention allows the use of one or two flowmeters indifferently, and therefore to be interchangeable for different types of flow modes. operational, without that there? involves a structural difference, but simply requiring a different setting.

Furthermore, according to a variant, the apparatus according to the invention comprises at least one element for selecting the flow of the oxygen supply to the Venturi device, suitable for regulating the Oxygen titration of the gas mixture to be delivered to the patient in the presence of titration requests exceeding 70%. (the terminology ?up to 100%? by itself does not represent a limitation because, from a purely formal point of view, it would include all the percentages and any device would fall within it, therefore it is better to adopt a lower limit for this we have used 70%. We then add in the description and in the claim that this percentage, as you reported, can reach ?up to 100%?).

Advantageously, according to this embodiment in which the adoption of a single flowmeter is envisaged, the flow selection element of the supply Oxygen of the venturi device allows to set the Oxygen titration value of the mixture to be delivered to the patient also in extreme conditions where a large flow rate of pure oxygen is required.

According to a further alternative embodiment, in the apparatus according to the invention said first flowmeter ? integrated with said Venturi device and generates a drag flow which determines the mixing of air and oxygen.

Advantageously, this solution allows use in CPAP therapy or high flow oxygen therapy with a single flowmeter.

Still preferably, the apparatus according to the invention further comprises an oximeter connected in line to the Venturi device and able to measure and monitor the percentage of oxygen in the gas mixture administered to the patient.

Advantageously, there? allows you to constantly monitor the concentration of Oxygen present in the mixture dispensed.

Further preferably, the apparatus, according to the invention, also comprises at least one antimicrobial filter able to protect the patient, and to attenuate the noise level. of this equipment.

Advantageously, this solution protects the patient from contamination by viruses or bacteria, while at the same time increasing the comfort of use by reducing the noise generated by high flows.

Pi? preferably, the at least one interface element of the equipment comprises a mask or nasal cannulas, an oronasal mask or a helmet for CPAP therapy.

Alternatively, the? At least one interface element ? consisting of a high-flow nasal cannula HFNC, with which? It is possible to implement a high-flow oxygen therapy, thus providing the patient with non-invasive respiratory support with the release of heated, humidified and oxygen-enriched air, when Oxygen is required at a higher speed. flow pi? high.

There? improves oxygenation, respiratory rate, dyspnea and patient comfort and helps speed up patient rehabilitation after extubation, in different clinical settings, such as emergency room, semi-intensive and intensive care and recovery room.

Advantageously, the apparatus according to the invention is therefore suitable for a plurality? of users and for a plurality? of mode? therapeutic.

According to another aspect of the invention? a flow management system is provided for a device for non-invasive ventilation or high-flow oxygen therapy, comprising at least one carbon dioxide absorbent, a recirculation circuit, including at least one suction and vent conduit upstream of said carbon dioxide absorbent , and a flux generation apparatus as previously described.

Advantageously, such a system allows a saving of Oxygen delivered.

Further characteristics and advantages will become more apparent from the detailed description given hereinafter of a preferred, but not exclusive, embodiment of the apparatus according to the present invention, with reference to the accompanying figures given by way of non-limiting example.

Brief description of the drawings

In such drawings:

? Figure 1 represents a schematic view of a first embodiment of a flow generation apparatus for non-invasive ventilation or high-flow oxygen therapy according to the invention;

? Figure 2A, 2B, 2C, 2D represent in schematic form a series of respective comparative diagrams which illustrate the performance variation of the apparatus of Figure 1 as the setting of the Oxygen value varies.

? Figure 3 represents a schematic view of a second embodiment of a flow generating apparatus for non-invasive ventilation according to the invention;

? Figures 4A, 4B, 4C, 4D, 4E represent in schematic form a series of respective comparative diagrams which illustrate the performance variation of the apparatus of Figure 3 as the setting of the Oxygen value varies;

? Figure 5 represents a variation of the second embodiment of Figure 3;

? Figure 6 represents a schematic view of a third embodiment of a flow generating apparatus for non-invasive ventilation according to the invention;

? Figure 7 represents a schematic view of a flow management system with recirculation for a non-invasive ventilation apparatus according to the invention, in which it is adopted in a CPAP therapy.

Detailed description

With reference to the attached figures, 1 globally and schematically indicates a first embodiment of a flow generation apparatus for non-invasive ventilation, made in accordance with the present invention.

In particular, in Figure 1 ? represented a first embodiment, called hereinafter for convenience? ?double flowmeter?.

This embodiment comprises a Venturi device 2. The Venturi device 2 acts as a flow generator for non-invasive ventilation, being clearly shaped like a duct to take advantage of the homonymous effect.

Does equipment 1 also include an at least one air inlet 3, comprising at least one choke element 3A suitable for dosing the quantity? of air drawn into the venturi device 2.

The choke element 3A in the present description and in the Figures ? consisting of a knob element, but nothing prevents the proposing of equivalent solutions, all included in the ambit of the attached claims.

Furthermore, the Venturi 2 device? connected, by means of a supply fitting 4, to a first flowmeter 5, interfaced directly to a source of oxygen.

The first flowmeter 5 ? preferably a high-flow flowmeter capable of reaching and managing flow rates of at least 15 L/min, or even more.

Still further, in the present embodiment the Venturi device 2 is connected, by means of a flexible fitting 6, to a second flowmeter 7. This solution ? however optional, how will it turn out? clear from the continuation of the description.

In the present embodiment, the feed fitting 4 and the flexible fitting 6 each comprise, at the first flowmeter 5 and the second flowmeter 7 respectively, an outlet fitting 8, for example of the type with 9/16? UNF (Unified Fine Threads). This is clearly an exemplary and non-limiting embodiment, multiple alternative forms of interconnection being possible.

The second flowmeter 7 ? a high-flow flowmeter capable of reaching and managing flow rates of at least 15 L/min.

The first flowmeter 5 acts as a source ?driver? for the Venturi 2 device.

The second flowmeter 7, on the other hand, allows the titration value in Oxygen of the mixture to be delivered to the patient to be increased by means of the flexible connector 6 connected to the Venturi device 2.

The Venturi device 2 further comprises a delivery outlet 9 from which a first duct 10 departs towards an inlet mouth of the fresh gas mixture 11 of an interface element 12 which completely or partially covers the patient's respiratory tract.

In any case, the apparatus 1 according to the invention provides for the use in ventilation of a specific interface element 12.

The interface element 12 can? be selected, in the application in CPAP therapy, between a nasal mask, nasal cannulas, an oronasal mask or a helmet for CPAP therapy.

Naturally, nothing will forbid the use of different connecting elements, also in accordance with future developments in medical therapies.

In an alternative embodiment (not shown), ? in fact, it is possible to use a high-flow nasal cannula HFNC, with which ? It is possible to implement a high-flow oxygen therapy, thus providing the patient with non-invasive respiratory support with the release of heated, humidified and oxygen-enriched air.

There? improves oxygenation, respiratory rate, dyspnea, and patient comfort, and helps speed patient rehabilitation after extubation.

Instead, the interface element 12 comprises, in the application in CPAP therapy and in the embodiments shown in the attached figures, an outlet 13 from which a second duct 14 departs for the excess gases and the patient?s breath.

The inlet mouth 11 can? coincide with the outlet mouth 13, with a Y branch which addresses the flows differently.

At the outlet 13 of the excess gas and of the patient's exhaled ? preferably associated with a positive pressure maintenance valve, or PEEP valve, 15. The valve 15 is a device for maintaining positive end expiratory pressure and connected to the outlet connector of the CPAP mask or helmet.

Consequently, the patient is administered a gas mixture, suitably titrated in Oxygen and dosed in L/min through the first flowmeter 5 and the second flowmeter 7, both for Oxygen; if you want to obtain the CPAP effect, it is obtained by evacuating the exhaled gases through the PEEP valve 15.

Furthermore, according to the present embodiment, the apparatus comprises an oximeter 16, connected in line with the Venturi device 2, arranged in a position substantially opposite to that of the first flowmeter 5 and of the second flowmeter 7.

The oximeter 16 allows constant monitoring of the concentration of oxygen present in the mixture delivered to the patient.

Still further, according to the present embodiment, two antimicrobial filters 17 are preferably connected, respectively positioned one on the first duct 10 and one on the second duct 14.

The antimicrobial filter 17 on the first duct 10, in addition to guaranteeing protection for the patient, allows the noise generated by the flow of the mixture to be attenuated, thus obtaining also greater acoustic comfort for the patient during therapy.

The antimicrobial filter 17 on the second duct 14 ? located downstream of the exhaled gas outlet 13 and upstream of any PEEP valve 15, to also protect the patient's exhaled gas.

Figures 2A, 2B and 2C, 2D show respective performance tables or diagrams of the apparatus 1 as the regulation parameters vary, in particular the oxygen value. These are tables shown by way of example and to better understand the possible adjustment for the patient using the apparatus 1. Within these tables, the flow from the second flowmeter 7 is kept at 0 L/min.

It can therefore be seen in these Figures how the curve of the mixture varies as a function of the value of Oxygen and how the consequent curve of the resulting FiO2 evolves.

It should be emphasized that the scale adopted on the ordinate axis is greatly amplified to allow the evolution of the curve to be noted more clearly. Consequently, these curves are advantageously very flat, thus guaranteeing even minimal titration variations.

Figure 3 shows a second embodiment of a flow generation apparatus 101 for non-invasive ventilation according to the invention, referred to as the "single flowmeter".

The present second embodiment differs from the first embodiment by the presence of a single first flowmeter 105 in place of the first flowmeter 5 and second flowmeter 7.

The remaining elements are similar for the two embodiments and the same reference numbers will therefore be used for them.

? always present in particular the air inlet 3, comprising the choke element 3A.

Precisely through the use of this characteristic ? in fact, it is possible to apply the same apparatus both to a ?double flowmeter? how that of the first embodiment is a case of ?single flowmeter? like the one described here.

In fact, thanks to the possibility to dose the? Incoming air through the? Throttle element 3A ? You can adjust the inspired fraction FiO2 accordingly.

The first flowmeter 105 ? a flowmeter for high flow oxygen. Eg, ? It is possible to adopt a flowmeter capable of managing flow rates of at least 15 L/min and with a dual range, i.e. 2-10 L/min and 6-50 L/min.

The Venturi 2 device ? connected to the outlet of the first high flow variable area 105 Oxygen flowmeter.

Also in this case the first flowmeter 105 acts as a ?driver? for the Venturi 2 device.

Therefore, in this embodiment, in order to obtain the correct titration in oxygen, instead of having a further addition of oxygen, there is a reduction of the aspirated ambient air.

Also in the present embodiment ? an oximeter 16 is provided, connected in line with the Venturi device 2, arranged opposite the first flowmeter 105, which allows constant monitoring of the concentration of oxygen present in the mixture delivered to the patient.

Still further, also in the present second embodiment, ? connected to an antimicrobial filter 17, which can? be positioned either on the first duct 10 or on the second duct 14.

The antimicrobial filter 17, when positioned on the first duct 10, in addition to guaranteeing protection for the patient, allows the noise generated by the flow of the mixture to be attenuated, thus obtaining also greater acoustic comfort for the patient during therapy.

Figures 4A, 4B, 4C, 4D, 4E show, also in this case, respective performance tables or diagrams of the apparatus 101 as the regulation parameters vary, in particular the oxygen value.

These tables are shown only by way of example and to better understand the possible adjustment for the patient using the apparatus 101.

Among the various tables, the variable parameter ? the position of the restrictor element 3A.

In Figure 5 ? then represented a variant 101? of the apparatus 101 of the second embodiment described above, this variant being designed in particular for precarious clinical conditions which require an oxygen titration in the order of 70% or higher, and specifically up to 100%.

That 101 variant? it further provides for the presence of a flow selection element 106 which allows the first flowmeter 105 to be directly functionally connected to the first duct 10, without passing through the Venturi device 2.

The flow selection element 106 ? represented by an alternative conduit which opens at the same time as the passage between the first flowmeter 105 and the Venturi device 2 is closed, at the time of a request for the aforementioned titration.

Such a solution? due to an intrinsic technical limitation in the use of the Venturi device in the presence of a single flowmeter.

In fact, if a FiO2 of the order of 70% or higher is required, and specifically up to 100%, in the presence of a single flowmeter, the total opening of the flow of the flowmeter 105 and the closure of the choke element 3A do not ? sufficient, given that the injector inside the Venturi 2 device would in any case limit the flow of pure oxygen. So the only way for this extreme case is to bypass Venturi 2 by creating an alternate circuit.

This type of mode, called ?flush?, allows you to feed the system with flow rates of up to 70 L/min of pure oxygen.

According to a third embodiment, visible in particular in Figure 6, the present invention provides a flow generation apparatus 201 for non-invasive ventilation furthermore an integrated structure 202.

The remaining elements are similar for the two embodiments and the same reference numbers will therefore be adopted.

? presented here a ?single flowmeter? solution. Nothing forbid? with further developments to provide for an integrated "double flowmeter" structure.

The integrated structure 202 comprises a first flowmeter 203, which generates a entrainment flow which determines the mixing of air and oxygen; eg, ? It is possible to adopt a high flow oxygen flowmeter to manage flow rates of at least 50 L/min and dual range, i.e. 2-10 L/min and 6-50 L/min.

Furthermore, the first flowmeter 203 ? integrated with a Venturi 204 device. ? therefore possible, with a single device, the use in CPAP therapy and high flow oxygen therapy (HFNC).

Also according to the present embodiment the Venturi device 203 functions as a flow generator and amplifier and requires only the power supply from an Oxygen source.

Also in this case ? always present the?element of bottleneck 3A, thanks to which? It is possible to regulate the air sucked in from the environment and consequently the inspired FiO2 fraction.

? therefore also present in the integrated structure is a knob 206 for regulating the flow from the first flowmeter 203.

The integrated structure 202 also provides a hook terminal 204 for a secure connection.

At the entrance to the integrated structure 202 ? preferably a connection with specific gas threading is provided for connection to the Oxygen source via a flexible tube (not shown), the latter equipped with a coupling appropriate to the user's distribution system and fixed in an irremovable manner.

Also in the present embodiment ? an oximeter 205 is provided, also integrated in the integrated structure 20 and in line with the first flowmeter 204, which allows constant monitoring of the concentration of oxygen present in the mixture delivered to the patient.

Still further, also in the present second embodiment, ? connected to an antimicrobial filter 17, which can? be positioned either on the first duct 10 or on the second duct 14.

The antimicrobial filter 17, when positioned on the first duct 10, in addition to guaranteeing protection for the patient, allows the noise generated by the flow of the mixture to be attenuated, thus obtaining also greater acoustic comfort for the patient during therapy.

According to a different aspect, the present invention provides a flow management system 1000 for an apparatus for non-invasive ventilation which comprises an apparatus 1, 101, 1012, 201 according to one of the embodiments described above.

Specifically, in Figure 7 ? shown is a system 1000 comprising an apparatus 201, but nothing prevents the adoption of one of the other embodiments described.

The system 1000 further comprises at least one carbon dioxide absorber 1001, a recirculation circuit 1002 comprising at least one intake and vent duct 1003 upstream of this carbon dioxide absorber 1001.

The 1002 recirculation circuit ? configured to recover at least part of the gas exhaled by the patient.

The 1003 intake and vent duct? configured to avoid under- or over-pressure within the 1001 system.

Furthermore, if there is a depression inside the recirculation circuit 1002, and therefore an insufficient quantity? of the mixture in the recirculation circuit 1002 pu? be mitigated by a suction directly from the outside through the suction and vent duct 1003.

Therefore this intake and vent duct 1003 has a dual function according to the direction imposed by the pressure conditions between inside and outside of the recirculation circuit 1002 itself.

In other words, in the event that there is a greater pressure inside the system with respect to the external conditions, there is a vent function, while in the case in which there is a depression inside the system 1000 with respect to the external conditions, there is an aspiration function going to carry out a sort of compensation within the 1000 system.

The 1002 Carbon Dioxide Absorber can? include a soda lime element, a solid amine element or other solutions such as the so-called ?electro-swing? batteries.

Advantageously, the present invention allows to optimize the advantages of using both CPAP type therapy and high flow oxygen therapy (HFNC), at the same time mitigating the drawbacks still present in devices of the prior art.

Advantageously, the apparatus according to the invention allows it to be adapted to solutions comprising one or two flowmeters, without structural variations thereof, but simply by means of a different type of regulation.

In other words, the apparatus according to the invention can be adopted in a non-invasive ventilation system which provides for the adoption of two flowmeters obtaining the desired titration through the influx of further oxygen, and in a non-invasive ventilation system which provides for the adoption of a single flowmeter by regulating the inflow of air via the throttle element.

The equipment according to the invention sees its main fields of use for:

? the treatment of ARDS (Acute Respiratory Distress Syndrome);

? acute respiratory failure;

? postoperative hypoxemia;

? exacerbations of COPD (Chronic Obstructive Pulmonary Disease);

? pulmonary contusions from chest trauma;

? pulmonary edema

? atelectasis of various origins,

? after weaning from the mechanical ventilator.

Furthermore, the present solution allows to obtain an optimal mixture generation and dosage for a patient with a correct regulation of the titration value in Oxygen of said gas mixture.

Even further, a technician in the sector will appreciate? how the present invention is specific for CPAP therapy and for high flow oxygen therapy but in any case applicable to different types of pre-existing systems and circuits within the scope of this therapy to enhance their overall performance.

Finally, still advantageously, the present solution is simple to implement from a production point of view.

Will the sector expert understand? that the presented embodiment can? be subject to further modifications and variations, according to specific and contingent needs, all included within the scope of protection of the invention, as defined by the following claims.

Claims (13)

A flow generating apparatus (1, 101, 101?, 201) for non-invasive ventilation or high flow oxygen therapy comprising: - at least one venturi device (2, 204), able to supply a gas mixture; - at least one air inlet (3) in said Venturi device, comprising at least one choke element (3A) able to dose the quantity? of air sucked into said Venturi device (2, 204); - an interface element (12) which completely or partially covers the patient's respiratory tract and comprising an inlet port for the fresh gas mixture (11); - a first duct (10) able to functionally connect said Venturi device (2, 204) to said interface element (12); - at least a first flowmeter (5, 105, 203), associated with said Venturi device (2, 204) by means of at least one supply fitting (4) and suitable for dosing said gas mixture. The flow generating apparatus (1, 101, 101?, 201) for non-invasive ventilation or high-flow oxygen therapy according to claim 1, further comprising an outlet port for excess gases and patient exhaled (13) and a second duct (14) adapted to evacuate from said interface element (12) the gases exhaled by the patient through said outlet mouth (13). The flow generation apparatus (1, 101, 101?, 201) for non-invasive ventilation or high flow oxygen therapy according to claim 2, further comprising a positive pressure maintenance valve (15) associated with said outlet port ( 13). The flow generation apparatus (1, 101, 101?, 201) for non-invasive ventilation or high flow oxygen therapy according to any one of claims 1 to 3, wherein said at least one first flow meter (5, 105, 203) ? a high-flow flowmeter able to reach flow rates of at least 15 L/min. 5. Flow generating apparatus (1) for non-invasive ventilation or high flow oxygen therapy according to any one of claims 1 to 4, further comprising a second flowmeter (7), adapted to regulate the titration value in said gas mixture , comprising a flexible fitting (6) which can be associated with at least one Venturi device (2). The flow generating apparatus (1) for non-invasive ventilation or high flow oxygen therapy according to claim 5, wherein said second flowmeter (7) is a high-flow flowmeter able to reach flow rates of at least 15 L/min. The flow generating apparatus (101?) for non-invasive ventilation or high flow oxygen therapy according to any one of claims 1 to 4, further comprising at least one flow selector element adapted to adjust the Oxygen titration value of said gas mixture in the presence of titration requests above 70% and up to 100%. The flow generating apparatus (201) for noninvasive ventilation or high flow oxygen therapy according to claim 1, wherein said first flowmeter (203) is a flow generator. integrated with said Venturi device (204) and generates a drag flow which determines the mixing of air and oxygen. The flow generating apparatus (1, 101, 101?, 201) for non-invasive ventilation or high flow oxygen therapy according to any one of claims 1 to 8, further comprising an oximeter (16, 205) connected in-line to said Venturi device (2, 204) and suitable for measuring and monitoring the titration degree of Oxygen in said gas mixture. The flow generation apparatus (1, 101, 101?, 201) for non-invasive ventilation or high-flow oxygen therapy according to any one of claims 1 to 9, further comprising at least one antimicrobial filter (17) adapted to protect the patient , further suitable to reduce the noisiness? of this equipment. The flow generation apparatus (1, 101, 101?, 201) for non-invasive ventilation or high-flow oxygen therapy according to any one of claims 1 to 10, wherein said at least one interface element (12) with the pathways a patient's respiratory system includes a nasal mask, a full face mask, or a CPAP therapy helmet. The flow generation apparatus (1, 101, 101?, 201) for non-invasive ventilation or high-flow oxygen therapy according to any one of claims 1 to 10, wherein said at least one interface element (12) with the pathways respiratory system of a patient? consisting of a high-flow nasal cannula HFNC. 13. A flow management system (1000) for a device for noninvasive ventilation or high flow oxygen therapy, comprising: - at least one carbon dioxide absorber (1001); - a recirculation circuit (1002), comprising at least one intake and vent duct (1003) upstream of said carbon dioxide absorber (1001); - a flow generating apparatus (1, 101, 101?, 201) according to any one of the preceding claims from 1 to 12.