Anesthesia system

Abstract

A device (11) on a circuit system (8) for an anesthesia system (100) is shown and described, which is designed to increase the amount of oxygen (O2) in the circuit system (8) in a special operating situation, taking into account an individual ventilation situation.

Description

[0001] The present invention relates to an anesthesia system. Anesthesia systems are used for the safe administration of inhalation anesthesia. Modern anesthesia systems have a closed or semi-closed breathing system, often also referred to as a closed-loop system, in which the majority of the breathing gas does not leave the device. The exhaled carbon dioxide is absorbed by soda lime, and fresh gas is mixed back into the exhaled gas when it is recirculated. This method has the advantage that the substances used for anesthesia (general anesthetics) can be used efficiently. STATE OF THE ART

[0002] Various types of anesthesia devices with a radial blower (blower, radial compressor, fan) are described in US 5875783 A. US 5875783 A shows a circular system that can be designed with a radial blower. To understand the function and advantages of the prior art circular system as described in DE 19714644 C2, this application will refer to the figure descriptions in that application. Fig. Section 6 of DE19714644 C2 describes the functions of the circuit system. During inhalation, a radial blower draws in an anesthetic gas, a mixture of oxygen, air, nitrous oxide, and vaporized anesthetic from a so-called fresh gas line, as well as buffered respiratory gas from a hand-held resuscitation bag. If the pressure level in the patient's lungs is lower than the pressure level at the radial blower, this respiratory gas passes through a carbon dioxide absorber and an inspiratory check valve, then through breathing tubes, a patient connector (patient Y-piece), and an airway access device (breathing mask, endotracheal tube, tracheostomy) to and into the patient. As soon as the pressure conditions reverse, i.e., as soon as the pressure level in the patient's lungs is higher than the pressure level at the radial blower, the gas flows from the patient back into the manual resuscitation bag through an expiratory check valve.

[0003] With regard to the volatile anesthetic gases most commonly used, it should also be noted that saving anesthetic gases when performing so-called low-flow anesthesia with low fresh gas flow rates in closed or semi-open anesthesia systems results in significant cost savings, but also reduces the release of anesthetic gases into the environment.

[0004] Reducing the amount of anesthetic gases released into the environment is also highly desirable for climate protection reasons, as volatile anesthetic gases such as desflurane, isoflurane, enflurane, sevoflurane, and halothane can act as greenhouse gases, similar to carbon dioxide or methane. However, when administering anesthesia with low fresh gas flow rates, it must be ensured at all times that the patient receives a sufficient amount of oxygen. In particular, it must be ensured that, in all operating states of the anesthesia machine or system, the oxygen concentration does not fall significantly below the proportion of oxygen in natural ambient air, which is approximately 21%.

[0005] Based on the current state of the art, the task is therefore to further develop an anesthesia system in such a way as to provide a sufficient supply of oxygen – i.e., an optimized oxygen supply – even when performing the procedure with small amounts of fresh gas.

[0006] The problem is solved by the features of independent patent claims.

[0007] The problem is solved by an anesthesia system with the features of claim 1.

[0008] The invention is explained in more detail below, with partial reference to the figures. REVELATION OF THE INVENTION

[0009] Embodiments create possibilities and variations of an anesthesia system. Further features and details of the invention and advantageous embodiments will become apparent from the dependent claims, the description, and the drawings.

[0010] The cross-references used here point to the further development of the subject matter of the main claim by the features of the respective subclaim and are not to be understood as a waiver of the achievement of independent, substantive protection for the feature combinations of the cross-referenced subclaims. Furthermore, with regard to the interpretation of the claims and the description, when specifying a feature in more detail in a subordinate claim, it must be assumed that such a limitation is not present in the preceding claims or in a more general embodiment of the device in question.

[0011] Therefore, any reference in the description to aspects of subordinate claims is to be read as a description of optional features, even without specific indication.

[0012] An anesthesia system according to the invention for performing anesthesia on a living being with optimized oxygen supply comprises at least the following components: - a control unit, - a breathing gas supply system with a mixing unit, a circuit system, an absorber unit for removing carbon dioxide (CO2) from the circuit system and a gas delivery unit for supplying quantities of a gas mixture for administering anesthesia to the living being, - a sensor system with • at least one pressure sensor P1, • at least one gas sensor G1, • at least one V1 flow sensor.

[0013] The mixing unit is designed and configured to mix at least two gases to form a fresh gas mixture FG, which is then provided as a breathing gas mixture.

[0014] The respiratory gas supply system includes means – for example, the gas delivery unit and / or, in particular, metering valves or adjustable proportional valves – for the controlled supply and / or metering of an inspiratory respiratory gas quantity and a device for controlling an expiratory respiratory gas quantity – for example, and in particular, an expiratory valve (PEEP valve) – for controlling an expiratory respiratory gas quantity.

[0015] Furthermore, the breathing gas supply system includes an oxygen dosing unit for the controlled addition of oxygen to the system. This oxygen dosing unit can be integrated into the breathing gas supply system such that the additional oxygen is added at an inlet (gas inlet) of the gas delivery unit. Alternatively, the oxygen dosing unit can be integrated into the breathing gas supply system so that the additional oxygen is added at the outlet (gas outlet) of the gas delivery unit.

[0016] The circular system pneumatically connects the components of the breathing gas supply system, sensor components and other components, and provides an inspiratory port and an expiratory port for forming pneumatic connections with the piping system.

[0017] The anesthesia system, in its usual configurations for performing inhalation anesthesia and / or intravenous anesthesia, may include further components, such as: - an anesthetic dosing unit, - an anesthetic gas delivery system, - a flushing valve arrangement, - an APL valve arrangement, - a breathing bag, - additional sensors for pressure and flow rate measurement or for gas measurement.

[0018] The breathing bag represents a reservoir in the circulatory system, which collects the amounts of respiratory gas mixture exhaled by the patient.

[0019] The flushing valve arrangement can be designed as a controllable metering valve and is designed for flushing parts or components of the circuit system or the circuit system.

[0020] The APL valve assembly provides an adjustable pressure limitation valve (APL valve) in the closed-loop system. In a simplified version of the closed-loop system, the breathing bag, purge valve assembly, and / or the APL valve assembly can be omitted.

[0021] The anesthesia system is operated by a piping system with the following components: - a patient connecting element (Y-piece), - an inspiratory breathing tube, - supplemented by an expiratory breathing tube.

[0022] The piping system is designed as a breathing tube system with the connecting element (Y-piece) for supplying respiratory gas quantities (inhalation gas) to the living being and for conveying respiratory gas quantities (exhalation gas) away from the living being, and thus serves for the pneumatic and fluidic connection of the patient to the circuit system of the anesthesia system.

[0023] An inspiratory check valve and an expiratory check valve are located in the inspiratory path of the transpiration system to clearly define the direction of flow of inhaled and exhaled gases within the recirculation and transpiration systems. The breathing tubes are connected to the recirculation system via inspiratory and expiratory ports on the device side and to the patient-side connection element.

[0024] The patient connection element is followed by an element for supplying gas to the patient, for example an endotracheal tube, a face mask or a tracheostomy (windpipe access).

[0025] The at least one flow sensor V1 of the sensor system is arranged on the breathing gas supply system, on the circuit system or on the piping system in such a way as to continuously detect at least one flow rate that can indicate quantities supplied to the living being or quantities of breathing gas mixture carried away by the patient, or to indicate quantities of breathing gas mixture supplied or carried away over a period of time and to provide the control unit with measured values.

[0026] The at least one gas sensor G1 of the sensor system is arranged on the breathing gas supply system, on the circuit system or on the piping system in such a way as to continuously detect at least one gas concentration that indicates a current concentration of oxygen supplied to the living being or to indicate a time course of current amounts of oxygen supplied and to provide this information to the control unit as measured values.

[0027] The at least one pressure sensor P1 of the sensor system is arranged on the breathing gas supply system, the recirculating system, or the piping system in such a way as to continuously acquire measured values ​​indicating at least one pressure level and to provide these measured values ​​to the control unit. The measured values ​​indicate an airway pressure or a time course of an airway pressure. In possible variants or configurations of anesthesia systems or anesthesia devices, an anesthetic gas delivery device may optionally be present or connected to the recirculating system. Such an anesthetic gas delivery device serves to rapidly release a current gas mixture or consumed gas quantities from the recirculating system, for example, in situations involving user-initiated increases in the fresh gas flow (FG) or activation of the O2 flush function, in order to achieve a rapid change in the concentration ratios in the breathing gas mixture.

[0028] In various configurations or designs of anesthesia systems or devices, a breathing bag may be attached to the circulation system or the respiratory gas supply system. Such a breathing bag can be used for manual or hand-assisted ventilation by the user – for example, during specific phases of a surgical procedure. A valve (APL valve) can be used to limit the airway pressure delivered to the patient.

[0029] Possible suitable positions for arranging the at least one gas sensor G1 on the breathing gas supply system, on the circuit system or on the piping system are, for example: - in the circulatory system in both the inspiratory and expiratory pathways, - on the piping system both in the inspiratory path (inspirative breathing tube) and in the expiratory path (exspirative breathing tube) as well as on the patient connection element (Y-piece), - on the breathing bag, - on the gas delivery unit or on components of the gas delivery unit, in particular on the housing of a piston drive, provided that the gas delivery unit is designed as a piston drive.

[0030] Possible suitable positions for arranging the at least one flow rate sensor V1 on the breathing gas supply system, on the circuit system or on the piping system are, for example: - in the circulatory system in both the inspiratory and expiratory pathways, - on the piping system both in the inspiratory path (insp. breathing tube) and in the expiratory path (exsp. breathing tube) as well as on the patient connection element (Y-piece).

[0031] Possible suitable positions for arranging the at least one pressure sensor P1 on the breathing gas supply system, on the circuit system or on the piping system are, for example: - in the circulatory system in both the inspiratory and expiratory pathways, - in or on the breathing bag (BB), - at the gas delivery unit, - on the piping system both in the inspiratory path (insp. breathing tube) and in the expiratory path (exsp. breathing tube) as well as on the patient connection element (Y-piece).

[0032] Representations of possible suitable positions for arranging the at least one pressure sensor P1, as well as of other possible suitable positions for arrangements of pressure sensors, also result from the Fig. 1, Fig. 2a and Fig. 2b. Representations of possible suitable positions for arranging the at least one gas sensor G1 designed as an oxygen sensor, as well as of other possible suitable positions for arrangements of gas sensors, also result from the Fig. 1, Fig. 2a, Fig. 2b and Fig. 2c. Representations of possible suitable positions for arranging the at least one flow rate sensor V1, as well as of other possible suitable positions for arrangements of flow rate sensors, also result from the Fig. 1, Fig. 2a and Fig. 2b.

[0033] Possible suitable positions for the breathing bag (BB) are found on the breathing gas supply system or on the expiratory path of the recirculating system. Advantageously, the breathing bag (BB) can be positioned downstream of the expiratory check valve in the direction of flow.

[0034] One possible suitable position for connecting an anesthetic gas delivery device (NGF, AGS) is, for example, on the expiratory pathway of the circulatory system.

[0035] The closed-loop system, with its mixing unit, allows for the blending of gases into a gas mixture suitable and intended for administering anesthesia, which can then be supplied to a patient via the closed-loop system. This gas mixture, known as "fresh gas," consists of air and oxygen, and optionally also nitrous oxide and usually a volatile anesthetic (halothane, desflurane, enflurane, sevoflurane, isoflurane), which is introduced into the gas mixture by the anesthetic dosing unit, for example, in the form of a vaporizer.

[0036] The gas delivery unit can be designed as a blower drive with a radial blower or as a piston drive with a piston and is designed to deliver quantities of the breathing gas mixture. The gas delivery unit is designed and intended to deliver the gas mixture to the patient.

[0037] The delivery of quantities of gas mixture to the patient takes place in a closed-loop system via the inspiratory path, in which an inspiratory check valve is arranged, which prevents a backflow of gases from the patient back into the inspiratory path.

[0038] The return flow from the patient occurs via the expiratory pathway into the recirculating system. An expiratory check valve is installed in the expiratory pathway, which prevents the backflow of gases to the patient.

[0039] Gas is supplied to the patient via the patient connection element, where the inspiratory path is joined and connected to an inspiratory breathing tube, and the expiratory path to an expiratory breathing tube. During automatic ventilation, the gas delivery unit pumps a mixture of breathing gases from the mixing unit through the recirculation system into the inspiratory path as inhaled gas to the patient during the inspiration phase. During ventilation, the exhaled gas flows back from the patient through the expiratory check valve into the recirculation system during the expiratory phase.

[0040] The control unit is designed and intended to organize, monitor, control, or regulate the operation and / or process of the anesthesia system. The control unit preferably comprises components (microcontroller, microprocessor, PC) with an associated operating system (OS), data storage (RAM, ROM, EEPROM), and software for process control, monitoring, and regulation.

[0041] In at least some embodiments, the control unit is associated with or connected to further electronic elements such as components for signal acquisition (ADµC), signal amplification, analog and / or digital signal processing (ASIC), components for analog and / or digital signal filtering (DSP, FPGA, GAL, µC, µP), and signal conversion (A / D converter). Based on the measured values ​​provided by the sensors, the control unit is designed to control and coordinate the inspiratory and expiratory quantities of the breathing gas mixture for the ventilation of the living being, in particular with the means for controlled dosing and the device (PEEP valve) for controlling the expiratory volume of breathing gas.An anesthetic dosing unit allows for the addition of anesthetic gases to the inspiratory and expiratory volumes of the breathing gas mixture. This process is controlled and coordinated by the control unit, thus enabling the administration of anesthesia or inhalation anesthesia to the patient. The control unit can incorporate readings from at least one pressure sensor (P1) and / or at least one flow rate sensor to monitor the timing of inspiration and expiration. Based on these readings, the control unit can also determine the respiratory phases, including the progression of inspiration and expiration, even during spontaneous patient breathing.The control unit can thus, taking into account the measured values ​​of at least one flow sensor V1 and the measured values ​​of at least one pressure sensor P1, determine the amounts of breathing gas mixture supplied to the patient and the resulting inspiration (P. inspThe control unit monitors the pressure levels during inspiration and expiration (PEEP) and the sequence of inspiration and expiration, as well as the ventilation mode, by controlling the gas delivery unit, for example, by appropriately varying the speed of the radial fan of the blower drive or by appropriately changing the stroke of the piston of the piston drive. During operation of the anesthesia system, the control unit continuously acquires and evaluates the measured values ​​from at least one pressure sensor P1 and at least one flow sensor V1. Based on the measured values ​​from the at least one flow sensor V1, the control unit is designed to determine the volumes of breathing gas mixture currently being delivered to the patient, such as tidal volume VT or minute volume MV.The control unit is also designed to determine the oxygen concentration in the breathing gas mixture currently being supplied to the living being, based on the measured values ​​of at least one gas sensor G1. Furthermore, the control unit is designed to determine, based on the measured values ​​provided by the sensors, whether a special operating situation exists.

[0042] For this purpose, the control unit uses measured values ​​provided by the sensors, specifically from at least one flow rate sensor and at least one gas sensor, and compares them with lower threshold values. A special operating situation is characterized by a condition in which the current oxygen concentration in the respiratory gas supplied to the organism is below a predetermined lower oxygen concentration threshold. A special operating situation also exists if the current volume supplied to the organism is below a predetermined lower volume threshold.

[0043] The control unit is designed to determine an individual ventilation situation based on provided information regarding the patient's tidal volume and / or minute volume, or based on sensor readings of pressure ratios and / or flow rates of the breathing gas mixture. The control unit is designed to determine the oxygen concentration threshold and / or the volume threshold based on the individual ventilation situation and to apply this to determine the specific operating situation. According to the invention, the control unit is designed to initiate an increase in the amount of oxygen delivered to the circulating system if a specific operating situation exists.By determining the specific operating situation and the individual ventilation situation, a specific condition is identified during the course of anesthesia of a patient, and consequently, an increase in the dosage of oxygen is carried out by the control unit, adapted to the specific condition.

[0044] This offers the advantage of continuously adjusting the oxygen dosage, taking into account the patient's individual minute volume (MV) or tidal volume (VT), as specific operational conditions arise during a surgical procedure under anesthesia. By incorporating individual tidal volumes and / or minute volumes, beneficial and specific adjustments in concentration, quantity, and / or duration of oxygen dosage increases can be made indirectly, considering patient categories such as adults, adolescents, children, infants, and newborns or premature infants.

[0045] In a preferred embodiment, the control unit can be configured to incorporate a delay time—in particular, an individually configurable delay time—when a specific operating situation arises and the amount of oxygen supplied to the circulating system is increased. In a preferred embodiment, the control unit can determine the delay time based on the specific operating situation or user input. A delay time configurable via user input offers the advantage that the user, taking into account their assessment and diagnostics based on additional information such as the patient's laboratory status or measurements of blood pressure, heart rate, etc., can adapt the delay time to the specific surgical procedure.Furthermore, the control unit can be configured to determine the individual delay time based on the patient's specific ventilation needs and / or operating conditions. This offers the advantage that short-term intervals during which the specific operating conditions are present do not immediately trigger an increase in the oxygen dosage into the circulating system, but instead wait for the duration of the individual delay time. This prevents overly frequent oxygen dosing into the respiratory system. Additionally, during the individual delay time, the user has the opportunity to observe the patient's specific ventilation needs and / or operating conditions and, if necessary, to make appropriate adjustments to the anesthesia system independently, without intervention from the control unit, to ensure a safe and comfortable operating condition with adequate oxygen supply for the patient.Advantageously, the individual delay time can also be chosen depending on patient categories such as adults, adolescents, children, infants as well as newborns or premature babies.

[0046] In a further preferred embodiment, the control unit can be configured to incorporate a measure of the deviation of the current oxygen concentration from a lower oxygen alarm limit into the determination of the individual delay time. Including this measure of deviation from the lower oxygen alarm limit in the determination of the individual delay time also offers the advantage that, for example, adults can be allowed a greater tolerance for short-term drops than children, and this can then be taken into account when determining the individual delay time. Advantageously, the individual delay time can also be selected to suit the specific ventilation situation.

[0047] In a further preferred embodiment, the control unit can be configured to increase the amount of oxygen being dosed. - to initiate after a predetermined delay time, - to initiate depending on a current error or alarm situation, - to initiate depending on a sensor error situation, - to initiate depending on signals or data provided by the sensors, - to initiate depending on a lower oxygen alarm limit, - to initiate depending on information or data provided via a data interface.

[0048] These preferred embodiments offer the advantage of incorporating current error or operating situations of the anesthesia system or sensors, the current alarm situation, as well as external data for increasing the amount of oxygen administered.

[0049] In a further preferred embodiment, the control unit can be configured to carry out an increase in the metering quantity of oxygen, to initiate a metering of oxygen into a fresh gas mixture FG at the mixing unit.

[0050] In a further preferred embodiment, the control unit can be configured to initiate the addition of oxygen to the breathing gas supply system or the circuit system at a gas inlet or at a gas outlet on the gas supply unit, the absorber unit or an anesthetic dosing unit by means of an oxygen dosing unit.

[0051] In a further preferred embodiment, the control unit can be configured to adjust the composition of the fresh gas mixture FG by means of the mixing unit in such a way that an increase in the proportion of oxygen in the fresh gas mixture FG results.

[0052] This preferred embodiment demonstrates ways to increase the proportion of oxygen in the fresh gas mixture FG for different application situations with different gas mixtures and the resulting operating conditions of anesthesia systems. For example, when administering anesthesia with a mixture of nitrous oxide and oxygen as the fresh gas mixture FG, an increase in the concentration and quantity of oxygen in the fresh gas mixture FG can be achieved by switching – at least for a short time interval – to a mixture of air and oxygen as the fresh gas mixture FG, or by switching the control unit accordingly.

[0053] In a further preferred embodiment, the control unit can be configured to keep the total amount of fresh gas mixture FG constant by increasing the metering quantity of oxygen.

[0054] In a further preferred embodiment, the control unit can be configured to simultaneously increase the total amount of fresh gas mixture FG when increasing the metering quantity of oxygen.

[0055] In a further preferred embodiment, the control unit can be configured to limit the total amount of fresh gas mixture FG to a predetermined maximum level.

[0056] These preferred embodiments offer the advantage that both user-specified restrictions – such as keeping the total amount of fresh gas constant – or concessions – such as allowing an increase in the total amount of fresh gas – can be taken into account by the control unit when increasing the metering quantity of oxygen.

[0057] These preferred embodiments demonstrate possibilities for different constellations of anesthesia systems with breathing gas supply system, circuit system, mixing unit, gas delivery unit, absorber unit, anesthetic dosing unit, oxygen dosing unit and / or other components, each showing suitable positions for the addition of oxygen.

[0058] In a further preferred embodiment, the control unit can be configured to incorporate information provided for determining the individual ventilation situation—in particular, information provided at the data interface and / or at an input interface—relating to the weight, sex, age, or height of the individual, as well as information on minute volume (MV) and / or tidal volume (VT) or the patient category of the individual. These preferred embodiments offer the advantage that information available from a data network (LAN, WLAN, Ethernet, serial interfaces) can be included in determining the individual ventilation situation. This allows, if necessary,Information on measurements or examination results, diagnostic or therapeutic information, or current medication may also be included in determining the individual ventilation situation.

[0059] In a further preferred embodiment, the control unit can be configured to increase the amount of oxygen delivered depending on the individual ventilation situation, with at least two levels of oxygen concentration.

[0060] In a further preferred embodiment, the control unit can be configured to limit the increase in the oxygen dosage to a predetermined maximum oxygen concentration value in the respiratory supply system. A two-stage or even multi-stage increase, as well as an increase in the oxygen dosage limited to a maximum oxygen concentration value depending on the individual ventilation situation, can allow for a gradual approach to the increase. This can, for example, prevent an increase in the oxygen dosage with too large an excess of fresh gas mixture and thus a waste of gas and / or anesthetic agent.

[0061] In a further preferred embodiment, the control unit can be configured to provide an output signal or an alarm signal to an output unit or a data interface, indicating the individual ventilation situation, the specific operating situation, the current oxygen concentration, the individual delay time, the oxygen dosage, or the amount of fresh gas mixture FG. This preferred embodiment offers several advantages for informing the user about the function and operating mode of the anesthesia system.

[0062] In a further preferred embodiment, at least components of the sensor system – for example, pressure sensors – can be arranged on the piping system, preferably on the patient connection element (Y-piece), to detect the pressure in the airways of the living being. In a further preferred embodiment, at least components of the sensor system – for example, a gas sensor configured as an infrared-optical carbon dioxide sensor – can be arranged close to the patient on the piping system, preferably on the patient connection element (Y-piece), to detect the amount of carbon dioxide exhaled by the living being. In a further preferred embodiment, at least components of the sensor system – for example, a gas sensor configured as an electrochemical or paramagnetic oxygen sensor – can be arranged close to the patient on the piping system, preferably on the patient connection element (Y-piece), to detect the amount of oxygen inhaled by the living being.

[0063] In a further preferred embodiment, sensor components – for example, a flow rate sensor – can be arranged on the piping system, preferably on the patient connection element (Y-piece), to record the volume of gas mixture inhaled and / or exhaled by the living being. In a further preferred embodiment, the anesthetic dosing unit can be arranged in or on the anesthesia system, or associated with the anesthesia system, downstream of the mixing unit, particularly at an outlet of the mixing unit. The anesthetic dosing unit is designed to add an anesthetic agent to the fresh gas or the breathing gas mixture. In a further preferred embodiment, an anesthetic gas delivery unit can be arranged in or on the anesthesia system, or associated with the anesthesia system, downstream of the device for measuring the expiratory volume (expiratory valve, PEEP valve).The anesthetic gas delivery unit is designed to deliver gas quantities from the anesthesia system to an external location.

[0064] These embodiments demonstrate ways in which anesthesia systems can be designed in a variety of ways to implement the inventive functions and advantages for patient and user in practice.

[0065] In a further preferred embodiment, the control unit can be configured to terminate a state with an increased oxygen dosage or the special operating situation after a predetermined maximum activation time, depending on an operator action, signals or data provided by the sensors, or information or data provided via a data interface. These embodiments demonstrate how anesthesia systems can be configured in various ways to return to an operating state without increased oxygen dosage after an increase in the oxygen dosage.

[0066] The present invention will now be explained in more detail with the help of the following figures and the associated figure descriptions, without restrictions on the general inventive concept.

[0067] They show: the Fig. 1. a basic structure of an anesthesia machine, the Fig. 2a a variant of an anesthesia device with piston drive, the Fig. 2b a variant of an anesthesia device with blower drive (radial blower, blower), the Fig. 2c an alternative variant according to the Fig. 2a with a piston drive, the Fig. 3 a procedure for determining a special operational situation.

[0068] Identical elements in the Fig. 1, Fig. 2a, Fig. 2b, Fig. 2c, Fig. 3 are in the Fig. 1, Fig. 2a, Fig. 2b, Fig. 2c, Fig. 3 with identical reference numbers.

[0069] The Fig. Figure 1 shows a basic structure of an anesthesia machine 100 with a breathing gas supply system 5, a mixing unit 1, a gas delivery unit 4, an expiratory valve 6, a recirculation system 8, and an absorber unit 9. Gases such as oxygen, air, or nitrous oxide are supplied to the mixing unit 1 via a gas supply 10. The absorber unit 9 enables the removal of carbon dioxide from the recirculation system 8.

[0070] The circuit system 8 comprises an inspiratory path 34 and an expiratory path 35, as well as an inspiratory check valve 37 and an expiratory check valve 39. Via a tubing system 38, the inspiratory and expiratory paths 34 and 35 are routed through a connecting element (Y-piece) 36 to a patient 50, thus enabling its pneumatic connection to the anesthesia machine 100.

[0071] An oxygen supplementary metering unit 11 with an inlet 16 is connected or coupled to the gas supply 10, the outlet C 17 of which can be connected to the gas delivery unit 4 at two different positions, A 18 or B 19. The difference between the two positions A 18 and B 19 is that when C 17 is connected to position A 18, additional quantities of oxygen are introduced at the inlet of the gas delivery unit 4, whereas when C 17 is connected to position B 19, additional quantities of oxygen are introduced at the outlet of the gas delivery unit 4 into the recirculation system 8. A fresh gas line 3 carries quantities of fresh gas (FG) from the mixing unit 1 into the inspiratory path 34 of the breathing system 8. A return air line 44 allows the introduction of gas quantities, freed of carbon dioxide by the absorber unit 9, into the inspiratory path 34.

[0072] A connection of C 17 with position A 18 (inlet of the gas supply unit 4) is a preferred embodiment of the anesthesia device 100 such that the gas supply unit 4 is a piston drive ( Fig. 2a) is designed. A connection of C 17 with position B 19 (outlet of the gas supply unit 4) is a preferred embodiment of the anesthesia device 100 such that the gas supply unit 4 functions as a blower drive ( Fig. 2b) is trained.

[0073] The anesthesia machine 100 has a sensor array 30 with at least one pressure sensor P1 32, at least one flow rate sensor V1 33, and at least one gas sensor G1 31 designed as an oxygen sensor. Further sensor array 30 with alternative or additional pressure sensors 32', flow rate sensors 33', or gas sensors 31' can supplement the anesthesia machine 100, as shown in the following. Fig. 2a, Fig. 2b, Fig. 2c will be explained in more detail. A control unit 20 serves to control the anesthesia machine 100, as described in the Fig. 2a, Fig. 2b, Fig. 2c will be explained in more detail. The control by control unit 20 can be designed with aspects of coordination, process control, state control and / or regulation.

[0074] The Fig. Figure 2a shows the basic structure of an anesthesia machine 100 according to the Fig. 1, wherein the gas delivery unit 4 is designed as a piston drive. Fig. Figure 2b shows the basic structure of an anesthesia machine 100 according to the Fig. 1, wherein the gas conveying unit 4 is designed as a blower drive. The Fig. Figure 2c shows a variant of a basic design for an anesthesia device 100 according to the Fig. 2a. The Fig. 2a and Fig. 2b will be explained in more detail below in a joint character description. Identical elements in the Fig. 2a and Fig. 2b are in both Fig. 2a and Fig. 2b is designated with identical reference numbers.

[0075] In the Fig. 2a and Fig. Figure 2b shows an anesthetic gas dosing unit 2 arranged in the inspiratory path 34 of the breathing circuit 8. The anesthetic gas dosing unit 2 can be connected to the anesthesia machine 100 as an additional component or designed as an integral element of the anesthesia machine 100. A fresh gas line 3 carries quantities of fresh gas (FG) from the mixing unit 1 via an anesthetic gas dosing unit 2 into the inspiratory path 34 of the breathing system 8. A rebreathing line 44 connects and enables the supply of gas quantities, freed of carbon dioxide by means of the absorber unit 9, into the inspiratory path 34. For the supplemental oxygen dosing 11, the Fig. 2a is selected as feed point A, the inlet 18 of the gas delivery unit 4 (piston drive). For the oxygen dosing 11, in the Fig. 2b was selected as the feed point B of the output 19 of the gas supply unit 4 (blower).

[0076] However, it should also be mentioned that in practical implementations, both feed points 18, 19 can be selected for a gas supply unit 4 configured as either a blower drive or a piston drive. A control unit 20 is arranged in the anesthesia machine 100, which is designed and intended to control the piston drive or the blower drive of the gas supply unit 4, the expiratory valve 6, and the oxygen supply dosing unit 11 for the administration of anesthesia to a patient 50. Furthermore, the control unit 20 can—as in the Fig. 2a, Fig. 2b, Fig. 2c shown - is trained and intended to control mixing unit 1 in order to adjust the gas composition of a fresh gas mixture (FG). In the Fig. 2a and Fig. 2b at least one gas sensor G1 31 is arranged in the circuit system 8 or on the piping system 38. The at least one gas sensor G1 31 is in these two Fig. 2a and Fig. 2b is configured as a patient-proximal O2 gas sensor 31 with a suction measuring functionality via a measuring gas line 36' to a measurement at the patient connection element (Y-piece) 36. In optional embodiments, the at least one gas sensor 31 can also be arranged downstream of the inspiratory check valve 37 in the direction of flow. In the Fig. 2a and Fig. 2b at least one pressure sensor P1 32 is arranged in or on the circular system 8.

[0077] In the Fig. 2a and Fig. 2b at least one flow rate sensor V1 33 is arranged in or on the circuit system 8. In the Fig. Figure 2a shows a breathing bag BB 80 arranged in or on the circular system 8. In the Fig. 2b shows the breathing bag BB 80' in an alternative position. Alternative and / or optional arrangements of sensors 30 with the respective sensors 31', 32', 33' result at positions in the anesthesia machine 100 that are specially marked by hatched ellipses. Alternative and / or optional arrangements of gas sensors result at positions as designated by the reference numeral 31'. Such an optional gas sensor 31' can additionally and / or optionally include the sensor 30 ( Fig. 1) Supplement. Alternative and / or optional arrangements of pressure sensors result at positions as designated by the reference numeral 32'. Such optional pressure sensor 32' can additionally and / or optionally include sensor 30 ( Fig. 1) Supplement. Alternative and / or optional arrangements of flow rate sensors result at positions as designated by reference numeral 33'. Such an optional flow rate sensor 33' can additionally and / or optionally include the sensor 30 ( Fig. 1) Add. In the Fig. 2a and Fig. Figure 2b shows an anesthetic gas delivery unit 7 arranged on the circular system 8. An alternative arrangement of an anesthetic gas delivery unit is shown – as in the Fig. 2a and 2b are additionally shown - at a position which is designated by the reference numeral 7'.

[0078] The Fig. 2c shows a design variant according to the Fig. 2a with a gas delivery unit designed as a piston drive 4. Identical elements in the Fig. 2a, Fig. 2b and Fig. 2c are in both Fig. 2a, Fig. 2b and Fig. 2c is designated with identical reference numerals. For the sake of clarity, the representation of sensor 30 and also of optional sensor 31', 32', 33' using hatched symbols is omitted in this diagram. Fig. 2c is omitted; suitable positions for the optional sensors are 31', 32', 33' in the Fig. 2c accordingly possible and feasible, as to the Fig. 1 and Fig. 2a shown and described. The gas sensor 30 ( Fig. 1) is in this Fig. 2c is designed as an oxygen gas sensor G2 31, which is arranged on the piston drive of the gas delivery unit 4 or on the housing of the gas delivery unit 4.

[0079] Fresh gas pipeline 3 leads in this Fig. 2c - unlike the Fig. 1, Fig. 2a and Fig. 2b - from the outlet of the anesthetic gas dosing unit 2 to the inlet of the gas delivery unit 4. A rebreathing line 44 enables the supply of quantities of gas freed from carbon dioxide by means of the absorber unit 9 and of quantities of fresh gas (FG) into the inspiratory path.

[0080] The Fig. Figure 3 shows a sequence of 200 leading to the activation of the oxygen supplementation dose 11 ( Fig. 1) by a control unit 20 in special situations during the administration of ventilation or anesthesia by an anesthesia machine 100 ( Fig. 1) Starting with a start 201, continuous measurement data 203 of a sensor 30 is acquired, which includes at least one gas sensor G1 31 designed as an oxygen sensor and a flow rate sensor V1 33.

[0081] The acquisition of pressure measurements, which are necessary for ventilation and / or anesthesia operation, is not shown to maintain clarity in the process flow 200. Following the measurement data acquisition 203, signal processing 205 of the flow rate measurements and integral calculation to determine tidal volume VT and / or minute volume MV takes place, as well as a threshold comparison 207 with a volume threshold 51 and a threshold comparison 209 with a concentration threshold 53.

[0082] The volume threshold 51 can be adjusted based on provided information 210 regarding tidal volumes and / or minute volumes, for example, with regard to patient categories such as age (adults, children, infants), sex, height, weight, pre-existing conditions, and clinical picture. The results of the two comparisons 205, 207 are combined to determine 72 whether an individual ventilation situation exists. Once the individual ventilation situation 72 has been determined, the results of the two comparisons 207, 209 are consolidated 211, taking into account the information 210, to determine whether a special operating situation 74 exists.

[0083] The special operating situation 74 is present when comparisons 205, 207 have shown that the current tidal volume VT and / or the current minute volume MV are below the volume threshold 51 - now adjusted by means of the individual ventilation situation - and also the current oxygen concentration is below the concentration threshold 53.

[0084] If the special operating situation 74 is present, activation 213 of the O2 additional dosing 11 takes place ( Fig. 1) to increase 76 a quantity or concentration of oxygen in the respiratory circuit 8 ( Fig. 1) to effect. Subsequently, the process 200 leads to the activation of the supplemental oxygen dosage to an end 299, and the anesthesia procedure continues. Reference number list 1 mixing unit 2 anesthetic dosing units (optional) 3 Fresh gas line 4 Gas delivery unit 5 Breathing gas supply system 6. Expiratory dosing device, expiratory valve 7 Anesthesia gas delivery unit, AGS, NFV, internal, external (optional) 7' optional positions for anesthesia gas delivery unit on the breathing gas supply system or on the circuit system 8-circle system 9 absorber units, CO2 absorbers 10 Gas supply 11 Oxygen supplementation, O2 supplementation (O2) 16. Oxygen dosing inlet with connection to the gas supply 17 Output C of the oxygen supplementary dosing system with connection to the gas delivery unit 18 Injection point A at the inlet of the gas delivery unit 19 Injection point B at the outlet of the gas delivery unit 20 Control unit 30 sensors 31 patient-proximal O2 gas sensor G1, G2 31 optional positions for O2 gas sensors 31'' O2 gas sensor G2 on piston drive 32 Pressure sensor P1 32 optional positions for pressure sensors 33 Flow rate sensor V1 33' optional positions for flow rate sensors 34 inspiratory pathway 35 expiratory pathway 36 Connecting element, Y-piece, 36' measuring gas line (optional) 37 Inspiratory check valve 38. Piping system, breathing tube system 39 Expiratory check valve 44 Rebreathing line 50 living beings, patient 51 Volume threshold 53 Concentration threshold 72 Determining an individual ventilation situation 74 special operating situation 76 Increasing a dosage amount 80 breathing bags BB 100 anesthesia machines, anesthesia systems 200 Expiry 201 Start 203 Measurement data acquisition by the control unit 205 Signal processing of flow measurements and integral calculation for determining tidal volume VT and / or minute volume MV 207 Threshold comparison volume: VT_actual <> VT_target or MV_actual <> MV_target 209 Threshold comparison Concentration: O2_actual <> O2_target 210 pieces of information on tidal volume, minute volume, patient categories 211 Consolidation of threshold comparisons 213 Activation of the O2 supplemental dosing (O2) 299 End, Stop QUOTES INCLUDED IN THE DESCRIPTION

[0000] This list of documents cited by the applicant was automatically generated and is included solely for the reader's convenience. The list is not part of the German patent or utility model application. The DPMA accepts no liability for any errors or omissions. Cited patent literature

[0000] US 5875783 A

[0002] DE 19714644 C2

[0002]

Claims

[1] Anesthesia system (100) for performing anesthesia on a living being (50) with optimized oxygen supply with: - a control unit (20), a sensor system (30), - a breathing gas supply system (5) with a mixing unit (1), a circuit system (8) with an absorber unit (9) for the removal of carbon dioxide (CO2) from the circuit system (8) and a gas delivery unit (4), - a conduit system which is designed as a breathing tube system (38) with a connecting element (36) and is designed to supply quantities of respiratory gas to the living being (50) and to convey quantities of respiratory gas away from the living being (50), a) wherein the mixing unit (1) is designed to mix at least two gases supplied by a gas supply (10) to a quantity of a fresh gas mixture FG and to supply the fresh gas mixture FG into the circuit system (8), b) wherein the breathing gas supply system (5) is designed by means of the gas supply unit (4) to supply the fresh gas mixture and provide it as a breathing gas mixture for the living being (50) and to provide and / or meter an inspiratory quantity of breathing gas into the circuit system (8) in a controlled manner, c) wherein the breathing gas supply system (5) includes a device (6) for controlling an expiratory breathing gas quantity into the circuit system (8), d) wherein the sensor system (30) includes at least one gas sensor G1 (31) which is arranged on the breathing gas supply system (5), on the circuit system (8) or on the piping system (38, 36) in such a way as to continuously detect at least one gas concentration as measured values, wherein the measured values ​​indicate a current concentration of oxygen supplied to the organism (50) or a time course of current amounts of oxygen supplied, wherein the sensors (30) of the control unit (20) provide the measured values, e) wherein the sensor system (30) comprises at least one pressure sensor P1 (32) which is arranged on the breathing gas supply system (5), on the circuit system (8) or on the piping system (38, 36) to continuously detect measured values ​​indicating at least one pressure level and to provide the measured values ​​to the control unit (20), wherein the measured values ​​indicate an airway pressure or a time course of an airway pressure, f) wherein the sensor system (30) includes at least one flow rate sensor V1 (33) which is arranged on the breathing gas supply system (5), on the circuit system (8) or on the piping system (38) in such a way as to continuously record at least one flow rate as measured values, wherein the measured values ​​indicate quantities of breathing gas mixture supplied to the living organism (50) or a time course of quantities of breathing gas mixture supplied, wherein the sensors (30) of the control unit (20) provide the measured values, g) wherein the control unit (20) is designed to control and coordinate inspiratory and expiratory quantities of the breathing gas mixture for the ventilation of the living being (50) on the basis of the measured values ​​provided by the sensor system (30) with the breathing gas supply system (5), h) wherein the control unit (20) is configured to determine, on the basis of the measured values ​​provided by the sensor (30), whether a special operating situation (74) exists, which is characterized by the fact that a condition exists, in which the current oxygen concentration in the quantities of respiratory gas supplied to the organism (50) is below a predetermined lower oxygen concentration threshold (53), and / or a condition exists in which a current volume supplied to the living organism (50) is below a predetermined lower volume threshold (51), i) wherein the control unit (20) is designed to determine an individual ventilation situation (72) based on provided information (210) on a tidal volume VT and / or a minute volume MV of the patient and / or on the basis of measured values ​​provided by the sensors (30) on pressure ratios and / or flow rates of the breathing gas mixture, j) wherein the control unit (20) is configured to determine the oxygen concentration threshold (53) and / or the volume threshold (51) based on the individual ventilation situation (72) and to apply it to determine the specific operating situation (74), k) wherein the control unit (20) is configured to initiate an increase (76) of a metering quantity of oxygen (O2) into the circuit system (8) depending on the particular operating situation (74). [2] Anesthesia system (100) according to claim 1, wherein the control unit (20) is designed to include a delay period - in particular an individual delay period - when the special operating situation (74) occurs upon activation of the increase (76) of the dosage quantity of oxygen (O2) into the circuit system (8), wherein the control unit (20) is designed to determine the delay time duration based on the specific operating situation (74) or a user input; and / or wherein the control unit (20) is trained to determine the individual delay time based on the individual ventilation situation (72) and / or the specific operating situation (74). [3] Anesthesia system (100) according to claim 2, wherein the control unit (20) is configured to include in the determination of the individual delay time a measure of a deviation of a current oxygen concentration to a lower oxygen alarm limit. [4] Anesthesia system (100) according to one of claims 1 to 3, wherein the control unit (20) is configured to increase the dosage of oxygen - to initiate after a predetermined delay period, - to initiate depending on a current error or alarm situation, - to initiate depending on a sensor fault situation (30), - to initiate depending on signals or data provided by the sensor (30), - to initiate depending on a lower oxygen alarm limit, - to initiate depending on information or data provided via a data interface. [5] Anesthesia system (100) according to one of claims 1 to 4, wherein the control unit (20) is designed to carry out the increase (76) of the dosage amount of oxygen (O2), - to initiate the addition of oxygen to a fresh gas mixture FG at the mixing unit (1), - to initiate the addition of oxygen (O2) to the breathing gas supply system (5) by means of an oxygen dosing unit (11) into a gas inlet or at a gas outlet on the gas supply unit (4), on the absorber unit (9) or on an anesthetic dosing unit (2), - to adjust the composition of the fresh gas mixture FG by means of the mixing unit (1) in such a way that an increase in the proportion of oxygen (O2) in the fresh gas mixture FG results. [6] Anesthesia system (100) according to any one of claims 1 to 5, wherein the control unit (20) is designed to keep the total amount of fresh gas mixture FG constant by increasing (76) the metering quantity of oxygen (O2), or wherein the control unit (20) is designed to increase the total amount of fresh gas mixture FG when (76) the amount of oxygen (O2) is increased, or wherein the control unit (20) is designed to limit the total quantity of fresh gas mixture FG to a predetermined maximum level. [7] Anesthesia system (100) according to one of claims 1 to 6, wherein the control unit (20) is configured to include information provided for determining the individual ventilation situation (72) - in particular information provided at the data interface and / or at an input interface (GUI) - relating to a weight, sex, age or body size of the being (50) as well as information (210) on minute volume MV and / or information on tidal volume VT or a patient category of the being (50). [8] Anesthesia system (100) according to one of the preceding claims, wherein the control unit (20) is configured - to increase (76) the amount of oxygen (O2) depending on the individual ventilation situation (72) with at least two levels of oxygen concentration and / or - to limit the increase (76) of the dosage of oxygen (O2) to a predetermined maximum concentration value of oxygen (O2) in the respiratory circuit supply system (8). [9] Anesthesia system (100) according to any one of the preceding claims, wherein the control unit (20) is configured to provide an output signal or an alarm signal to an output unit or to a data interface, which includes the individual ventilation situation (72), the specific operating situation (74), the current oxygen concentration, the individual delay time duration, The dosage amount of oxygen (O2) or the amount of fresh gas mixture FG is indicated. [10] Anesthesia system (100) according to one of the preceding claims, wherein the control unit (20) is configured to detect a state with an increased dosage of oxygen (O2) or the special operating situation (74) - to end after a predetermined maximum activation time, - to end depending on a user action, - to terminate depending on signals or data provided by the sensor (30), - to terminate depending on information or data provided via a data interface.

Images