Device and system for generating a continuous positive airway pressure, especially for respiratory support in premature and newborn infants

Abstract

Device (1) for generating a continuous positive airway pressure, in particular for respiratory support in premature and newborn infants (2), comprising: an inlet-side inlet channel (3), for connection to a compressed air supply, an outlet-side collecting channel (4) for connection to a ventilation mask (5) or a mononasal pharyngeal tube (6) or a binasal prong, a connecting piece (7) between the inlet-side inflow channel (3) and the outlet-side collecting channel (4), wherein the connecting piece (7) has at least three openings (8) to the environment, characterized by the fact that the connecting piece (7) is designed as a hollow cylinder with open ends and the inlet-side inflow channel (3) and the outlet-side collecting channel (4) are arranged opposite each other in the hollow cylinder wall of the connecting piece (7) and axially to each other.

Description

[0001] The invention relates to a device and a system for generating continuous positive airway pressure, also referred to as a CPAP (Continuous Positive Airway Pressure) device. The CPAP device is designed, for example, as a nasal CPAP device (nCPAP). CPAP devices are also used, in particular, to provide respiratory support to premature and newborn infants in cases of premature birth-associated surfactant deficiency or transient tachypnea in newborns.

[0002] The operating principle of CPAP devices is based on the patient breathing against a pressure higher than atmospheric pressure. By generating PEEP (positive end-expiratory pressure) in the alveoli, a CPAP device attempts to prevent collapse of the alveoli, thus preventing atelectasis and thus a reduction in functional residual capacity.

[0003] In contrast, conventional ventilation devices, for example, only provide air during inhalation, while negative pressure is generated during exhalation. For example, DE 31 19 814 A1 discloses a ventilator with a controllable breathing gas source and a device for generating negative pressure, which supplies the patient with high-frequency, high-pressure gas pulses during the inspiration phase. The ventilator supplies at least one jet nozzle in a tracheal tube with the high-pressure gas pulses via the controllable breathing gas source.To improve efficacy during the expiratory phase, particularly CO2 elimination, while simultaneously avoiding obstruction of spontaneous breathing processes such as coughing, the tracheal tube is connected, at least during the expiratory phase, to a negative pressure generating device that connects the proximal end of the tube to the ambient atmosphere during both respiratory phases. The ventilator can be used for patients with respiratory impairment, but the negative pressure generated during the expiratory phase does not prevent alveolar collapse in premature and newborn infants. Other comparable ventilator devices are known, for example, from US Pat. Nos. 3,977,432 A and 3,794,072 A.

[0004] EP 0 447 443 A1 discloses a device for generating continuous positive airway pressure (CPAP) by means of an ejection process, comprising a breathing channel that opens to the atmosphere at its free end and can be provided at its other end with a coupling piece for attachment to the patient's nose and / or mouth, and an inlet channel for fresh gas that is connected to the breathing channel at a point between its ends and whose flow is adjustable to achieve an adjustable positive pressure in the breathing channel. The breathing channel has a first branch channel that can be connected to the coupling piece and a second branch channel that is open to the atmosphere, the two branch channels forming an angle with each other.The inlet channel is essentially an extension of the first branch channel and is connected to the second branch channel in such a way that the fresh gas flow is directed primarily coaxially into the first branch channel, thereby causing an ejection process. The cross-sectional area of ​​each branch channel is several times larger than the smallest cross-sectional area of ​​the inlet channel. The length of each branch channel is relatively short, preferably five times its inner diameter. The breathing channel is assembled with the inlet channel to form a compact unit that can be attached to the patient's nose and / or mouth using an adhesive strip or similar means.

[0005] WO 99 / 24101 A1 criticizes the complicated design of the two aforementioned CPAP and nCPAP devices, particularly the separate inlet and outlet channels, which make the devices difficult to sterilize and expensive disposable items. Furthermore, the devices are not flexible in handling and in connection with compressed air generators and pressure gauges.According to WO 99 / 24101 A1, these disadvantages are avoided by a device for generating a continuous positive airway pressure (CPAP device), in particular a nasal CPAP device (nCPAP device), comprising a hollow body in which an overpressure can be built up; a first opening provided in a side wall of the hollow body for supplying an air flow directed into the hollow body and for discharging the exhaled air flow; a connecting piece attachable to the hollow body for connecting the hollow body to a nose and / or mouthpiece; and a spacer attachable to the hollow body, to which a flow nozzle for directing the air flow towards the opening can be attached.

[0006] EP 1 897 577 A1 discloses a further development of the device from WO 99 / 24101 A1 with an additional inlet for a medicament flow.

[0007] EP 0 658 356 A1 further discloses a CPAP device having a pair of nasal prongs each with a cannula tip for insertion into the nostrils of a patient.

[0008] GB 2570052 B discloses a CPAP device with multiple closable ports to provide a variety of different ventilation therapies.

[0009] EP 2 269 676 A2 discloses a CPAP device with a controllable valve in the compressed air supply to adjust the supplied air flow.

[0010] Especially when providing respiratory support to premature and newborn babies using a CPAP device, it is important to ensure that the strain on the premature and newborn babies' heads is kept as low as possible, as the skull bones are still soft and malleable in the first few weeks after birth. Continuous strain on the skull from the CPAP device can lead to pressure sores and deformities, which should be avoided.

[0011] The invention is therefore based on the object of providing a CPAP device which is optimized for use in premature and newborn babies and in particular minimizes the load on the skull of the premature and newborn babies.

[0012] The object is achieved according to the invention by a device for generating a continuous positive airway pressure, in particular for respiratory support in premature and newborn babies, comprising: an inlet channel on the inlet side, for connection to a compressed air supply, an outlet-side collecting channel for connection to a ventilation mask or a mononasal pharyngeal tube or a binasal prong, a connecting piece between the inlet-side inflow channel and the outlet-side collecting channel, wherein the connecting piece has at least three openings to the environment, which is characterized by the connecting piece is designed as a hollow cylinder with open ends and the inlet-side inflow channel and the outlet-side collecting channel are arranged opposite one another in the hollow cylinder wall of the connecting piece and axially to one another.

[0013] A compressed air / oxygen stream is introduced into the device according to the invention via the inlet-side inflow channel, with the introduced compressed air / oxygen stream having a higher pressure than the ambient atmosphere. The compressed air / oxygen stream is condensed by the inner diameter of the inflow channel. The resulting increased flow velocity (Venturi effect) leads to a pressure drop (Bernoulli effect) as the air exits the inflow channel into the connecting piece and transitions into the axially arranged collecting channel. This pressure drop can also draw in ambient air at high air flows. Thus, the device according to the invention supports the oxygen supply during inspiration and, as in the prior art, ensures improved gas exchange due to the generated overpressure.

[0014] The connecting piece has at least three, preferably four, openings to the environment. These openings allow the breathing air to escape during expiration. The open ends of the hollow cylindrical connecting piece form two of the three openings, and the third opening is conveniently located in the hollow cylindrical wall of the connecting piece. This ensures that breathing air can always escape and virtually eliminates the possibility of a user accidentally closing all three openings of the connecting piece with just one hand. This safety feature prevents the lungs of premature and newborn babies from being overexpanded due to excessive pressure, or alveoli from bursting (pneumothorax).

[0015] The device according to the invention has a minimalist design with only one inlet channel, one outlet channel, and a connecting piece between the two channels. The hollow cylindrical connecting piece automatically forms two of the three openings through its two open ends. This allows the device to be particularly compact and lightweight, significantly reducing stress on the skull of premature and newborn babies. Furthermore, the axial alignment of the inlet channel and the outlet channel optimizes the flow within the connecting piece, reducing the overall size and consequently the overall weight of the device.

[0016] A hollow cylindrical connector optimizes the compressed air / oxygen flow within the connector, both during inspiration and expiration. The curved inner wall of the hollow cylindrical connector better directs the compressed air / oxygen flow from the flow channel into the collection channel. The curved inner surface of the hollow cylindrical connector ensures that the air flow entering the connector through the inlet channel is directed into the outlet channel.

[0017] In principle, the device according to the invention can be used or connected to a wide variety of devices for respiratory support, wherein the aforementioned ventilation mask, the aforementioned mononasal pharyngeal tube or the aforementioned binasal prong represent the most common devices for respiratory support.

[0018] In contrast to the prior art according to WO 99 / 24101 A1 and EP 1 897 577 A1, the device according to the invention dispenses with the hollow body in which the positive pressure is generated according to the prior art. This significantly reduces the weight of the device according to the invention compared to this prior art.

[0019] The device according to EP 0 658 356 A1 is fixed directly to the patient's head and is therefore only suitable to a limited extent for use on premature and newborn babies.

[0020] In an advantageous variant of the invention, the inlet-side inflow channel and the outlet-side collecting channel are straight. The device according to the invention thus has an axial flow channel from the inlet of the inflow channel via the connecting piece to the outlet of the collecting channel. This not only promotes the flow behavior within the device according to the invention, but also allows for more flexible positioning of the connecting tube on the inlet-side inflow channel. In the prior art according to WO 99 / 24101 A1, EP 1 897 577 A1, EP 0 658 356 A1, and WO 90 / 24101 A1, the inlet-side compressed air connection is angled relative to the outlet-side ventilation connection, which significantly restricts the positioning of both the device and the hose connected to the inlet for the compressed air supply.However, especially with premature and newborn babies, it is essential that the device is positioned in such a way that unnecessary strain on the patient's head is effectively avoided. The device according to the invention facilitates positioning due to its axial design, since the compressed air hose connected to the inlet side can be positioned much more freely.

[0021] According to a suitable variant of the invention, the device comprises a connector on the outlet-side collecting channel, in particular a female M15 adapter. The adapter is designed, for example, according to DIN EN ISO 80369-2. The adapter allows the device according to the invention to be quickly, easily, and safely connected to a ventilation mask or a mononasal pharyngeal tube or a binasal prong, which, for example, have a corresponding mating connector, such as a male M15 adapter.

[0022] According to a variant of the invention, the connector comprises ribs on its outer surface as reinforcement and / or grooves as a grip element. The reinforcing ribs ensure easy connection, as the connector does not deform during handling, which could, for example, complicate the insertion of an M15 male adapter into an M15 female adapter. The grooves serving as a grip element generally improve the handling of the device.

[0023] In an advantageous variant of the invention, the ribs extend from the connecting piece over the outer surface of the outlet-side collecting channel and the outer surface of the connector. Thus, in addition to the connector, the outer surface of the collecting channel is also stabilized and protected against deformation. A negative influence of deformation on the patient-side (outlet-side) flow in the collecting channel is thus prevented.

[0024] According to a particularly preferred variant of the invention, the device is constructed in one piece. The one-piece design of the device according to the invention allows for optimized flow characteristics. In particular, dead spaces are avoided in the area of ​​connections, such as a detachable connection between the outlet-side collection channel and the optional connector. Such dead spaces can, for example, impede the exhalation of CO2-containing air, are difficult to sterilize using conventional methods, and promote the colonization of germs during use. The one-piece design avoids such dead spaces or prevents them from occurring due to insecure or imprecise connection points.

[0025] According to a variant of the invention, the device is made of plastic. This allows for simple and cost-effective manufacture. Furthermore, the weight of the device can be minimized, making the device particularly suitable for respiratory support in premature and newborn babies. For example, a device according to the invention, including the optional connector, in a one-piece plastic design weighs less than 5 g, in particular less than 4 g.

[0026] In a practical variant of the invention, the inlet channel on the input side has a smaller inner diameter than the outlet channel. The smaller inner diameter of the inlet channel condenses the compressed air / oxygen flow more effectively. The resulting increased flow velocity (Venturi effect) leads to an optimal pressure drop (Bernoulli effect) as the air exits the inlet channel into the connecting piece and transitions into the larger, axially arranged collection channel. This can also draw in ambient air at high air flows.

[0027] According to a suitable variant, the inlet-side inlet channel has a diameter of 2 mm to 4 mm, in particular 3 mm.

[0028] According to a further variant of the invention, the outlet-side collecting channel has a diameter of 3 mm to 5 mm, in particular 4 mm.

[0029] In an advantageous variant of the invention, the inlet-side inflow channel extends into the connecting piece, and the outlet-side collecting channel ends at the wall of the connecting piece. This optimizes, in particular, the transition from the inlet-side inflow channel to the outlet-side collecting channel in the connecting piece. The end of the inflow channel extending into the connecting piece is positioned so that a sufficient compressed air / oxygen flow flows into the outlet-side collecting channel at a pressure higher than the surrounding atmosphere. The end of the outlet-side collecting channel arranged on the connecting piece ends at the curved wall of the hollow-cylindrical connecting piece, whereby the curved wall of the hollow-cylindrical connecting piece directs the compressed air / oxygen flow from the flow channel into the collecting channel.

[0030] According to a suitable variant of the invention, the distance between the inlet-side inflow channel and the outlet-side collecting channel in the region of the connecting piece is between 3.5 mm and 5.5 mm, in particular 4.5 mm. In particular, the dimensions of the connecting piece, the inlet-side inflow channel, and the outlet-side collecting channel are designed such that a positive end-expiratory pressure (PEEP) of at least 3 cm H2O up to 12 cm H2O is achieved, preferably between 5 cm H2O and 8 cm H2O.

[0031] According to an expedient variant of the invention, the open ends of the hollow-cylindrical connecting piece form two of the at least three openings. The at least remaining third opening is arranged in the hollow-cylindrical wall of the connecting piece.

[0032] In an advantageous variant, the third opening is positioned centrally between the inlet inlet channel and the outlet collecting channel in the hollow cylinder wall. In this position, the third opening has the least influence on the air flow within the connecting piece, since the distance to both the inlet inlet channel and the outlet collecting channel is maximized.

[0033] According to a variant of the invention, the height of the hollow cylindrical connecting piece is smaller than the diameter of the hollow cylindrical connecting piece.

[0034] According to a further variant of the invention, the height of the hollow cylindrical connecting piece is greater than the outer diameter of the inlet-side inlet channel. The circular connecting piece thus simultaneously serves as a stop for an air supply hose attached to the inlet channel and prevents the openings in the connecting piece from becoming blocked.

[0035] The object is further achieved by a system for generating a continuous positive airway pressure, in particular for respiratory support in premature and newborn babies, comprising: a compressed air supply which provides an air flow at a constant pressure; a ventilation mask, a mononasal pharyngeal tube or a binasal prong for the premature or newborn infant; and a device according to the invention, wherein the inlet-side inflow channel is connected to the compressed air supply via a first air hose and the outlet-side collection channel is connected to the ventilation mask, the mononasal throat tube or the binasal prong via a second air hose.

[0036] In a variant according to the invention, the compressed air supply provides a constant output pressure between 2.2 and 6.6 bar, in particular between 3.3 and 5.5 bar.

[0037] The invention is explained in more detail below with reference to exemplary embodiments illustrated in the figures. They show: Fig. 1 a perspective view of a first embodiment of a device according to the invention for generating a continuous positive airway pressure, Fig. 2 a sectional view of a second embodiment of a device according to the invention for generating a continuous positive breathing pressure, Fig. 3 a first view of the first embodiment of Fig. 1 in an exemplary incorrect position of the device according to the invention in the area of ​​the connecting piece, Fig. 4 a second view of the first embodiment of Fig. 1 in an exemplary incorrect position of the device according to the invention in the area of ​​the connecting piece, Fig. 5 is a perspective view of a third embodiment of a device according to the invention in conjunction with an air supply tube and a mononasal throat tube, Fig. 6 a perspective view of the device of Fig. 5 during respiratory support of a premature or newborn baby, Fig. 7 is a perspective view of a fourth embodiment of a device according to the invention in conjunction with an air supply tube and a mononasal throat tube, Fig. 8 a perspective view of the device of Fig. 7 during respiratory support of a premature and newborn baby, and Fig. 9 a side view of a fifth embodiment of a device according to the invention.

[0038] Fig. 1 shows a perspective view of a first embodiment of a device 1 according to the invention for generating a continuous positive airway pressure, in particular for respiratory support in premature and newborn babies 2. Such devices are also known under the designation CPAP (Continuous Positive Airway Pressure).

[0039] The device 1 according to the Fig. The first embodiment shown in Figure 1 comprises an inlet-side inflow channel 3, an outlet-side collecting channel 4, and a connecting piece 7 between the inlet-side inflow channel 3 and the outlet-side collecting channel 4. Furthermore, the device 1 comprises a connector 9 on the outlet-side collecting channel 4.

[0040] According to the invention, the connecting piece 7 is designed as a hollow cylinder with open ends (hollow-cylindrical). The inlet-side inflow channel 3 and the outlet-side collecting channel 4 are arranged opposite one another in the hollow cylinder wall of the connecting piece 7 and axially relative to one another. Furthermore, the inlet-side inflow channel 3 and the outlet-side collecting channel 4 are straight, so that they extend axially with one another.

[0041] The hollow cylindrical connecting piece 7 has at least three openings 8, wherein the connecting piece 7 according to the first embodiment consists of Fig. 1 has four openings 8. The expelled air can escape into the environment through these multiple openings 8. The open ends of the hollow cylindrical connecting piece 7 form two of these four openings 8. The remaining two openings 8 are arranged opposite one another on the circular connecting piece 7 and positioned centrally between the inlet-side inflow channel 3 and the outlet-side collection channel 4. Including the two open ends of the circular connecting piece 7, four openings 8 are thus arranged in the connecting piece 7, which establish a connection to the environment. This makes it almost impossible for a single hand to cover all openings 8 at the same time.

[0042] The inlet-side inflow channel 3 serves for connection to a compressed air supply (not shown), in particular a compressed air / oxygen supply. A compressed air / oxygen stream is introduced from the compressed air supply into the device 1 according to the invention via the inlet-side inflow channel 3, wherein the introduced compressed air / oxygen stream has a higher pressure than the ambient atmosphere. For example, the compressed air supply is connected to the inlet-side inflow channel 3 via an air supply hose 12, wherein the air supply hose 12 is expediently plugged onto the free end of the inlet-side inflow channel 3.

[0043] The compressed air / oxygen flow is condensed by the inner diameter of the inflow channel 3. The resulting increased flow velocity (Venturi effect) leads to a pressure drop (Bernoulli effect) as the air exits the inflow channel 3 into the connecting piece 7 and transitions into the axially arranged collecting channel 4. This pressure drop can also draw in ambient air at high air flows. Thus, the device 1 according to the invention supports the oxygen supply during inspiration and, as in the prior art, ensures improved gas exchange due to the generated overpressure. Furthermore, the inlet pressure at the inflow channel 3 can be reduced, which significantly reduces the generated noise. Noise reduction is particularly advantageous in neonatology, since the generated noise places additional stress on premature or newborn babies 2.

[0044] The outlet-side collecting channel 4 is connected to a ventilation mask 5 or a mononasal pharyngeal tube 6 or a binasal prong. For this purpose, a connector 9, such as a female M15 adapter according to DIN EN ISO 80369-2, is preferably arranged on the outlet-side collecting channel 4. The mononasal pharyngeal tube 6 is expediently connected directly or via a connecting tube 13 to the outlet-side collecting channel 4 of the device 1 according to the invention, just as, for example, a ventilation mask 5 can be connected directly to the connector 9 or via a connecting tube 13. For this purpose, the connecting tube 13, the ventilation mask 5, the mononasal pharyngeal tube 6 or the binasal prong, for example, has a connecting counterpart 14, in particular a male M15 adapter, which can be inserted into the female M15 adapter (connector 9).

[0045] The connector 9 comprises a total of four ribs 10 on its outer surface as reinforcement. The four reinforcing ribs 10 are evenly distributed over the circumference of the connector 9, i.e., at a distance of 90°. According to the first embodiment of Fig. 1, the reinforcing ribs 10 extend from the connecting piece 7 over the outer surface of the output-side collecting channel 4 and the outer surface of the connector 9. Thus, the entire output-side region of the device 1 according to the invention is reinforced.

[0046] The height of the hollow cylindrical connecting piece 7 is according to the embodiment of Fig. 1 is larger than the outer diameter of the inlet-side inlet channel 3. The circular connecting piece 7 thus also serves as a stop for the air supply hose 12 and prevents the openings 8 on the connecting piece 7 from being closed.

[0047] The device 1 according to the invention is preferably designed in one piece and is made in particular from a plastic.

[0048] According to the Fig. In the first embodiment shown in Figure 1, the inlet-side inflow channel 3 has a smaller diameter than the outlet-side collecting channel 4. For example, the inlet-side inflow channel 3 has a diameter of 2 mm to 4 mm, in particular 3 mm, and the outlet-side collecting channel 4 has a diameter of 3 mm to 5 mm, in particular 4 mm.

[0049] Again Fig. 1 can still be removed, the inlet-side inflow channel 3 projects into the connecting piece 7 and the outlet-side collecting channel 4 ends at the wall of the connecting piece 7. The distance between the inlet-side inflow channel 3 and the outlet-side collecting channel 4 in the region of the connecting piece 7 is preferably between 3.5 mm and 5.5 mm, in particular 4.5 mm.

[0050] Fig. Figure 2 shows a sectional view of a second embodiment of a device 1 according to the invention for generating a continuous positive breathing pressure. Fig. The second embodiment shown in Figure 2 essentially corresponds to the first embodiment shown in Fig. 1. In Fig. 2, the device 1 according to the invention is connected at the inlet side of the flow channel to an air supply hose 12, which is connected at the other end to a compressed air / oxygen supply (compressed air source). The connector 9 at the outlet side of the collecting channel 4 is connected via a corresponding mating connector 14 to a connecting hose 13, which in turn merges into a mononasal pharyngeal tube 6 or is connected to one of these. Fig. 2 it can be seen in particular that the flow channel through the device 1 according to the invention is axial and has no bends.

[0051] The connector 9 and the mating connector 14 are not only precisely matched to establish a secure connection between the device 1 according to the invention and the mononasal pharyngeal tube 6, the ventilation mask 5, or the binasal prong, but also to minimize dead space within the connection. Unnecessary dead space makes exhaling CO2 difficult, especially for premature and newborn infants 2, and should therefore be avoided or at least minimized.

[0052] The Fig. 3 and Fig. 4 show a first and second view of the first embodiment of Fig. 1 shows an example of an incorrect position of the device 1 according to the invention in the area of ​​the connecting piece 7 by the medical personnel. As shown, the hand 15 of the medical personnel grasps the device 1 according to the invention in the area of ​​the connecting piece 7 and in doing so partially covers the openings 8 to the environment. Due to the number and arrangement of the openings 8, however, the invention prevents the medical personnel from inadvertently covering and consequently closing all of the openings 8 to the environment at the same time. If there is no longer any connection to the environment, the premature or newborn baby 2 would have to exhale against the inlet-side compressed air / oxygen supply, which is not possible due to the not yet fully developed lung function. This would therefore lead to overexpansion of the lungs of the premature or newborn baby, which is prevented by the invention.

[0053] If the medical staff grasps the device 1 in the area of ​​the upper and lower opening 8 of the hollow cylindrical connecting piece 7, as shown in Fig. 3, the exhaled air can escape through the openings 8 in the peripheral wall of the hollow cylinder. If the medical personnel grasps the device 1 in the area of ​​the two openings 8 in the peripheral wall of the hollow cylindrical connecting piece 7, the exhaled air can escape from the upper and lower openings 8 of the hollow cylindrical connecting piece 7 ( Fig. 4).

[0054] Fig. Figure 5 shows a perspective view of a third embodiment of a device 1 according to the invention in connection with an air supply tube 12 and a mononasal throat tube 6. The device 1 essentially corresponds to the device from Fig. 1, which is connected on the inlet side to an air supply tube 12. A counter-connector 14 is inserted into the connector 9 on the outlet-side collecting channel 4, which is connected to a mononasal pharyngeal tube 6 via a connecting tube 13 or merges into it.

[0055] The combination of the connecting piece 7 with the ventilation mask 5, the mononasal pharyngeal tube 6 or the binasal prong and the connected compressed air supply (not shown) forms a system according to the invention for generating a continuous positive airway pressure, in particular for respiratory support in premature and newborn babies 2.

[0056] Fig. 6 shows the use of the system or device 1 from Fig. 5 during respiratory support via a mononasal pharyngeal tube of a premature and newborn infant 2. The Fig. 6 shows that the straight, axial design of the device 1 according to the invention hardly restricts the guidance of the air supply hose 12, in particular in comparison to the angled devices known from the prior art.

[0057] Fig. Figure 7 shows a perspective view of a fourth embodiment of a device 1 according to the invention in connection with an air supply hose 12 and a ventilation mask 5. The device 1 essentially corresponds to the device from Fig. 1, which is connected on the inlet side to an air supply hose 12. A counter-connector 14, arranged directly on the ventilation mask 5, is inserted into the connector 9 on the outlet-side collecting channel 4.

[0058] Fig. 8 shows the use of the system or device 1 from Fig. 7 during the respiratory support of a premature and newborn baby 2 by means of a ventilation mask 5. Here too, it can be seen that the straight, axial design of the device 1 according to the invention hardly restricts the guidance of the air supply tube 12.

[0059] Fig. Figure 9 shows a side view of a fifth embodiment of a device 1 according to the invention for generating a continuous positive airway pressure, in particular for respiratory support in premature and newborn babies 2. The fifth embodiment of Fig.9 differs from the previous embodiments in particular in that the connector 9 additionally has grooves 11 to improve grip. The grooves 11 are arranged on the circular outer surface of the connector 9. According to the fifth embodiment, the reinforcing ribs 10 extend from the connecting piece 7 across the outlet-side collecting channel 4 and along the radial side surface of the connector 9.

[0060] Furthermore, in the fifth embodiment, the shape of the openings 8 in the circular peripheral wall of the connecting piece 7 has been adapted; they are now oval / rectangular and no longer round as in the previously illustrated embodiments. In principle, the openings 8 can have any shape, as long as they are suitable for discharging the exhaled air from the device 1. List of reference symbols 1 device 2 premature / newborn babies 3 Inlet channel 4 Collecting channel 5 Ventilation mask 6 mononasal pharyngeal tube 7 connecting piece 8 Opening (connecting piece) 9 connectors 10 Reinforcing rib 11 Groove (grip element) 12 Air supply hose 13 Connecting tube (ventilation mask / mononasal pharyngeal tube) 14 Connecting counterpart 15 Hand (medical personnel) QUOTES CONTAINED IN THE DESCRIPTION

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

[0000] DE 31 19 814 A1

[0003] US 3,977,432 A

[0003] US 3,794,072 A

[0003] EP 0 447 443 A1

[0004] WO 99 / 24101 A1 [0005, 0006, 0018, 0020] EP 1 897 577 A1 [0006, 0018, 0020] EP 0 658 356 A1 [0007, 0019, 0020] GB 2570052 B

[0008] EP 2 269 676 A2

[0009] WO 90 / 24101 A1

[0020] Cited non-patent literature

[0000] DIN EN ISO 80369-2

[0021]

Claims

[1] Device (1) for generating a continuous positive airway pressure, in particular for respiratory support in premature and newborn babies (2), comprising: an inlet-side inlet channel (3) for connection to a compressed air supply, an outlet-side collecting channel (4) for connection to a ventilation mask (5) or a mononasal throat tube (6) or a binasal prong, a connecting piece (7) between the inlet-side inflow channel (3) and the outlet-side collecting channel (4), wherein the connecting piece (7) has at least three openings (8) to the environment, characterized by , that the connecting piece (7) is designed as a hollow cylinder with open ends and the inlet-side inflow channel (3) and the outlet-side collecting channel (4) are arranged opposite one another in the hollow cylinder wall of the connecting piece (7) and axially to one another. [2] Device (1) according to claim 1, wherein the inlet-side inflow channel (3) and the outlet-side collecting channel (4) are straight. [3] Device (1) according to claim 1 or claim 2, further comprising a connector (9) on the output-side collecting channel (4), in particular a female M15 adapter. [4] Device (1) according to claim 3, wherein the connector (9) comprises ribs (10) as reinforcement and / or grooves (11) as gripping element on its outer surface. [5] Device (1) according to claim 4, wherein the ribs (10) extend from the connecting piece (7) over the outer surface of the output-side collecting channel (4) and the outer surface of the connector (9). [6] Device (1) according to one of claims 1 to 5, wherein the device (1) is formed in one piece. [7] Device (1) according to one of claims 1 to 6, wherein the device (1) is made of a plastic. [8] Device (1) according to one of claims 1 to 7, wherein the inlet-side inflow channel (3) has a smaller diameter than the outlet-side collecting channel (4). [9] Device (1) according to one of claims 1 to 8, wherein the inlet-side inflow channel (3) projects into the connecting piece (7) and the outlet-side collecting channel (4) ends at the wall of the connecting piece (7). [10] Device (1) according to one of claims 1 to 9, wherein the open ends of the hollow cylindrical connecting piece (7) form two of the three openings (8) and the third opening (8) is arranged in the hollow cylindrical wall of the connecting piece (7). [11] Device (1) according to claim 10, wherein the third opening (8) is arranged centrally between the inlet-side inflow channel (3) and the outlet-side collecting channel (4) in the hollow cylinder wall. [12] Device (1) according to one of claims 1 to 11, wherein the height of the hollow cylindrical connecting piece (7) is smaller than the diameter of the hollow cylindrical connecting piece (7). [13] Device according to one of claims 1 to 12, wherein the height of the hollow cylindrical connecting piece (7) is greater than the outer diameter of the inlet-side inflow channel (3). [14] System for generating continuous positive airway pressure, in particular for respiratory support in premature and newborn babies (2), comprising: a compressed air supply which provides an air flow at a constant pressure; a ventilation mask (5), a mononasal pharyngeal tube (6) or a binasal prong for the premature or newborn infant (2); and a device (1) according to one of claims 1 to 13, wherein the inlet-side inflow channel (3) is connected to the compressed air supply via a first air hose and the outlet-side collecting channel (4) is connected to the ventilation mask (5), the mononasal throat tube (6) or the binasal prong via a second air hose. [15] System according to claim 14, where the compressed air supply has a constant output pressure between 2.2 and 6.6 bar, especially between 3.3 and 5.5 bar.

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