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

Description

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

[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 their collapse, thereby preventing atelectasis and thus a reduction in functional residual capacity.

[0003] In contrast, conventional ventilators, for example, only provide air during inhalation and create negative pressure during exhalation. For instance, German patent DE 31 19 814 A1 discloses a ventilator with a controllable respiratory gas source and a device for generating negative pressure, which supplies the patient with high-frequency, high-pressure gas pulses during the inspiratory phase. The ventilator feeds at least one jet nozzle in a tracheal tube with the high-pressure gas pulses via the controllable respiratory gas source.To improve efficacy during the expiratory phase, and in particular CO₂ elimination, while simultaneously avoiding obstruction of spontaneous breathing processes such as coughs, the tracheal tube is designed to be connected, at least during the expiratory phase, to a negative pressure generator that establishes a connection between the proximal end of the tube and the ambient atmosphere during both phases of breathing. The ventilator is usable in patients with respiratory distress, but due to the negative pressure generated during the expiratory phase, it does not prevent alveolar collapse in premature and newborn infants. Other comparable ventilators are known, for example, from US 3,977,432 A and US 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 fitted at its other end with a coupling 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 rate 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 and a second branch channel that is open to the atmosphere, the two branch channels forming an angle with each other.The inlet channel lies essentially in line with the first branch channel and is connected to the second branch channel in such a way that the fresh gas flow is directed mainly coaxially into the first branch channel, thereby causing an ejection process. The cross-sectional area of ​​each branch channel is many 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 adhesive tape or a similar device.

[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 result in expensive disposable items. Furthermore, the devices are not flexible in their handling and in their connection with compressed air generators and pressure gauges.According to WO 99 / 24101 A1, these disadvantages are avoided by a device for generating continuous positive airway pressure (CPAP device), in particular a nasal CPAP device (nCPAP device), with a hollow body in which positive pressure can be built up; a first opening provided in a side wall of the hollow body for supplying an airflow directed into the hollow body and for expelling the exhaled airflow; a connector attachable to the hollow body for connecting the hollow body to a nasal and / or mouthpiece; and a spacer attachable to the hollow body on which a flow nozzle can be attached to direct the airflow towards the opening.

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

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

[0008] GB 2570052 B discloses a CPAP device with multiple lockable 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 airflow.

[0010] Especially when providing respiratory support to premature and newborn infants using a CPAP device, it is crucial to minimize pressure on the infant's head, as the skull bones are still soft and malleable in the first few weeks after birth. Prolonged pressure 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 objective of providing a CPAP device that is optimized for use in premature and newborn infants and in particular minimizes the strain on the skull of the premature and newborn infant.

[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 infants, comprising: an inlet-side inflow channel 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, wherein 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 each other in the hollow cylinder wall of the connecting piece and axially to each other, wherein the device comprises a connector on the outlet-side collecting channel for connection to a ventilation mask, a mononasal pharyngeal tube or a binasal prong, characterized in that the device is formed in one piece and the outlet-side collecting channel terminates at the wall of the connecting piece.

[0013] A compressed air / oxygen flow is introduced into the device according to the invention via the inlet channel, wherein the introduced compressed air / oxygen flow has a higher pressure compared to the ambient atmosphere. The compressed air / oxygen flow is condensed by the inner diameter of the inlet channel. The resulting increased flow velocity (Venturi effect) leads to a pressure drop (Bernoulli effect) when the air exits the inlet channel into the connecting piece and transitions into the axially arranged collecting channel. At high airflows, this pressure drop can also draw in ambient air. 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 connector has at least three, preferably four, openings to the environment. These openings allow exhaled air to escape during expiration. The open ends of the hollow cylindrical connector form two of the three openings, and the third opening is advantageously located in the hollow cylindrical wall of the connector. This ensures that exhaled air can always escape and virtually eliminates the possibility of a user accidentally closing all three openings of the connector with only one hand. This safety feature prevents the lungs of premature and newborn infants from being overstretched by excessive pressure, or from alveoli rupturing (pneumothorax).

[0015] The device according to the invention features a minimalist design with only one inlet channel, one outlet collecting 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 designed to be particularly compact and lightweight, thus significantly reducing stress on the skull of premature and newborn infants. Furthermore, the axial alignment of the inlet channel and the outlet collecting channel optimizes the flow within the connecting piece, thereby 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, during both inspiration and expiration. The curved inner wall of the hollow cylindrical connector directs the compressed air / oxygen flow more effectively from the flow channel into the collection channel. The curved inner surface of the hollow cylindrical connector ensures that the airflow entering the connector through the inlet channel is guided into the outlet collection channel.

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

[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 conditionally suitable for use in premature and newborn infants.

[0020] In an advantageous embodiment 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, through the connecting piece, to the outlet of the collecting channel. This is not only beneficial for the flow behavior within the device according to the invention, but also allows for more flexible positioning of the connecting hose 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 inlet-side connected hose for the compressed air supply.However, especially with premature and newborn infants, it is essential that the device is positioned in such a way as to effectively avoid unnecessary strain on the patient's head. The device according to the invention facilitates positioning due to its axial design, as the compressed air hose connected at the inlet can be positioned much more freely.

[0021] According to a practical embodiment of the invention, the connector on the outlet-side collecting channel is 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 connected quickly, easily, and securely to a ventilation mask, a mononasal tube, or a binasal prong, which, for example, have a corresponding mating connector, such as a male M15 adapter.

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

[0023] In an advantageous embodiment of the invention, the ribs extend from the connector over the outer surface of the outlet-side collecting channel and the outer surface of the connector. This stabilizes not only the connector but also the outer surface of the collecting channel and protects it against deformation. A negative impact of deformation on the patient-side (outlet-side) flow in the collecting channel is thus prevented.

[0024] According to the invention, the device is formed in one piece. The one-piece design of the device according to the invention allows for the optimization of flow characteristics. In particular, dead spaces in the area of ​​connections, such as a detachable connection between the outlet-side collecting channel and an optional connector, are avoided. Such dead spaces can, for example, impede the exhalation of CO₂-containing breathing air and are difficult to sterilize using conventional methods, thus promoting the colonization of germs during use. The one-piece design avoids such dead spaces, or rather, prevents them from arising due to unreliable or imprecise connection points.

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

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

[0027] According to one 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 embodiment of the invention, the inlet-side inflow channel projects into the connector. This optimizes, in particular, the transition from the inlet-side inflow channel to the outlet-side collecting channel within the connector. The end of the inlet channel projecting into the connector is positioned such that a sufficient flow of compressed air / oxygen at a pressure higher than that of the surrounding atmosphere flows into the outlet-side collecting channel. The end of the outlet-side collecting channel located on the connector terminates at the curved wall of the hollow cylindrical connector, whereby the curved wall of the hollow cylindrical connector directs the compressed air / oxygen flow from the flow channel into the collecting channel.

[0030] According to a preferred embodiment 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 a preferred embodiment of the invention, the open ends of the hollow cylindrical connecting piece form two of the at least three openings. The remaining third opening is arranged in the hollow cylindrical wall of the connecting piece.

[0032] In an advantageous embodiment, the third opening is arranged centrally between the inlet-side inflow channel and the outlet-side collection channel in the hollow cylinder wall. In this position, the third opening has the least influence on the airflow within the connecting piece, since the distance to both the inlet-side inflow channel and the outlet-side collection channel is maximized.

[0033] According to one 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 embodiment 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 on the connecting piece from becoming blocked.

[0035] The task is further solved by a system for generating a continuous positive airway pressure, especially for respiratory support in premature and newborn infants, comprising: a compressed air supply which provides an airflow at a constant pressure; a ventilation mask, a mononasal 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 tube and the outlet-side collecting channel is connected to the ventilation mask, the mononasal tube or the binasal prong via a second air tube.

[0036] In one embodiment 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 will now be explained in more detail with reference to exemplary embodiments shown in the figures. The figures 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 airway pressure, Fig. 3 a first view of the first embodiment from Fig. 1 In the case of an exemplary incorrect position of the device according to the invention in the area of ​​the connecting piece, Fig. 4 shows a second view of the first embodiment. Fig. 1 In an exemplary incorrect position of the device according to the invention in the area of ​​the connecting piece, Fig. 5 shows a perspective view of a third embodiment of a device according to the invention in conjunction with an air supply hose and a mononasal pharyngeal tube, Fig. 6 shows a perspective view of the device made of Fig. 5 during respiratory support of a premature and newborn infant, Fig. 7 a perspective view of a fourth embodiment of a device according to the invention in conjunction with an air supply tube and a mononasal pharyngeal tube, Fig. 8 a perspective view of the device made of Fig. 7 during respiratory support of a premature and newborn infant, and Fig. 9 a side view of a fifth embodiment of a device according to the invention.

[0038] Fig. 1 Figure 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 infants 2. Such devices are also known under the name CPAP (Continuous Positive Airway Pressure).

[0039] The device 1 according to the in Fig. 1 The illustrated first embodiment 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 shape). 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 relative to each other. Furthermore, the inlet-side inflow channel 3 and the outlet-side collecting channel 4 are straight, so that they run axially relative to each other.

[0041] The hollow cylindrical connecting piece 7 has at least three openings 8, wherein the connecting piece 7 according to the first embodiment is made of Fig. 1 The connecting piece 7 has four openings 8. Exhaled air can escape into the environment through these 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 each other on the circular connecting piece 7 and positioned centrally between the inlet-side inlet channel 3 and the outlet-side collection channel 4. Including the two open ends of the circular connecting piece 7, there are thus four openings 8 in the connecting piece 7, which establish a connection to the environment. This makes it virtually impossible for a single hand to cover all openings 8 simultaneously.

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

[0043] The compressed air / oxygen flow is condensed by the inner diameter of the inlet channel 3. The resulting increased flow velocity (Venturi effect) leads to a pressure drop (Bernoulli effect) when the air exits the inlet channel 3 into the connecting piece 7 and transitions into the axially arranged collecting channel 4. At high airflow rates, this pressure drop can also draw in ambient air. 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, this allows the inlet pressure at the inlet channel 3 to be reduced, which significantly reduces the noise generated. Noise reduction is particularly advantageous in neonatology, as the generated noise places additional stress on premature or newborn infants 2.

[0044] The outlet-side collecting channel 4 is connected to a ventilation mask 5, a mononasal 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 arranged on the outlet-side collecting channel 4. The mononasal tube 6 is advantageously 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 to it. For this purpose, the connecting tube 13, the ventilation mask 5, the mononasal tube 6, or the binasal prong has, for example, 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 reinforcing ribs 10 on its outer surface. The four reinforcing ribs 10 are evenly distributed around the circumference of the connector 9, i.e., at intervals of 90°. According to the first embodiment from Fig. 1 The reinforcing ribs 10 extend from the connecting piece 7 over the outer surface of the outlet-side collecting channel 4 and the outer surface of the connector 9. Thus, the entire outlet-side area 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, made of Fig. 1 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 closing.

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

[0048] According to the in Fig. 1 In the first embodiment shown, 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 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 area of ​​the connecting piece 7 is preferably between 3.5 mm and 5.5 mm, in particular 4.5 mm.

[0050] Fig. 2 Figure 1 shows a sectional view of a second embodiment of a device 1 according to the invention for generating a continuous positive breathing pressure. The Fig. 2 The second embodiment shown is essentially the same as the first embodiment. Fig. 1 In Fig. 2 The device 1 according to the invention is connected at the inlet-side 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 collecting channel 4 is connected via a corresponding counterpart connector 14 to a connecting hose 13, which in turn leads into or is connected to a mononasal pharyngeal tube 6. 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 curvatures.

[0051] The connector 9 and the mating connector 14 are not only precisely matched to each other 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 the dead space within the connection. Unnecessary dead space makes it difficult to exhale CO2, especially for premature and newborn infants 2, and should therefore be avoided or at least minimized.

[0052] The Figuren 3 und 4 show a first or second view of the first embodiment. Fig. 1 In the case of an exemplary incorrect positioning of the device 1 according to the invention in the area of ​​the connecting piece 7 by the medical personnel, as illustrated, the hand 15 of the medical personnel grasps the device 1 according to the invention in the area of ​​the connecting piece 7, partially obscuring the openings 8 to the environment. However, due to the number and arrangement of the openings 8, the invention prevents the medical personnel from unintentionally covering and consequently closing all openings 8 to the environment simultaneously. If there were no longer any connection to the environment, the premature or newborn infant 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 premature or newborn infant's lungs, which is prevented according to the invention.

[0053] If the medical personnel grasp 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 As shown, the exhaled air can escape through the openings 8 in the circumferential wall of the hollow cylinder. If the medical personnel grasp the device 1 in the area of ​​the two openings 8 in the circumferential wall of the hollow cylindrical connector 7, the exhaled air can escape from the upper and lower openings 8 of the hollow cylindrical connector 7. Fig. 4 ).

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

[0055] The combination of 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 infants 2.

[0056] Fig. 6 shows the use of system or device 1 from Fig. 5 during respiratory support via a mononasal tube in a premature or newborn infant. 2. The Fig. 6 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 hose 12, especially in comparison to the angled devices known from the prior art.

[0057] Fig. 7 Figure 1 shows a perspective view of a fourth embodiment of a device 1 according to the invention in conjunction with an air supply hose 12 and a breathing mask 5. The device 1 essentially corresponds to the device shown in Figure 1. Fig. 1 , which is connected on the inlet side to an air supply hose 12. A counter-connector 14, located 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 system or device 1 from Fig. 7 during the respiratory support of a premature and newborn infant 2 by means of a ventilation mask 5. Here too it is evident 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. 9 Figure 1 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 infants 2. The fifth embodiment from Fig. 9This embodiment 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 circumferential wall of the connecting piece 7 was adapted; they are now oval / rectangular and no longer round as in the previously described embodiments. In principle, the openings 8 can have any shape, as long as they are suitable for venting the exhaled air from the device 1.

[0061] The present invention is defined by the following claims. Reference symbol list

[0062] 1 Device 2 Premature / Newborn Infant 3 Inflow Channel 4 Collecting Channel 5 Ventilation Mask 6 Mononasal Tube 7 Connector 8 Opening (Connector) 9 Connector 10 Reinforcing Rib 11 Groove (Grip Element) 12 Air Supply Tube 13 Connecting Tube (Ventilation Mask / Mononasal Tube) 14 Connecting Piece 15 Hand (Medical Personnel)

Claims

1. Device (1) for generating a continuous positive airway pressure, in particular for respiratory support in premature and newborn infants (2), comprising: an inlet channel (3) on the inlet side, for connection to a compressed air supply, a collecting channel (4) on the outlet side, for connection to a respiratory mask (5) or a mononasal pharyngeal tube (6) or a binasal prong, a connecting piece (7) between the inlet channel (3) on the inlet side and the collecting channel (4) on the outlet side, the connecting piece (7) having at least three openings (8) to the environment, the connecting piece (7) is designed as a hollow cylinder with open ends and the inlet channel (3) on the inlet side and the collecting channel (4) on the outlet side are arranged opposite one another in the hollow cylinder wall of the connecting piece (7) and axially to one another, wherein the device (1) at the collecting channel (4) on the outlet side comprises a connector (9), for connecting with a respiratory mask, a mononasal pharyngeal tube or a binasal prong, characterized in that, the device (1) is formed in one piece and the collecting channel (4) on the outlet side ends at the wall of the connecting piece (7).

2. Device (1) according to claim 1, wherein the inlet channel (3) on the inlet side and the collecting channel (4) on the outlet side are straight.

3. Device (1) according to claim 1 or claim 2, Wherein the connector (9) at the collecting channel (4) on the outlet side, is a female M15 adapter.

4. Device (1) according to claim 3, wherein the connector (9) comprises on its outer surface ribs (10) as reinforcement and / or grooves (11) as grip element.

5. Device (1) according to claim 4, wherein the ribs (10) extend from the connector (7) over the outer surface of the collecting channel (4) on the outlet side and the outer surface of the connector (9).

6. Device (1) according to one of claims 1 to 5, wherein the device (1) is made of a plastic.

7. Device (1) according to one of claims 1 to 6, wherein the inlet channel (3) on the inlet side has a smaller diameter than the collecting channel (4) on the outlet side.

8. Device (1) according to one of the claims 1 to 7, wherein the inlet channel (3) on the inlet side projects into the connecting piece (7).

9. Device (1) according to one of the claims 1 to 8 wherein the open ends of the hollow cylindrical connector (7) form two of the three openings (8) and the third opening (8) is arranged in the hollow cylindrical wall of the connector (7).

10. Device (1) according to claim 9, wherein the third opening (8) is arranged centrally between the inlet channel (3) on the inlet side and the collecting channel (4) on the outlet side in the hollow cylinder wall.

11. Device (1) according to one of claims 1 to 10, wherein the height of the hollow cylindrical connector (7) is smaller than the diameter of the hollow cylindrical connector (7).

12. Device according to any of the claims 1 to 11, wherein the height of the hollow cylindrical connecting piece (7) is greater than the outer diameter of the inlet channel (3) on the inlet side.

13. A system for providing continuous positive airway pressure, particularly for respiratory support in premature and newborn infants (2), comprising: a compressed air supply providing a flow of air at a constant pressure; a respiratory 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 12, wherein the inlet channel (3) on the inlet side is connected to the compressed air supply via a first air hose and the collection channel (4) on the outlet side is connected to the respiratory mask (5), the mononasal pharyngeal tube (6) or the binasal prong via a second air hose.

14. System according to claim 13, wherein 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.