Equipment for supplying breathing gases

Abstract

The present invention relates to a respiratory gas supply device comprising at least one respiratory gas line for guiding a respiratory gas mixture. The respiratory gas line comprises at least one outlet from which the respiratory gas mixture can be discharged at least partially and at least temporarily. The respiratory gas line comprises an inspiratory branch tube configured to guide respiratory gas to a connection for a patient interface. The respiratory gas line comprises an expiratory branch tube configured to guide respiratory gas between the connection for a patient interface and the outlet. The device is characterized in that the respiratory gas line comprises at least one shut-off valve configured and designed to establish at least temporarily a connection for guiding respiratory gas from the expiratory branch tube to the inspiratory branch tube.

Description

[Technical Field]

[0001] The present invention relates to an apparatus for anesthesia and / or ventilation. [Background technology]

[0002] An anesthesia workstation is typically configured to deliver respiratory gases to the circulatory system, replenish consumed gases such as oxygen (O2), and remove carbon dioxide (CO2) from the circulatory system. In such a circulatory system, volatile anesthetics can be added and separated under controlled conditions. A respiratory gas source and check valve ensure that the gases flow in a specified direction. Inspiration is delivered to the patient via the inspiratory branch of the respiratory gas circulatory system. After inspiration, the patient's exhaled breath is returned to the circulatory system via the expiratory branch. CO2 is then separated from the exhaled breath, and the respiratory gases are mixed with fresh gases and supplied back to the patient. Typically, CO2 is removed from the respiratory gas mixture by a chemical CO2 absorber. [Overview of the project] [Problems that the invention aims to solve]

[0003] The object of the present invention is to provide a device that can be used for both the administration of volatile anesthetics and ventilation or respiratory support, and that is simple, flexible, and operates safely. [Means for solving the problem]

[0004] The above problem is solved by the apparatus described in claim 1. Improved and advantageous forms are the subject of the dependent claims. Further advantages and features will become apparent from the general description and the description of the embodiments.

[0005] It should be noted that the features individually recited in the claims can be arbitrarily combined with each other in a technically meaningful way, showing further forms of the present invention. This specification further characterizes and embodies the present invention, particularly in relation to the drawings. The dependent claims relate to various advantageous improvements of the present invention that are independent of each other, and their features can be freely combined with each other by those skilled in the art within a technically meaningful range. This is particularly applicable even beyond the framework of different claim categories.

[0006] The present invention relates to a device for supplying breathing gas, comprising at least one breathing gas line for guiding a breathing gas mixture, the breathing gas line having at least one outlet through which the breathing gas mixture can be at least partially and at least temporarily discharged, the breathing gas line having an intake side branch pipe configured to guide breathing gas to a connection for a patient interface, the breathing gas line having an exhalation side branch pipe configured to guide breathing gas between the connection for the patient interface and the outlet, and in the breathing gas line, at least one shut-off valve is arranged, and the at least one shut-off valve is configured and designed to at least temporarily establish a connection for guiding breathing gas from the exhalation side branch pipe to the intake side branch pipe.

[0007] In some embodiments, the device comprises at least one reservoir for the breathing gas mixture and at least one blower designed to provide conveying energy for the breathing gas mixture, and the reservoir and the blower are arranged inside or on the surface of the intake side branch pipe.

[0008] In some embodiments, the device is characterized in that the shut-off valve is configured and designed as a check valve so as to establish a connection for guiding breathing gas in the flow direction from the exhalation side branch pipe to the intake side branch pipe.

[0009] In some embodiments, the device is characterized in that the shut-off valve is configured and designed as a shut-off check valve so as to at least temporarily shut off the breathing gas line in both flow directions.

[0010] In some embodiments, the device comprises a control device and at least one power supply. In some embodiments, the device is characterized in that a shut-off valve is designed to shut off the breathing gas line in both flow directions when energized by at least one power supply. In some embodiments, the device is characterized in that a shut-off valve is designed to shut off the connection leading breathing gas from the expiratory branch to the inspiratory branch when energized. In some embodiments, the device is characterized in that the breathing gas mixture can be completely discharged from the expiratory branch through the outlet when the shut-off valve is energized.

[0011] In some embodiments, the device is characterized in that the inspiratory and expiratory branch tubes constitute at least a first circulation system when the shut-off valve is de-energized, allowing the respiratory gas mixture to be introduced within the first circulation system, and the respiratory gas mixture can be at least partially discharged through the outlet.

[0012] In some embodiments, the device is characterized by comprising at least one adjustable pressure regulating valve. In some embodiments, the device is characterized by the pressure regulating valve controlling the intake pressure P insp and / or breath pressure P exsp The device is characterized by being designed to adjust the pressure. In some embodiments, the device is characterized in that the pressure regulating valve is manually and / or electrically configurable.

[0013] In some embodiments, the apparatus has an intake pressure P insp The device is characterized by having an APL valve to adjust the breathing gas mixture, and the pressure in the breathing gas line is the inspiratory pressure P. inspThe device is characterized in that it can discharge through the outlet when it exceeds a certain value. In some embodiments, the device is characterized in that the APL valve is designed as an adjustable biased check valve. In some embodiments, the device is characterized in that the APL valve is equipped with a stepping motor that can adjust the APL valve. In some embodiments, the device is characterized in that the valve position of the APL valve is set and / or held when energized. In some embodiments, the device is characterized in that the valve position of the APL valve remains at the last set value when de-energized. In some embodiments, the device is characterized in that the APL valve is manually and / or electrically configurable.

[0014] In some embodiments, the device controls the respiratory pressure P exsp The device is characterized by having a pressure regulating valve that adjusts the end-expiratory positive pressure (PEEP). In some embodiments, the device is characterized in that the pressure regulating valve is located in the expiratory side branch tube. In some embodiments, the device is characterized in that the pressure regulating valve is designed to adjust the end-expiratory positive pressure (PEEP). In some embodiments, the device is characterized in that when the pressure regulating valve is not energized, it adjusts the preset expiratory pressure PEEP. exsp It is characterized by being designed to be passively adjusted to a preset respiratory pressure P of the pressure regulating valve. In some embodiments, the device controls the preset respiratory pressure P of the pressure regulating valve. exsp However, it is characterized by being between 3 hPa and 10 hPa, for example, 5 hPa.

[0015] In some embodiments, the apparatus is characterized in that the respiratory gas mixture contains fresh gas and / or oxygen (O2) and / or a volatile anesthetic. In some embodiments, the apparatus is characterized in that it includes at least one anesthetic supply line for introducing the volatile anesthetic into the respiratory gas line.

[0016] In some embodiments, the device is characterized in that a first pressure acts in the breathing gas line and a second pressure acts in the anesthetic supply line, and the first pressure is less than the second pressure. In some embodiments, the device is characterized in that the second pressure is at least 100 kPa, preferably at least 180 kPa. In some embodiments, the device is characterized in that the first pressure is less than 100 kPa, preferably less than 50 kPa, and particularly preferably less than 10 kPa. In some embodiments, the device is characterized in that the first pressure is less than 8 kPa, preferably less than 5 kPa, and particularly preferably less than 3 kPa. In some embodiments, the device is characterized in that it is operable at room temperature.

[0017] In some embodiments, the apparatus is characterized in that the volatile anesthetic is selected from the group including isoflurane, sevoflurane, desflurane, halothane, enflurane, and methoxyflurane. In some embodiments, the apparatus is characterized in that the volatile anesthetic in the anesthetic supply line can be introduced as a liquid into the breathing gas line. In some embodiments, the apparatus is characterized in that the volatile anesthetic evaporates at an evaporation rate of 0 l / min to 2 l / min when introduced into the breathing gas line. In some embodiments, the apparatus is characterized in that the evaporated volatile anesthetic is mixed with the breathing gas mixture in the breathing gas line.

[0018] In some embodiments, the device is characterized by comprising at least one safety valve designed and configured to shut off the supply of volatile anesthetic. In some embodiments, the device is characterized in that the safety valve is configured as a switching valve. In some embodiments, the device is characterized in that the safety valve is electrically and / or manually configurable. In some embodiments, the device is characterized in that the safety valve is configured as an electrically driven switching valve, and the safety valve is designed to shut off the introduction of volatile anesthetic into the respiratory gas mixture when de-energized.

[0019] In some embodiments, the apparatus is characterized in that the outlet comprises at least one filter. In some embodiments, the apparatus is characterized in that the filter is replaceable. In some embodiments, the apparatus is characterized in that the respiratory gas mixture discharged through the outlet completely passes through the filter. In some embodiments, the apparatus is characterized in that the filter is and / or contains an absorbent and is designed and configured to absorb at least volatile anesthetics and / or their metabolites. In some embodiments, the apparatus is characterized in that the filter comprises activated carbon. In some embodiments, the apparatus is characterized in that a double filter system comprising a first filter and a second filter is arranged at the outlet, the second filter being located downstream of the first filter in the flow direction.

[0020] In some embodiments, the device is characterized by comprising at least one sensor located inside or on the surface of the outlet. In some embodiments, the device is characterized in that the sensor is configured and designed to detect the concentration of a volatile anesthetic and / or its metabolites and transmit it to a control device. In some embodiments, the device is characterized in that the concentration of the volatile anesthetic and / or its metabolites is detectable at least upstream and / or downstream of the first filter in the flow direction and transmitable to a control device.

[0021] In some embodiments, the apparatus is characterized in that the control device is designed to sound an alarm when the concentration of a volatile anesthetic and / or its metabolites exceeds a threshold.

[0022] In some embodiments, the apparatus is characterized by comprising separation means designed to separate at least CO2 from the respiratory gas mixture. In some embodiments, the apparatus is characterized in that the separation means is a chemical separation means and / or a mechanical separation means.

[0023] In some embodiments, the apparatus is characterized in that the chemical separation means includes at least one CO2-binding absorbent selected from the group including calcium hydroxide, sodium hydroxide, potassium hydroxide, barium hydroxide, and soda lime. In some embodiments, the apparatus is characterized in that, when the inspiratory and expiratory branches constitute a circulatory system, the chemical separation means can be passed through by expiratory breathing gas.

[0024] In some embodiments, the device is characterized in that the mechanical separation means is located in the expiratory side branch tube. In some embodiments, the device is characterized in that the mechanical separation means is adjacent to a connection for the patient interface. In some embodiments, the device is characterized in that the separation means comprises at least one diffusion filter, the diffusion filter is configured as a semipermeable membrane and is permeable to at least CO2 molecules. In some embodiments, the device is characterized in that the diffusion filter is impermeable to at least volatile anesthetics.

[0025] In some embodiments, the apparatus is characterized in that the separation means is configured as a two-chamber system comprising at least one first chamber and at least one second chamber, wherein the first and second chambers guide gases and are separated from each other by a diffusion filter. In some embodiments, the apparatus is characterized in that the first chamber is designed to contain expiratory breathing gas and the second chamber is designed to contain sweep gas, wherein the sweep gas has a CO2 concentration at least lower than that of the expiratory breathing gas. In some embodiments, the apparatus is characterized in that the first chamber is designed so that the expiratory breathing gas is guided in the direction of the main flow and the second chamber is designed so that the sweep gas is guided in the direction of the sweep gas flow, wherein the direction of the main flow is opposite to the direction of the sweep gas flow. In some embodiments, the apparatus is characterized in that the CO2 concentration of the sweep gas when introduced into the second chamber is less than 10%, preferably less than 5%, and particularly preferably 0%.

[0026] In some embodiments, the device comprises at least one sweep gas supply line that provides sweep gas to a mechanical separation means, and the sweep gas supply line comprises at least one valve for measuring the sweep gas. In some embodiments, the device is characterized in that the flow rate of the sweep gas is greater than or equal to the flow rate of the expiratory breathing gas. In some embodiments, the device is characterized in that the flow rate of the sweep gas is 0 l / min to 20 l / min, preferably 0 l / min to 10 l / min. In some embodiments, the device is characterized in that the flow rate of the sweep gas is set in relation to the minute ventilation. In some embodiments, the device is characterized in that the flow rate of the sweep gas is 1.1 to 2 times the minute ventilation, preferably 1.2 to 1.5 times the minute ventilation.

[0027] In some embodiments, the device is characterized by comprising at least one valve for measuring fresh gas and / or oxygen O2. In some embodiments, the device is characterized by comprising at least one valve for measuring volatile anesthetics. In some embodiments, the device is characterized in that the metering valve is selected from the group including needle valves, proportional valves, switching valves, throttles, and throttling valves. In some embodiments, the device is characterized in that the metering valve is configured as a needle valve. In some embodiments, the device is characterized in that the metering valve comprises at least one stepping motor, each capable of adjusting the metering valve. In some embodiments, the device is characterized in that the valve position of the metering valve is set and / or held when energized. In some embodiments, the device is characterized in that, when de-energized, the valve position of the metering valve remains at the last set value and / or returns to the open base position. In some embodiments, the device is characterized by comprising at least one sensor for detecting at least one ventilation-specific parameter.

[0028] In some embodiments, the device is characterized in that the ventilation-specific parameters include at least one of the following parameters: inspiratory patient pressure, inspiratory patient flow rate, inspiratory tidal volume, inspiratory minute ventilation, inspiratory respiratory rate, inspiratory O2 concentration, inspiratory CO2 concentration, inspiratory N2O concentration, inspiratory anesthetic gas concentration; expiratory patient pressure, expiratory patient flow rate, expiratory tidal volume, expiratory minute ventilation, expiratory respiratory rate, expiratory O2 concentration, expiratory CO2 concentration, expiratory N2O concentration, expiratory anesthetic gas concentration; gas temperature, gas humidity, fresh gas flow rate, and leakage.

[0029] In some embodiments, the device is characterized by comprising at least one storage unit designed and configured to store ventilation-specific parameters detected at least during respiratory gas supply.

[0030] In some embodiments, the device is characterized in that a memory unit is designed to store patient parameters, the patient parameters including at least one of the following parameters: age, weight, height, body mass index (BMI), and medical history. In some embodiments, the device is characterized in that the sweep gas flow rate can be dynamically adjusted to ventilation-specific parameters and / or patient parameters.

[0031] In some embodiments, the device is characterized by having a respiratory gas line that includes a bypass branching off from the inspiratory branch and joining the expiratory branch between a mechanical separation means and an outlet. In some embodiments, the device is characterized by being designed to at least temporarily establish a connection for guiding respiratory gas from the inspiratory branch to the expiratory branch, such that the bypass constitutes a second circulatory system capable of guiding the respiratory gas mixture. In some embodiments, the device is characterized in that the second circulatory system corresponds at least partially to the first circulatory system, and the connection for the patient interface is located only in the first circulatory system.

[0032] In some embodiments, the apparatus is characterized in that the mechanical separation means is located only in the first circulation system.

[0033] In some embodiments, the device is characterized in that the bypass comprises at least one bypass shut-off valve. In some embodiments, the device is characterized in that the bypass shut-off valve is configured and designed as a check valve to at least temporarily establish a connection that leads breathing gas from the inspiratory branch to the expiratory branch in the flow direction. In some embodiments, the device is characterized in that the bypass shut-off valve is configured and designed as a shut-off check valve that shuts off the bypass at least temporarily in both flow directions. In some embodiments, the device is characterized in that the bypass shut-off valve is designed to shut off the bypass in both flow directions when energized by at least one power source.

[0034] In some embodiments, the apparatus is characterized in that it is possible to guide the breathing gas mixture into a second circulation system, at least partially, when the shut-off valve and bypass shut-off valve are not energized.

[0035] In some embodiments, the device is capable of introducing the respiratory gas mixture by a main flow in a first circulatory system and by a bypass flow in a second circulatory system. In some embodiments, the device is capable of introducing the respiratory gas mixture by a main flow depending on the respiratory phase of the patient receiving ventilation. In some embodiments, the device is capable of introducing the bypass flow independently of the respiratory phase of the patient receiving ventilation.

[0036] In some embodiments, the device is characterized in that at least a bypass flow from a second circulation system is guided through a PEEP valve.

[0037] In some embodiments, the device is characterized by being able to operate in different operating modes. In some embodiments, the device is characterized by being able to operate in an automatic operating mode in which a blower supplies transport energy to the breathing gas mixture. In some embodiments, the device is characterized by being able to operate in a manual operating mode in which a reservoir supplies transport energy to the breathing gas mixture. In some embodiments, the device is characterized in that the reservoir is configured as a manual bag.

[0038] In some embodiments, the device is capable of operating in an operating mode with administration of a volatile anesthetic and / or in an operating mode without administration of a volatile anesthetic, and the safety valve is designed to allow the introduction of a volatile anesthetic into the respiratory gas mixture when energized and to block the introduction of a volatile anesthetic into the respiratory gas mixture when not energized.

[0039] In some embodiments, the device is characterized by being able to operate in an operating mode selected from the group including an anesthetic mode using volatile anesthetics; an anesthetic mode using intravenously administered anesthetics (TIVA mode); a ventilation mode with anesthetics; a ventilation mode without anesthetics; an O2 therapy mode; a high-flow O2 therapy mode (HFOT mode); a CPAP mode; a BiLevel mode; a SIMV mode; and an emergency mode.

[0040] In some embodiments, the device is characterized in that the operating mode can be set manually and / or automatically by a control unit.

[0041] In some embodiments, the device is characterized by being able to operate without power supply and / or with low power consumption in emergency mode. In some embodiments, the device is characterized by being able to automatically switch to emergency mode and / or be manually set. In some embodiments, the device is characterized by automatically switching to emergency mode if the functions of the power supply and / or control device and / or blower are limited or stopped.

[0042] In some embodiments, the device is capable of guiding the breathing gas mixture at least in a first circulation system in an emergency mode and is characterized in that the breathing gas mixture can be at least partially discharged via an outlet. In some embodiments, the device is characterized in that it is capable of guiding the breathing gas mixture in a second circulation system in an emergency mode. In some embodiments, the device is characterized in that the transport energy for the breathing gas mixture is provided by a reservoir in an emergency mode.

[0043] In some embodiments, the device is characterized in that the APL valve is adjusted to the last set inspiratory pressure P insp in an emergency mode. In some embodiments, the device is characterized in that the pressure regulating valve passively regulates the expiratory pressure P exsp in an emergency mode.

[0044] In some embodiments, the device is characterized in that the chemical separation means and / or the mechanical separation means are in an operating state when not energized.

[0045] In some embodiments, the device is characterized in that the safety valve is closed in an emergency mode and the safety valve can be manually opened.

[0046] In some embodiments, the device is characterized in that the metering valve is not energized in an emergency mode, whereby the metering of fresh gas and / or oxygen and / or volatile anesthetic and / or sweep gas is held at the last set value. In some embodiments, the device is characterized in that the valve for metering the sweep gas sets the metering of the sweep gas to 1.2 to 2 times, preferably 1.5 times, the last set minute ventilation volume in an emergency mode. In some embodiments, the device is characterized in that fresh gas and / or oxygen is supplied to the breathing gas mixture via the metering valve in an emergency mode.

[0047] In some embodiments, the apparatus is characterized in that fresh gas and / or oxygen are supplied in at least one pressurized gas cylinder, and the pressure of the pressurized gas cylinders supplies the transport energy to the fresh gas and / or oxygen.

[0048] In some embodiments, the apparatus is characterized in that volatile anesthetics are supplied in at least one tank, and pressure acts on the tanks. In some embodiments, the apparatus is characterized in that the pressure in the tanks is at least 100 kPa, preferably at least 180 kPa. In some embodiments, the apparatus is characterized in that the pressure in the tanks supplies transport energy to the volatile anesthetics.

[0049] In a further embodiment, the present invention relates to a method for introducing at least one volatile anesthetic into a respiratory gas mixture, wherein the respiratory gas mixture is introduced into a respiratory gas line under a first pressure, the volatile anesthetic in the anesthetic supply line is introduced into the respiratory gas line as a liquid under a second pressure, the first pressure is less than the second pressure, and the volatile anesthetic, upon introduction into the respiratory gas line, is exposed to the first pressure and becomes gaseous.

[0050] In the following embodiments, the apparatus 100 according to the present invention is described illustratively. Further features and advantages of the present invention will become apparent in the following description of embodiments based on the drawings. The present invention is not limited to the illustrated embodiments.

[0051] Device 100 is configured for respiratory gas supply. Device 100 has a ventilatory function and / or anesthesia function. Therefore, device 100 can be used as a ventilator or an anesthesia machine. Also, device 100 can be used as both a ventilator and an anesthesia machine. This allows the patient to receive ventilation or respiratory support using device 100, and alternatively or additionally, to be maintained in an anesthetic state.

[0052] A ventilator is understood to be any device that assists the natural breathing of a user or patient, and / or replaces ventilation of a user or patient, and / or provides respiratory therapy, and / or otherwise affects the breathing of a user or patient. As used herein, the term “ventilation” includes all forms of ventilation, respiratory support, or respiratory therapy in the context of the present invention. In some cases, the term “ventilation” also applies herein to anesthesia, i.e., whenever a volatile anesthetic or anesthetic gas is added to the respiratory gas.

[0053] The device 100 can be connected to a user or patient via a patient interface 91. In the context of the present invention, the patient interface 91 is understood as any peripheral device configured for interaction with an individual. The patient interface 91 may be configured as a tracheal tube or tracheal cannula. The patient interface 91 may also be configured as a breathing mask, nasal mask, mask with nasal pads, nasal cannula or oxygen cannula, full-face mask or total face mask. The patient interface 91 is preferably designed and configured to allow the respiratory gas mixture to be supplied and / or discharged without leakage from the device 100 to the patient and / or from the patient to the device 100.

[0054] The drawings show an embodiment of the apparatus according to the present invention. [Brief explanation of the drawing]

[0055] [Figure 1] This is a schematic diagram of the apparatus in the first embodiment. [Figure 1A] This figure shows the device in the first operating mode for manual ventilation accompanied by the administration of a volatile anesthetic, among the various operating modes of the device as illustrated by the first embodiment. [Figure 1B] This figure shows the device in a second operating mode for automatic ventilation accompanied by the administration of a volatile anesthetic, among the various operating modes of the device as exemplified by the first embodiment. [Figure 1C]This figure shows the device in a third operating mode for manual ventilation without the administration of volatile anesthetics, among the various operating modes of the device as illustrated by the first embodiment. [Figure 1D] This figure shows the device in a fourth operating mode for automatic ventilation without the administration of volatile anesthetics, among the various operating modes of the device as illustrated by the first embodiment. [Figure 1E] This figure shows the device in a fifth operating mode for manual ventilation in battery mode and / or fault mode, among the various operating modes of the device as illustrated by the first embodiment. [Figure 1F] This figure shows the apparatus in a sixth operating mode for constant flow rate (HFOT), among the various operating modes of the apparatus as exemplified by the first embodiment, in which the administration of volatile anesthetics can be optionally selected. [Figure 1G] This figure shows the device in the seventh operating mode, which is the service mode, among the various operating modes of the device, using the first embodiment as an example. [Figure 2] This is a schematic diagram of an example supply line configuration. [Figure 3] This is a schematic diagram of a portion of the breathing gas line where an evaporative element connected to the anesthetic module via an anesthetic supply line is located. [Figure 4] This is a schematic diagram of the apparatus in the second embodiment. [Figure 5] This is a schematic diagram of a mechanical separation means equipped with a diffusion filter. [Modes for carrying out the invention]

[0056] Figure 1 shows a schematic configuration of the apparatus 100 in the first embodiment. The apparatus 100 according to the present invention is designed for respiratory gas supply and comprises at least one respiratory gas line 4 that guides a respiratory gas mixture 5. The respiratory gas line 4 comprises at least one outlet 14-A that can at least partially and at least temporarily discharge the respiratory gas mixture 5. The respiratory gas line 4 comprises an inspiratory side branch tube 1 configured to guide respiratory gas to a connection 93 for a patient interface. The respiratory gas line 4 comprises an expiratory side branch tube 2 configured to guide respiratory gas between the connection 93 for a patient interface and the outlet 14-A. The apparatus 100 is characterized in that at least one shut-off valve 28 is provided in the respiratory gas line 4 and is configured and designed to at least temporarily establish a connection that guides respiratory gas from the expiratory side branch tube 2 to the inspiratory side branch tube 1.

[0057] The apparatus 100 according to the present invention can be an anesthesia workstation. The apparatus 100 can be designed to ventilate and / or anesthetize a living organism. To this end, the apparatus 100 can be designed to provide and / or guide, and / or prepare and / or discard a respiratory gas mixture or anesthesia gas mixture. The apparatus 100 is designed and configured to ventilate or anesthetize a living organism mechanically and / or manually. For this purpose, the apparatus 100 comprises at least one respiratory gas line 4 and at least one exhaust system 14.

[0058] The apparatus 100 comprises at least one blower unit 3. The blower unit 3 is designed and configured to generate a respiratory gas flow for patient ventilation and / or anesthesia and to deliver it toward the patient as needed. The blower unit 3 can deliver a respiratory gas mixture 5 for ventilation and / or anesthesia. Thus, the blower unit 3 can supply the energy to deliver the respiratory gas mixture 5. The respiratory gas mixture 5 can be respiratory air from the normal ambient environment, or pure oxygen O2 or oxygen O2-enriched respiratory air. In particular, the respiratory gas mixture 5 may also contain at least one anesthetic A. Thus, the respiratory gas mixture 5 can also be an anesthetic gas in particular. The respiratory gas flow may be delivered from ambient air and / or pressurized gas cylinders and / or the hospital's central gas system (ZGA: zentralen Gasanlage) (not shown).

[0059] The blower unit 3 is preferably configured as at least one blower 3 and may include at least one fan wheel that generates a breathing gas flow. In some embodiments, multiple blowers 3 may be connected in series or in parallel. In alternative embodiments, the device 100 may also include another technical unit that can perform the breathing work or generate transport energy for the breathing gas mixture instead of blowers. In such examples, the blower unit 3 may include, for example, at least one driven bellows or at least one piston motor. Thus, in alternative embodiments, the device 100 may also be operated by a piston motor having, for example, multiple pistons and corresponding valves (not shown). In preferred embodiments, the blower unit 3 can be configured as at least one blower 3. Hereinafter, for simplicity, the blower unit 3 may be simply referred to as blower 3, but this does not exclude the above embodiments comprising multiple blowers, technical units, bellows, or piston motors. For the operation of blower 3, the device 100 may include at least one electrically driven unit (not shown).

[0060] The device 100 can receive power via at least one power supply 103, 104 as shown herein. Preferably, the device can be supplied with energy via the primary power supply 103, and alternatively, via at least one secondary power supply 104. For this purpose, the device 100 may be equipped with a power plug and may also be equipped with a battery and / or capacitor located inside the device.

[0061] Device 100 can be connected to the power grid via a power plug, thereby receiving an energy supply. In this case, the power plug and the power grid can function as a primary power source 103. Alternatively or additionally, the device can be supplied with energy via a battery / capacitor. In this case, the battery / capacitor can function as a secondary power source 104. Thus, device 100 can operate on commercial power and / or battery power.

[0062] The device 100 may include at least one display device (not shown). The display device may be designed as a monitor, such as a touchscreen, for displaying and / or inputting medical data. Multiple monitors may also be arranged.

[0063] The device 100 comprises at least one control device 101 and at least one storage unit 102. The blower 3 is controlled via the control device 101. Typically, the control device 101 controls the blower 3 based on settings stored in the storage unit 102.

[0064] For example, the control device 101 sets the fan wheel to a specific rotational speed or adjusts the fan speed to a target value. In this way, the blower 3 can define the flow rate and / or pressure and / or volume of the breathing gas. In a preferred embodiment, the blower 3 can generate a defined flow rate. In a particularly preferred embodiment, the blower 3 can generate a pressure-independent flow rate. Since the flow rate and pressure can be defined independently of each other, the flow rate can be generated independently of pressure. This has the advantage that various pressure-controlled breathing patterns can be constructed by defining the required flow rate. For example, the target value of the flow rate can be set based on treatment settings and / or sensor signals.

[0065] The device 100 is specifically designed and configured to provide the respiratory gas mixture 5 in the form of a patient flow. The patient flow is used to supply the respiratory gas to the patient. The patient flow may vary depending on the patient's respiratory phase.

[0066] Alternatively or additionally, the device 100 is designed and configured to provide a constant byflow. The byflow may be present regardless of the patient's respiratory phase. The patient flow and the byflow can be configured to run parallel to each other in the respiratory gas line 4.

[0067] The device 100 includes at least one sensor 15, 16, 17, 18, 19, 20, 39. In a preferred embodiment, the device 100 includes a number of sensors 15, 16, 17, 18, 19, 20, 39 (see below).

[0068] The blower 3 can be adaptively controlled. Adaptive control can be performed, for example, based on ventilation parameters identified and analyzed during ventilation. The memory unit 102 is designed to store ventilation-related parameters. These ventilation-related parameters may be ventilation-specific parameters 110 detected during respiratory gas delivery, and / or patient parameters 111 stored in the memory unit 102. The patient parameters 111 can be identified in advance. The patient parameters 111 can also be identified during ventilation. Stored patient parameters 111 can be selected from a group including the patient's age, sex, weight, height, medical history, body fat percentage, body mass index (BMI), ideal weight (BWI), health status, nutritional status, metabolism, tidal volume, indirect calorimetry, etc.

[0069] The blower 3 is equipped with at least one blower outlet 3a. The blower 3 discharges the breathing gas mixture 5 through the blower outlet 3a into at least one breathing gas line 4. The breathing gas mixture 5 is transported through the breathing gas line 4. Here, the blower 3 defines the main stream S of the breathing gas mixture 5, its direction of which is indicated by a dashed line in Figure 1. The breathing gas line 4 is equipped with an inspiratory side branch 1. Furthermore, the breathing gas line 4 may be equipped with an expiratory side branch 2. The breathing gas line 4 may further be equipped with a reservoir line 13.

[0070] The inspiratory branch tube 1 can be configured to guide at least respiratory gas to a connection 93 for a patient interface. The expiratory branch tube 2 can be configured to guide at least respiratory gas between the connection 93 for a patient interface and at least one outlet 14-A. A patient interface can be connected to the connection 93, and a connection to the patient 90 can be established via the patient interface.

[0071] The reservoir line 13 can be considered a component of the inspiratory branch tube 1. The reservoir 12 is pneumatically connected to the breathing gas line 4 via the reservoir line 13. Gas from the reservoir 12 can be introduced at at least one reservoir inlet point 213. The breathing gas line 4 can be pneumatically connected to a discharge system 14 that discharges the breathing gas mixture 5.

[0072] The respiratory gas line 4, comprising an inspiratory branch tube 1 and an expiratory branch tube 2, can be configured at least partially within the device. The respiratory gas line 4, comprising an inspiratory branch tube 1 and an expiratory branch tube 2, can also be configured at least partially outside the device, for example, within a tubing system.

[0073] In the specific embodiment shown in the drawings, the breathing gas line 4 includes a reservoir line 13, an inspiratory branch tube 1, and an expiratory branch tube 2, which are pneumatically connected to each other. The breathing gas line 4 is also pneumatically connected to the exhaust system 14.

[0074] For the introduction of respiratory gases and / or anesthetics to provide the respiratory gas mixture 5, the respiratory gas line 4 is pneumatically connected to at least one fresh gas supply line 7 and / or at least one O2 flush supply line 11 and / or at least one anesthetic supply line 9 and / or nitrogen oxide supply line 44. Here, the supply lines 7, 9, 11, and 44 typically merge into the inspiratory side branch 1 of the respiratory gas line 4. The respiratory gases and / or anesthetics are supplied to the respiratory gas line 4 via the supply lines 7, 9, 11, and 44. Check valves in the supply lines 7, 9, 11, and 44 ensure that there is no possibility of the respiratory gas mixture 5 being discharged through the supply lines 7, 9, 11, and 44.

[0075] The blower 3 is preferably located in the inspiratory branch tube 1. The blower 3 is preferably located downstream of the expiratory branch tube 2. In the inspiratory branch tube 1, the inspiratory breathing gas 5 is normally present. inspThe inspiratory side branch tube 1 can be used to introduce fresh gas and / or oxygen and / or an anesthetic. At least one fan 3 can be placed in the inspiratory side branch tube to define the respiratory gas flow S. Inspiratory respiratory gas 5 is delivered via the inspiratory side branch tube 1. insp This can be delivered to patient 90 via the patient interface.

[0076] In the expiratory branch tube 2, normally, expiratory breathing gas 5 exsp Patient 90 is transported. Patient 90 has expiratory respiratory gas 5 exsp This can be released into the expiratory branch tube 2 via the patient interface. Expiratory breathing gas 5 exsp It can be transported from the patient. Expiratory breathing gas 5 is delivered via the expiratory branch tube 2. exsp This can be transported to a device 40 that separates at least CO2. The expiratory side branch tube 2 can extend at least from the patient interface to the separation means 40, 60.

[0077] The main stream S of the respiratory gas mixture 5 can flow from the blower outlet 3a along the inspiratory branch tube 1 to the connection 93 for the patient interface. From the connection 93, the respiratory gas mixture 5 can flow again along the expiratory branch tube 2 to the inspiratory branch tube 1. For example, the respiratory gas mixture 5 can flow along the expiratory branch tube 2 to the blower inlet of the blower 3, which is not shown in detail here. In this way, the respiratory gas can remain within at least one (essentially) closed first circulatory system K1.

[0078] Therefore, the inspiratory branch tube 1 and the expiratory branch tube 2 can constitute at least a first circulatory system K1 capable of guiding the respiratory gas mixture 5. In this case, the respiratory gas mixture 5 can be at least partially discharged through outlet 14-A. The respiratory gas mixture 5 may be guided by a main flow S within the first circulatory system K1. In addition to patient flow, a constant biflow may also flow, advantageously.

[0079] Biflow offers the advantage that blower 3 does not need to be stopped during operation. Blower 3 is always rotating at its lowest speed. Biflow creates a constant flow in the breathing gas line 4.

[0080] A patient interface 91 can be connected to the connection part 93, and the respiratory gas mixture 5 can be supplied to the patient via the patient interface 91. The respiratory gas mixture 5 can be supplied to the patient 90 via the inspiratory side branch tube 1. For this purpose, the device 100 has at least one interface for connecting a tubing system 92. The respiratory gas mixture 5 can be supplied to the patient 90 via the tubing system 92. For this purpose, the patient interface 91 can be connected to the tubing system 92.

[0081] The tubing system 92 can be a two-tube system and may include at least one inspiratory tube and at least one expiratory tube. In this case, the patient 90 can receive the respiratory gas mixture 5 through the inspiratory tube and patient interface 91 of the tubing system 92 and exhale through the expiratory tube of the tubing system 92. This allows the exhaled gas to be returned to the device 100 through the expiratory tube, and at least one closed circulatory system can be established. A closed circulatory system is established when the exhaled gas is used again for inhalation (after being prepared). When using a two-tube system, the connection part 93 can be configured as a Y-joint, and the inspiratory tube and the expiratory tube can be connected via the Y-joint.

[0082] In some embodiments, the tubing system 92 may be a single-tubing system and may include only an inspiratory tube. In this case, the patient 90 can receive the respiratory gas mixture 5 through the tubing system 92 and the patient interface 91 and exhale into the surrounding environment. In this way, an open circulatory system without expiratory branch tubes can be established.

[0083] In some embodiments, the tubing system 92 may also be a two-tube system, including an inspiratory tube and an expiratory tube, but the respiratory gas does not flow through a closed circulatory system. This system is referred to herein as a semi-open circulatory system. In the context of the present invention, a semi-open circulatory system means that the respiratory gas mixture 5 is supplied to the patient 90 via the inspiratory tube and patient interface 91 of the tubing system 92, and that exhalation can be performed via the expiratory tube of the tubing system 92, with the exhaled gas being released into the surrounding environment through the expiratory tube.

[0084] The device 100 is designed and configured to constitute a closed circulatory system and / or a semi-open circulatory system and / or an open circulatory system, depending on the application of the tubing system and the settings of the device 100. In this way, the respiratory gas line 4 can constitute a closed circulatory system and / or a semi-open circulatory system and / or an open circulatory system, so the device 100 can be used flexibly. Depending on the application, it can be switched between a closed circulatory system, a semi-open circulatory system and an open circulatory system.

[0085] In the context of the present invention, a closed circulating system means that the respiratory gas mixture 5 is introduced in the circulating system through the main stream S, and that oxygen O2 and / or anesthetics and / or other gases, gaseous components, or substances can be supplied or removed.

[0086] Gas exchange takes place in the patient's lungs. Oxygen (O2) is taken into the bloodstream, and carbon dioxide (CO2) is separated. In this way, the patient removes gas or gaseous components from the circulatory system and adds new and / or altered gas or gaseous components to the circulatory system. Therefore, the respiratory gas mixture introduced into the circulatory system must normally be constantly depleted and / or supplied with gas or gaseous components. For example, oxygen (O2) and / or anesthetics and / or other gases can be replenished as consumed. Carbon dioxide (CO2) and / or other unwanted gaseous components can be removed from the circulatory system. In this way, gaseous components can be used and / or removed and disposed of as prescribed.

[0087] Here, the control device 101 and / or the user can adjust / control the proportion of components in the breathing gas mixture 5. For this purpose, fresh gas and / or oxygen O2 and / or anesthetic and / or CO2 are introduced, discharged, or separated.

[0088] The device 100 may be equipped with at least one PAUX port for pneumatic accessories (not shown). Preferably, the device 100 has two or more ports, for example, two, three, or four or more ports. The PAUX ports may be designed and configured to connect ventilation and / or anesthesia-related accessories to the device 100. These accessories may be selected from a group including laryngeal masks, tracheal tubes, cuffs, esophageal catheters, and bladder catheters. These accessories may function using balloons to which flow rate and / or pressure and / or volume may be supplied via the PAUX port. The PAUX ports may be designed and configured to allow automatic testing of the function of the connected accessories. For this purpose, the device 100 may be configured to supply or discharge flow rate and / or pressure to the PAUX ports. Furthermore, sensors may be connected to the PAUX ports to test the function of the accessories.

[0089] To monitor the gas composition of the respiratory gas mixture 5, the apparatus 100 may be equipped with at least one sensor 19. At least one sensor 19 is located inside and / or on the surface of the respiratory gas line 4. The sensor 19 can, for example, detect oxygen concentration and / or CO2 concentration (capnometry) and / or the concentration of one or more anesthetics and / or humidity. Thus, the sensor 19 can be configured as an oxygen sensor and / or a CO2 sensor and / or an anesthetic gas sensor and / or a humidity sensor.

[0090] The device 100 may also optionally or additionally include a multi-gas sensor 20. The multi-gas sensor 20 is designed and configured to detect different gas components in parallel. In a preferred embodiment, the device 100 includes at least one multi-gas sensor 20.

[0091] Sensor 19 and / or multi-gas sensor 20 are placed at least one location in the breathing gas line 4. Sensor 19 and / or multi-gas sensor 20 detect the gas composition of the breathing gas mixture 5. Sensor 19 and / or multi-gas sensor 20 can be placed in the inspiratory side branch 1 and / or expiratory side branch 2 of the breathing gas line 4.

[0092] In the exemplary embodiment shown in the drawings, at least one multi-gas sensor 20 can be positioned at or near the patient interface, immediately upstream of the patient. For example, the multi-gas sensor 20 can be connected to a Y-connector 93 of the tubing system 92. The multi-gas sensor 20 can collect a sample gas at the Y-connector 93 so that inhalation and exhalation values ​​can be measured.

[0093] In some embodiments, the multi-gas sensor 20 can be equipped with a switching valve so that the concentration of the anesthetic can be directly measured at the point of evaporation. This offers a safety advantage when the anesthetic needs to be replaced. It can also be used to expedite the adjustment of the anesthetic concentration. This is advantageous because the total volume of gas in the device and lungs is very large (8 to 9 liters), and the anesthetic must be mixed.

[0094] In some embodiments, sensors 19 can also be placed at multiple locations along the respiratory gas line 4 to monitor the gas composition of the respiratory gas mixture 5 in detail. For example, CO2 sensors and / or O2 sensors can be placed upstream and downstream of the patient, and upstream and downstream of the CO2 separation device, i.e., chemical separation means 40 and / or mechanical separation means 60 (see below). This allows monitoring of the function of the separation means 40 and 60.

[0095] In the exemplary embodiment shown in the drawings, at least one oxygen sensor 19 can be placed immediately downstream of the blower 3 to detect the oxygen concentration.

[0096] The components of the respiratory gas mixture 5 are controlled or adjusted by the control device 101. Stored instructions and / or preset treatment conditions and / or user settings and / or detected sensor signals may be taken into consideration. User settings can be manually performed by the user, such as a healthcare professional. User settings can be performed in advance and / or during ventilation / anesthesia.

[0097] The control device 101 takes into account the detected sensor signals, particularly the sensor signals of at least one CO2 sensor 19 and / or an O2 sensor 19 and / or an anesthetic gas sensor 19 and / or a multi-gas sensor 20. This allows the control device 101 to adaptively adjust the components of the respiratory gas mixture 5 to suit the respective conditions during ventilation or anesthesia.

[0098] Normally, the respiratory gas mixture 5 passes through sensor 19 or multi-gas sensor 20 for measurement and then returns to the circulating system of the respiratory gas line 4. However, it is also possible to remove the respiratory gas mixture 5 from the circulating system to examine its gas components and not return the gas to the circulating system afterward. This may be advantageous for more sensitive evaluation of the measured signal.

[0099] The device may preferably include at least one flow sensor 17, 18 and / or at least one pressure sensor 15, 16, 39. The device 100 may include at least one inspiratory flow sensor 17. At least one inspiratory flow sensor 17 may be located, for example, downstream of the blower 3 in the inspiratory branch pipe 1 of the breathing gas line 4. In the embodiment shown in Figure 1, the inspiratory flow sensor 17 is located between the blower 3 and the O2 flush supply line 11. The inspiratory flow sensor 17 is designed and configured to measure at least one inspiratory flow rate.

[0100] Alternatively or additionally, the device 100 may include at least one inspiratory pressure sensor 15. The at least one inspiratory pressure sensor 15 may be located, for example, downstream of the blower 3 in the inspiratory branch tube 1 of the breathing gas line 4. In the embodiment shown in Figure 1, the inspiratory pressure sensor 15 is located immediately before the patient 90 or the patient interface. The inspiratory pressure sensor 15 is designed and configured to measure at least one inspiratory pressure.

[0101] Alternatively or additionally, the apparatus 100 may include at least one pressure sensor 39. The pressure sensor 39 may be located, for example, inside or on the surface of the reservoir line 13. In the embodiment shown in Figure 1, the pressure sensor 39 is located in the reservoir line 13 adjacent to the reservoir 12. The pressure sensor 39 is designed and configured to measure at least one pressure in the reservoir 12. The bag pressure of the reservoir 12 can be detected via the pressure sensor 39. The pressure sensor 39 can transmit the detected pressure value to the control device 101 in order to monitor the pressure in the reservoir 12.

[0102] Furthermore, the device 100 may include at least one expiratory flow sensor 18. The at least one expiratory flow sensor 18 may be located, for example, in the expiratory branch tube 2 of the respiratory gas line 4. The expiratory flow sensor 18 is designed and configured to measure at least one expiratory flow rate.

[0103] Alternatively or additionally, the device 100 may include at least one expiratory pressure sensor 16. The at least one expiratory pressure sensor 16 may be located, for example, in the expiratory branch tube 2 of the respiratory gas line 4. In the embodiment shown in Figure 1, the expiratory pressure sensor 16 is located immediately downstream of the patient 90 or the patient interface. The expiratory pressure sensor 16 is designed and configured to measure at least one expiratory pressure.

[0104] Flow sensors 17, 18 and / or pressure sensors 15, 16, 39 and / or sensors 19, 20 are configured as measuring devices and are capable of detecting at least one ventilation-specific parameter 110. The ventilation-specific parameter 110 is selected from the group including inspiratory patient pressure, inspiratory patient flow rate, inspiratory tidal volume, inspiratory minute ventilation, inspiratory respiratory rate, inspiratory O2 concentration, inspiratory CO2 concentration, inspiratory N2O concentration, inspiratory anesthetic gas concentration; expiratory patient pressure, expiratory patient flow rate, expiratory tidal volume, expiratory minute ventilation, expiratory respiratory rate, expiratory O2 concentration, expiratory CO2 concentration, expiratory N2O concentration, expiratory anesthetic gas concentration; gas temperature, gas humidity, leakage rate, etc. The ventilation-specific parameter 110 to be detected is not limited to these examples.

[0105] The control device 101 is designed and configured to adaptively adjust the mechanism of action of the device 100 according to the identified and analyzed ventilation parameters.

[0106] In this process, for example, measured values ​​and parameters of accessories such as cuff pressure (seal cuff of the tube), pressure of the gastric or bladder catheter, pressure of the seal portion of the laryngeal mask, leakage rate, resistance value, and bag pressure can also be detected and acquired.

[0107] Based on these ventilation-specific parameters 110, a control device 101 communicating with a measuring device can determine and, in particular, adaptively adapt technical ventilation parameters. These technical ventilation parameters include pressure, flow rate, or volume, as well as the supply of fresh gas and / or oxygen (O2) and / or anesthetics.

[0108] Based on the measurement device, the possibility of a leak can also be detected and transmitted to the control device 101. The device 100 may be equipped with an alarm that can emit an alarm signal when a leak is detected.

[0109] The apparatus 100 may comprise at least one reservoir 12 and at least one reservoir line 13. The reservoir 12 may be configured, for example, as a manual bag. The reservoir 12 may also be configured as a respiratory bellows, either alternatively or additionally. The reservoir 12 can supply transport energy to the respiratory gas mixture 5. The reservoir 12 can be operated manually, in particular by the user. For example, the user can operate the reservoir 12 by squeezing it, thereby providing transport energy to the respiratory gas mixture 5.

[0110] The reservoir 12 is designed and configured to provide volume for the breathing gas mixture 5, particularly for the purpose of pressure monitoring or pressure balancing. For this purpose, the reservoir 12 is pneumatically connected to the breathing gas line 4 via the reservoir line 13. The reservoir 12 can function as both a pressure source and a pressure absorber. Furthermore, the reservoir 12 can function as both a volume source and a volume absorber.

[0111] The reservoir line 13 is designed to allow the flow of the breathing gas mixture 5 toward the reservoir 12. The reservoir line 13 is further designed to allow the flow of the breathing gas mixture 5 toward the reservoir 12. During inspiration, the reservoir 12 can function as a pressure source and / or a volume source. During expiration, the reservoir 12 can function as a pressure absorber and / or a volume absorber.

[0112] The reservoir 12 has a volume sufficient for at least one breath. For example, the reservoir 12 has a volume of at least 250 ml, preferably at least 500 ml, and particularly preferably at least 1 liter. In specific examples, the reservoir has a volume of 1 liter to 5 liters, for example, 2 liters to 2.5 liters.

[0113] Reservoir 12 is specifically designed and configured to supply the volume to be delivered to the blower 3. The majority of the tidal volume delivered to patient 90 can be delivered from reservoir 12 to patient 90 via blower 3. When patient 90 breathes, gas exchange occurs in the lungs, and as a result, the volume decreases with each breath. Therefore, the closed circulatory system must be constantly replenished to at least compensate for the oxygen consumed by breathing.

[0114] In some embodiments, at least one of the O2 flash supply lines 11 of the device 100 can be configured to directly fill the reservoir 12 with oxygen. In this way, an additional safety step can be formed as a large amount of oxygen and / or an oxygen mixture can be rapidly and directly filled into the reservoir 12. This may be particularly advantageous when the device 100 is operating in TIVA mode and / or HFOT mode.

[0115] In some embodiments, the device 100 may include at least one pressure sensor 39. The pressure sensor 39 may be designed and configured to detect the pressure of the reservoir 12. Preferably, the pressure sensor 39 is located inside or on the surface of the reservoir line 13. The pressure sensor 39 may be designed and configured to detect the pressure of the reservoir 12 and transmit it to the control device 101. The filling state of the reservoir 12 can be detected and monitored via the pressure sensor 39.

[0116] The control device 101 can store the maximum and / or minimum pressure of the reservoir 12. An action may be triggered if the pressure in the reservoir 12 falls below a critical level and / or rises above a critical level. For example, an alarm may be triggered. For this purpose, the device 100 may include an alarm (not shown) controlled by the control device 101. The alarm can notify the control device 101 and / or the user, i.e., a medical professional, that the pressure in the reservoir 12 needs to be increased or decreased.

[0117] If the pressure in reservoir 12 falls below the minimum pressure, pressure can be added to reservoir 12. For example, the pressure in reservoir 12 can be increased by controlling or operating the fresh gas module 6 and / or O2 flush 10 to introduce fresh gas and / or oxygen into reservoir 12.

[0118] If the maximum pressure of reservoir 12 is exceeded, the pressure can be released from reservoir 12. For this purpose, the reservoir line 13 is pneumatically connected to the discharge system 14. The discharge system may include at least one overflow valve 25 that can release pressure from reservoir 12. This prevents overfilling of reservoir 12.

[0119] The apparatus 100 may include at least one exhaust system 14 capable of exhausting excess gas, for example, excess respiratory gas mixture 5. The exhaust system 14 may be designed and configured to exhaust at least a portion of the respiratory gas mixture 5 for the purpose of pressure monitoring or pressure balancing. The exhaust system 14 may also be designed and configured to regulate the oxygen concentration and / or anesthetic concentration of the respiratory gas mixture 5.

[0120] The discharge system 14 is configured as a line for guiding gas and is pneumatically connected to the breathing gas line 4. The discharge system 14 has at least one outlet 14-A. The discharge system 14 may have one or more lines, all of which converge to the same outlet 14-A (see Figure 1). Multiple lines may also be connected to multiple outlets 14-A (not shown). The breathing gas mixture 5 can be discharged through the discharge system 14 by flow S3. The direction of flow S3 is always from the breathing gas line 4 towards outlet 14-A.

[0121] In the specific embodiment shown in Figure 1, the discharge system 14 includes, for example, three lines: a first line 14i, a second line 14ii, and a third line 14iii. Lines 14i, 14ii, and 14iii are each pneumatically connected to at least the breathing gas line 4 and converge at outlets 14-A, respectively. In this way, the breathing gas mixture 5 can be discharged from the breathing gas line 4 through at least three different paths. Multiple lines and multiple outlets 14-A are also conceivable. The apparatus 100 is not limited to the illustrated embodiment.

[0122] The breathing gas mixture 5 can be discharged into the surrounding environment via outlet 14-A or remain in the circulation system. For this purpose, the discharge system 14 may optionally be equipped with a pump (not shown here) that can re-guide the breathing gas mixture 5 discharged from outlet 14-A back to the fresh gas module 6 via a line (not shown).

[0123] Outlet 14-A may be equipped with at least one filter 94 (not shown). In a preferred embodiment, outlet 14-A may be equipped with a dual filter system. Multiple filters 94 are also conceivable. The filters 94 are preferably arranged to be replaceable at outlet 14-A. The exhausted respiratory gas can be filtered through the filters 94 at outlet 14-A, thereby preventing substances that may be harmful to the environment or health from being released into the environment unfiltered.

[0124] The filter 94 may include, for example, activated carbon. Activated carbon can function as an absorbent for volatile anesthetics and / or their metabolites and / or other substances. Therefore, the filter 94 can be configured as an activated carbon filter, thereby filtering out volatile anesthetics VA and / or their metabolites and / or other substances that may be harmful to the environment or health from the exhausted respiratory gas mixture 5. Due to absorption, the absorbed substances accumulate in the activated carbon and eventually require replacement or washing to restore filtration performance.

[0125] In a preferred embodiment, at least one sensor 95 (not shown) can be placed inside or on the surface of outlet 14-A. The sensor 95 is preferably positioned downstream of the filter 94 in the flow direction. The sensor 95 can be configured, for example, as an optical sensor and can be designed to detect the anesthetic concentration in the discharged respiratory gas mixture 5 and / or transmit it to the control device 101. In this way, the filtration performance of the activated carbon filter can be determined.

[0126] In exemplary embodiments, a first filter 94i and a second filter 94ii can be positioned inside or on the surface of outlet 14-A. The first filter 94i and the second filter 94ii can constitute a dual filter system with a magazine function that can effectively prevent the outflow of anesthetic. In the dual filter system, for example, two activated carbon filters can be arranged in series. A sensor 95 can be positioned upstream and / or downstream of the first filter 94i. Alternatively or additionally, a sensor can also be positioned upstream and / or downstream of the second filter 94i. Thus, the sensor can detect the anesthetic concentration upstream and downstream of the filter, respectively. If the anesthetic gas concentration downstream of the first filter exceeds a predetermined threshold, the second filter can further filter the respiratory gas mixture.

[0127] Such a dual-filter system equipped with sensors offers the advantage that the first filter only needs to be replaced when it becomes clear that it can no longer filter anesthetic from the breathing gas. The second filter still ensures effective filtration of the breathing gas mixture. This saves on disposal costs and filter material costs.

[0128] Therefore, the discharge system 14 can be designed and configured to dispose of anesthetic gases under control and / or to refurbish them for fresh use.

[0129] The apparatus 100 is designed and configured to allow the respiratory gas mixture 5 to be introduced within a closed circulating system. This has the advantage that volatile anesthetics VA, which are primarily harmful to the environment and climate, remain within the system and are not released into the surrounding environment uncontrolled. Furthermore, the apparatus 100 according to the present invention enables the economical and therefore cost-effective use of anesthetics, as unused anesthetics can be reused without being released into the surrounding environment.

[0130] Since the patient's exhaled breath remains in the respiratory gas line 4 of the closed circulatory system, it becomes necessary to remove carbon dioxide (CO2) from the respiratory gas mixture 5. For this reason, the device 100 is equipped with at least one separation means 40, 60 for separating CO2 from the respiratory gas mixture 5.

[0131] In the first embodiment shown in Figure 1, the apparatus comprises at least one separation means 40. The separation means 40 can be configured as a chemical CO2 absorber. To this end, the separation means 40 may include one or more chemically acting absorbents that bind CO2. The separation means 40 is also referred to herein as the chemical separation means 40. The separation means 60 is also referred to herein as the mechanical separation means 60 (see below).

[0132] The chemical absorbent can be selected from the group including calcium hydroxide, sodium hydroxide, potassium hydroxide, and barium hydroxide. For example, a mixture of one or more of these components is used in the form of soda lime, through which the post-exhaled respiratory gas mixture 5 is passed. A chemical reaction between the chemical absorbent and CO2 results in the binding of CO2 and the production of water (H2O). This reaction is exothermic and can produce temperatures of 60°C to 70°C. Since the chemical absorbent also binds to some of the anesthetic, the anesthetic concentration can be monitored downstream of the separation means 40, allowing for additional administration of the anesthetic as consumed. The CO2 binding of the chemical separation means 40 is highly sensitive and exhibits activity even at very low CO2 concentrations in the respiratory gas mixture 5.

[0133] Due to the chemical absorption of CO2, water is generated in the chemical absorber, and the respiratory gas mixture 5 after passing through the chemical separation means 40 is enriched with H2O. For this reason, the apparatus 100 may be equipped with a humidity control module 41. The humidity control module 41 is designed and configured to control the humidity of the respiratory gas mixture 5. The humidity control module 41 can be designed, for example, as a cold trap and may include a water reservoir that can capture and discard any excess water produced.

[0134] Optionally, the apparatus 100 may be equipped with one or more humidity sensors (not shown). Humidity sensors are particularly advantageous when the apparatus 100 operates in conjunction with the chemical separation means 40. The humidity sensors can be designed and configured to measure the humidity of the respiratory gas mixture 5 and provide feedback to the control device 101 and / or humidity control module 41. The humidity sensors are preferably located in the inspiratory side branch tube 1 and can measure the humidity of the respiratory gas mixture 5 on the inspiratory side.

[0135] To introduce fresh gas and / or oxygen (O2) and / or anesthetics, the apparatus 100 may comprise at least one module 6, 8, 10. Modules 6, 8, 10 are connected to the breathing gas line 4 via at least one supply line 7, 9, 11, respectively. The supply lines may be pneumatically connected to the breathing gas line 4 and may be open at all times or open and / or closed under the control of valves. Modules 6, 8, 10 may function as pressure sources and / or volume sources, and the breathing gas line 4 may function as a pressure absorber and / or volume absorber.

[0136] The apparatus 100 may comprise at least one fresh gas module 6 and at least one fresh gas supply line 7. Fresh gas can be added to the breathing gas mixture 5 via the fresh gas supply line 7. For this purpose, the fresh gas supply line 7 is pneumatically connected to the breathing gas line 4. The fresh gas can be introduced at at least one fresh gas introduction point 207.

[0137] In the context of the present invention, fresh gas includes any fluid, breathing gas, and / or gas mixture suitable for and usable for respiration, ventilation, and / or respiratory therapy. Fresh gas may be, for example, supplied ambient air, or a gas mixture of ambient air and an additive gas, or the additive gas alone. Fresh gas may also be supplied directly from ambient air and / or taken in from a pressurized gas cylinder and / or a hospital's central gas system (ZGA). Fresh gas may also be oxygen or oxygen-enriched air. In some embodiments, fresh gas may also include at least one anesthetic gas.

[0138] The fresh gas supply line 7 typically connects to the inspiratory side branch pipe 1 of the breathing gas line 4. Fresh gas can be introduced into the breathing gas line 4 either upstream or downstream of the blower 3.

[0139] The oxygen-containing gas mixture and / or oxygen can be introduced into the breathing gas line 4 via the fresh gas module 6 to maintain or control the oxygen concentration of the breathing gas mixture 5. Within the breathing gas line 4, the breathing gas mixture 5 is transported, and fresh gas is supplied to the breathing gas mixture 5 via the fresh gas module 6, thus enabling it to be enriched with oxygen.

[0140] The oxygen content of the respiratory gas mixture 5 is controlled or regulated by the control device 101. The control or regulation of the oxygen content of the respiratory gas mixture 5 can be performed automatically based on detected sensor signals. The control or regulation of the oxygen content of the respiratory gas mixture 5 can also be performed manually, for example, by a user such as a healthcare professional. This allows healthcare professionals to supply fresh gas or oxygen to patients under ventilation and / or anesthesia as needed at any time.

[0141] The introduction of oxygen can be adjusted so that the oxygen concentration in the respiratory gas mixture 5 is typically in the range of 10% to 60%, preferably 20% to 50%. An oxygen saturation of 40% to 50% can usually be used for continuous ventilation and / or anesthesia.

[0142] In a preferred embodiment shown in the drawings, fresh gas is introduced into the breathing gas mixture 5 upstream of the blower 3. To this end, at least one fresh gas supply line 7 merges with the breathing gas line 4 upstream of the blower 3.

[0143] In some embodiments, fresh gas can be introduced at two or more locations in the breathing gas line 4, for example, at least two locations. For example, the device 100 can be designed so that the fresh gas module 6 can be connected to the breathing gas line 4 via at least two supply lines 7i, 7ii.

[0144] In a specific embodiment shown in Figure 1, the fresh gas supply line 7 can be branched into at least two fresh gas supply lines 7i, 7ii, i.e., a first fresh gas supply line 7i and a second fresh gas supply line 7ii.

[0145] The first fresh gas supply line 7i and the second fresh gas supply line 7ii can be pneumatically connected to the breathing gas line 4. Preferably, the first fresh gas supply line 7i and the second fresh gas supply line 7ii can merge into the breathing gas line 4 at different points.

[0146] In some embodiments, fresh gas supply lines 7i and 7ii can simultaneously introduce fresh gas into the breathing gas line, respectively (not shown).

[0147] In a preferred embodiment, the fresh gas supply lines 7, 7i, and 7ii can be adjusted via at least one fresh gas switching valve 32 so that only one of the fresh gas supply lines 7i or 7ii can introduce fresh gas into the breathing gas line.

[0148] The fresh gas switching valve 32 allows adjustment of which of the fresh gas supply lines 7, 7i, or 7ii is used to introduce fresh gas into the breathing gas line 4. Therefore, the introduction point of fresh gas into the breathing gas line 4 can be adjusted via the fresh gas switching valve 32.

[0149] The fresh gas switching valve 32 can be switched electronically and / or mechanically. The fresh gas switching valve 32 can be switched automatically by the control device 101 and / or manually by the user.

[0150] The fresh gas switching valve 32 can be configured as a monostable or bistable directional valve. In a preferred embodiment, the fresh gas switching valve 32 is configured as a monostable directional valve. For example, the fresh gas switching valve 32 comprises an electromagnetic coil and a spring, and the valve can be switched by the interaction of these. When the electromagnetic coil is energized, the valve 32 actively moves to a first switching position. When not energized, the electromagnetic coil is in a non-operating state, the spring relaxes, and the valve moves to a second switching position. When not energized, the valve 32 is in its basic position. As can be seen from Figure 1, when the valve 32 is in its basic position, i.e., when not energized, fresh gas is introduced through the first fresh gas supply line 7i. When the valve 32 is energized, the second fresh gas supply line 7ii is activated.

[0151] In the exemplary embodiment shown in Figure 1, the fresh gas module 6 is connected to a fresh gas supply line 7. The fresh gas supply line 7 is connected to a fresh gas switching valve 32. The fresh gas switching valve 32 can be configured, for example, as a 2 / 3 directional valve and thus can have three ports and two switching positions. The fresh gas switching valve 32 can then be connected to a first fresh gas supply line 7i and a second fresh gas supply line 7ii, and depending on the switching position, fresh gas from the fresh gas module 6 can be supplied to either the first fresh gas supply line 7i or the second fresh gas supply line 7ii.

[0152] In the exemplary embodiment shown in Figure 1, the first fresh gas supply line 7i and the second fresh gas supply line 7ii merge into the breathing gas line 4 at different points. Therefore, the device 100 can be designed to adjust the point at which fresh gas is introduced into the breathing gas line 4.

[0153] For example, the first fresh gas supply line 7i can merge with the breathing gas line 4 upstream of the first check valve 21 in the flow direction. For example, the second fresh gas supply line 7ii can merge with the breathing gas line 4 downstream of the first check valve 21 in the flow direction. For example, the second fresh gas supply line 7ii can merge with the breathing gas line 4 between the first check valve 21 and the evaporator element 8a (Figure 1).

[0154] In alternative embodiments, the apparatus 100 may also be configured with at least two 2 / 2 type fresh gas directional valves instead of the 2 / 3 type fresh gas directional valve 32. For example, the first fresh gas supply line 7i may be configured with a first fresh gas directional valve which can be configured as a 2 / 2 type directional valve having two ports and two switching positions. For example, the second fresh gas supply line 7ii may be configured with a second fresh gas directional valve which can similarly be configured as a 2 / 2 type directional valve which can also have two ports and two switching positions (not shown).

[0155] Next, the 2 / 2 directional valve can be connected in parallel by the control device 101, and either the first fresh gas supply line 7i or the second fresh gas supply line 7ii can be opened to introduce fresh gas into the breathing gas mixture 5.

[0156] Alternatively or additionally, the apparatus 100 may include at least one oxygen module 10. The oxygen module 10 may be configured as an O2 flash 10 and may include at least one O2 flash supply line 11. Oxygen O2 or an oxygen-containing gas mixture can be introduced into the breathing gas line 4 via the O2 flash supply line 11. For this purpose, the O2 flash supply line 11 is pneumatically connected to the breathing gas line 4. Oxygen can be introduced at at least one O2 flash introduction point 211.

[0157] Oxygen can be supplied from pressurized gas cylinders and / or the hospital's central gas system (ZGA). The device 100 is preferably connected to the central gas system (ZGA) and includes additional connections to at least one pressurized gas cylinder. Therefore, oxygen can be supplied from either the central gas system (ZGA) or the pressurized gas cylinders. This ensures an oxygen supply via the pressurized gas cylinders for at least a certain period of time, even in the event of a failure of the central gas system.

[0158] The O2 flush 10 can be configured and designed so that a user, such as a healthcare worker, can quickly fill the respiratory gas line 4 (circulation section) and / or reservoir 12 with oxygen.

[0159] O2 Flash 10 can be used for the following purposes: - Refill the breathing gas line 4 and / or reservoir 12, which became empty after the leak. - Wash the anesthetic out of the patient's lungs. - The patient is ventilated with pure oxygen for a certain period of time.

[0160] In particular, the O2 flush of the oxygen module 10 is configured and designed to rapidly fill the breathing gas line 4 and / or reservoir 12 and / or the patient's lungs with oxygen in an emergency. The flow rate of oxygen or oxygen-containing gas mixture may be, for example, 60 l / min. A particularly high flow rate is advantageous, as it allows the breathing gas line 4 and / or reservoir 12 to be quickly refilled after a leak and / or anesthetic to be rapidly flushed out.

[0161] The respiratory gas line 4 and / or reservoir 12 may become empty due to leakage, intentionally or unintentionally, for example, after tube replacement, filter replacement, sensor replacement, or improper use of the tube system 92 or patient interface 91. In such cases, the loss of respiratory gas mixture 5 in the respiratory gas line 4 and / or reservoir 12 cannot be replenished quickly enough by the normal fresh gas flow rate. Therefore, O2 flushing allows for the rapid refilling of the respiratory gas line 4 and / or reservoir 12 with breathable gas.

[0162] Furthermore, via the O2 flush, the patient can be ventilated with undiluted oxygen for at least a short time, for example, over several breaths, as needed. The patient can be supplied with at least 90% oxygen, preferably at least 93%, via the O2 flush. Through the O2 flush of the oxygen module 10, oxygen can be supplied directly from the supply source (i.e., a central gas system or pressurized gas cylinder) to the breathing gas line 4 without dilution.

[0163] Oxygen introduction via O2 flush 10 can adjust the oxygen concentration of the respiratory gas mixture 5 to a maximum of 100% for at least a specified short period of time. During surgery, it may be necessary to ventilate with up to 100% oxygen for a short period of time. For example, during the induction of anesthesia, the patient is ventilated with up to 100% oxygen for a short period of time.

[0164] Oxygen introduction via O2 flush 10 can also be used to adjust the oxygen concentration of the respiratory gas mixture 5 to, for example, at least 60% for at least a specified short time. To flush out the anesthetic, an oxygen saturation of 60% or more, preferably 80% or more, and particularly preferably at least 90% can be used. During surgery, situations may arise where the anesthetic must be rapidly removed from the patient's body, for example, if the patient has an allergic reaction to the anesthetic, such as developing malignant hyperthermia. To rapidly remove the anesthetic from the patient's lungs, lavage with pure oxygen or high-concentration oxygen can be performed. Oxygen lavage of such a patient's lungs can rapidly reduce the concentration of the anesthetic.

[0165] The O2 flush supply line 11 can merge with the inspiratory side branch pipe 1 of the breathing gas line 4. Oxygen can be introduced upstream or downstream of the blower 3. In a preferred embodiment shown in the drawings, oxygen can be introduced into the breathing gas mixture 5 downstream of the blower 3. Therefore, the O2 flush supply line 11 merges with the breathing gas line 4 downstream of the blower 3. This has the advantage that the oxygen-enriched breathing gas mixture 5 does not pass through the blower 3, thereby increasing safety. If the oxygen concentration in the blower 3 is too high, it may lead to problems such as short circuits, fires, or damage to individual components of the blower 3. In some embodiments, there may be multiple O2 flush supply lines 11 that can merge with the breathing gas line 4 at different locations.

[0166] In some embodiments, oxygen can be introduced at two or more locations, for example, at least two locations, in the breathing gas line 4 via the O2 flush 10. For example, the device 100 can be designed so that the O2 flush 10 can be connected to the breathing gas line 4 via at least two O2 flush supply lines 11i, 11ii.

[0167] In a preferred embodiment shown in the drawings, the O2 flash can be introduced into the breathing gas mixture 5 upstream of the blower 3 and / or downstream of the blower 3. Therefore, at least one O2 flash supply line 11 joins the breathing gas line 4 upstream of the blower 3 and / or downstream of the blower 3.

[0168] In some embodiments, the oxygen from the O2 flush 10 can be introduced at two or more locations in the breathing gas line 4, for example, at least two locations. For example, the device 100 can be designed so that the O2 flush 10 can be connected to the breathing gas line 4 via at least two O2 flush supply lines 11i, 11ii.

[0169] In a specific embodiment shown in Figure 1, the O2 flash supply line 11 can be branched into at least two O2 flash supply lines 11i, 11ii, i.e., a first O2 flash supply line 11i and a second O2 flash supply line 11ii.

[0170] The first O2 flush supply line 11i and the second O2 flush supply line 11ii can be pneumatically connected to the breathing gas line 4. Preferably, the first O2 flush supply line 11i and the second O2 flush supply line 11ii can merge into the breathing gas line 4 at different points.

[0171] In some embodiments, the O2 flash supply lines 11i and 11ii can simultaneously introduce oxygen into the breathing gas line 4, respectively (not shown).

[0172] In a preferred embodiment, the O2 flash supply lines 11, 11i, and 11ii can be adjusted via at least one O2 flash switching valve 31 so that only one of the O2 flash supply lines 11i or 11ii can introduce oxygen into the breathing gas line 4. The O2 flash switching valve 31 can be used to adjust which of the O2 flash supply lines 11, 11i, or 11ii introduces oxygen into the breathing gas line 4. Thus, the point at which oxygen is introduced into the breathing gas line 4 can be adjusted via the O2 flash switching valve 31.

[0173] The O2 flush switching valve 31 can be configured as a monostable or bistable directional valve. In a preferred embodiment, the O2 flush switching valve 31 is configured as a monostable directional valve comprising an electromagnetic coil and a spring, similar to the fresh gas switching valve 32. When the electromagnetic coil is energized, the valve 31 actively moves to a first switching position. When not energized, the electromagnetic coil is inactive, the spring relaxes, and the valve moves to a second switching position. When not energized, the valve 31 is in its basic position.

[0174] The O2 flush switching valve 31 can be switched electronically and / or mechanically. The O2 flush switching valve 31 can be switched automatically by the control device 101 and / or manually by the user. In particular, the O2 flush switching valve 31 can be switched manually so that the user (healthcare worker) can supply oxygen as needed and determine the introduction position into the breathing gas line 4.

[0175] As can be seen in Figure 1, when valve 31 is in its basic position, i.e., when it is not energized, oxygen is introduced through the first O2 flush supply line 11i. When valve 32 is energized, the second O2 flush supply line 11ii is activated.

[0176] In the exemplary embodiment shown in Figure 1, the O2 flash 10 is connected to an O2 flash supply line 11. The O2 flash supply line 11 is connected to an O2 flash switching valve 31. The O2 flash switching valve 31 is configured, for example, as a 2 / 3 directional valve and can therefore have three ports and two switching positions. The O2 flash switching valve 31 can then be connected to a first O2 flash supply line 11i and a second O2 flash supply line 11ii, and depending on the switching position, oxygen from the O2 flash 10 can be supplied to either the first O2 flash supply line 11i or the second O2 flash supply line 11ii.

[0177] In the exemplary embodiment shown in Figure 1, the first O2 flush supply line 11i and the second O2 flush supply line 11ii merge into the breathing gas line 4 at different points. Therefore, the device 100 can be designed to adjust the oxygen introduction point into the breathing gas line 4.

[0178] For example, the first O2 flush supply line 11i can merge with the breathing gas line 4 downstream of the blower 3 in the flow direction. In some embodiments, it may be particularly advantageous if the O2 flush supply line 11 merges with the breathing gas line 4 as close to the patient as possible.

[0179] For example, the second O2 flush supply line 11ii can merge with the breathing gas line 4 upstream of the blower 3 in the flow direction. For example, the second O2 flush supply line 11ii can merge with the breathing gas line 4 upstream of the first check valve 21 in the flow direction (Figure 1).

[0180] In alternative embodiments, the device 100 may also be configured with at least two 2 / 2 directional valves 31 instead of the 2 / 3 directional valve 31 (not shown). For example, the first O2 flush supply line 11i may be configured with a first O2 flush switching valve which can be configured as a 2 / 2 directional valve having two ports and two switching positions. For example, the second O2 flush supply line 11ii may be configured with a second O2 flush switching valve which can similarly be configured as a 2 / 2 directional valve having two ports and two switching positions.

[0181] Next, both 2 / 2 directional valves can be connected in parallel by the control device 101, and either the first O2 flash supply line 11i or the second O2 flash supply line 11ii can be opened to introduce oxygen for the O2 flash into the breathing gas mixture 5.

[0182] The apparatus 100 may optionally include a separate nitrogen oxide module 43 and at least one nitrogen oxide supply line 44 (not shown). Nitrogen oxides, such as nitrous oxide (N2O), can be used, for example, to enhance anesthesia and / or relieve pain. For this purpose, nitrous oxide (N2O) may be administered in addition to at least one volatile anesthetic. The nitrogen oxide module 43 may be designed and arranged in the apparatus in parallel and equivalent to the fresh gas module 6 and / or the oxygen module 10. The nitrogen oxide module 43 may be provided with a separate nitrogen oxide supply line 44. In some embodiments, nitrogen oxides (nitrous oxide) can be introduced into the respiratory gas line 4 together with fresh gas and / or another anesthetic. The nitrogen oxide supply line 44 may be equipped with an additional safety valve to monitor the nitrogen oxide concentration. In the event of failure of the oxygen module 10 and / or the fresh gas module 6, the nitrogen oxide supply can be quickly and reliably shut off via the additional safety valve.

[0183] The supply lines, particularly the fresh gas supply line 7, the O2 flash supply line 11, and the nitrogen oxide supply line 44, may each be equipped with at least one element to ensure the functionality and safety of the supply lines 7, 11, and 44. These elements may be provided in single or multiple configurations, and their arrangement may also vary. The supply lines 7, 11, and 44 may have the same configuration or may differ from each other. In particular, the fresh gas supply line 7, the O2 flash supply line 11, and the nitrogen oxide supply line 44 may, in principle, have substantially the same configuration.

[0184] Figure 2 schematically shows an exemplary configuration of supply lines 7, 11, 44, and 71.

[0185] Oxygen and / or oxygen-containing gas mixtures and / or fresh gas and / or nitrogen oxides can each be taken in from at least one supply source 89. For safety reasons, it is preferable to have at least two supply sources 89. For example, oxygen and / or oxygen-containing gas mixtures and / or fresh gas and / or nitrogen oxides can each be taken in from at least one pressurized gas cylinder 89 and / or gas equipment, such as the central gas equipment ZGA of a hospital, and introduced into the respiratory gas line 4 via supply lines 7, 11, and 44, respectively.

[0186] In an advantageous embodiment, fresh gas, oxygen, and nitrogen oxides can be taken in from both the ZGA and the pressurized gas cylinder 89. In this case, the apparatus 100 comprises at least two supply lines 7, 11, and 44. Thus, oxygen can be supplied to the breathing gas line 4 via a first supply line 11 from the ZGA and optionally via a second supply line 11 from the pressurized gas cylinder 89. Similarly, fresh gas can be supplied to the breathing gas line 4 via a first supply line 7 from the ZGA and optionally via a second supply line 7 from the pressurized gas cylinder 89. Likewise, nitrogen oxides can be supplied to the breathing gas line 4 via a first supply line 44 from the ZGA and optionally via a second supply line 44 from the pressurized gas cylinder 89. In this case, the control device 101 can control the supply lines 7, 11, and 44 to prioritize the supply from the ZGA, respectively. The gas supply from the pressurized gas cylinder 89 is activated only when the ZGA fails or when it is no longer usable or can no longer be used for other reasons. Therefore, the pressurized gas cylinder 89 can be used, for example, as an emergency backup. Similarly, it is conceivable to have multiple pressurized gas cylinders 89.

[0187] Each of the supply lines 7, 11, and 44 may be equipped with at least one filter 82. The filter 82 is designed and configured to filter out any solid particles that may be present in the introduced fluid. The filter 82 is designed as an optional safety element. It is preferable that the filter 82 be positioned immediately downstream of the supply source 89. Optionally and additionally, a water separator and / or oil separator may be further positioned inside or on the surface of the supply lines 7, 11, and 44 (not shown).

[0188] At least one sensor 84, 85 can be placed inside or on the surface of each of the supply lines 7, 11, and 44. Sensors 84, 85 can be designed and configured to detect or monitor the pressure and / or volume and / or flow rate in the supply lines 7, 11, and 44. For example, at least one pressure sensor 84 can be placed in each of the supply lines 7, 11, and 44. The pressure sensor 84 can detect how much pressure and / or volume is being drawn from the pressurized gas cylinder 89. The filling level of the pressurized gas cylinder 89 can be monitored via the pressure sensor 84 and transmitted to the control device 101. If the filling level falls below a critical level, an alarm can be issued. For this purpose, the device may include an alarm (not shown) controlled by the control device 101.

[0189] The pressure sensor 84 can preferably be placed immediately downstream of the pressurized gas cylinder 89 and the filter 82. For example, at least one flow sensor 85 can be placed in each of the supply lines 7, 11, and 44. The flow sensor 85 can detect the gas flow rate in the supply lines 7, 11, and 44. The flow rate in the supply lines 7, 11, and 44 can be monitored via the flow sensor 85 and transmitted to the control device 101. The flow sensor 85 can preferably be placed upstream immediately before the confluence with the breathing gas line 4. By using the flow sensor 85, fine adjustment of the flow rate can be achieved.

[0190] At least one pressure regulator 80 and / or throttling section 81 can be placed inside or on the surface of each of the supply lines 7, 11, and 44. The pressure regulator 80 can be configured as a pressure reducer 80. The pressure reducer 80 and / or throttling section 81 can be designed to adjust the pressure from the supply source 89 so that the pressure is reliably below a minimum specified supply pressure. The supply pressure of the central gas supply equipment and pressurized gas cylinders can fluctuate significantly. However, the metering valve for the gas requires a constant pre-supply pressure because its characteristic curve depends on the pre-supply pressure. Therefore, the pressure regulator 80 and / or throttling section 81 adjust the pressure to a value below a minimum specified supply pressure. This ensures that the metering valve always operates the same way.

[0191] The pressurized gas cylinder 89 may have a pressure of up to approximately 20 MPa. The pressure reducer 80 and / or throttling section 81 are designed and configured to adjust the pressure from the pressurized gas cylinder 89 to at least half, preferably at least one-quarter, and particularly preferably at least one-tenth, of the pressure originally present in the pressurized gas cylinder 89. For example, the pressure reducer 80 and / or throttling section 81 are designed and configured to adjust a pressure of approximately 20 MPa to preferably typically 450 ± 50 kPa. The pressure reducer 80 and / or throttling section 81 may be designed and configured to set the pressure to be less than the minimum operating pressure of the device 100.

[0192] At least one valve 83, 86, 87, 88, 31, 32 may be placed inside or on the surface of each of the supply lines 7, 11, and 44. Each of the supply lines 7, 11, and 44 preferably has at least one overpressure valve 83, preferably at least two overpressure valves 83. The overpressure valves 83 may be designed and configured as open pressure valves to release the corresponding gas from the supply lines 7, 11, and 44 when the pressure in the supply lines 7, 11, and 44 becomes too high.

[0193] A first overpressure valve 83 may be positioned downstream of the pressure regulator 80 and / or the throttling section 81. The first overpressure valve 83 may be designed and configured to release pressure. This provides special protection in the event that the pressure regulator 80 fails and the pressure from the supply source 89 becomes too high in the supply lines 7, 11, and 44.

[0194] In some embodiments, at least one second overpressure valve 83 can be provided in the supply lines 7, 11, and 44. For example, the second overpressure valve 83 can be provided just upstream of the inlet to the breathing gas line 4. The overpressure valve 83 provides the added benefit of safety. Excess gas can be discharged into the ambient environment. In some embodiments, excess gas can be intentionally discharged and reused (not shown).

[0195] The overpressure valve 83 and the throttling section 81 are designed and configured to limit the maximum flow rate. In particular, the overpressure valve 83 and the throttling section 81 can limit the maximum flow rate in the event of a malfunction. If the pressure regulator 80 malfunctions, i.e., if the pressure regulator 80 allows all the gas from the supply source 89 to pass through, the overpressure valve 83 can discharge the excess gas. In the event of a malfunction of the pressure regulator 80, the throttling section 81 can be designed to limit the maximum flow rate in order to protect the overpressure valve 83 and discharge the flow rate of the overpressure valve 83.

[0196] Furthermore, it is preferable that each of the supply lines 7, 11, and 44 is provided with at least one check valve 86. In some embodiments, the check valve 86 can be configured as a simple check valve. In a preferred embodiment, the check valve is configured as a spring-forced check valve 86. The check valve 86 controls the flow direction in the supply lines 7, 11, and 44 and is designed in particular to prevent gas from flowing back into the supply source 89. The check valve 86 ensures that the supply source 89 is not contaminated by the breathing gas mixture 5 from the breathing gas line 4.

[0197] Each supply line 7, 11, 44, and 71 may further comprise at least one switching valve 87, 31, 32 and / or at least one metering valve 88, 88i, respectively. The switching valves 87, 31, 32 and / or the metering valves 88, 88i may be configured as bistable valves in a preferred embodiment. The metering valves 88, 88i may be configured, for example, as needle valves.

[0198] The bistable switching valve 87 and / or metering valve 88 are preferably positioned upstream of the confluence with the breathing gas line 4 and designed to control the supply line and / or the amount supplied to the breathing gas line 4. For example, the bistable switching valve 87 and / or metering valve 88 can control the flow rate and / or volume and / or pressure introduced into the breathing gas line 4. In some embodiments, the flow rate can be controlled in particular via the bistable switching valve 87 and / or metering valve 88.

[0199] For example, at least one switching valve 87 can be provided in each of the supply lines 7, 11, and 44. For example, at least one switching valve 87 in each of the supply lines 7, 11, and 44 can be configured as, for example, a bistable valve.

[0200] For example, the fresh gas supply line 7 may have at least one bistable switching valve 87. Furthermore, the nitrogen oxide supply line 44 may have at least one bistable switching valve 87. Furthermore, the O2 flash supply line 11 may have at least one bistable switching valve 87. It is preferable that all supply lines 7, 11, and 44 are equipped with at least one bistable switching valve 87. The bistable switching valves 87 may each be located downstream immediately after the check valve 86.

[0201] The bistable switching valve 87 is preferably switchable between an open position and a closed position. The open position allows gas flow to pass through without restriction. The closed position can hermetically shut off the supply line and prevent gas flow within the supply line. The bistable switching valve 87 is preferably switchable from the open position to the closed position. The position of the bistable switching valve 87 can be controlled by the control device 101.

[0202] The position of the switching valve 87 allows adjustment of which of lines 7, 11, and 44 are opened and which are closed. Therefore, the position of the switching valve 87 allows adjustment of which supply source the gas is introduced into the breathing gas line 4. For example, the position of the switching valve 87 allows adjustment of whether each gas is introduced into the breathing gas line 4 from the ZGA, from a pressurized gas cylinder, or not introduced at all.

[0203] The bistable switching valve 87 can be designed to require energization for switching between the open and closed states, and vice versa. In this case, the switching energy can be selected to be very small. Therefore, the bistable switching valve 87 can remain open or closed without requiring additional energy. Thus, the bistable switching valve 87 can remain in a given position without energization. This has the advantage that in emergencies such as a power outage or reduced available power, a software crash, or other technical failure, the last selected function and setting can be retained, and ventilation can continue. The bistable switching valve 87 can be further designed to be manually switchable. Thus, a state that allows medical staff to respond in emergencies is maintained.

[0204] Device 100 also allows for manual ventilation to ensure patient safety. In the event of a power supply and / or software failure, device 100 switches to a state where the user can administer emergency treatment to the patient by manual ventilation without user intervention. In this state, pressure changes must be possible. Fresh gas must continue to flow, and CO2 must be absorbed and / or diffused and removed. For this reason, all valves in the oxygen module 10 and / or fresh gas module 6 remain in their last switching position in the event of a power supply or software failure.

[0205] In some embodiments, the bistable switching valve 87 can be designed and configured so that it remains in the closed position only when energy consumption is involved. Therefore, gas can be introduced into the breathing gas line 4 only when the bistable switching valve 87 is not energized. This has the advantage that gas introduction into the breathing gas line 4 is guaranteed even in emergencies, such as during a power outage. In this way, it can be ensured that the supply of oxygen and / or fresh gas can be maintained. Furthermore, it can be ensured that the supply of anesthetic gas can be maintained, and that anesthesia can be maintained.

[0206] In some embodiments, the bistable switching valve 87 can also be designed and configured to remain open only when energy consumption is involved. Thus, gas can only be introduced into the breathing gas line 4 when power is supplied to the bistable switching valve 87. This provides the advantage that gas introduction into the breathing gas line 4 can be interrupted in emergencies, such as a power outage, allowing for manual ventilation, such as ventilation using a manual bag.

[0207] Alternatively or additionally, at least one metering valve 88, 88i may be provided in each of the supply lines 7, 11, 44, and 71. At least one metering valve 88, 88i in each of the supply lines 7, 11, 44, and 71 may be configured as, for example, needle valves 88, 88i.

[0208] In an alternative embodiment, the metering valve 88 can be configured as a proportional valve. In some embodiments, metering can be performed by arranging multiple switching valves having different throttles, and the flow rate can be adjusted by different throttle diameters / throttling stages.

[0209] However, in a preferred embodiment, the metering valve 88 is configured as a needle valve. The needle valve offers the advantage of being able to achieve a nearly infinite number of switching positions. The needle valve enables very accurate metering. The needle valve offers the advantage of a very wide adjustment range, within which both very small and very large flow rates can be precisely adjusted.

[0210] For example, the fresh gas supply line 7 may have at least one needle valve 88. Furthermore, the nitrogen oxide supply line 44 may have at least one needle valve 88. Furthermore, the O2 flash supply line 11 may have at least one needle valve 88. It is preferable that all supply lines 7, 11, and 44 each have at least one needle valve 88.

[0211] The needle valve 88 offers the advantage of very precise pressure control at low flow rates. At the same time, the needle valve 88 can also accommodate very high flow rates. The needle valve 88 can be designed and configured to allow adjustment at very low flow rates (0 l / min to 30 l / min), very high flow rates (80 l / min to 120 l / min), and at all intermediate levels. Therefore, this device is suitable for both ventilation under anesthesia where relatively low flow rates are required, and ventilation with high flow rates, such as high-flow ventilation.

[0212] For the same reason, device 100 is particularly suitable for both adult ventilation / anesthesia requiring higher flow rates and ventilation / anesthesia for children, infants, neonates, and premature infants requiring lower flow rates.

[0213] The needle valve 88 can be designed and configured to introduce a flow rate of 0 l / min to 100 l / min into the breathing gas line 4. Preferably, a flow rate of 0 l / min to 60 l / min is introduced into the breathing gas line 4.

[0214] The device 100 can operate in various operating modes and, accordingly, can be set to different flow rates. The flow rate is usually set automatically via the control device 101. The flow rate can be set, for example, by setting the needle valves 88 in the supply lines 7, 11, and 44.

[0215] The needle valve 88 can be designed and configured to generate flow rates from 0 l / min to 120 l / min. In a specific embodiment, the needle valve 88 can be designed and configured to generate flow rates from 0 l / min to 60 l / min.

[0216] In the operating mode for high-flow ventilation, a flow rate of up to 120 l / min, for example, up to 100 l / min, can be generated. In high-flow therapy, the flow rate can be directed through the non-operating blower 3, and the flow rate can only be generated through the oxygen module 10 and / or the O2 flush supply line 11.

[0217] In the operating mode for total intravenous anesthesia, a flow rate of less than 60 l / min can be generated, for example, less than 30 l / min, preferably less than 20 l / min. For example, in the operating mode for total intravenous anesthesia, a flow rate of 18 l / min is generated.

[0218] In anesthesia modes using volatile anesthetics (VA), flow rates of less than 60 l / min, for example less than 30 l / min, preferably less than 20 l / min, can be generated. For example, in anesthesia modes using volatile anesthetics (VA), a flow rate of 18 l / min can be generated.

[0219] In the operating mode for CPAP ventilation, a flow rate of less than 60 l / min can be generated, for example, less than 30 l / min, preferably less than 20 l / min. For example, in CPAP mode, a flow rate of 15 l / min is generated.

[0220] In some embodiments, the needle valve 88 can be configured as a bistable needle valve equipped with a stepping motor. This allows the needle valve 88 to function as a metering valve. The combination of the needle valve and the stepping motor offers the advantage of being able to measure both very small and very large flow rates. The needle valve equipped with a stepping motor has very high resolution even at very small flow rates.

[0221] The bistable needle valves 88 equipped with stepping motors can be designed and configured to remain in their last set positions without energy supply. This provides a special safety feature to the device 100, as it ensures that the addition of fresh gas and / or oxygen and / or nitrogen oxides can be maintained during a power outage.

[0222] It is advantageous for the device 100 to be equipped with at least one battery. This allows the needle valve 88 to be adjusted using battery energy during a power outage. Furthermore, the needle valve 88 can be designed and configured to allow manual adjustment during a power outage. This enables medical personnel to respond in emergencies.

[0223] The supply lines 7, 11, and 44 may each further include at least two switching valves 31 and 32, which have already been described herein in reference to Figure 1. The two switching valves 31 and 32 are preferably located immediately upstream of the confluence of the supply lines with the breathing gas line 4. The two switching valves 31 and 32 control which gas is introduced to which position in the breathing gas line 4. The two switching valves 31 and 32 are designed and configured to adjust the introduction point of the gas (fresh gas, oxygen).

[0224] The apparatus 100 may optionally include at least one anesthetic module 8 and at least one anesthetic supply line 9. The anesthetic module 8 is designed and configured to supply anesthetic to the system via the anesthetic supply line 9. The anesthetic module 8 can be controlled via a control device 101.

[0225] The device 100 can be used for inhalation anesthesia or inhalation general anesthesia. For inhalation anesthesia or inhalation general anesthesia, a volatile anesthetic agent (VA) can be used. For example, the volatile anesthetic agent (VA) can be selected from the group including isoflurane, sevoflurane, desflurane, halothane, enflurane, and methoxyflurane. Particularly preferred volatile anesthetic agents (VA) are selected from the group including isoflurane, sevoflurane, desflurane, and halothane.

[0226] For inhalation anesthesia or inhalation general anesthesia, gaseous anesthetics such as xenon, argon, or nitrous oxide (N2O) may be used as an alternative or additional measure. In particular, nitrous oxide may be added to the respiratory gas mixture 5 to assist or enhance the mechanism of action of volatile anesthetics VA, depending on the application.

[0227] Volatile anesthetics (VAs) are used to achieve optimal conditions for the patient with respect to at least the following parameters: - Loss of consciousness (patient falls asleep / hypnotized) - Pain relief / suppression of pain perception (analgesia) - Relaxation of muscle tension - Suppression of autonomic nervous system reflexes and protective reflexes

[0228] Volatile anesthetics (VAs) are low molecular weight, have high vapor pressure and relatively low boiling points.

[0229] [Table 1]

[0230] In some embodiments, the anesthetic can be introduced into the respiratory gas line 4 in gaseous form (not shown). When introduced in gaseous form, the anesthetic VA or gaseous anesthetic can be pre-mixed with fresh gas. For this purpose, the apparatus 100 may be equipped with a mixing chamber (not shown). The gaseous anesthetic mixed with fresh gas can then be introduced into the respiratory gas line 4 via the anesthetic supply line 9, where it is mixed with the respiratory gas mixture 5.

[0231] In a preferred embodiment, the volatile anesthetic VA is introduced into the respiratory gas line 4 by liquid administration. For this purpose, the apparatus 100 may include at least one evaporation element 8a. The evaporation element 8a may be located inside or on the surface of the respiratory gas line 4. The evaporation element 8a may be configured as an integral component of the respiratory gas line 4. Thus, the volatile anesthetic VA can be introduced into the evaporation element 8a of the respiratory gas line 4 via the anesthetic module 8 and the anesthetic supply line 9. For this purpose, the anesthetic module 8 is pneumatically connected to the evaporation element 8a of the respiratory gas line 4 via the anesthetic supply line 9. Within the evaporation element 8a, the volatile anesthetic VA introduced as a liquid can be evaporated and integrated with the respiratory gas mixture 5.

[0232] Liquid administration of volatile anesthetic VA can be achieved by cooling and / or pressurizing the anesthetic VA in a tank. In a preferred embodiment, a first pressure P1 acts in the breathing gas line 4 and a second pressure P2 acts in at least the anesthetic supply line 9. In this case, the first pressure P1 is less than the second pressure P2. The second pressure P2 is, for example, at least 100 kPa. In a preferred embodiment, the second pressure P2 may be at least 180 kPa. This allows the volatile anesthetic VA to be introduced as a liquid into the evaporation element 8a via the anesthetic module 8 and the anesthetic supply line 9. The anesthetic VA can then evaporate for the first time in the evaporation element 8a and integrate with the breathing gas mixture 5.

[0233] The concentration of the anesthetic VA is typically selected so that the concentration of the anesthetic in the respiratory gas mixture 5 is, for example, in the range of 0% to 25%. The device 100 is designed so that the user, for example, a medical professional such as an anesthesiologist, can set the concentration of the anesthetic VA with great precision and variability. The anesthesiologist can set the concentration of the anesthetic depending on the anesthetic used, the patient, and / or the type of surgery, and adaptively adjust it to the conditions during the surgery.

[0234] For the sedation of patient 90, the concentrations of individual volatile anesthetic agents (VA) in the respiratory gas mixture 5 are typically selected as follows: isoflurane 0%-5%, halothane 0%-5%, sevoflurane 0%-8%, and desflurane 0%-18%. Volatile anesthetic agents (VA) are not usually used in combination. Higher concentrations are also possible and are left to the discretion of the user, i.e., the anesthesiologist. The apparatus 100 is designed and configured to accommodate all concentration settings.

[0235] Liquid administration of volatile anesthetics offers advantages over gaseous administration with pre-mixing with fresh gas, such as the following: - Allows for more precise and economical administration of anesthetics. - The supply of anesthetic drugs does not depend on the supply of fresh gas or oxygen. - The anesthetic concentration is independent of the fresh gas concentration and / or oxygen concentration. - The pressure from the pressurized gas cylinder for the anesthetic can supply the energy needed to deliver the anesthetic.

[0236] The anesthetic supply line 9 can merge with the evaporation element 8a. Within the evaporation element 8a, the physical state of the volatile anesthetic VA changes. By flowing into the evaporation element 8a of the breathing gas line 4, the volatile anesthetic VA is exposed to the pressure P1 of the breathing gas line 4 and thereby becomes gaseous. The evaporation element 8a can be located in the inspiratory side branch 1 of the breathing gas line 4. Therefore, the anesthetic VA can be introduced into the inspiratory side branch 1 of the breathing gas line 4. The evaporation element 8a can be located upstream or downstream of the blower 3. In the preferred embodiment shown in the drawings, the evaporation element 8a can be located upstream of the blower 3. Preferably, the evaporation element 8a can be located downstream of the fresh gas supply lines 7i and 7ii. In the specific embodiment shown in the drawings, the evaporation element 8a is located between the junction of the first fresh gas supply line 7i with the breathing gas line 4 and the blower 3.

[0237] It is advantageous that the device 100 is designed so that at least one continuous flow, i.e., a biflow, is formed within the breathing gas line 4. This biflow ensures that the breathing gas mixture 5 is always in a flowing state within the breathing gas line 4. Within the evaporation element 8a, the biflow has a favorable effect on the evaporation rate of the volatile anesthetic VA.

[0238] The biflow within the evaporation element 8a can be generated and maintained through the reservoir 12 and / or the blower 3 and / or the fresh gas module 6 and / or the oxygen module 10. The biflow within the evaporation element 8a allows the volatile anesthetic VA supplied as a liquid to evaporate and be optimally mixed with the breathing gas mixture 5.

[0239] Figure 3 schematically shows a portion of the breathing gas line 4 in which an evaporating element 8a connected to the anesthetic module 8 via the anesthetic supply line 9 is located.

[0240] As can be seen from Figure 3, the evaporation element 8a can be positioned in the breathing gas line 4 between the first check valve 21 and the blower 3. Preferably, the evaporation element 8a can be positioned immediately upstream of the blower 3. Preferably, the evaporation element 8a can be positioned downstream of the fresh gas introduction point 207 of the first fresh gas supply line 7i. Preferably, the evaporation element 8a can be positioned downstream of the first check valve 21. Therefore, the check valve 21 can prevent the breathing gas mixture 5 being transported in the breathing gas line 4 from flowing against the main flow S.

[0241] The anesthetic module 8 can be connected to the evaporation element 8a via the anesthetic supply line 9. Through the evaporation element 8a, anesthetic can be introduced into the respiratory gas mixture 5 by the anesthetic introduction unit 209. Various volatile anesthetics VA can be supplied to the respiratory gas mixture 5 via the anesthetic module 8. Typically, only one anesthetic is administered to each patient at a time. It is also possible to change the anesthetics during surgery via the anesthetic module 8. Through the anesthetic module 8, at least one volatile anesthetic VA can be introduced into the evaporation element 8a as a liquid. Within the evaporation element 8a, the volatile anesthetic VA can be evaporated and mixed with the respiratory gas mixture 5.

[0242] To provide the volatile anesthetic VA in liquid form, the anesthetic module 8 and the anesthetic supply line 9 can be cooled and / or pressurized. The anesthetic module 8 and the anesthetic supply line 9 are preferably maintained under a second pressure P2, which is preferably at least 180 kPa. Under this pressure, the volatile anesthetic VA will be in a liquid state, as long as the temperature is below 40°C. The volatile anesthetic VA is preferably selected from the group including, for example, isoflurane, sevoflurane, desflurane, and halothane.

[0243] The anesthetic module 8 may include at least one of the following: a pressure supply unit 810, a containment unit 820, a selection unit 830, a metering unit 840, a safety unit 850, and a temperature unit 860. The anesthetic module 8 is understood as a pneumatic unit. All units of module 8 are interconnected pneumatically (directly or indirectly). This connection can be established via at least one anesthetic supply line 9. The anesthetic module 8 and the anesthetic supply line 9 are preferably placed under pressure P2 to hold the volatile anesthetic VA being transported as a liquid. Storage and / or release and / or control of the anesthetic from the anesthetic module 8 can be controlled by a control device 101.

[0244] The anesthetic module 8 may be connectable to at least one volatile anesthetic storage device 800. This device may be configured as an anesthetic tank 800 for storing volatile anesthetics. At least one tank 800 is designed and configured to contain and / or store and / or release volatile anesthetics VA. In this case, it is preferable that a separate tank 800 is used for each individual volatile anesthetic VA.

[0245] Each tank 800 is designed and configured to contain and / or store and / or release one volatile anesthetic VA. In this case, the tank 800 is preferably pressurized so that the stored volatile anesthetic is in a liquid state at room temperature. The pressure inside the tank 800 can be in the range of 100 kPa to 500 kPa in order to keep the anesthetic as a liquid. Preferably, the pressure inside the tank 800 is in the range of 150 kPa to 300 kPa. For example, the pressure inside the tank 800 is at least 180 kPa. Thus, the tank 800 is also designed and configured to receive and / or hold and / or release pressure.

[0246] Tank 800 may be refillable with anesthetic VA. Tank 800 may be designed and configured to allow detection of the anesthetic fill level (not shown). The fill level can be detected visually. For this purpose, Tank 800 may be at least partially transparent. For example, Tank 800 may optionally be equipped with a viewing window having markings, thereby allowing the fill level of Tank 800 to be visually read. The fill level can also be detected by a sensor. For this purpose, Tank 800 may be equipped with a floating element, for example, a magnetic one, that floats above the anesthetic. The magnetic field strength can be detected via a magnetic sensor. Based on the magnetic field strength, the location of the floating element can be determined. Based on the location of the floating element, the fill level of the anesthetic can be determined.

[0247] Tank 800 may further include elements (not shown) that enable unique identification. For example, code information that enables unique identification of individual tanks 800 or the anesthetic held inside them may be provided on the inside or surface of Tank 800. This code information may be provided, for example, mechanically and / or by sensors and / or visually.

[0248] To connect the tank 800 to the apparatus 100, the anesthetic module 8 may comprise at least one housing unit 820. The housing unit 820 comprises at least one housing bay 821. Through the housing bay 821, the housing unit 820 can accommodate at least one tank 800. Preferably, the housing unit 820 comprises two or more housing bays 821, for example, two (see Figure 3) or more (not shown) housing bays 821, to accommodate multiple different tanks 800.

[0249] The apparatus 100 may have a dedicated storage bay 821 for each individual tank 800, i.e., for each anesthetic. In some embodiments, it is also conceivable that one storage bay 821 may be configured to accommodate individual different tanks 800 containing different anesthetics.

[0250] The storage bay 821 may be equipped with at least one device (not shown herein) for identifying individual tanks 800. This provides an additional safety benefit by eliminating the possibility of mixing up different anesthetics. Identification can be performed mechanically and / or visually and / or by sensor. In this way, it can be ensured that the correct tank 800 containing the correct anesthetic is housed in the correspondingly provided storage bay 821. The storage bay 821 may be equipped with, for example, tank-specific connection devices for mechanically identifying individual tanks 800. Identification can also be performed alternatively or additionally by visual coding, for example, by color coding of individual tanks 800 and their respective storage bays 821. Identification can also be performed alternatively or additionally by sensor-based or electrical coding. For this purpose, the tank 800 may be equipped with, for example, a barcode, and the storage bay 821 may be equipped with a corresponding sensor.

[0251] The housing unit 820 is designed and configured to house one or more tanks 800 such that the tanks 800 are pressurized. Preferably, the housing unit 820 is designed to maintain the pressure inside the tanks 800 at, for example, at least 180 kPa. To this end, the housing unit 820 is designed and configured to supply pressure to the tanks 800 and / or to release pressure from the tanks 800. For this purpose, the housing unit 820 can be connected to at least one pressure supply unit 810.

[0252] The pressure supply unit 810 is designed and configured to supply or release pressure to the containment unit 820 and the associated tank 800. The pressure supply unit 810 can supply and / or relieve pressure. For example, the pressure supply unit 810 can be connected to a fresh gas module 6 and / or an oxygen module 10 to take in fresh gas and / or oxygen to provide pressure. In a preferred embodiment, the pressure supply unit 810 takes in fresh gas at a regulated pre-supply pressure to provide pressure.

[0253] The pressure supply unit 810 may preferably be equipped with a pressure regulator to adjust the pressure from the fresh gas module 6 to the required pressure level in the tank 800. The pressure supply unit 810 may further be equipped with at least one pressure sensor to detect the pressure in each tank 800. The pressure supply unit 810 may further be equipped with at least one temperature sensor to detect the temperature. The device 100 may be equipped with at least one alarm (not shown). The anesthetic module 8 can interact with the alarm via the control unit 101. The alarm can therefore sound an alarm, for example, if the temperature exceeds a certain value and it can no longer be guaranteed that all volatile anesthetics can still be kept in a liquid state. The alarm can also, alternatively or additionally, sound an alarm if the pressure falls below a certain value and it can no longer be guaranteed that all volatile anesthetics can still be kept in a liquid state.

[0254] The pressure supply unit 810 may preferably be equipped with a dedicated reservoir for storing fresh gas so that it can maintain pressure for a certain period of time without access to the fresh gas module 6 (not shown). The pressure supply unit 810 may further be equipped with at least one check valve so that the fresh gas supply can only flow from the fresh gas module 6 to the pressure supply unit 810 and not backflow.

[0255] The pressure supply unit 810 may include at least one valve 811 for pressurizing the containment unit 820 and / or tank 800, and at least one valve 812 for depressurizing. This allows the containment unit 820 and / or tank 800 to receive pressure through the fresh gas module 6 and valve 811. Pressure can be released from the containment unit 820 and / or tank 800 through valve 812. For this purpose, the anesthetic module 8 is connected to outlet 14-A so that pressure can be released through valve 812 and outlet 14-A.

[0256] The pressure supply unit 810 may include at least one switching valve 813 for selecting each of the tanks 800 to be supplied. In specific embodiments, it is advantageous to have multiple valves 811, 812, 813, which can be controlled by a control device 101 or directly by the user so that the pressure is adjustable in all tanks 800 in use.

[0257] The containment unit 820 is further designed and configured to contain one or more tanks 800 so that the tanks 800 can contain and / or store and / or release anesthetics. The containment of anesthetics into each tank 800 can be done either inside or outside the containment bay 821. For this purpose, each tank 800 may be equipped with a filling valve (not shown). Containment of anesthetics can be done when the tank 800 is degassed. Containment of anesthetics can also be done when the tank 800 is pressurized. This may be particularly advantageous in the case of desflurane, as its vapor pressure reaches a pressure of about 1.8 bar at 40°C.

[0258] The storage unit 820 is further designed and configured to ensure that anesthetic is released from the tank 800 in a controlled manner. The anesthetic module 8 is designed and configured to release anesthetic from the tank 800 to the anesthetic supply line 9 only when each tank 800 and the anesthetic supply line 9 are pressurized. Thereafter, the volatile anesthetic VA is released in liquid form.

[0259] The valve of the storage unit 820 and / or the tank 800 and / or the pressure supply unit 810 are designed and configured to enable various functions to cooperate. For example, - The tank 800 is mounted in the storage bay, in a pressurized state, and supplies the volatile anesthetic VA. - The tank 800 is mounted in the storage bay, in a pressurized state, and does not supply the volatile anesthetic VA. - The tank 800 is mounted in the storage bay, in a pressurized state, and can be filled with the volatile anesthetic VA. - The tank 800 is mounted in the storage bay, not in a pressurized state, and can be filled with the volatile anesthetic VA. - The tank 800 is mounted in the storage bay, not in a pressurized state, and can be removed.

[0260] The storage unit 820 can be pneumatically connected to the selection unit 830 via the anesthetic supply line 9. The selection unit 830 of the anesthetic module 8 is designed and configured to select each anesthetic. At this time, usually, only one volatile anesthetic VA is used at a time to avoid undesirable interactions between the volatile anesthetics VA. The selection of the anesthetic is performed by medical staff. For this purpose, an input can be made to the device 100.

[0261] The selection unit 830, which is not shown in detail here, includes at least one selection valve 831. The selection valve 831 can be configured, for example, as a 2 / 2-way switching valve. In a specific embodiment, the selection unit 830 can include a plurality of selection valves 831, one for each individual anesthetic.

[0262] The selection valve 831 is preferably configured as a bistable 2 / 2-way directional control valve. The selection valve 831 can be designed and configured to block the path to the metering unit 840 and / or the evaporation element 8a in a state without energy. By energization, any one of the selection valves 831 can be switched, thereby releasing the path to the metering unit 840 and / or the evaporation element 8a. At this time, the control unit 101 is preferably set to be able to open only one selection valve 831 at a time. This ensures that only one of the anesthetics is supplied to the breathing gas line 4. A check valve can be arranged respectively on the downstream side of the selection valve 831 to prevent the backflow of the anesthetic (not shown).

[0263] The selection unit 830 can be pneumatically connected to the metering unit 840 via the anesthetic supply line 9. The metering units 840 of the anesthetic module 8 are designed and configured to meter the respective selected anesthetics.

[0264] The metering unit 840, which is not shown in detail here, can for this purpose comprise at least one metering valve 841. The metering valve 841 is designed and configured to enable the metering of volatile anesthetics. The metering can be performed in the liquid state or the gaseous state of the anesthetic. In a preferred embodiment, the metering is performed in the liquid state of the anesthetic. The metering valve 841 can be designed and configured to apply flow rate and / or volume and / or pressure. The metering valve 841 can preferably define a certain flow rate. The metering valve 841 is preferably designed and configured to enable continuous metering. The metering valve 841 can be configured as a needle valve in some embodiments. The metering valve 841 can be configured as a needle valve with a stepping motor in some embodiments. The needle valve offers the advantages of safe and accurate metering. Furthermore, position coding is possible.

[0265] Through position coding, the metering valve 841 can be configured and designed to meter different anesthetic VAs. For example, two or more anesthetics, e.g., three or more, e.g., at least three different volatile anesthetic VAs, can be metered and supplied to the circulatory system. For example, isoflurane and / or sevoflurane and / or desflurane can be administered to the circulatory system under control via the position coding of the metering valve 841.

[0266] The metering valve 841 can be designed and configured so that, when de-energized, the valve position remains at the last set value and / or returns to the open basic position and / or returns to the closed basic position. In a preferred embodiment, the metering valve 841 can be designed and configured so that, in the absence of energy supply, the valve position remains at each of the last set positions. The metering valve 841 can be designed and configured so that, in the absence of energy supply, the last set flow rate is measured. This provides the device 100 with a special safety function in the event of a power outage, on the one hand, because the metering valve 841 remains at its position, and on the other hand, because the energy for transporting the anesthetic VA is obtained from the pressurized gas cylinder, allowing for continued anesthetic administration.

[0267] Furthermore, the metering unit 840 may be equipped with at least one flow sensor and / or at least one pressure sensor and / or at least one temperature sensor (not shown). These sensors allow the flow rate and / or pressure and / or temperature to be detected within the metering unit 840 and controlled by the control unit 101.

[0268] The metering unit 840 can be pneumatically connected to the safety unit 850 via the anesthetic supply line 9. The safety unit 850 of the anesthetic module 8 is designed and configured to control the introduction of the anesthetic into the evaporation element 8a. The introduction of the anesthetic into the evaporation element 8a can be permitted and / or stopped via the safety unit 850. The safety unit 850 can be pneumatically connected to the evaporation element 8a via the supply line 9. Furthermore, the safety unit 850 can be pneumatically connected to the outlet 14-A (not shown).

[0269] For this purpose, the safety unit 850 comprises at least one valve 851, 852. In some embodiments, the safety unit 850 may comprise at least two valves 851, 852. The valves 851, 852 may be connected in series, for example. The valves 851, 852 may preferably be configured as 2 / 2-way switching valves and / or 3 / 2-way switching valves. The valves 851, 852 may preferably be configured as monostable valves.

[0270] In a specific embodiment, the safety unit 850 comprises a first valve 851 and a second valve 852. The valves 851 and 852 can be arranged, for example, between the metering valve 841 and the evaporation element 8a in the anesthetic supply line 9.

[0271] The first valve 851 can be configured and designed as a monostable 2 / 2 directional switching valve to open or close the path to the evaporator element 8a, for example. The valve 851 may be intended to close when de-energized and open when energized, or vice versa. Preferably, the anesthetic can flow into the evaporator element 8a only when the first valve 851 is energized. In this way, the first valve 851 can function as a safety valve, allowing the introduction of the anesthetic into the evaporator element 8a to be done only actively. Therefore, in an emergency (power outage and / or software failure), the valve 851 can automatically shut off the introduction of the volatile anesthetic. However, it is also preferable that the first valve 851 can be designed to be manually switched. In this way, even in an emergency, the metering valve 841 remains in its position, the transport energy for the anesthetic VA is obtained from the pressurized gas cylinder, and the first valve 851 opens, opening the path to the evaporator element 8a, thus establishing the introduction of the volatile anesthetic VA.

[0272] The second valve 852 can be configured and designed as a monostable 3 / 2 directional control valve to open or close the pathway to the evaporation element 8a and / or outlet 14-A, for example. The valve 852 may be intended to open the pathway to the evaporation element 8a when de-energized and open the pathway to outlet 14-A when energized, or vice versa. Preferably, the anesthetic can flow out to outlet 14-A only when the second valve 852 is energized. In this way, the anesthetic can be actively discharged to outlet 14-A through the second valve 852. In this way, the safety unit 850 can also be designed and configured to flush out the anesthetic VA from the anesthetic supply line 9. This may be particularly advantageous when switching anesthetics. By flushing out the anesthetic supply line 9, it is possible to prevent the presence of two or more anesthetics in the anesthetic supply line 9 at one time.

[0273] Furthermore, the safety unit 850 may be equipped with a tilt sensor (not shown). The tilt sensor can be used to determine the spatial orientation of the evaporation element 8a and / or the entire apparatus 100.

[0274] The temperature unit 860 of the anesthetic module 8 is designed and configured to detect and / or regulate the temperature inside or on the surface of the evaporation element 8a. The temperature unit 860 may include at least one temperature sensor to detect the temperature inside or on the surface of the evaporation element 8a. Furthermore, the temperature unit 860 may include at least one heating element 861. At least one heating element 861 may be designed and configured to affect the temperature inside the evaporation element 8a. For example, the heating element 861 may heat the evaporation element 8a to a temperature preferably above room temperature. For example, the temperature may be set to a maximum of 40°C to increase the evaporation rate of the anesthetic inside the evaporation element 8a. The temperature of the evaporation element 8a affects the evaporation rate of the anesthetic. Basically, the higher the temperature, the higher the evaporation rate. The evaporation rate can thus reach a maximum of 2 liters per minute.

[0275] At the start of anesthesia, an evaporation rate of up to 2 l / min may be required to induce anesthesia. If the adipose tissue is saturated, a lower evaporation rate may be required to maintain anesthesia. Subsequently, the device 100 can be set to an evaporation rate of less than 2 l / min, for example, less than 1 l / min or less than 0.5 l / min. If the adipose tissue is saturated, an evaporation rate of 1 ml / min to 100 ml / min may be sufficient to maintain anesthesia in some cases. The evaporation rate can be variably set via the anesthetic module 8.

[0276] The apparatus 100 may be equipped with a number of further functional valves 21, 22, 23, 24, 25, 26, 27, 28, 29, 30 as described below. Terms such as “first,” “second,” etc., as used herein, are merely for the purpose of distinguishing different valves and do not have any technical meaning, particularly priority.

[0277] As can be seen in Figure 1, the apparatus 100 may include at least one pressure regulating valve 30 located in the breathing gas line 4. The pressure regulating valve 30 may be designed to influence or regulate the flow direction of the main flow line S. The pressure regulating valve 30 may be designed to allow or regulate a variable volumetric flow rate.

[0278] In some embodiments, the pressure regulating valve 30 can be configured as a bistable switching valve. The pressure regulating valve 30 can be switched to an open position, a closed position, or at least one intermediate position. The open position releases the gas flow without restriction. The closed position can hermetically shut off the supply line and block the gas flow in the breathing gas line 4. The intermediate position can release the gas flow with restrictions.

[0279] In a preferred embodiment, the pressure regulating valve 30 can be configured as a proportional valve. For example, the pressure regulating valve 30 can be configured as a 2 / 2 type proportional directional valve (see drawing).

[0280] The pressure regulating valve 30 is preferably designed to block flow in at least one direction. By positioning the pressure regulating valve 30 in the breathing gas line 4, the flow direction of the breathing gas mixture 5 cannot be reversed.

[0281] The pressure regulating valve 30 controls the respiratory pressure P exsp It is preferable that the pressure regulating valve 30 be configured as an adjustable pressure regulating valve 30. The pressure regulating valve 30 can be configured and designed as a PEEP valve to set or maintain at least positive end-expiratory pressure (PEEP). The pressure regulating valve 30 can prevent the pressure drop during exhalation from reaching ambient air pressure. The pressure regulating valve 30 forms an adjustable throttling section.

[0282] The pressure regulating valve 30 can be electrically set to a certain value and / or can be passively adjusted to a preset value. The pressure regulating valve 30 can be set to the patient-specific PEEP. The patient-specific PEEP can be determined in advance and set. In healthy adults, the PEEP is usually 15 hPa to 20 hPa. In cases of previous lung injury and / or during surgery, a higher PEEP may be required. The PEEP can be preset and / or can be set during use.

[0283] The operating pressure of the pressure regulating valve 30 can be electrically set. Preferably, the operating pressure of the pressure regulating valve 30 can be set to a PEEP of 0 hPa to 100 hPa, preferably 0 hPa to 80 hPa, particularly preferably 3 hPa to 80 hPa. The pressure regulating valve 30 is designed and configured to take any switching position within its operating range. The setting of the pressure regulating valve 30 can be controlled manually and / or by the control device 101.

[0284] The pressure regulating valve 30 can be designed to require power only when changing the operating pressure. Therefore, the pressure regulating valve 30 can be designed to remain in a preset position without requiring power.

[0285] In some embodiments, the pressure regulating valve 30 can be designed to return to a basic state with a defined pressure in the non-powered state. In the basic state when not powered, the PEEP valve 30 can be passively adjusted, for example, in the range of 3 hPa to 10 hPa. In a specific embodiment, the PEEP valve 30 can be passively adjusted to a PEEP of, for example, 5 hPa. Therefore, the device 100 can maintain a PEEP of, for example, 5 hPa even in an emergency, such as a power outage.

[0286] At least the bi-flow always flows through the PEEP valve 30, thereby sealing the valve. The bi-flow has a positive impact on the function of the PEEP valve 30.

[0287] The device 100 is designed and configured to perform complex procedures to determine optimal ventilation parameters. For example, it can automatically determine PEEP and / or inspiratory pressure. For example, it can use pressure and / or flow rate and / or volume loops, such as a pressure-volume loop (PV loop). Thus, the device can be used advantageously for ventilation and anesthesia, and can also perform complex procedures such as loops or PEEP finders.

[0288] The device 100 may be equipped with a series of additional valves that contribute to the safety and / or functionality of the device. For example, the device 100 may be equipped with valves 21, 22, 23, 24, 25, 26, 27, 28, and 29. Valves 21, 22, 23, 24, 25, 26, 27, 28, and 29 may be configured as, for example, check valves. Check valves can control and / or limit and / or block the flow rate of a gas, for example, a breathing gas mixture 5, in one direction. When a check valve is opened, the flow is released. When a check valve is closed, the flow is selectively blocked in at least one direction. Check valves can limit or block the backflow of gas against the direction of flow.

[0289] Valves 21, 22, 23, 24, 25, 26, 27, 28, and 29 can be configured as follows: - A simple check valve, or - For example, a shut-off check valve equipped with an electromagnetic coil, or - For example, a simple biased check valve equipped with a spring, or - For example, an adjustable biased check valve equipped with an electromagnetic coil and a spring, or - For example, a continuously adjustable biased check valve comprising an electromagnetic coil, a spring, and a stepping motor.

[0290] A simple check valve releases the flow in only one direction. In particular, valves 21, 22, and 23 can be configured as, for example, simple check valves.

[0291] A shuttable check valve can, in its stationary position, release the flow in one direction and shut it off in one direction. In its operating position, for example, when the electromagnetic coil is energized, a shuttable check valve can shut off the flow in both directions. It is preferable that valve 28 be configured as a shuttable check valve.

[0292] A biased check valve releases flow in only one direction and is closed in its stationary position. A simple biased check valve is biased, for example, by a spring and opens at a predetermined pressure (operating pressure) depending on the spring setting. The operating pressure in a simple spring-biased check valve can be constant. It is preferable that valve 27 be configured as a simple biased check valve.

[0293] The operating pressure in an adjustable spring-driven check valve may be adjustable. Adjustment of the operating pressure of a driven check valve and shutting off a shut-off check valve can be performed automatically and / or manually. Adjustment of the operating pressure of a driven or shut-off check valve can be performed, for example, by spring tension and / or an electromagnetic coil and / or a stepping motor. An adjustable driven check valve may also include, for example, an electromagnetic coil in addition to a spring, which can at least partially or completely counteract the spring tension. When the electromagnetic coil is energized, the spring tension is reduced or completely offset, thereby increasing or releasing the flow. When de-energized, the spring is activated, thereby reducing or closing the flow. Valves 24, 25, and 26 can be configured, for example, as adjustable driven check valves comprising a spring and an electromagnetic coil. The addition of a stepping motor allows for continuous adjustment of the flow rate. The APL valve 29 can be configured, for example, as a continuously adjustable biased check valve comprising a spring, an electromagnetic coil, and a stepping motor.

[0294] The device 100 may, for example, be equipped with at least one simple check valve 21, 22. For example, the device 100 may be equipped with at least one first simple check valve 21 in the inspiratory branch pipe 1, and additionally or alternatively, at least one second simple check valve 22 in the expiratory branch pipe 2.

[0295] Therefore, in the specific embodiment shown in Figure 1, the first check valve 21 and / or the second check valve 22 can be placed in the breathing gas line 4. In some embodiments, it may also be useful and possible to place multiple simple check valves in the breathing gas line 4 (see Figure 4).

[0296] The first check valve 21 can be positioned in the breathing gas line 4 upstream of the blower 3 in the flow direction. In the specific embodiment shown in Figure 1, the first check valve 21 is positioned upstream of the confluence of the first fresh gas supply line 7i with the breathing gas line 4 in the flow direction. In the specific embodiment shown in Figure 1, the first check valve 21 is positioned downstream of the confluence of the second fresh gas supply line 7ii with the breathing gas line 4 in the flow direction.

[0297] In the specific embodiment shown in Figure 1, the first check valve 21 is positioned upstream of the confluence of the first O2 flush supply line 11i with the breathing gas line 4 in the flow direction. In the specific embodiment shown in Figure 1, the first check valve 21 is positioned downstream of the confluence of the second O2 flush supply line 11ii with the breathing gas line 4 in the flow direction.

[0298] For example, the first check valve 21 is configured as a simple check valve. In some embodiments, the first check valve 21 may also be configured as a spring-biased check valve (not shown).

[0299] The second check valve 22 can be located in the expiratory side branch tube 2. The second check valve 22 can be located in the respiratory gas line 4, downstream of the patient interface in the flow direction. For example, the second check valve 22 is configured as a simple check valve. In some embodiments, the second check valve 22 can also be configured as a spring-driven check valve (not shown).

[0300] The check valves 21 and 22 can be designed and configured as simple check valves to control at least the flow direction of the main flow S. The first check valve 21 can be designed and configured to control at least the flow direction of the main flow S and, in particular, to prevent backflow of the respiratory gas mixture 5 into the reservoir 12. The second check valve 22 can be designed and configured to control at least the flow direction of the main flow S and, in particular, to prevent backflow of the respiratory gas mixture 5 to the patient 90. Further simple check valves can also be placed in the respiratory gas line 4, for example, as shown in Figure 4 (see below).

[0301] The device 100 may further include valves 23, 24 located inside or on the surface of the breathing gas line 4. According to specific embodiments shown in Figures 1 and 4, the device 100 may include at least one first safety valve 23 and / or at least one second safety valve 24.

[0302] The first safety valve 23 and / or the second safety valve 24 can be located in the breathing gas line 4. The first safety valve 23 and / or the second safety valve 24 can be located downstream of the blower 3 in the breathing gas line 4. In the specific embodiment shown in Figures 1 and 4, the safety valves 23 and 24 are located in the breathing gas line 4 immediately downstream of the confluence of the first O2 flush supply line 11i with the breathing gas line 4, and therefore immediately upstream of the patient interface. Therefore, the first safety valve 23 and / or the second safety valve 24 are preferably located in the inspiratory side branch pipe 1.

[0303] The safety valves 23 and 24 are preferably arranged in opposite directions. The safety valves 23 and 24 can be designed and configured to ensure the safety of the device 100 in an emergency. An emergency may occur, for example, in the event of a power outage, insufficient power supply, or a technical defect in the device 100 or a part of the device 100. The safety valves 23 and 24 can further ensure the safety of the device 100 in the event of excessive and / or insufficient pressure in the breathing gas line 4.

[0304] The patient can spontaneously inhale and / or exhale via safety valves 23 and 24. The patient can also be manually ventilated via safety valves 23 and 24, for example, by a manual ventilation bag. In this case, spontaneous breathing and / or manual ventilation can be performed only through the inspiratory side branch tube 1 and safety valves 23 and 24 of the device 100, bypassing the rest of the device 100.

[0305] The first safety valve 23 can be designed as a spontaneous breathing valve or an inspiratory deficiency valve. Preferably, the first safety valve 23 is configured as a simple check valve. Through the first safety valve 23, for example, if the blower 3 fails and no transport energy is supplied, the patient can inhale. Therefore, there is a possibility that inhalation can be performed, for example, through the first safety valve 23. In this case, the inhaled gas can be taken in directly from the ambient air.

[0306] The second safety valve 24 can be designed as a static overpressure valve. Preferably, the second safety valve 24 is configured as a spring-driven check valve. For example, the second safety valve 24 can be an adjustable spring-driven check valve. Preferably, the second safety valve further comprises an electromagnetic coil capable of acting the spring.

[0307] A certain pressure can be applied to the second safety valve 24, so that the safety valve 24 remains closed during the normal operation of the device 100. Subsequently, the second safety valve 24 can be opened when the pressure in the breathing gas line 4 becomes higher than the operating pressure of the safety valve 24, allowing pressure and / or volume to be released through the safety valve 24. The second safety valve 24 can also be opened electronically, for example by energizing an electromagnetic coil. Thus, the second safety valve 24 can be configured as a mechanical and / or electrical overpressure valve.

[0308] If the pressure in the breathing gas line 4 rises, the second safety valve 24 can be opened passively and / or actively. The pressure in the breathing gas line 4 may rise, for example, if the expiratory path is blocked, for example, if the tubing system 92 is blocked by dirt or kinks.

[0309] Therefore, there is a possibility that exhalation can be performed in an emergency via the second safety valve 24. In this case, the exhalation breathing gas 5 exsp The gas can be directly released into the ambient air via the intake side branch pipe 1 and the second safety valve 24.

[0310] The device 100 may include at least one, preferably more than one, additional valves 25, 26, 27, 28, 29. In the specific embodiment shown in the drawings, the device 100 may include, for example, five additional valves 25, 26, 27, 28, 29 arranged in different configurations. Hereinafter, the valves 25, 26, 27, 28, 29 will be referred to as the overflow valve 25, the discharge valve 26, the inlet valve 27, the shut-off valve 28, and the APL valve 29 for clarity.

[0311] The device 100 may include at least one overflow valve 25. Alternatively or additionally, the device 100 may include at least one discharge valve 26. Alternatively or additionally, the device 100 may include at least one inlet valve 27. Alternatively or additionally, the device 100 may include at least one shut-off valve 28. Alternatively or additionally, the device 100 may include at least one APL valve 29 (airway pressure limiting valve).

[0312] The overflow valve 25, discharge valve 26, inlet valve 27, and APL valve 29 are preferably configured as spring-biased check valves. The shut-off valve 28 is preferably configured as a shut-off check valve.

[0313] The overflow valve 25, discharge valve 26, inlet valve 27, shut-off valve 28, and APL valve 29 can be set to the same or different adjustable operating pressures. The operating pressures can be set manually and / or automatically. The operating pressures may be preset or adjusted (manually or automatically) during the operation of the device 100. The operating pressures of the overflow valve 25, discharge valve 26, inlet valve 27, shut-off valve 28, and APL valve 29 can be preset to at least one set value.

[0314] The inlet valve 27 can be set to have an operating pressure greater than 0 hPa, for example, in the range of 0.1 hPa to 10 hPa. Preferably, the operating pressure of the inlet valve 27 can be predetermined to a certain set value. In some embodiments, the operating pressure of the inlet valve 27 can have at least two set values. In the specific embodiment shown in Figure 1, the inlet valve 27 can be set to a relatively low operating pressure. For example, the operating pressure of the inlet valve 27 can be set to 2 hPa. In such a setting, the inlet valve 27 can be opened, allowing ambient air to be introduced into the breathing gas line 4 and / or reservoir line 13, thereby preventing the reservoir 12 from becoming completely empty during mechanical ventilation.

[0315] The shut-off valve 28 and / or the discharge valve 26 and / or the overflow valve 25 can similarly be predefined to set values. In a preferred embodiment, the operating pressure of the shut-off valve 28 and / or the discharge valve 26 and / or the overflow valve 25 can preferably be at least two different operating pressures, i.e., at least two set values. The operating pressures of the shut-off valve 28 and / or the discharge valve 26 and / or the overflow valve 25 can each be set to a range of 0 hPa to 200 hPa. For example, the operating pressure of the shut-off valve 28 and / or the discharge valve 26 and / or the overflow valve 25 can be at least one relatively high operating pressure or at least one relatively low operating pressure.

[0316] The shut-off valve 28 and / or the discharge valve 26 and / or the overflow valve 25 may be designed to be adjustable between at least two setpoints. Preferably, the operating pressure can be switched manually and / or automatically between at least a first setpoint and a second setpoint. Preferably, the operating pressure can be switched between a lower operating pressure and a higher operating pressure. A lower operating pressure is, by definition, an operating pressure of less than 50 hPa. A higher operating pressure is an operating pressure greater than 50 hPa.

[0317] For example, the operating pressure of the shut-off valve 28 and / or the discharge valve 26 and / or the overflow valve 25 can be set to 10 hPa or less, preferably 5 hPa or less, for example, 2 hPa or less, in the first set value.

[0318] For example, the operating pressure of the shut-off valve 28 and / or the discharge valve 26 and / or the overflow valve 25 can be set to 50 hPa or more, preferably 100 hPa or more, in the second set value.

[0319] For example, if the operating pressure is set to a lower value of 2 hPa or less, the corresponding valve will be in a semi-open position in the device, and therefore, gas will be able to pass through.

[0320] For example, if the operating pressure is set to a higher value of 100 hPa or more, the corresponding valve will be in a semi-closed position in the device, and therefore, gas passage will not be permitted.

[0321] The operating pressure of the APL valve 29 can be set to at least one, preferably more, and especially preferably more than one setting. For this purpose, the APL valve 29 may be equipped with a stepping motor that preferably allows for continuous adjustment of the spring tension.

[0322] The overflow valve 25 and / or discharge valve 26 and / or APL valve 29 can be located inside or on the surface of the discharge system 14. This allows the exhaled breathing gas 5 to be normally expelled through the overflow valve 25, discharge valve 26, and APL valve 29. exsp Only those will be led.

[0323] In the specific embodiment shown in Figure 1, the valve arrangement is as follows:

[0324] The overflow valve 25 can be located, for example, in the first line 14i of the discharge system 14. The overflow valve 25 can be located between the reservoir 12 and the outlet 14-A. The overflow valve 25 can be designed and configured to control the pressure in the reservoir 12. The overflow valve 25 is preferably configured as a spring-driven check valve. The overflow valve 25 can be designed and configured to discharge pressure from the reservoir 12.

[0325] The APL valve 29 can be located, for example, in the second line 14ii of the discharge system 14. The discharge valve 26 can be located, for example, in the third line 14iii of the discharge system 14. The discharge valve 26 and the APL valve 29 can be located, for example, in parallel lines 14ii and 14iii of the discharge system 14. The discharge valve 26 can be designed to transport gas by bypassing the APL valve.

[0326] The inlet valve 27 can be located inside or on the surface of the breathing gas line 4. Ambient air can be supplied to the breathing gas line 4 via the inlet valve 27. The inlet valve 27 can be located in the breathing gas line 4, for example, downstream of the separation means 40. The inlet valve 27 can be located in the breathing gas line 4, for example, upstream of the humidity control module 41. The inlet valve 27 can preferably be branched between the chemical separation means 40 and the humidity control module 41. The inlet valve 27 can optionally supply ambient air to the breathing gas line 4, for example, between the chemical separation means 40 and the humidity control module 41. The supply of ambient air via the inlet valve 27 can be done at the ambient air inlet point 227 in the breathing gas line 4.

[0327] The shut-off valve 28 can be located in the breathing gas line 4. The shut-off valve 28 can be located, for example, downstream of the separation means 40. The shut-off valve 28 can be located, for example, upstream of the humidity control module 41. The shut-off valve 28 can preferably be located between the chemical separation means 40 and the humidity control module 41.

[0328] Valves 25, 26, 27, 28, and 29 are specifically designed and configured to affect the function of the device 100. Through the different functions and / or settings of valves 25, 26, 27, 28, and 29, for example, the flow path of the breathing gas mixture 5 can be affected. The different functions and / or settings of valves 25, 26, 27, 28, and 29 can, for example, control whether the breathing gas mixture 5 remains in the circulation system and / or is transported through the discharge system 14 and / or ambient air is introduced into the breathing gas mixture 5.

[0329] In particular, the shut-off valve 28 and / or the APL valve 29 and / or the discharge valve 26 can be designed and configured to control the path of the breathing gas mixture 5. Depending on the setting of the operating pressure of the shut-off valve 28 and / or the APL valve 29 and / or the discharge valve 26, the breathing gas mixture 5 can be guided in a closed or semi-open circulation system.

[0330] A closed circulation system may be useful, for example, when the device 100 operates in an anesthetic mode using a volatile anesthetic agent VA. A semi-open circulation system may be useful, for example, when the device 100 operates in TIVA mode. A semi-open circulation system may also be useful when the device 100 operates in service mode, for example, in drying mode.

[0331] By setting valves 25, 26, 27, 28, and 29, and optionally setting blower 3 and / or pressure regulating valve 30, and operating reservoir 12, the device 100 can operate in various operating modes as described below. The operating modes of the device 100 can be set manually and / or automatically by control device 101.

[0332] The device 100 can be used to administer and transport volatile anesthetic VA, and to intentionally evacuate it, particularly for disposal or reuse. However, the device 100 can also be used to perform ventilation without using volatile anesthetics.

[0333] The device 100 can operate in an operating mode selected from a group including, for example, an anesthetic mode using volatile anesthetics (VA); an anesthetic mode using intravenously administered anesthetics (TIVA mode); a ventilation mode with anesthetics; and a ventilation mode without anesthetics, such as O2 therapy, high-flow O2 therapy (HFOT), CPAP, BiLevel, and SIMV (synchronized intermittent mandatory ventilation). In essence, the device 100 can provide all the ventilation modes commonly used in intensive care.

[0334] Device 100 offers the advantage of enabling lung-protective ventilation even under anesthesia. For example, it can perform pressure-controlled ventilation, which places a relatively low load on the lungs. Pressure-controlled ventilation is particularly beneficial for patients with lung damage.

[0335] The control device 101 can control the device 100 so that it can be operated in various operating modes. This control can be performed, for example, based on the various configurability of the components, namely the blower 3 and / or valves 25, 26, 27, 28, 29 and / or pressure regulating valve 30. In particular, the setting of the operating pressure levels of the spring-driven check valves 25, 26, 27, 28, 29 can affect the flow path of the breathing gas mixture 5 and, consequently, the operation of the entire device 100.

[0336] The operating mode of the device 100 can be set before operation begins or switched during operation. Switching from one operating mode to another can be done manually by the user, for example, a healthcare professional. Switching from one operating mode to another can also be done automatically by the control device 101 if conditions change during ventilation and / or anesthesia.

[0337] For example, the device 100 can operate in anesthesia mode, ventilation mode, or a combination of anesthesia mode and ventilation mode. Each operating mode may be operated in a different manner, for example, automatic ventilation (mechanical ventilation), manual ventilation (ventilation by manual operation), or in a malfunction mode.

[0338] Manual ventilation is necessary or may be necessary, particularly during the induction and / or evacuation of anesthesia, during surgery in the pharyngeal or laryngeal region, and / or in emergencies.

[0339] Mechanical ventilation can be used, for example, during surgery using volatile anesthetics and / or intravenously administered anesthetics. Mechanical ventilation can also be used for ventilation and / or respiratory support in patients who are unable to breathe spontaneously or who require respiratory support.

[0340] Operation in fault mode may help reduce power consumption and / or may be necessary in the event of a power outage, software crash, or other technical failure. Operation in fault mode provides a safe condition that allows for manual ventilation with at least one fresh gas flow.

[0341] Figures 1A to 1G show the apparatus 100 of the first embodiment in different circuit configurations and settings to realize different operating modes. Elements and connections in the non-operating and / or disconnected state are shown with dashed lines, and elements and connections in the operating and / or open state are shown with solid lines.

[0342] With respect to an element, "operating state" means, as specified herein, that the element is able to perform the function described and / or that gas can flow through it. With respect to an element, "non-operating state" means, as specified herein, that the element is not performing the function described and / or that gas does not flow or flows passively. With respect to a line, "operating state" means, as specified herein, that gas can be guided through the line and the path is not blocked or at least not completely blocked. With respect to a line, "blocked state" means, as specified herein, that gas cannot be guided through the line and the line is preferably hermetically sealed.

[0343] Different functional valves, particularly the overflow valve 25, discharge valve 26, inlet valve 27, and shut-off valve 28, can each be set to a relatively high operating pressure or a relatively low operating pressure to achieve different operating modes.

[0344] In the context of this invention, high operating pressure means that each valve is closed and the flow of gas in the line in which the valve is located is interrupted. For example, high operating pressure may exist when an operating pressure exceeding 50 hPa, for example 100 hPa, is applied to the corresponding valve.

[0345] In the context of the present invention, low operating pressure means that each valve can be opened and gas can flow in the line in which the valve is located. For example, low operating pressure can exist when an operating pressure of less than 10 hPa, e.g., 2 hPa, or less than 0.5 hPa is applied to the corresponding valve.

[0346] The operating pressure of the APL valve 29 can preferably be continuously adjusted, allowing for a number of settings. Thus, the APL valve 29 can restrict and / or block the flow of gas in the corresponding line.

[0347] The APL valve 29 is preferably configured as an electrically configurable valve. The APL valve 29 controls the intake pressure Pinsp It is designed to adjust the pressure in the breathing gas line 4 to the inspiratory pressure P. The APL valve 29 adjusts the pressure in the breathing gas line 4 to the inspiratory pressure P. insp When the pressure exceeds the limit, the breathing gas mixture 5 can function to be discharged through outlet 14-A. In a preferred embodiment, the APL valve 29 is designed as an adjustable biased check valve equipped with a stepping motor. The APL valve 29 is preferably designed to remain in the last set position when de-energized. Thus, the APL valve 29 remains in the last set intake pressure P when de-energized. insp It can be adjusted to this setting. This is particularly advantageous during power outages because it allows the APL valve 29 to continue performing its function.

[0348] In a preferred embodiment, the APL valve 29 can be configured as a digital APL valve 29. The APL valve 29 can preferably be automatically adjusted by software or a control device 101. The APL valve can also be operated manually, either or additionally. In this way, medical staff can operate the APL valve manually, for example, using a tactile encoder (rotary knob), to load or release the APL as needed.

[0349] Figure 1A shows the apparatus 100 in a first operating mode M1 for manual ventilation with administration of a volatile anesthetic. As can be seen from Figure 1A, in the first operating mode M1, the blower 3 is in a non-operating state. The non-operating state of the blower 3 means that the blower 3 is not supplying transport energy. The fan wheel of the blower 3 is not driven in the non-operating blower. Even in the non-operating state, the respiratory gas mixture 5 can flow through the blower 3. In the first operating mode M1, the reservoir 12 supplies transport energy to the respiratory gas mixture 5. The reservoir 12 can be configured, for example, in the form of a manual bag and is operated manually or automatically in the first operating mode M1. Therefore, the reservoir 12 can supply respiratory energy in the first operating mode M1.

[0350] When reservoir 12 is activated, the respiratory gas mixture 5 is transported to reservoir line 13. High operating pressure is applied to the overflow valve 25, closing the first line 14i. Thus, the respiratory gas mixture 5 can be introduced from reservoir line 13 into the inspiratory branch tube 1 of respiratory gas line 4. Check valve 21 prevents the respiratory gas mixture 5 from flowing back into reservoir line 13.

[0351] In the first operating mode M1, the fresh gas module 6 is in operation. In the first operating mode M1, the fresh gas switching valve 32 is in its basic position, and therefore, fresh gas can be introduced into the breathing gas line 4 via the first fresh gas supply line 7i. In the first operating mode M1, the first fresh gas supply line 7i is in operation. Also, in the first operating mode M1, the second fresh gas supply line 7ii is inactive. The introduction of fresh gas can be performed downstream of the check valve 21 in the flow direction. Therefore, the fresh gas introduction point 207 can be located between the first check valve 21 and the evaporation element 8a (and consequently the anesthetic introduction section 209). The introduction of fresh gas can preferably be performed at a constant flow rate. Thereafter, the fresh gas can form at least a biflow.

[0352] In the first operating mode M1, the anesthetic module 8 is in operation. In the first operating mode M1, the volatile anesthetic VA can be introduced to the evaporator element 8a via the anesthetic module 8 and the anesthetic supply line 9, thereby being added to the respiratory gas mixture 5 as needed. The respiratory gas mixture 5 can be optimally enriched with the volatile anesthetic VA via fresh gas biflow.

[0353] In the first operating mode M1, the oxygen module 10 is in the operating state. The oxygen module 10 being in the operating state means that oxygen can be optionally introduced via the O2 flash 10. In the first operating mode M1, the O2 flash switching valve 31 is in the basic position, and therefore, oxygen can be optionally introduced into the breathing gas line 4 via the first O2 flash supply line 11i. In the first operating mode M1, the first O2 flash supply line 11i is in the operating state. In the first operating mode M1, the second O2 flash supply line 11ii is in the non-operating state. Oxygen introduction via the O2 flash 10 can be optionally performed after the O2 flash 10 has been activated (manually or automatically). In this case, oxygen is introduced via the O2 flash 10 and the first O2 flash supply line 11i, downstream of the blower 3 and upstream of the safety valves 23 and 24 in the flow direction. Therefore, the O2 flush introduction point 211 can be positioned between the blower 3 and the safety valves 23 and 24. This has the advantage that volatile anesthetics can be rapidly flushed out of the lungs by oxygen flushing as needed. The O2 flush 10 can also be used to fill the reservoir 12, for example, after a leak. Oxygen then flows from the O2 flush 10 through the introduction point 211 to the breathing gas line 4, and from there, in the direction of the main stream S, through the inspiratory branch tube 1 and the expiratory branch tube 2 to the reservoir 12.

[0354] In the first operating mode M1, the patient manually inhales inspiratory breathing gas 5 via the inspiratory branch tube 1. insp Furthermore, the patient can optionally receive a supply of volatile anesthetic VA. In addition, in the first operating mode M1, the expiratory side branch tube 2 and its elements are in an operating state, and the expiratory breathing gas 5 exsp It can expel the following. In the first operating mode M1, the expiratory breathing gas 5 exsp It can be transported from the patient via the expiratory side branch tube 2. The check valve 22 controls the expiratory breathing gas 5 exsp This prevents backflow to the patient. The PEEP valve 30 is in the activated state and is set to an individual PEEP level.

[0355] The main flow direction S of the respiratory gas mixture 5 is toward the patient interface via the inspiratory branch tube 1 and from the patient interface toward the expiratory branch tube 2. Sensors 16, 17, 18, 19, 20, and 39 are in operation in the first operating mode M1.

[0356] In operating mode M1, valves 26, 28, and 29 are switched so that the respiratory gas mixture 5 in the expiratory side branch tube 2 can take two different paths. The respiratory gas mixture 5 or a portion of the respiratory gas mixture 5 can be directed in the direction of the main stream S within the circulatory system and / or discharged from the circulatory system through the discharge system 14.

[0357] In the first operating mode M1, a low operating pressure is applied to the shut-off valve 28, and the breathing gas line 4 is opened. In the first operating mode, the shut-off valve 28 can function as a simple check valve without the action of the electromagnetic coil. Thus, in the operating mode M1, the breathing gas mixture 5 can be directed, at least partially, in the direction of the main flow channel S within the circulatory system. The breathing gas mixture 5 is then reintroduced from the expiratory branch tube 2 to the inspiratory branch tube 1. At this point, the breathing gas mixture 5 passes through the separation means 40 and the humidity control module 41, which are operating in the first operating mode M1. In the separation means 40, CO2 is separated, and in the humidity control module 41, moisture can be removed from the breathing gas mixture 5. In the inspiratory branch tube 1, fresh gas and / or oxygen and / or anesthetic can be resupplied to the breathing gas mixture 5.

[0358] The settings of the discharge valve 26 and the APL valve 29 can activate the second line 14ii and the third line 14iii, and thus affect whether or not gas is conducted. As can be seen from Figure 1A, in the first operating mode M1, the second line 14ii is activated and the third line 14iii is shut off.

[0359] In the first operating mode M1, a high operating pressure is applied to the discharge valve 26, shutting off the third line 14iii. In the first operating mode M1, the APL valve 29 receives an operating pressure that partially releases the gas flow in the second line 14ii. As a result, the breathing gas mixture 5 can be discharged from the circulation system at least partially through the second line 14ii of the discharge system 14.

[0360] The APL valve 29 controls the patient's specific inspiratory pressure P insp It can be set to a patient-specific inspiratory pressure P. insp This can be requested and set in advance. For a healthy adult, the inspiratory pressure P insp The normal inspiratory pressure is 20 hPa to 25 hPa. Higher inspiratory pressures are used if there is a history of lung injury and / or during surgery. insp Intake pressure P is necessary or may be necessary. insp The settings can be configured in advance and also during use. The settings of the APL valve 29 can be controlled manually and / or by the control device 101.

[0361] By venting some of the gas from the circulating system, the APL valve 29 can limit the maximum pressure during inspiration. Furthermore, the venting of some of the gas ensures that gas exchange takes place. Gas exchange can remove pulmonary metabolites (e.g., methane or ammonia) from the circulating system. Fresh gas and / or oxygen and / or anesthetics can be supplied to the circulating system as needed.

[0362] During inhalation, the reservoir 12 is actively activated. The breathing gas mixture 5 is fed at the inspiratory pressure P set in the APL valve 29. insp The air is delivered to the patient via the Y-connector 93 until this is achieved within the patient. Subsequently, an inspiratory plateau may be maintained where no flow occurs between the patient and the patient.

[0363] During exhalation, the reservoir 12 ceases to function. The respiratory gas mixture 5 is sent from the patient to the expiratory branch tube 2 via the Y-connector 93, and the pressure decreases to the PEEP set in the pressure regulating valve 30. Subsequently, an expiratory plateau occurs where there is no flow between the patient and the respiratory gas mixture.

[0364] Manual ventilation always uses an excess flow of fresh gas. This excess volume can only be released into the exhaust system 14 during inspiration. Therefore, the reservoir 12 must always contain more than the patient's required amount.

[0365] Figure 1B shows the apparatus 100 in a second operating mode M2 ​​for automated ventilation with administration of volatile anesthetics. As can be seen from Figure 1B, in the second operating mode M2, the blower 3 is in operation. In operation, the blower 3 supplies transport energy to the respiratory gas mixture 5. The fan wheel of the blower 3 is driven to transport the respiratory gas mixture 5. In the second operating mode M2, the blower 3 can generate the required patient flow and a constant biflow. In the second operating mode M2, the blower 3 can generate a set flow pattern. In the second operating mode M2, the reservoir 12 functions as a storage unit for a portion of the respiratory gas mixture 5. In the second operating mode M2, the reservoir 12 does not supply transport energy to the respiratory gas mixture 5. In the second operating mode M2, the reservoir 12 can supply volume to the blower 3, at least partially.

[0366] In the second operating mode M2, the fresh gas switching valve 32 and the O2 flush switching valve 31 are in their basic positions, thereby allowing fresh gas to be introduced into the breathing gas line 4 via the first fresh gas supply line 7i, and optionally oxygen via the first O2 flush supply line 11i. In the second operating mode M2, the fresh gas introduction can be performed downstream of the check valve 21 in the flow direction. The fresh gas introduction can preferably be performed at a constant flow rate. The fresh gas forms a biflow together with the blower flow.

[0367] In the second operating mode M2, the anesthetic module 8 is in operation. In the second operating mode M2, the volatile anesthetic VA can be introduced into the evaporator 8a via the anesthetic module 8 and the anesthetic supply line 9, thereby being added to the respiratory gas mixture 5 as needed. The respiratory gas mixture 5 can be optimally enriched with the volatile anesthetic VA via biflow.

[0368] In the second operating mode M2, the patient receives inspiratory breathing gas 5 through the inspiratory branch tube 1. insp Furthermore, a volatile anesthetic can be supplied at the user's discretion. In addition, in the second operating mode M2, the expiratory side branch tube 2 can be in an activated state, thereby supplying the expiratory breathing gas 5 exsp It is transported from the patient via the expiratory side branch tube 2. Check valves 21 and 22 prevent the respiratory gas mixture 5 from flowing back against the main flow direction S. The PEEP valve 30 is activated and set to individual PEEP levels.

[0369] The main flow direction S of the respiratory gas mixture 5 flows through the inspiratory branch tube 1 towards the patient interface, and from the patient interface through the expiratory branch tube 2. Subsequently, the respiratory gas mixture 5 is reintroduced from the expiratory branch tube 2 to the inspiratory branch tube 1 and / or reservoir 12.

[0370] The respiratory gas mixture 5 flows mostly to the patient during inspiration, eventually reaching the inspiratory plateau. The biflow flows through the expiratory side tube 2. Upon reaching the inspiratory plateau, the blower 3 primarily delivers the biflow, thereby flushing the circulatory system K1. At this stage, the reservoir 12 is refilled by the biflow.

[0371] In the second operating mode M2, valves 26, 28, and 29 are switched so that the breathing gas mixture 5 essentially flows through the circulation system along the main flow direction S. In the second operating mode M2, a low operating pressure is applied to the shut-off valve 28, and the breathing gas line 4 is opened. A higher operating pressure is applied to the APL valve 29 than to the shut-off valve 28, and therefore the second line 14ii is shut off. A high operating pressure is applied to the discharge valve 26, and the third line 14iii is shut off.

[0372] This allows the respiratory gas mixture 5 to be introduced into the circulating system in the main flow direction S in the second operating mode M2. The respiratory gas mixture 5 is then reintroduced from the expiratory branch tube 2 to the inspiratory branch tube 1. At this time, the respiratory gas mixture 5 passes through the separation means 40 and the humidity control module 41. In the separation means 40, CO2 is separated, and in the humidity module 41, moisture can be removed from the respiratory gas mixture 5. In the inspiratory branch tube 1, fresh gas and / or oxygen and / or anesthetic can be supplied to the respiratory gas mixture 5 again.

[0373] In the second operating mode M2, a low operating pressure is applied to the overflow valve 25, allowing the first line 14i to be released. This allows the breathing gas mixture 5 or a portion of the breathing gas mixture 5 to be guided through the first line 14i of the discharge system 14 to outlet 14-A and released into the surrounding environment. When the reservoir 12 becomes full, i.e., when the pressure in the reservoir 12 exceeds the set pressure of the overflow valve 25, the breathing gas can be discharged from the reservoir 12 to outlet 14-A through the first line 14i and the overflow valve 25. This effectively prevents overfilling of the reservoir 12, which may lead to damage to and / or rupture of the reservoir.

[0374] The inlet valve 27 can be configured as a volume deficiency valve and / or flow deficiency valve. The inlet valve 27 can be set to a low operating pressure. Preferably, the inlet valve 27 is set so that it can supply outside air to the circulation system when negative pressure occurs in the breathing gas line 4. In the second operating mode M2, negative pressure in the breathing gas line 4 may occur, for example, due to a (unintentional or intended) leak. If the blower 3 is operated with a leak in the system, the reservoir 12 may become empty and negative pressure may occur in the breathing gas line 4. The negative pressure in the breathing gas line 4 may open the inlet valve 27, thereby supplying ambient air to the breathing gas line 4 through the inlet valve 27. For example, the inlet valve 27 is set to an operating pressure of 2 hPa. This corresponds to the pressure of a filled reservoir 12.

[0375] For example, referring to Figures 1A and 1B, it is shown that the respiratory gas mixture 5 can be guided in essentially closed and / or essentially semi-open circulating systems. In this case, the cooperation of the shut-off valve 28, the discharge valve 26, and the APL valve 29 is important. The cooperation of valves 26, 28, and 29 can be carried out as follows.

[0376] If the operating pressure of the shut-off valve 28 is set low and the operating pressures of the discharge valve 26 and APL valve 29 are set high, the breathing gas mixture 5 can be guided within an essentially closed circulation system. A closed circulation system is established when the operating pressure of the shut-off valve 28 is lower than the operating pressures of the discharge valve 26 and APL valve 29. The operating pressures of the discharge valve 26 and APL valve 29 being higher than the operating pressure of the shut-off valve 28 shuts off the path to outlet 14-A. The operating pressures of the discharge valve 26 and APL valve 29 being higher than the operating pressure of the shut-off valve 28 opens the path of the breathing gas line 4 to the separation means 40 and / or humidity control module 41.

[0377] If the operating pressure of the shut-off valve 28 is high and the operating pressures of the exhaust valve 26 and / or APL valve 29 are low, the respiratory gas mixture 5 can be guided in a semi-open circulation system. A semi-open circulation system is established when the operating pressure of the shut-off valve 28 is higher than the operating pressures of the exhaust valve 26 and APL valve 29. In this case, the shut-off valve 228 blocks the path to the blower 3. Therefore, the flow direction of the respiratory gas mixture 5 is (roughly) from the blower 3 through the inspiratory side branch tube 1 to the patient interface and patient 90, and from the patient 90 through the expiratory side branch tube 2 to the outlet 14-A. The operating pressure of the shut-off valve 28 being higher than the operating pressures of the exhaust valve 26 and APL valve 29 blocks the path to the chemical separation means 40 or the blower 3. The operating pressure of the shut-off valve 28 being higher than the operating pressures of the exhaust valve 26 and APL valve 29 opens the path to the outlet 14-A.

[0378] Figure 1C shows the device 100 in the third operating mode M3 for manual ventilation without administration of volatile anesthetics. Figure 1D shows the device 100 in the fourth operating mode M4 for automatic ventilation without administration of volatile anesthetics.

[0379] Alternatively or in addition to use with volatile anesthetics, the device 100 can operate in an operating mode without the administration of volatile anesthetics. Therefore, the device 100 is also configured and designed to provide ventilation to a patient without volatile anesthetics. Thus, the device 100 can be used under the application of total intravenous anesthesia (TIVA) and / or under the application of local anesthesia, such as spinal anesthesia. In TIVA, an anesthetic, such as propofol, is injected into the blood circulatory system. Additional anesthesia with inhaled anesthetics is also possible. The device 100 offers the advantage of being able to provide ventilation in combination with total intravenous anesthesia, and alternatively or additionally, volatile anesthetics (VA) can also be supplied via the respiratory pathway. In an operating mode without the addition of inhaled anesthetics (VA), the device 100 can operate, for example, in an open circulatory system and / or a semi-open circulatory system. In operation without inhaled anesthetics (VA), the respiratory gas can be discharged into the ambient environment. In an operating mode without the addition of inhaled anesthetics (VA), the respiratory gas mixture can be completely replaced with each respiratory phase (inspiration and expiration). This ensures that minute ventilation is constantly being provided. For adult treatment, this means that an average of approximately 6 l / min of respiratory gas mixture is being provided and applied.

[0380] Figure 1C shows that in the third operating mode M3, the blower 3 is in a non-operating state, and therefore the breathing gas mixture 5 simply passes through the blower 3. In the third operating mode M3, the reservoir 12 supplies transport energy, i.e., breathing energy, to the breathing gas mixture 5.

[0381] In the third operating mode M3, the anesthetic module 8 is normally inactive. In the third operating mode M3, the volatile anesthetic VA is normally not added to the breathing gas mixture 5.

[0382] When the reservoir 12 is activated, the respiratory gas mixture 5 is transported to the reservoir line 13. From the reservoir line 13, the respiratory gas mixture 5 is introduced into the inspiratory branch tube 1 of the respiratory gas line 4. The check valve 21 prevents the respiratory gas mixture 5 from flowing back into the reservoir line 13.

[0383] In the third operating mode M3, it is preferable that the fresh gas switching valve 32 can be switched to allow fresh gas to be introduced into the breathing gas line 4 via the second fresh gas supply line 7ii. Therefore, the introduction of fresh gas can be performed upstream of the first check valve 21 in the flow direction.

[0384] In the third operating mode M3, it is preferable that the O2 flush switching valve 31 can be optionally switched to allow oxygen to be introduced into the breathing gas line 4 via the second O2 flush supply line 11ii. Oxygen introduction via the O2 flush 10 can optionally be performed after the O2 flush 10 has been activated (manually or automatically). Subsequently, oxygen introduction is performed upstream of the blower 3 in the flow direction via the O2 flush 10 and the second O2 flush supply line 11ii. In the third operating mode M3, oxygen introduction via the O2 flush 10 is preferably performed upstream of the first check valve 21 in the flow direction.

[0385] Therefore, in the third operating mode M3, fresh gas and / or oxygen can be supplied to the breathing gas line 4 upstream of the first check valve 21, thereby allowing the reservoir 12 to be filled as needed.

[0386] In the third operating mode M3, the patient manually inhales inspiratory breathing gas 5 via at least the inspiratory branch tube 1. insp In addition, in the third operating mode M3, the expiratory side branch tube 2 and its elements can be in an operating state. In the third operating mode M3, the expiratory breathing gas 5 exsp It can be transported from the patient via the expiratory side branch tube 2. The PEEP valve 30 is in the activated state here and is set to an individual PEEP. The PEEP valve 30 can be adjusted to the set PEEP pressure.

[0387] The main flow direction S of the respiratory gas mixture 5 flows towards the patient interface via the inspiratory branch tube 1, and from the patient interface flows through the expiratory branch tube 2. In operating mode M3, since volatile anesthetic VA is not usually administered, the respiratory gas does not need to be guided within a closed circulatory system. In operating mode M3, expiratory respiratory gas 5 exsp The respiratory gas mixture 5 can be discharged into the surrounding environment via the expiratory side branch 2 and the discharge system 14. In the third operating mode M3, the respiratory gas mixture 5 is guided within a semi-open circulation system, that is, inspiration flows through the inspiratory side branch 1, and expiration flows through the expiratory side branch 2, and the expiratory respiratory gas 5 exsp It is discharged via the discharge system 14 and is not supplied back to the intake side branch pipe 1.

[0388] For this reason, in the third operating mode M3, a high operating pressure is applied to the shut-off valve 28, which can shut off the connection between the inspiratory branch tube 1 and the expiratory branch tube 2. This allows the expiratory breathing gas 5 to be blocked. exsp The gas cannot be reintroduced into the inspiratory side branch tube. In the third operating mode M3, no breathing gas passes through the separation means 40 and the humidity control module 41, and the separation means 40 and the humidity control module 41 are in a non-operating state.

[0389] In the third operating mode M3, a low operating pressure is applied to the discharge valve 26, and the third line 14iii is opened. A higher operating pressure is applied to the APL valve 29 than to the discharge valve 26, thereby shutting off the second line 14ii.

[0390] Due to the low operating pressure of the exhaust valve 26, the expiratory breathing gas 5 exsp The gas bypasses the APL valve 29 and is discharged to outlet 14-A and the surrounding environment via the third line. In the third operating mode M3, the APL valve 29 is in a non-operating state, and therefore the PEEP valve 30 is at intake pressure P insp It also specifies that in the third operating mode M3, PEEP is the intake pressure P insp This corresponds to the following: During exhalation, the PEEP valve 30 adjusts to the PEEP pressure. During inhalation, the PEEP valve 30 adjusts the inspiratory patient pressure.

[0391] In the third operating mode M3, the breathing gas mixture 5 is not processed, and the entire used gas is discharged into the surrounding environment via the exhaust system 14.

[0392] Figure 1D shows that in the fourth operating mode M4, the respiratory gas mixture 5 is guided through a semi-open circulation system, similar to the third operating mode M3. The flow path in the fourth operating mode M4 is essentially equivalent to the flow path in the third operating mode M3.

[0393] Unlike the third operating mode, in the fourth operating mode M4, the blower 3 is in operation and supplies transport energy to the respiratory gas mixture 5. In the fourth operating mode M4, the blower 3 can generate the required patient flow and a constant biflow. In the fourth operating mode M4, the blower 3 can dynamically generate a set patient flow pattern. In the fourth operating mode M4, the reservoir 12 can supply volume to the blower 3, at least partially. Fresh gas introduction can preferably be performed at a constant flow rate. The fresh gas forms a biflow together with the blower flow.

[0394] Because the blower 3 is in operation, a negative pressure is generated upstream of the blower 3 in the intake branch pipe 1, allowing the inlet valve 27 to be activated in the fourth operating mode M4. If the supply of fresh gas and / or oxygen is insufficient, ambient air can be transported to the breathing gas line 4 via the inlet valve 27.

[0395] In the fourth operating mode M4, a low operating pressure is applied to the overflow valve 25, allowing the first line 14i to be released. This allows the breathing gas mixture 5 to be at least partially guided through the first line 14i to outlet 14-A and released into the ambient environment. The overflow valve 25 can be designed and configured to protect the reservoir 12 from over-expansion and / or rupture.

[0396] In the fourth operating mode M4, fresh gas can be supplied to the breathing gas line 4 via the fresh gas module 6 and / or oxygen via the O2 flush 10 upstream of the first check valve 21, and the reservoir 12 can be quickly filled as needed. Overfilling of the reservoir 12 can be effectively prevented by the overflow valve 25.

[0397] Figure 1E shows the device 100 in the fifth operating mode M5 for manual ventilation in emergency mode.

[0398] The device 100 is designed and configured to operate safely even in emergencies by a fifth operating mode M5. An emergency may occur, for example, when the primary power supply 103 and / or the secondary power supply 104 fail. An emergency may also occur, for example, when the primary power supply 103 and / or the secondary power supply 104 can only provide limited energy. In an emergency, the power supply may be provided in a reduced state or may stop completely. In the fifth operating mode M5, the device 100 can operate in a de-energized and / or low-power state. In the fifth operating mode M5, the device 100 can operate without power and / or with only the secondary power supply 104.

[0399] An emergency may also occur if, as an alternative or additional measure, an important component of the device 100, such as the control device 101, software, hardware, or blower 3, fails partially or completely.

[0400] In the fifth operating mode M5, it is preferable that the device 100 retains the last selected function and settings, enabling continuous ventilation. The fifth operating mode M5 ensures that medical staff can respond even in emergencies. The device 100 is designed and configured to automatically switch to the fifth operating mode M5 in emergencies to ensure emergency supply. The fifth operating mode M5 can also be set manually. This may be advantageous in establishing energy-saving operation.

[0401] In the fifth operating mode M5, the monitor can be turned off to save power. In the fifth operating mode M5, all actuators can be de-energized. In the fifth operating mode M5, the sensor can be inactive. In the fifth operating mode M5, the blower 3 can also be switched to power-saving operation. For example, the blower can be operated with reduced dynamic behavior.

[0402] The device 100 can maintain a fresh gas flow in the fifth operating mode M5, and can therefore be designed and configured to administer volatile anesthetic VA.

[0403] In a preferred embodiment, in the fifth operating mode M5, the volatile anesthetic VA is not administered. The anesthetic module 8 and the evaporation element 8a are in a non-operating state, and therefore, continuous ventilation can be performed on the patient using the device 100, but without the administration of the volatile anesthetic. In this case, anesthesia using an intravenous anesthetic is possible.

[0404] As can be seen from Figure 1E, in the fifth operating mode M5, the blower 3 can be in a non-operating state. In the fifth operating mode M5, the reservoir 12 can supply transport energy to the breathing gas mixture 5. The breathing gas mixture 5 can (passively) pass through the blower 3. When the reservoir 12 is activated, the breathing gas mixture 5 is transported to the reservoir line 13. The breathing gas mixture 5 is introduced from the reservoir line 13 into the inspiratory branch tube 1 of the breathing gas line 4. The check valve 21 prevents the breathing gas mixture 5 from flowing back into the reservoir line 13.

[0405] When not energized, the fresh gas switching valve 32 is in its basic position. Therefore, in the fifth operating mode M5, fresh gas can be supplied to the breathing gas line 4 via the first fresh gas supply line 7i. Thus, the supply of fresh gas can be performed at the introduction point 207 and downstream of the check valve 21 in the flow direction.

[0406] In operating mode M5, the switching valve 87 and / or metering valve 88 of the fresh gas supply line 7 can remain in the last set position when not energized, so that fresh gas can be supplied to the breathing gas line at a constant flow rate. Therefore, the metering of fresh gas can be maintained at the last set value.

[0407] In the fifth operating mode M5, the O2 flush 10 can be manually activated, thereby optionally supplying oxygen to the breathing gas line 4. When not energized, the O2 flush switching valve 31 is in its basic position. Therefore, oxygen can be supplied via the first O2 flush supply line 11i. Thus, oxygen can be supplied at the inlet point 211 and upstream of the safety valves 23 and 24 in the flow direction.

[0408] Therefore, in the fifth operating mode M5, the patient can receive a supply of breathing gas and / or fresh gas and / or oxygen by the operation of the reservoir 12 and via the fresh gas module 6 and / or oxygen module 10.

[0409] Figure 1E shows that in the fifth operating mode M5, the expiratory breathing gas 5 is the same as in the first operating mode M1. exsp This indicates that the following is derived. The flow path of the fifth operating mode M5 is essentially equivalent to the flow path of the first operating mode M1.

[0410] Valves 26, 28, and 29 are switched in the fifth operating mode M5 so that the respiratory gas mixture 5 can take two different paths in the expiratory branch tube 2. The respiratory gas mixture 5 or a portion of the respiratory gas mixture 5 can be directed in the direction of the main stream S in the circulatory system and / or discharged from the circulatory system through the discharge system 14. In emergency mode M5, the respiratory gas mixture 5 may be directed at least within the first circulatory system K1. In emergency mode M5, the respiratory gas mixture 5 may be discharged at least partially through outlet 14-A.

[0411] The shut-off valve 28 is de-energized in the fifth operating mode M5 and is therefore in a non-operating state. Thus, the shut-off valve 28 functions as a simple check valve, opening the breathing gas line 4 in the direction of the main flow S. Therefore, the expiratory breathing gas 5 exsp This can be directed, at least partially, in the direction of the main stream S within the circulatory system. In this case, expiratory breathing gas 5 exsp The gas passes through the separation means 40, where CO2 can be chemically separated. The humidity control module 41 is in a non-operating state when not energized and is simply passed through. In the intake side branch tube 1, fresh gas and / or oxygen can be further supplied to the breathing gas mixture 5.

[0412] The third line 14iii of the discharge system 14 is shut off by the discharge valve 26 in the fifth operating mode M5. When de-energized, a high operating pressure is applied to the discharge valve 26. When de-energized, the discharge valve 26 can have an operating pressure of, for example, 100 hPa due to spring tension.

[0413] In the fifth operating mode M5, the APL valve 29 remains in the last set position when de-energized, so the second line 14ii of the discharge system 14 can remain operational. Therefore, in emergency mode M5, the APL valve 29 maintains the (last set) intake pressure P when de-energized. insp It can be adjusted further.

[0414] In the fifth operating mode M5, the operating pressure of the APL valve 29 is lower than the operating pressure of the exhaust valve 26, therefore the expiratory breathing gas 5 exsp This can be discharged, at least partially, through the second line 14ii and outlet 14-A.

[0415] Therefore, in the fifth operating mode M5, the gas flow in the second line 14ii can be released with limitations by the APL valve 29. Excess respiratory gas mixture 5 that cannot be guided into the circulatory system of the respiratory gas line 4 can be discharged through the second line 14ii during inspiration.

[0416] In the fifth operating mode M5, the pressure regulating valve 30 is de-energized and therefore normally no longer adjustable. In the fifth operating mode M5, the pressure regulating valve 30 controls the respiratory pressure P exsp It can be passively adjusted. When de-energized, the pressure regulating valve 30 returns to its passive operating pressure. In the fifth operating mode M5, the pressure regulating valve 30 can passively adjust PEEP to, for example, 5 hPa.

[0417] Unlike the first operating mode M1, in the fifth operating mode M5, sensors 15, 16, 17, 18, 19, 20, 39 and humidity control module 41 are de-energized and therefore in a non-operating state.

[0418] In addition to or alternative to the operating modes described herein, the device 100 can also operate in at least a sixth operating mode M6. In the sixth operating mode M6, a large and essentially constant flow rate can be provided. A constant flow rate can be used, for example, to perform high-flow therapy (HFOT). The device 100 can be used to perform HFOT. For this purpose, a humidifier and / or heating element, not shown herein, can be optionally connected to the device 100 to humidify and / or heat the breathing air.

[0419] The sixth operating mode, M6, can be used in combination with spinal anesthesia and / or another local anesthesia. The sixth operating mode, M6, can be used for awake patients who require respiratory support.

[0420] Figure 1F shows the apparatus 100 in the sixth operating mode M6 for constant flow rate (HFOT). Here, volatile anesthetic VA can be administered optionally.

[0421] The sixth operating mode M6 can be achieved without the addition of volatile anesthetics (see Figure 1F) or with the administration of volatile anesthetics (not shown). The sixth operating mode M6 can also be achieved in the failure mode (not shown).

[0422] Figure 1F shows the device 100 in the sixth operating mode for constant flow rate, without the administration of a volatile anesthetic. The device 100 is designed and configured to produce a nearly constant flow rate without generating or defining a breathing pattern. This flow rate is applied regardless of the patient's respiratory phase in the sixth operating mode M6.

[0423] In HFOT mode, a maximum flow rate of 80 l / min can be achieved. In HFOT mode, a constant flow rate of 60 l / min is typically generated. HFOT can be performed via an open circulation system and / or a semi-open circulation system.

[0424] HFOT is preferably implemented via an open circulatory system without expiratory branch tubes 2 (see Figure 1F). Therefore, the device 100 can be equipped with only an inspiratory tube. In this case, the patient 90 receives a supply of respiratory gas mixture 5 via the inspiratory tube and patient interface 91 and exhales into the surrounding environment. The patient interface 91 for implementing HFOT is preferably a nasal cannula.

[0425] As can be seen from Figure 1F, in the sixth operating mode M6, the blower 3 is not operating, and the reservoir 12 does not supply conveying energy. The breathing gas mixture 5 is driven solely by the fresh gas module 6.

[0426] In the sixth operating mode M6, the fresh gas switching valve 32 is in its basic position. Therefore, in the sixth operating mode M6, fresh gas can be supplied to the respiratory gas line 4 via the first fresh gas supply line 7i. Thus, the supply of fresh gas can be performed at the introduction point 207 and downstream of the check valve 21 in the flow direction. The supply of fresh gas can preferably provide a flow rate for HFOT. A constant fresh gas flow can preferably be led directly to the patient interface without being affected.

[0427] Optionally, in the sixth operating mode M6, the O2 flush 10 can be manually activated, and optionally, additional oxygen can be supplied to the breathing gas line 4. In the sixth operating mode M6, the O2 flush switching valve 31 is in its basic position. Therefore, oxygen can be supplied via the first O2 flush supply line 11i. Thus, oxygen can be supplied at the inlet point 211 and upstream of the safety valves 23 and 24 in the flow direction.

[0428] The intake pressure sensor 15 and / or intake flow sensor 17 and / or oxygen sensor 19 are preferably in an activated state in the sixth operating mode M6. The second safety valve 24 is electrically activatable in the sixth operating mode M6 and provides additional protection.

[0429] The device 100 is also designed (not shown) to provide a constant flow rate in the sixth operating mode M6 and simultaneously administer a volatile anesthetic VA.

[0430] Even when administering volatile anesthetics, a constant flow rate is generated, but in this case, it does not generate or define a breathing pattern and is independent of the patient's respiratory phase. In the sixth operating mode M6, the anesthetic module 8 and / or the evaporation element 8a can be optionally activated. A constant fresh gas flow is supplied via the fresh gas module 6 and the first fresh gas supply line 7i, and this gas flow, after being introduced into the evaporation element 8a, can be enriched with anesthetic VA and led directly to the patient interface without further influence.

[0431] Furthermore, the device 100 can be designed and configured to be connected to a manual bag 35 configured for this purpose, so that the volatile anesthetic is not released into the surrounding environment and can be reused via the manual bag 35 (not shown).

[0432] When administering a volatile anesthetic in the sixth operating mode M6, it is preferable that the multi-gas sensor 20 remains in an activated state. Furthermore, for safety reasons, O2 flushing is possible at a location close to the patient.

[0433] The device 100 is also designed (not shown) to provide a constant flow rate in failure mode without administering a volatile anesthetic, either as an alternative or additional measure.

[0434] In the fault mode of the sixth operating mode M6, that is, for example, when the system is de-energized, the switching valve 87 and / or metering valve 88 of the fresh gas supply line 7 can remain in the last set position when the system is de-energized, so that the fresh gas supply can continue downstream of the first check valve 21.

[0435] In the fault mode of the sixth operating mode M6, sensors 15, 17, and 19 can be deactivated. Therefore, in the fault mode, the intake flow sensor 17 and / or the O2 sensor 19 and / or the intake pressure sensor 15 do not perform measurements.

[0436] In the failure mode of the sixth operating mode M6, the anesthetic module 8 can be manually or automatically deactivated, thereby preventing further supply of anesthetic. The O2 flush 10 can continue to be manually activated in the failure mode of the sixth operating mode M6, thereby optionally supplying oxygen to the respiratory gas line 4 near the patient.

[0437] Figure 1G shows the device 100 in the seventh operating mode M7, which is a service mode. In the seventh operating mode M7, the device 100 is not normally connected to the patient 90.

[0438] The apparatus 100 can operate in a seventh operating mode M7, which allows for maintenance and / or service and / or drying, as an alternative to the operating modes described herein. For example, the apparatus 100 can also operate in standby mode in this manner. It is advantageous that the apparatus 100 can operate in the seventh operating mode M7 to allow for drying of the apparatus 100 or at least a portion of the apparatus 100. In this way, condensed moisture can be effectively removed from the breathing gas line 4 by using the chemical separation means 40.

[0439] In the seventh operating mode M7, the fresh gas module 6 is in a non-operating state. In the seventh operating mode M7, the fresh gas module 6 can be made non-operating by closing the metering valve 88 and / or switching valve 87 in the fresh gas supply line 7.

[0440] In the seventh operating mode M7, the blower 3 is in operation. The blower 3 can generate a constant pressure and / or a constant flow rate and / or a constant volume. The blower 3 can generate negative pressure in the breathing gas line 4 upstream of the blower 3 in the flow direction. Since the fresh gas module 6 is inactive, no fresh gas is supplied to the blower 3. Therefore, in the seventh operating mode M7, the inlet valve 27 can be opened. This allows air to be drawn into the device 100 from the ambient environment via the inlet valve 27. Ambient air can be supplied to the breathing gas line 4 via the inlet valve 27 at the ambient air inlet point 227.

[0441] In the specific embodiment shown in Figure 1, the ambient air inlet 227 can be located downstream of the separation means 40 in the flow direction. In this embodiment, the ambient air inlet 227 can preferably be located downstream of the shut-off valve 28 in the flow direction. The ambient air inlet 227 can be located, for example, upstream of the humidity control module 41 in the flow direction. In the specific embodiment shown in Figure 1, the ambient air inlet 227 is located between the shut-off valve 28 and the humidity control module 41.

[0442] As a result, the drawn-in ambient air is guided through the humidity control module 41. In the seventh operating mode M7, the humidity control module 41 is in a non-operating state, allowing the drawn-in ambient air to pass through passively. The ambient air can absorb moisture in the humidity control module 41. The ambient air then passes through the inspiratory branch tube 1 and the expiratory branch tube 2. The Y-connector 93 is closed on the patient side in the seventh operating mode M7. The ambient air can further pass through the first check valve 21, the blower 3, the inspiratory flow sensor 17, the tubing system 92, the second check valve 22, the PEEP valve 30, the expiratory flow sensor 18, and / or the discharge valve 26, where the ambient air can absorb moisture and be discharged through the outlet 14-A.

[0443] In the seventh operating mode M7, a low operating pressure is applied to the discharge valve 26, opening the third line 14iii. A higher operating pressure is applied to the APL valve 29 than to the discharge valve 26, thereby shutting off the second line 14ii.

[0444] Due to the low operating pressure of the discharge valve 26, the moisture-saturated ambient air bypasses the APL valve 29 and is discharged to outlet 14-A and the surrounding environment via the third line 14iii.

[0445] Figure 4 shows a schematic configuration of the apparatus in the second embodiment.

[0446] The embodiment shown in Figure 4 has an essential configuration corresponding to the embodiment shown in Figure 1, but may include at least one mechanical separation means 60. The separation means 60 may be configured as a mechanical CO2 absorber 60. The separation of CO2 can be performed mechanically via at least one diffusion filter 61, which will be described below with respect to Figure 4 in this specification. The mechanical separation means 60 may be provided as an alternative or additional means to the chemical separation means 40. However, it is preferable that the apparatus 100 includes either the chemical separation means 40 (see Figure 1) or the mechanical separation means 60 (see Figure 4).

[0447] The mechanical separation means 60 can be located inside or on the surface of the respiratory gas line 4. The mechanical separation means 60 can be located downstream of the patient interface. Preferably, the mechanical separation means 60 is located in the expiratory side branch tube 2 of the respiratory gas line 4. The mechanical separation means 60 can be located downstream of the multi-gas sensor 20. The mechanical separation means 60 can be located downstream of the expiratory side pressure sensor 16.

[0448] The mechanical separation means 60 can be located upstream of the discharge system 14. The mechanical separation means 60 can be located upstream of the PEEP valve 30. The mechanical separation means 60 can be located upstream of the junction of the bypass 75 to the expiratory side branch pipe 2. The mechanical separation means 60 can be located upstream of the second safety valve 22.

[0449] In the specific embodiment shown in Figure 3, the mechanical separation means 60 can be positioned between the junction of the bypass 75 to the expiratory side branch tube 2 and the patient interface.

[0450] The apparatus 100 in the embodiment shown in Figure 4 may include additional elements that enable or at least positively influence the function of the apparatus 100 equipped with the mechanical separation means 60, compared to the embodiment shown in Figure 1. The apparatus 100 in the embodiment shown in Figure 4 may also include fewer elements than the embodiment shown in Figure 1. For example, the embodiment shown in Figure 4 may be configured without the chemical separation means 40. Therefore, it is not necessary to include the humidity control module 41. However, in an alternative embodiment, the apparatus 100 may also include the mechanical separation means 60 and the humidity control module 41 (not shown).

[0451] The apparatus 100 may comprise at least one sweep gas module 70 and at least one sweep gas supply line 71 for supplying, introducing, discharging, and controlling sweep gas 64 to the mechanical separation means 60 (see also Figure 5, described later in this specification). The sweep gas module 70 is designed and configured to supply sweep gas 64 to the separation means 60. Through the sweep gas supply line 71, the sweep gas 64 can be introduced and / or discharged to the mechanical separation means 60 in a controlled manner. For this purpose, the sweep gas supply line 71 is pneumatically connected to the separation means 60.

[0452] The apparatus 100 may further include at least one bypass 75. The bypass 75 is configured as a line for guiding gas and can be pneumatically connected to the breathing gas line 4. At least a portion of the breathing gas mixture 5 can be guided through the bypass 75. The bypass 75 can allow or enable a bypass flow S1 in the direction indicated by the dashed line in Figure 4. In the embodiment according to Figure 4, the bypass flow S1 may be present in addition to the main flow S of the breathing gas mixture 5.

[0453] The bypass 75 is designed to at least temporarily establish a connection to guide the respiratory gas from the inspiratory branch 1 to the expiratory branch 2, thereby constituting a second circulatory system K2 capable of guiding the respiratory gas mixture 5. The second circulatory system K2 can, at least partially, correspond to the first circulatory system K1. Here, because the bypass 75 is positioned, the connection 93 for the patient interface is not positioned in the second circulatory system K2. The connection 93 for the patient interface is positioned only in the first circulatory system K1. Furthermore, because the bypass 75 is positioned, the mechanical separation means 60 is not positioned in the second circulatory system K2. The mechanical separation means 60 is positioned only in the first circulatory system K1.

[0454] The respiratory gas mixture 5 can be introduced by a main flow S in the first circulation system K1, and further introduced by a bypass flow S1 in the second circulation system K2. The bypass flow S1 and the main flow S of the respiratory gas mixture 5 can flow in parallel in at least some regions.

[0455] In the bypass 75, at least one valve 76 can be provided. The valve 76 can be configured as a check valve. Therefore, the valve 76 can at least define the direction of the bypass flow S1. In particular, the valve 76 can prevent the bypass flow S1 from flowing back into the inspiratory branch tube 1 of the breathing gas line 4. In some embodiments, the valve 76 can be configured as a simple check valve or a biased check valve (not shown).

[0456] In a preferred embodiment, the valve 76 can be configured as a shuttable check valve, and therefore as a bypass shuttable valve 76. In a specific embodiment shown in Figure 4, the bypass shuttable valve 76 can be configured, for example, as a shuttable check valve equipped with an electromagnetic coil. Therefore, the bypass shuttable valve 76 can preferably operate in at least two settings. In a first setting, for example in the stationary position, the bypass shuttable valve 76 opens the flow in one direction and shuts it off in one direction. In this first setting, the bypass shuttable valve 76 can function as a simple check valve. In a second setting, for example in the operating position, the bypass shuttable valve 76 can shut off the flow in both directions. The operating position of the valve 76 can be established, for example, by energizing the electromagnetic coil.

[0457] The bypass 75 can branch off in the inspiratory branch 1. The bypass 75 can merge into the expiratory branch 2. The bypass 75 can branch off between the blower 3 and the patient interface 91. Preferably, the bypass 75 can branch off between the blower 3 and the introduction point 211 of the first O2 flush supply line 11i. In the specific embodiment shown in Figure 4, the bypass 75 can branch off, for example, between the inspiratory flow sensor 17 and the introduction point 211 of the first O2 flush supply line 11i.

[0458] To prevent backflow of the oxygen module 10 into the bypass 75 and / or the blower 3, it may be advantageous to provide at least one additional check valve, i.e., a third safety valve 77. The third safety valve 77 may be located in the breathing gas line 4 between the branch of the bypass 75 and the introduction point 211 of the first O2 flush supply line 11i. For example, the third safety valve 77 may be configured as a simple check valve. In some embodiments, the third safety valve 77 may also be configured as a spring-driven check valve.

[0459] The bypass 75 can rejoin the respiratory gas line 4 between the patient interface 91 and the blower 3. Thus, the bypass 75 can rejoin the expiratory side branch 2. Preferably, the bypass 75 can rejoin the respiratory gas line 4 between the separation means 60 and the blower 3. In particular, the bypass 75 can rejoin the respiratory gas line 4 between the separation means 60 and the anesthetic module 8. In the specific embodiment shown in Figure 4, the bypass 75 can rejoin the expiratory side branch 2 of the respiratory gas line 4 downstream of the second safety valve 22. The second safety valve 22 can then prevent the bypass flow S1 from flowing against the main flow S towards the separation means 60. The bypass 75 branches off from the respiratory gas line 4 downstream of the blower 3 and can rejoin the respiratory gas line 4 at least upstream of the anesthetic module 8.

[0460] Bypass flow S1 can be generated via bypass 75. In the embodiment shown in Figure 4, bypass flow S1 is not directed to the patient 90. In the embodiment shown in Figure 4, bypass flow S1 is not generated at the junction of the oxygen module 10. In the embodiment shown in Figure 4, bypass flow S1 is not directed through the separation means 60. The second safety valve 22 prevents bypass flow S1 from flowing in the direction of the separation means 60.

[0461] In this embodiment, the bypass flow S1 flows at least from the blower 3 through the bypass 75 to the anesthetic module 8 and then back to the blower 3. Therefore, a second gas circulation system can be formed by the bypass flow S1 through the bypass 75. The second gas circulation system may exist as an alternative or additional system to the gas circulation system of the main flow S. The bypass flow S1 and the main flow S may flow in parallel within the breathing gas line 4 in at least some areas. The bypass flow S1 and the main flow S may not flow in a common line in at least some areas.

[0462] In liquid administration, one or more anesthetic agents VA are held under pressurized conditions and therefore as liquid within the anesthetic module 8 and / or anesthetic supply line 9, from which they are injected into the respiratory gas line 4. Upon reaching the respiratory gas line 4, the anesthetic agents VA evaporate and mix with the respiratory gas mixture 5. Because a constant gas flow exists within the evaporation element 8a due to the bypass flow S1, the anesthetic agents VA can mix particularly favorably with the respiratory gas mixture 5.

[0463] With this type of liquid administration, pre-mixing of the anesthetic VA with fresh gas is no longer necessary. Therefore, a mixing chamber separated from the breathing gas line 4 for the separation and mixing of fresh gas or breathing gas with the anesthetic VA is also no longer required. Liquid administration allows for highly accurate and economical administration of the anesthetic VA, independent of the supply of fresh gas and / or oxygen. The evaporation element 8a can replace the conventional mixing chamber.

[0464] Figure 5 shows a schematic structure of a mechanical separation means 60 equipped with a diffusion filter 61. The mechanical separation means 60 can, in principle, be configured as a two-chamber system 65, and may include at least one first chamber 62 and at least one second chamber 63. The first chamber 62 and the second chamber 63 are separated from each other by at least one diffusion filter 61.

[0465] The mechanical separation means 60 may comprise a number of such two-chamber systems 65 that can extend in parallel to one another.

[0466] In an exemplary embodiment, the two-chamber system 65 is configured as a gas-conducting tube. The tube can have a diameter of 0.1 mm to 10 mm, preferably 0.1 mm to 5 mm, and particularly preferably 0.3 mm to 1 mm. For example, the tube of the two-chamber system 65 has a diameter of 0.5 mm. For example, the mechanical separation means 60 comprises thousands of such tubes (not shown). It is advantageous that the total diameter of these tubes, and thus the diameter of the separation means 60, corresponds to the diameter of the breathing gas line 4.

[0467] The diffusion filter 61 can be configured as a semipermeable membrane and may have pores 65 designed so that only molecules below a certain size can pass through the membrane. The diffusion filter 61 is preferably made of a chemically inert material. The diffusion filter 61 is characterized by being washable, disinfectable, and reusable.

[0468] For example, the diffusion filter 61 is manufactured from plastic, ceramic, glass, metal, or a combination thereof. In exemplary embodiments, the material for the diffusion filter 61 is selected from the group including polysulfone, polyethersulfone, cellulose, cellulose ester, cellulose acetate, cellulose nitrate, regenerated cellulose, silicone, polyamide, polyamide-imide, polyamidourea, polycarbonate, ceramic, stainless steel, silver, silicon, zeolite, almosilicate, polyacrylonitrile, polyethylene, polypropylene, polytetrafluoroethylene, polyvinylidene fluoride, polyvinyl chloride, and polypiperazineamide. Combinations of these materials are also possible.

[0469] The respiratory gas mixture 5 can be guided through the first chamber 62 of the two-chamber system 65 in the direction of the main flow S. To separate CO2, the expiratory respiratory gas 5 exsp It is preferable that the expiratory breathing gas 5 is guided through the separation means 60. exsp The gas can be guided through the first chamber 62. For this purpose, the separation means 60 is preferably located in the expiratory side branch tube 2. It is particularly advantageous when the separation means 60 is located in close proximity to the patient 90. In some embodiments, the separation means 60 may also be designed to separate nitrous oxide (N2O) as an alternative or additional measure. The separation of N2O can be carried out in the same manner as the separation of CO2 described herein.

[0470] A sweep gas 64 can be introduced through the second chamber 63 of the two-chamber system 65. The sweep gas 64 is designed to wash out at least CO2 from the breathing gas mixture 5. The sweep gas 64 is guided through the second chamber 63 by a sweep gas flow S2 in the direction indicated by arrow S2 in Figure 5. The direction of the sweep gas flow S2 is preferably selected opposite to the direction of the main flow S of the breathing gas mixture 5, indicated here by arrow S.

[0471] The apparatus 100 may comprise at least one sweep gas module 70 and at least one sweep gas supply line 71. Sweep gas 64 can be introduced into the separation means 60 via the sweep gas supply line 71. The sweep gas 64 can be introduced, in particular, into the second chamber 63 of the separation means 60 via the sweep gas supply line 71. The sweep gas 64 can also be discharged from the second chamber 63 via the sweep gas supply line 71. For this purpose, the sweep gas supply line 71 is pneumatically connected to the second chamber 63. The sweep gas supply line 71 can supply and / or discharge sweep gas 64 to the separation means 60.

[0472] In some embodiments, the sweep gas 64 can be supplied from a pressurized gas cylinder. Alternatively or additionally, the sweep gas 64 can also be supplied via the oxygen module 10 and / or the fresh gas module 6.

[0473] The control device 101 and / or the sweep gas module 70 can define the composition of the sweep gas 64. The control device 101 and / or the sweep gas module 70 can define the flow rate and / or volume of the sweep gas 64. The sweep gas module 70 can be connected to and / or controlled by the control device 101.

[0474] The control device 101 and / or the sweep gas module 70 may also be designed to shut off or stop the sweep gas flow so that the device 100 can operate without the sweep gas 64. This is advantageous, for example, when the device 100 operates in a semi-open circulation system, such as in TIVA mode. When there is no sweep gas flow in the second chamber 63, the separation means 60 becomes inactive. In this case, the breathing gas mixture 5 can pass through the mechanical separation means 60, but gaseous components such as CO2 are not separated.

[0475] The sweep gas 64 is designed so that the CO2 concentration is significantly lower than that of the breathing gas mixture 5. The sweep gas 64 is designed so that the CO2 concentration of the sweep gas 64 when introduced into the second chamber 63 is less than 20%, preferably less than 10%, and particularly preferably less than 5%. Ideally, the CO2 concentration of the sweep gas 64 when introduced into the second chamber 63 is 0%. Furthermore, it is advantageous that the sweep gas 64 does not contain the anesthetic VA.

[0476] Furthermore, the sweep gas 64 is designed such that the concentration of oxygen O2 and / or nitrogen N2 is preferably at least the same as or higher than the concentration of the exhaled breathing gas mixture 5.

[0477] The O2 concentration of the sweep gas 64 when introduced into the second chamber 63 is greater than 0%, preferably greater than 20%, and particularly preferably greater than 40%. For example, the O2 concentration of the sweep gas 64 when introduced into the second chamber 63 may be 47%.

[0478] The N2 concentration of the sweep gas 64 when introduced into the second chamber 63 is greater than 0%, preferably greater than 20%, and particularly preferably greater than 40%. For example, the N2 concentration of the sweep gas 64 when introduced into the second chamber 63 may be 53%.

[0479] Based on the concentration gradient across the diffusion filter 61, the respiratory gas mixture 5 can be separated by the mechanical separation means 60. Due to the properties of the diffusion filter 61, particularly small molecules can be separated. In particular, molecules consisting of a small number of atoms, for example, fewer than 5 atoms, can be separated. In particular, CO2 molecules can be separated. Oxygen O2 and nitrogen N2 can also pass through the diffusion filter 61. On the other hand, anesthetic VA, which contains more than 5 atoms, cannot pass through the diffusion filter 61 and may remain in the respiratory gas mixture 5.

[0480] The initial concentration of the gas components in the sweep gas 64 allows control over which gas components are filtered from the breathing gas mixture 5 and which gas components remain in the breathing gas mixture 5.

[0481] Regarding carbon dioxide (CO2), the following scenarios may be favorable.

[0482] When the sweep gas 64 is introduced into the second chamber 63 and has a lower CO2 concentration than the respiratory gas mixture 5 in the first chamber 62, the CO2 can be filtered out of the respiratory gas mixture 5. This removes the CO2 from the respiratory gas mixture 5, making it suitable for inspiration again. Thus, the respiratory gas mixture 5 can be guided within a closed circulatory system.

[0483] With respect to oxygen O2 and / or N2, the following scenarios may be favorable.

[0484] If sweep gas 64 is introduced into the second chamber 63 and has the same and / or higher O2 concentration as the breathing gas mixture 5 in the first chamber 62, then O2 may remain in the breathing gas mixture 5. Subsequently, if the breathing gas mixture 5 is used for inhalation again, the breathing gas mixture 5 will contain oxygen at the concentration of sweep gas 64.

[0485] When sweep gas 64 is introduced into the second chamber 63 and has a lower O2 concentration than the respiratory gas mixture 5 in the first chamber 62, the O2 can be filtered out of the respiratory gas mixture 5. This may have the advantage of allowing the patient to reuse oxygen that has been temporarily supplied in excess, and / or allowing the respiratory gas mixture 5 to be reused even if there is a temporary excess of O2.

[0486] The retention or removal of N2 and / or N2O in the respiratory gas mixture 5 can also be controlled in the same manner according to a similar principle.

[0487] The gas concentration of the sweep gas 64 introduced can be controlled via the control device 101 and / or the sweep gas module 70. The volume and / or flow rate of the sweep gas 64 introduced can also be controlled via the control device 101 and / or the sweep gas module 70. In some embodiments, the sweep gas flow rate is constant through the separation means 60. In some embodiments, the sweep gas flow rate can also be adaptively adapted according to ventilation, and therefore, for example, according to tidal volume or minute ventilation. Control is preferably performed automatically by settings and values ​​stored in the control device 101, but can also be set manually by a healthcare professional if necessary.

[0488] In some embodiments, the sweep gas flow rate and / or sweep gas volume corresponds to the flow rate and / or volume of the respiratory gas mixture 5. In advantageous embodiments, the sweep gas 64 is introduced into the separation means 60 in excess of the respiratory gas mixture 5. For example, with each breath, the same amount of sweep gas 64 is introduced into the second chamber 63 as the amount of respiratory gas mixture 5 that flows into the first chamber 62. Advantageously, with each breath, more sweep gas 64 is introduced into the second chamber 63 than the amount of respiratory gas mixture 5 that flows into the first chamber 62.

[0489] The ratio of the amount of sweep gas 64 to the amount of breathing gas mixture 5 may be at least 1:1, preferably at least 1.2:1, and particularly preferably at least 1.4:1. For example, the ratio of sweep gas 64 to breathing gas mixture 5 may be 1.5:1 or higher. It is also conceivable that the ratio of sweep gas 64 to breathing gas mixture 5 may be at least 2:1 or at least 5:1. Typically, the sweep gas is measured to achieve a minute ventilation rate of 1.2 to 1.5 times the normal rate.

[0490] The ratio of the amount of sweep gas 64 to the amount of respiratory gas mixture 5 is variable and can be adaptively adjusted according to the corresponding ventilation conditions. The sweep gas flow rate is controlled by the expiratory respiratory gas 5 exspIt is preferable that the CO2 concentration be adjustable based on the CO2 concentration. The mechanical separation means 60 equipped with the sweep gas module 70 offers the advantage of being able to set the CO2 concentration of the respiratory gas mixture 5 quickly, precisely, highly dynamically, and cost-effectively. Since a high CO2 concentration promotes spontaneous breathing in the patient, the CO2 concentration can, for example, influence the patient's weaning from mechanical ventilation.

[0491] The sweep gas supply line 71 can be configured in accordance with the supply line shown in Figure 2. The sweep gas supply line 71 may also have more or fewer elements than the supply line shown in Figure 2. The sweep gas supply line 71 may include at least one valve 88i for measuring the sweep gas 64.

[0492] The sweep gas module 70 can be supplied with gas, in particular, through the fresh gas module 6 and / or the oxygen module 10. The sweep gas supply line 71 may then be equipped with at least one bistable switching valve 87 and / or at least one bistable needle valve 88, and at least one flow sensor 85, through which the introduction of sweep gas to the separation means 60 is controlled and regulated (not shown).

[0493] The advantages of the mechanical separation means 60 compared to the chemical separation means 40 are as follows: - Because the anesthetic remains in the circulatory system, i.e., in the respiratory gas mixture 5, without being filtered, the anesthetic VA is significantly reduced. - The mechanical separation means 60 is chemically neutral or inert. Therefore, no heat is generated or water is produced during CO2 removal. - Therefore, no special chemical waste is generated. - The mechanical separation means 60 is configured for very long-term use (up to one year) and does not require frequent replacement. Therefore, the separation means 60 can be replaced by a service representative. - Because it is replaced infrequently, the risk of contamination is low. - The separation means 60 can optionally be reused after reprocessing. - The separation means 60 is more cost-effective than the chemical separation means 40 due to its long lifespan.

[0494] Embodiments comprising mechanical separation means 60 and bypass 75 offer numerous advantages. Through the bypass 75, a constant gas flow (biflow) can be provided within the respiratory gas line 4, at least partially. In particular, a constant gas flow can be provided through the bypass 75 in the region of the respiratory gas line 4 where the anesthetic supply line 9 joins. Specifically, a constant gas flow can be present within the evaporation element 8a through the bypass 75. The presence of a constant flow (biflow) of the respiratory gas mixture 5 within the evaporation element 8a allows the anesthetic VA to be introduced and / or mixed into the respiratory gas mixture 5, particularly advantageously by liquid administration.

[0495] An advantage of embodiments with at least one bypass 75 is that the biflow is not directed throughout the entire system. The biflow can be restricted to the second circulatory system K2. The bypass 75 makes it possible that the biflow does not flow to the patient. The bypass 75 further makes it possible that the biflow does not flow through the mechanical separation means 60. This is particularly important for expiratory breathing gas 5 exsp This has the advantage that the CO2 is introduced into the separation means 60 without being diluted. This significantly improves the efficiency of the mechanical separation means 60. On the one hand, because there is no biflow within the separation means 60, the CO2 concentration when introduced into the separation means 60 is high, which has a favorable effect on CO2 removal. On the other hand, the expiratory breathing gas 5 exsp The residence time within the separation means 60 is increased. In the exhalation plateau, since there is no gas flow within the separation means 60, the diffusion of CO2 into the sweep gas is promoted.

[0496] The bypass shutoff valve 76 can establish or shut off the connection leading to the bypass respiratory gas. Shutoff of the bypass 75 may be advantageous when it is desired to rapidly change the concentration of anesthetic VA or oxygen in the respiratory gas mixture 5 in the inspiratory branch tube 1. It should be noted that the efficiency of the diffusion absorber decreases at this point.

[0497] The apparatus 100 of the second embodiment can operate in different operating modes M1, M2, M3, M4, M5, M6, and M7 as described with respect to Figures 1A to 1F. The operating modes can be set manually and / or automatically by the control device 101.

[0498] In the second embodiment as well, the volatile anesthetic VA can be administered and drained using the device 100, and in particular, can be intentionally drained for disposal or reuse. In the second embodiment as well, ventilation can also be performed using the device 100 without the volatile anesthetic VA.

[0499] The operating modes in the second embodiment can be achieved, for example, through the settings of valves 25, 26, 27, 28, and 29, and optionally through the settings of blower 3 and / or pressure regulating valve 30, and by the operation of reservoir 12. The operating modes in the second embodiment can be particularly influenced by the settings of bypass shut-off valve 76.

[0500] The operating modes M1 to M7 of the second embodiment largely correspond to the operating modes of the first embodiment described above. However, there are differences, particularly due to the bypass and different isolation means 40 and 60, as described below.

[0501] In the first operating mode M1 for manual ventilation with administration of a volatile anesthetic, in the second embodiment as well, the reservoir 12 supplies transport energy, and therefore respiratory energy, to the respiratory gas mixture 5. Inspiratory respiratory gas 5 insp It is delivered to the patient via the inspiratory side branch tube 1, and expiratory side breathing gas 5 exspIt is delivered from the patient via the expiratory side branch tube 2. The fresh gas switching valve 32 and the O2 flush switching valve 31 are in their basic positions. Therefore, fresh gas introduction can be performed downstream of the check valve 21 in the flow direction. Optional oxygen introduction by O2 flush 10 can be performed downstream of the blower 3 and upstream of the safety valves 23 and 24 in the flow direction. The anesthetic module 8 is in operation, thereby introducing the volatile anesthetic VA into the evaporator element 8a via the anesthetic supply line 9 and adding it to the respiratory gas mixture 5.

[0502] Exhalational breathing gas 5 exsp It can be transported from the patient via the expiratory branch tube 2. In the expiratory branch tube 2, expiratory breathing gas 5 exsp The gas passes through the mechanical separation means 60. The sweep gas module 70 is in operation in the first operating mode M1 and guides the sweep gas to the separation means 60. As a result, the separation means 60 also becomes operational and separates at least CO2 from the exhaled breathing gas 5 exsp It can be separated from the expiratory breathing gas 5. exsp It can pass through the PEEP valve 30, which is in an operating state and is adjusted to the individual breath pressure.

[0503] Subsequently, the respiratory gas mixture 5 can also take two different paths in the second embodiment.

[0504] On the one hand, a low operating pressure is applied to the shut-off valve 28, and the respiratory gas line 4 is opened, so that the respiratory gas mixture 5 can be guided in the direction of the main flow S within the circulatory system. In this case, unlike the first embodiment, the respiratory gas mixture 5 does not need to pass through the chemical CO2 absorber 40 and the humidity control module 41. Since the CO2 has already been separated by the mechanical separation means 60, the respiratory gas mixture 5 can be guided in the circulatory system and supplied again to the patient. However, in the second embodiment, it is also conceivable to include a humidity control module 41 (not shown) to remove and / or supply moisture to the circulatory system.

[0505] On the other hand, the breathing gas mixture 5 can also be discharged from the circulation system through the discharge system 14 via the APL valve 29, at least partially.

[0506] Unlike the first embodiment shown in Figure 1, the second embodiment shown in Figure 4 may have a second circulation system with bypass flow S1. The bypass 75 is designed and configured to accommodate the second circulation system as needed.

[0507] In the first operating mode M1, a low operating pressure is applied to the bypass shutoff valve 76, or it is in a stationary position. In the first operating mode M1, the bypass shutoff valve 76 can function as a simple check valve without the action of the electromagnetic coil. In the first operating mode M1, the bypass shutoff valve 76 opens the bypass 75 in the direction of the bypass flow S1.

[0508] The bypass 75 has the advantage of establishing a second circulating system for the respiratory gas mixture 5, which is not directed to the patient. In the second circulating system, a nearly constant flow rate can be generated, independent of the patient's respiratory phase. This nearly constant flow rate further flows through the evaporation element 8a, facilitating the liquid administration of the anesthetic. Furthermore, the bypass 75 has the advantage that the flow rate directed through the separation means 60 is reduced by the generation of the second circulating system, and therefore the sweep gas 64 can be conserved.

[0509] In the second operating mode M2 ​​for mechanical ventilation with administration of volatile anesthetics, as in the second embodiment, the blower 3 supplies transport energy, and therefore respiratory energy, to the respiratory gas mixture 5. The reservoir 12 functions as a storage unit for at least a portion of the respiratory gas mixture 5. The fresh gas switching valve 32 and the O2 flush switching valve 31 are in their basic positions. Fresh gas is introduced into the respiratory gas line 4 via the first fresh gas supply line 7i and transported to the patient by the blower 3. The anesthetic module 8 is in the operating state. In the second embodiment, the sweep gas module 70, and therefore the separation means 60, is also in the operating mode M2, thereby enabling the separation of at least CO2, and allowing at least a portion of the respiratory gas mixture 5 to remain in the circulating system.

[0510] When the blower 3 is operating, it can draw the breathing gas mixture 5 (enriched with fresh gas and / or anesthetic) from the breathing gas line 4, thereby creating at least a partial negative pressure upstream of the blower 3. This allows the breathing gas mixture 5 to be drawn from the reservoir 12. If the negative pressure persists, for example, if the volume provided by the fresh gas module 6 and / or reservoir 12 is insufficient, the inlet valve 27 can be opened to supply ambient air to the breathing gas line 4.

[0511] The ambient air inlet point 227 can be located in the breathing gas line 4. In some embodiments, the ambient air inlet point 227 can also be located in the reservoir line 13. For example, in the second embodiment shown in Figure 4, the ambient air inlet point 227 can be located in the reservoir line 13. In this specific embodiment, the ambient air inlet point 227 can be located in the breathing gas line 4 between the reservoir 12 and the reservoir inlet point 213. This allows ambient air to be supplied directly to the breathing gas line 4 via the reservoir line 13.

[0512] In the second operating mode M2, valves 26, 28, and 29 are switched so that the respiratory gas mixture 5 essentially flows along the main flow direction S within the circulation system. However, unlike the first embodiment, in the second embodiment the respiratory gas mixture 5 does not pass through the chemical separation means 40. A humidity control module 41 may be optionally provided, but can be omitted because the chemical separation means 40 is not present.

[0513] In the second operating mode M2, the bypass shutoff valve 76 of the second embodiment is in a stationary position. As a result, the bypass 75 becomes operational and can pass in the direction of the bypass flow S1. Therefore, in the operating mode M2 ​​of the second embodiment, a second circulation system for the breathing gas mixture 5 is established, similar to the first operating mode M1.

[0514] A third operating mode M3 for manual ventilation without the administration of volatile anesthetics can be very similar to that of the first and second embodiments. The respiratory gas mixture 5 can be introduced, for example, in a similar or analogous manner. This can be achieved, in particular, in the third operating mode M3 by the bypass 75 and / or sweep gas module 70 and / or mechanical separation means 60 of the second embodiment being in a non-operating state.

[0515] In the third operating mode M3, a high operating pressure is applied to the bypass shutoff valve 76, and / or it can be in an operating state. In the third operating mode M3, the bypass shutoff valve 76 can function as a shutoff valve under the action of the electromagnetic coil. In the third operating mode M3, the bypass shutoff valve 76 can shut off the bypass 75, thereby causing the bypass 75 to become inoperable. In the third operating mode M3, the operating bypass shutoff valve 76 shuts off the second circulation system for the breathing gas mixture 5.

[0516] In the third operating mode M3, the sweep gas module 70 can be in a non-operating state. In a non-operating state, the sweep gas module 70 does not transport the sweep gas 64 to the mechanical separation means 60. Because there is no sweep gas flow in the separation means 60, the mechanical separation means 60 is in a non-operating state. The separation means 60 can be passed through passively. In the third operating mode M3, the expiratory breathing gas 5 exsp The material can pass through the separation means 60, but the CO2 is not separated.

[0517] In the third operating mode M3, the respiratory gas mixture 5 does not normally contain the volatile anesthetic VA, therefore the expiratory respiratory gas 5 exsp As described above, this can be guided into a semi-open circulation system by shutting off the shut-off valve 28 and opening the discharge valve 26.

[0518] A fourth operating mode M4 for automatic ventilation without the administration of volatile anesthetics can be very similar to that in the first and second embodiments. The respiratory gas mixture 5 can be introduced, for example, in a similar or similar manner. This can be achieved, in particular, in the fourth operating mode M4 as well, by the bypass 75 and / or sweep gas module 70 and / or mechanical separation means 60 of the second embodiment being inactive. Similar to the first embodiment, in the second embodiment as well, in order to realize the fourth operating mode M4, the blower 3 is activated, a low operating pressure is applied to the overflow valve 25, and the first line 14i is activated. Furthermore, the shut-off valve 28 is activated to shut off the circulation system, and the discharge valve 26 is opened to activate the third line 14iii. Unlike the first embodiment, in the second embodiment, ambient air can be supplied directly to the reservoir line 13 through the introduction valve 27 if necessary.

[0519] The apparatus 100 according to the second embodiment can operate in battery mode and / or fault mode for manual ventilation in a fifth operating mode M5. The fifth operating mode M5 may be similar to that in the first and second embodiments. Emergency supply by manual ventilation can be ensured by the reservoir 12 supplying transport energy to the respiratory gas mixture 5 and supplying fresh gas at a constant flow rate to the respiratory gas line 4 via the first fresh gas supply line 7i. The fresh gas supply line 7i is open when not energized.

[0520] The respiratory gas flow path is essentially the same as in the first embodiment, flowing from the reservoir 12 to the patient via the inspiratory branch tube 1, and from the patient to the main stream S via the expiratory branch tube 2, through the circulatory system, and / or to the outlet 14-A via the APL valve 29 and the second line 14ii.

[0521] Unlike the first embodiment, in the second embodiment, the bypass 75 can be in an activated state. The bypass shutoff valve 76 can function as a simple check valve when not energized. This allows the breathing gas mixture 5 to be further guided through the second circulation system at a relatively constant flow rate.

[0522] In the fifth operating mode M5, the sweep gas module 70 is in an operating state when de-energized, and therefore the sweep gas 64 can be introduced into the mechanical separation means 60, and CO2 can be separated. When de-energized, the sweep gas supply line is open. The valve 88i for metering the sweep gas 64 can be designed so that the sweep gas metering is set to 1.2 to 2 times, preferably 1.5 times, the last set minute ventilation rate when de-energized. An advantage of the second embodiment is that mechanical CO2 separation does not cause the generation of special moisture. Furthermore, CO2 separation is ensured by the sweep gas module 70, which is in an operating state when de-energized.

[0523] A sixth operating mode M6 for constant flow rate (HFOT) with or without administration of a volatile anesthetic can be very similar to those in the first and second embodiments. The breathing gas mixture 5 can be introduced, for example, in a similar or analogous manner. This can be achieved, in particular, by the bypass 75 of the second embodiment being in a non-operating state in the sixth operating mode M6.

[0524] In the sixth operating mode M6, a high operating pressure is applied to the bypass shutoff valve 76, and / or it can be in the operating position. Therefore, the bypass shutoff valve 76 can deactivate or shut off the bypass 75. In the sixth operating mode M6, the deactivation of the bypass 75 means that the respiratory gas mixture 5 cannot pass through the bypass 75. In this case, the respiratory gas mixture 5 is guided in the open circulation system as described above. The respiratory gas mixture 5 is guided to the patient via the inspiratory side branch tube 1, thereby allowing the patient to receive a constant flow rate.

[0525] The seventh operating mode M7 can be implemented in the second embodiment in the same manner as in the first embodiment. Therefore, the apparatus 100 according to the second embodiment can also operate in service mode. The seventh operating mode M7 is specifically designed and configured to remove condensed moisture from the apparatus 100. Furthermore, if the advantageous mechanism of action of the mechanical separation means 60 can result in significantly less humidity being generated inside the apparatus 100 compared to the chemical separation means 40, then the seventh operating mode M7 can be implemented to remove condensed moisture.

[0526] In the seventh operating mode M7, when the blower 3 is operating and the fresh gas module 6 is inactive, ambient air can be introduced into the reservoir line 13 via the introduction valve 27 and then transported to the breathing gas line 4. The gas can then be discharged again via the outlet 14-A. In the seventh operating mode M7, the bypass 75 is in an active state and can be passed through. It is also conceivable that the bypass 75 will become inactive when the bypass shut-off valve 76 becomes active. During operation in the seventh operating mode M7, the sweep gas module 70 is in an inactive state and the mechanical separation means 60 can be passed through passively.

[0527] Although the present invention has been described in detail based on examples, it will be obvious to those skilled in the art that the present invention is not limited to these examples. Rather, modifications are possible so as long as they do not deviate from the scope of protection of the appended claims, individual features can be omitted or different combinations of the described features can be realized. This disclosure encompasses all combinations of the individual features presented. [Explanation of Symbols]

[0528] CO2 (carbon dioxide) O2 (Oxygen) K1 First Circulatory System K2 Second Circulatory System M1 First operating mode M2 Second operating mode M3 Third Operating Mode M4 4th operating mode M5 Fifth operating mode M6 6th operating mode M7 7th operating mode N2 Nitrogen P1 First pressure P2 Second pressure P insp Inhalation pressure P exsp Exhalation pressure PEEP (Positive End-Expiratory Pressure) S Mainstream S1 Bypass Flow S2 Sweep Gas Flow S3 discharge stream VA volatile anesthetics ZGA Central Gas Equipment 1. Intake side branch pipe 2. Exhalation side branch tube 3. Blower Unit / Blower 3a Blower outlet 4. Breathing gas lines 5. Breathing gas mixture 5 insp Inspiratory breathing gas 5 exsp Exhaling breathing gases 6. Fresh gas module 7. Fresh gas supply line 7i First fresh gas supply line 7ii Second fresh gas supply line 8. Anesthetic Modules 8a Evaporation element 9. Anesthetic drug supply line 10 Oxygen Modules / O2 Flash 11. O2 flash supply line 11i First O2 Flash Supply Line 11ii Second O2 flash supply line 12 Reservoirs 13 Reservoir Line 14 Emissions System 14i First Line 14ii Second line 14iii Third line 14-A Exit 15. Intake side pressure sensor 16. Exhalation pressure sensor 17 Intake side flow sensor 18. Exhalation-side flow sensor 19 sensors 20 Multi-gas sensors 21 First check valve 22 Second check valve 23 First safety valve 24. Second safety valve 25 Overflow valve 26 Discharge valve 27 Induction valve 28 Shut-off valve 29 APL valve 30 Pressure regulating valve (PEEP valve) 31 O2 flush selector valve 32 Fresh gas switching valve 35 Manual Bags 39 Pressure Sensor 40 Chemical separation means 41 Humidity control module 43 Nitrogen Oxide Modules 44 Nitrogen Oxide Supply Line 60 Mechanical separation means 61 Diffusion filter 62 First Chamber 63 The second room 64 Sweep Gas 65 2-room system 70 Sweep Gas Modules 71 Sweep gas supply line 75 Bypass 76 Bypass shutoff valve 77 Third safety valve 80 Pressure Regulator / Reducer 81 Aperture section 82 filters 83 Overpressure valve 84 Pressure Sensor 85 Flow Sensor 86 Check valve 87 Switching valve 88 Measuring valve 89 Source 90 patients 91 Patient Interface 92 Tube System 93 Connection part for patient interface 94 filters 95 Sensors 100 devices 101 Control Devices 102 Memory Units 103 Primary power supply 104 Secondary power supply 110 Ventilation-Specific Parameters 111 Patient Parameters 207 Fresh gas introduction points 209 Anesthetic drug induction section 211 O2 flush introduction point 213 Reservoir introduction point 214 Connection point (discharge system) 227 Point of introduction of ambient air 800 tank 810 Pressure supply unit 811 Pressure valve 812 Pressure Reducing Valve 813 Switching valve 820 storage units 821 storage bays 830 Selection Unit 831 Selector valve 840 weighing units 841 Measuring valve 850 Safety Unit 851 First valve (safety valve) 852 Second valve (safety valve) 860 temperature units 861 Heating Element

Claims

1. A respiratory gas supply device (100), comprising at least one respiratory gas line (4) for guiding a respiratory gas mixture (5), wherein the respiratory gas line (4) comprises at least one outlet (14-A) capable of at least partially and at least temporarily discharging the respiratory gas mixture (5), the respiratory gas line (4) comprises an inspiratory branch tube (1) configured to guide the respiratory gas to a connection (93) for a patient interface, the respiratory gas line (4) comprises an expiratory branch tube (2) configured to guide the respiratory gas between the connection (93) for a patient interface and the outlet (14-A), wherein at least one shut-off valve (28) is provided in the respiratory gas line (4), and the at least one shut-off valve (28) is configured and designed to at least temporarily establish a connection for guiding the respiratory gas from the expiratory branch tube (2) to the inspiratory branch tube (1).

2. The apparatus (100) according to claim 1, wherein the apparatus (100) comprises at least one reservoir (12) for the respiratory gas mixture (5) and at least one blower (3) designed to provide transport energy to the respiratory gas mixture (5), the reservoir (12) and the blower (3) being arranged inside or on the surface of the inspiratory side branch pipe (1).

3. The apparatus (100) according to claim 1 or 2, wherein the shut-off valve (28) is configured and designed as a check valve to establish a connection for guiding the breathing gas in the flow direction from the expiratory side branch pipe (2) to the inspiratory side branch pipe (1).

4. An apparatus (100) according to any one of claims 1 to 3, wherein the shut-off valve (28) is configured and designed as a shut-off check valve that shuts off the breathing gas line (4) at least temporarily in both flow directions.

5. An apparatus (100) according to any one of claims 1 to 4, wherein the apparatus (100) comprises a control device (101) and at least one power supply (103, 104), and the shut-off valve (28) is designed to shut off the breathing gas line (4) in both flow directions when energized by the at least one power supply (103, 104).

6. An apparatus (100) according to any one of claims 1 to 5, wherein the shut-off valve (28) is designed to shut off the connection that leads the respiratory gas from the expiratory branch tube (2) to the inspiratory branch tube (1) when energized, and / or the respiratory gas mixture (5) can be completely discharged from the expiratory branch tube (2) through the outlet (14-A) when the shut-off valve (28) is energized.

7. An apparatus (100) according to any one of claims 1 to 6, wherein the inspiratory side branch tube (1) and the expiratory side branch tube (2) constitute at least a first circulation system (K1) when the shut-off valve (28) is not energized, the respiratory gas mixture (5) can be introduced within the first circulation system (K1), and the respiratory gas mixture (5) can be at least partially discharged through the outlet (14-A).

8. An apparatus (100) according to any one of claims 1 to 7, wherein the apparatus (100) comprises at least one adjustable pressure regulating valve (29, 30), the pressure regulating valve (29, 30) controls the intake pressure (P ｉｎｓｐ ) and / or breathing pressure (P ｅｘｓｐ A device designed to adjust the pressure, wherein the pressure regulating valves (29, 30) are manually and / or electrically configurable.

9. The apparatus (100) according to claim 8, wherein the pressure control valve controls the intake pressure (P ｉｎｓｐ The APL valve (29) is configured to adjust the breathing gas mixture (5) such that the pressure in the breathing gas line (4) is the inspiratory pressure (P ｉｎｓｐ The apparatus is characterized in that, when the value exceeds the above, it can be discharged through the outlet (14-A).

10. The apparatus (100) according to claim 8 or 9, wherein the APL valve (29) is designed as an adjustable biased check valve, and / or the APL valve (29) is equipped with a stepping motor that can adjust the APL valve (29), and the valve position of the APL valve (29) is set and / or held in an energized state.

11. An apparatus (100) according to any one of claims 8 to 10, characterized in that the valve position of the APL valve (29) remains at the last set value when de-energized.

12. The apparatus (100) according to claim 8, wherein the pressure control valve controls the breath pressure (P ｅｘｓｐ The device is configured as a valve (30) that adjusts the pressure, the pressure regulating valve (30) is located in the expiratory side branch pipe (2), and the pressure regulating valve (30) is particularly designed to adjust the positive end-expiratory pressure (PEEP).

13. The apparatus (100) according to claim 8 or 12, wherein the pressure control valve (30) controls a preset respiratory pressure (P) when not energized. ｅｘｓｐ Designed to be passively adjusted to the preset breathing pressure (P) of the pressure regulating valve (30), ｅｘｓｐ The apparatus is characterized by having a pressure of 3 hPa to 10 hPa, for example, 5 hPa.

14. An apparatus (100) according to any one of claims 1 to 13, wherein the apparatus (100) comprises at least one anesthetic supply line (9) for introducing a volatile anesthetic (VA) into the breathing gas line (4), the breathing gas line (4) is configured such that a first pressure (P1) acts within the breathing gas line (4) when the apparatus (100) is in operation, and the anesthetic supply line (9) is configured such that a second pressure (P2) acts within the anesthetic supply line (9) when the apparatus (100) is in operation, the first pressure (P1) is smaller than the second pressure (P2).

15. The apparatus (100) according to claim 14, characterized in that the second pressure (P2) is at least 100 kPa, preferably at least 180 kPa, and / or the first pressure (P1) is less than 100 kPa, preferably less than 50 kPa, particularly preferably less than 10 kPa, and even more preferably less than 3 kPa.

16. The apparatus (100) according to claim 14 or 15, wherein the anesthetic supply line (9) is configured to introduce the volatile anesthetic (VA) as a liquid into the breathing gas line (4), and the volatile anesthetic (VA) evaporates at an evaporation rate of 0 l / min to 2 l / min when introduced into the breathing gas line (4).

17. An apparatus (100) according to any one of claims 1 to 16, wherein the apparatus (100) comprises at least one safety valve (851) designed and configured to shut off the supply of a volatile anesthetic (VA), the safety valve (851) being configured as an electrically and / or manually configurable switching valve.

18. The apparatus (100) according to claim 17, wherein the safety valve (851) is configured as an electrically driven switching valve, and the safety valve (851) is designed to block the introduction of volatile anesthetic (VA) into the respiratory gas mixture (5) when not energized.

19. An apparatus (100) according to any one of claims 1 to 18, wherein the outlet (14-A) comprises at least one filter (94), and the filter (94) is arranged such that the respiratory gas mixture (5) discharged through the outlet (14-A) passes completely through the filter (94).

20. The apparatus (100) according to claim 19, wherein the filter (94) is an absorbent and / or contains an absorbent and is designed and configured to absorb at least a volatile anesthetic (VA) and / or its metabolites, and a double filter system comprising a first filter (94i) and a second filter (94ii) is arranged at the outlet (14-A), wherein the second filter (94ii) is positioned downstream of the first filter (94i) in the flow direction.

21. An apparatus (100) according to any one of claims 1 to 20, wherein the apparatus (100) comprises at least one sensor (95) disposed inside or on the surface of the outlet (14-A), the sensor (95) being configured and designed to detect the concentration of a volatile anesthetic (VA) and / or its metabolites and transmit it to the control device (101).

22. The apparatus (100) according to claim 21, wherein the sensor (95) is configured to detect the concentration of a volatile anesthetic (VA) and / or its metabolites at least upstream and / or downstream of the first filter (94i) in the flow direction and transmit it to the control device (101), and the control device (101) is designed to issue an alarm when the concentration of the volatile anesthetic (VA) and / or its metabolites exceeds a threshold.

23. An apparatus (100) according to any one of claims 1 to 22, wherein the apparatus (100) comprises at least CO ２ An apparatus comprising separation means (40, 60) designed to separate from the respiratory gas mixture (5), wherein the separation means is a chemical separation means (40) and / or a mechanical separation means (60).

24. The apparatus (100) according to claim 23, wherein the mechanical separation means (60) is arranged in the expiratory side branch pipe (2), the mechanical separation means (60) comprises at least one diffusion filter (61), the diffusion filter (61) is configured as a semi-permeable membrane, and is permeable to at least CO ２ molecules, and / or is non-permeable to at least volatile anesthetics (VA). The apparatus is characterized by this.

25. The apparatus (100) according to claim 23 or 24, wherein the separation means (60) is configured as a two-chamber system (65) comprising at least one first chamber (62) and at least one second chamber (63), the first chamber (62) and the second chamber (63) guide gas and are separated from each other by the diffusion filter (61), and / or the first chamber (62) is expiratory breathing gas (5 ｅｘｓｐ The second chamber (63) is designed to contain the sweep gas (64), and the sweep gas (64) contains at least the expiratory breathing gas (5 ｅｘｓｐ ) Lower CO ２ An apparatus characterized by having a concentration.

26. The apparatus (100) according to any one of claims 23 to 25, wherein the first chamber (62) is the expiratory breathing gas (5 ｅｘｓｐ The apparatus is characterized in that the second chamber (63) is designed so that the sweep gas (64) is guided in the direction of the main flow (S), the sweep gas (64) is guided in the direction of the sweep gas flow (S2), and the flow direction of the main flow (S) is opposite to the flow direction of the sweep gas flow (S2).

27. The apparatus (100) according to any one of claims 3 to 26, wherein the CO of the sweep gas (64) when introduced into the second chamber (63) ２ The apparatus is characterized in that the concentration is less than 10%, preferably less than 5%, and particularly preferably 0%.

28. An apparatus (100) according to any one of claims 1 to 27, wherein the apparatus (100) comprises at least one sweep gas supply line (71) for supplying sweep gas (64) to a mechanical separation means (60), and the sweep gas supply line (71) comprises at least one valve (88i) for measuring the sweep gas (64).

29. The apparatus (100) according to claim 28, wherein the valve (88i) controls the flow rate of the sweep gas (64) to control the exhalation side breathing gas (5 ｅｘｓｐ The apparatus is characterized in that it is configured to measure the flow rate of the sweep gas (64) to be greater than or equal to a certain amount, and / or the valve (88i) is configured to measure the flow rate of the sweep gas (64) to be between 0 l / min and 20 l / min, preferably between 0 l / min and 10 l / min.

30. An apparatus (100) according to any one of claims 1 to 29, wherein the valve (88i) is configured such that the flow rate of the sweep gas (64) is set in relation to the minute ventilation rate, and the flow rate of the sweep gas (64) is 1.1 to 2 times the minute ventilation rate, preferably 1.2 to 1.5 times the minute ventilation rate.

31. An apparatus (100) according to any one of claims 1 to 30, wherein the apparatus (100) provides fresh gas and / or oxygen O ２ The apparatus comprises at least one valve (88) for measuring and / or the apparatus (100) comprises at least one valve (841) for measuring a volatile anesthetic (VA), wherein the measuring valves (88, 88i, 841) are selected from the group including needle valves, proportional valves, switching valves, throttles, and throttle valves.

32. An apparatus (100) according to any one of claims 1 to 31, wherein the metering valves (88, 88i, 841) are configured as needle valves each equipped with at least one stepping motor that is adjustable, and the valve position of the metering valves (88, 88i, 841) is set and / or held when energized.

33. A device (100) according to any one of claims 1 to 32, characterized in that the valve position of the metering valve (88, 88i, 841) remains at the last set value and / or returns to the open basic position when not energized.

34. An apparatus (100) according to any one of claims 1 to 33, wherein the apparatus (100) comprises at least one sensor (15, 16, 17, 18, 19, 20) for detecting at least one ventilation-specific parameter (110).

35. An apparatus (100) according to any one of claims 1 to 34, wherein the apparatus (100) comprises at least one storage unit (102) designed and configured to store ventilation-specific parameters (110) and / or patient parameters (111) detected during respiratory gas delivery, wherein the patient parameters (111) include at least one of the following parameters: age, weight, height, body mass index (BMI), and medical history.

36. An apparatus (100) according to any one of claims 1 to 35, wherein the apparatus is designed to dynamically adjust the flow rate of the sweep gas (64) to the ventilation-specific parameter (110) and / or the patient parameter (111).

37. An apparatus (100) according to any one of claims 1 to 36, wherein the respiratory gas line (4) includes a bypass (75) that branches off from the inspiratory branch (1) and merges with the expiratory branch (2) between the mechanical separation means (60) and the outlet (14-A), and the bypass (75) is designed to at least temporarily establish a connection for guiding the respiratory gas from the inspiratory branch (1) to the expiratory branch (2) so as to constitute a second circulation system (K2) capable of guiding the respiratory gas mixture (5).

38. The apparatus (100) according to claim 37, wherein the second circulatory system (K2) corresponds at least partially to the first circulatory system (K1), the connection portion (93) for the patient interface is located only in the first circulatory system (K1), and / or the mechanical separation means (60) is located only in the first circulatory system (K1).

39. The apparatus (100) according to claim 37 or 38, wherein the bypass (75) comprises at least one bypass shut-off valve (76) configured and designed to at least temporarily establish a connection that guides breathing gas from the inspiratory branch (1) to the expiratory branch (2) in the flow direction.

40. The apparatus (100) according to claim 39, wherein the bypass shutoff valve (76) is configured and designed as a shutoff check valve to shut off the bypass (75) at least temporarily in both flow directions, the bypass shutoff valve (76) is designed to shut off the bypass (75) in both flow directions when energized by the at least one power source (103, 104), and / or the breathing gas mixture (5) can be guided at least partially into the second circulation system (K2) when the shutoff valve (28) and the bypass shutoff valve (76) are not energized.

41. An apparatus (100) according to any one of claims 1 to 40, wherein the apparatus (100) is designed to guide the respiratory gas mixture (5) through the main flow (S) in the first circulatory system (K1) and through the bypass flow (S1) in the second circulatory system (K2), characterized in that the main flow (S) is dependent on the respiratory phase of the patient receiving ventilation and the bypass flow (S1) is independent of the respiratory phase of the patient receiving ventilation.

42. An apparatus (100) according to any one of claims 1 to 41, characterized in that at least the bypass flow (S1) of the second circulation system (K2) is guided through the PEEP valve (30).

43. An apparatus (100) according to any one of claims 1 to 42, wherein the apparatus (100) is capable of operating in different operating modes (M1, M2, M3, M4, M5, M6, M7), the apparatus (100) is capable of operating in an automatic operating mode (M2, M4, M6, M7) in which the blower (3) supplies transport energy to the breathing gas mixture (5), and the apparatus (100) is capable of operating in a manual operating mode (M1, M3, M5) in which the reservoir (12) supplies transport energy to the breathing gas mixture (5).

44. An apparatus (100) according to any one of claims 1 to 43, wherein the apparatus (100) is capable of operating in operating modes (M1, M2, M5, M6) with administration of a volatile anesthetic and / or operating modes (M3, M4, M5, M6, M7) without administration of a volatile anesthetic, and the safety valve (851) is designed to allow the introduction of the volatile anesthetic (VA) into the respiratory gas mixture (5) when energized and to block the introduction of the volatile anesthetic (VA) into the respiratory gas mixture (5) when not energized.

45. A device (100) according to any one of claims 1 to 44, wherein the device (100) is capable of operating without power supply and / or with low power consumption in emergency mode (M5), and is capable of automatically transitioning to and / or manually setting emergency mode (M5).

46. The apparatus (100) according to claim 45, wherein if the functions of the power supply (103, 104) and / or the control device (101) and / or the blower (3) are limited or stopped, the apparatus automatically switches to the emergency mode (M5), the breathing gas mixture (5) can be introduced in at least the first circulation system (K1) in the emergency mode (M5), and the breathing gas mixture (5) can be at least partially discharged through the outlet (14-A).

47. The apparatus (100) according to claim 45 or 46, wherein the breathing gas mixture (5) can be introduced in the second circulation system (K2) in the emergency mode (M5), and the transport energy to the breathing gas mixture (5) is provided in the emergency mode (M5) by the reservoir (12), the reservoir (12) being configured as a manual bag.

48. The apparatus (100) according to any one of claims 1 to 47, wherein the APL valve (29) in the emergency mode (M5) last set intake pressure (P ｉｎｓｐ ) is adjusted to and / or the pressure regulating valve (30) in the emergency mode (M5), the breathing pressure (P ｅｘｓｐ A device characterized by passively adjusting ).

49. An apparatus (100) according to any one of claims 1 to 48, wherein the chemical separation means (40) and / or the mechanical separation means (60) are in operation when no power is applied.

50. An apparatus (100) according to any one of claims 1 to 49, wherein the safety valve (851) is closed in the emergency mode (M5), and the safety valve (851) can be opened manually.

51. The apparatus (100) according to any one of claims 1 to 50, wherein the metering valves (88, 88i, 841) are not energized in the emergency mode (M5), thereby providing fresh gas and / or oxygen O ２ The apparatus is characterized in that the metering of and / or volatile anesthetic (VA) and / or sweep gas (64) is maintained at the last set value.

52. An apparatus (100) according to any one of claims 1 to 51, wherein the valve (88i) for measuring sweep gas (64) is characterized in that, in the emergency mode (M5), the metering of the sweep gas is set to 1.2 to 2 times, preferably 1.5 times, the last set minute ventilation rate.

53. The apparatus (100) according to any one of claims 1 to 52, wherein in the emergency mode (M5), fresh gas and / or oxygen O is supplied to the breathing gas mixture (5) via the metering valve (88). ２ A device characterized by supplying [something].

54. Apparatus (100) according to any one of claims 1 to 53, comprising fresh gas and / or oxygen O ２ Each is supplied in at least one pressurized gas cylinder (89), and the pressure of the pressurized gas cylinder is supplied by fresh gas and / or oxygen O ２ A device characterized by supplying transport energy to a target.

55. An apparatus (100) according to any one of claims 1 to 54, wherein the volatile anesthetic (VA) is provided in at least one tank (800), pressure is applied to the tank (800), the pressure inside the tank (800) is at least 100 kPa, preferably at least 180 kPa, and the pressure inside the tank (800) supplies the transport energy to the volatile anesthetic (VA).

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