WO2005079898A2

WO2005079898A2 - Modular device for humidifying respiratory air

Info

Publication number: WO2005079898A2
Application number: PCT/DE2005/000291
Authority: WO
Inventors: Karl-Andreas Feldhahn; Christof Göbel; Gerd Schulz; Wolfgang Wedler; Mark Brandmeier; Frank Herrmann; Matthias Pulla; Rainer Paesch; Martin Eifler; Thomas Marx; Petra Grote; Elmar Vitt
Original assignee: Weinmann Geräte für Medizin GmbH & Co. KG
Priority date: 2004-02-20
Filing date: 2005-02-18
Publication date: 2005-09-01
Also published as: DE112005000942A5; WO2005079898A3; DE102005063661B3; DE102005007773A1

Abstract

The invention relates to a device which is used to humidify respiratory air. Said device comprises at least one component which can change place in a modular manner with an alternative part.

Description

Modular device for humidifying breathing gas

The invention relates to a device for humidifying breathing gas.

Such devices contain a device functioning as a water dispenser, which is typically either configured as a fillable tank for providing a water supply, or is a continuous source or contain an element which itself extracts and provides water, for example by condensation of moisture from the air or by chemical synthesis, in addition to this water extraction element, a storage container may be present, but need not be. In addition, there are not necessarily, but typically other elements, such as a device for heating the water or the breathing gas, for example in the form of a heater, an element closing the water supply, for example a cover, a connection for connection to a breathing gas hose or a connection for Connection with a breathing gas supply. A typical use of such respiratory air humidifiers is in connection with respiratory air supplies that are used in the context of CPAP therapy (Continuous Positive Airway Pressure). Applications for so-called bilevel, APAP and home ventilation are also possible. Such respiratory air humidifiers are also used in the clinic for intensive ventilation. In order to prevent the airways from drying out, it proves expedient, particularly in the case of longer ventilation phases, to humidify the breathing air. Such humidification of the breathing air can also be implemented in other applications.

The known humidifiers are typically constructed in such a way that the respective humidifier is assigned to a specific ventilator and a specific breathing mask with a breathing tube. This hinders universal usability and in particular the configurability of an overall system depending on the respective application requirements. In addition, the known respiratory gas humidifiers cannot yet meet all the requirements that e.g. be placed on a simple and at the same time thorough cleanability.

The object of the present invention is therefore to construct a device of the type mentioned in the introduction in such a way that a device which can be used universally and is easy to handle and clean is provided. In particular, it is contemplated to provide a device that consists of a basic module and many supplementary modules. In addition, interchangeable, mutually substituting element groups are provided, which can be individually adapted to the needs. enable the user. The aim of the invention is to provide a respiratory gas humidifier that accompanies the user for life. Depending on the requirements of the user, any modules can be added or replaced. Above all, it is contemplated that the humidifier according to the invention can be used together with ventilators of any type, depending on the supplementary modules used.

This object is achieved in that the respiratory gas humidifier consists of a basic or functional element and all supplementary or replacement modules can be adapted easily, safely and quickly as required. The respiratory gas humidifier contains at least one component that can be exchanged modularly for an alternative part.

In one exemplary embodiment, the typical respiratory gas humidifier is built up modularly from individual functional elements. The respiratory gas humidifier is provided with a water supply, a water supply and a hose connection. The hose connection is designed, for example, in the form of a socket and is used to connect a ventilation hose. The respiratory gas humidifier is supplied with respiratory gas via a supply connection. The breathing gas is provided by a breathing gas supply. The supply connection can also be used to couple the respiratory gas humidifier to the respiratory gas supply. A flow space extends above the water supply. The water supply can be closed by a lid and connected to the supply connection and the hose connection. The water supply can be arranged in the area of the lid. The exchange modules are provided in particular in order to be able to adapt individual functional elements to the individual needs of the user. It is also possible to meet later changes to the requirements of the device with little effort by replacing the corresponding part. The device changes with the requirements of the user and can therefore be used by the user over a long period of time. Due to the modular structure, the device can be adapted to individual needs.

The water supply can be selected in various sizes depending on the water requirement and space available, whereby the presence, type and performance of water heating or elements to prevent the water from tipping over can be added as required. If higher pressure of the breathing gas is required, which results in excessive noise when the air is routed simply, the air routing, for example integrated into the lid of the water supply, can be exchanged for a model provided with a noise attenuation. Different connection elements adapt different hoses and additional connections, such as measuring and control lines.

A measuring line for pressure, flow, moisture or similar applications can be arranged next to the breathing gas hose and / or inside the breathing gas hose. The breathing gas hose is connected to a hose coupling of a breathing mask, for example, via an exhalation element. As an alternative to the breathing mask, all known interfaces can be used on the patient side, for example tubes, cannulas or similar components. The modular and separable design of the components makes it possible to design them independently of one another in such a way that optimized individual properties are provided in each case. For example, it is possible to optimize the properties with regard to optimized cleaning ability. The respiratory gas humidifier can also be configured such that it is suitable for very high ventilation pressures. In addition, it is also possible to design the cover and the water supply universally and to design the supply connection and the hose connection in the region of their ends facing away from the cover to certain breathing hoses or respirators. As a result, the hose connection and the supply connection can be used as adapter pieces, which couple individual devices which can in fact be selected as desired via a respiratory gas humidifier which is universally designed apart from the adapter pieces.

The supply connection and the hose connection can extend tubularly along a main flow axis at least in regions. The supply connection and the hose connection are then preferably arranged with respect to a base plane of the cover on an elevated base which delimits the flow space in some areas. This increases the leakage protection and prevents the water tank from overfilling.

In the area of the hose connection there is a connection which is arranged essentially coaxially with the cylindrical outer wall of the hose connection and which is provided for connection to a measuring line which runs here, for example, inside the breathing gas hose. In an advantageous embodiment, the modular system contains modular, interchangeable elements for the water supply and corresponding standardized locking systems for simple, secure and easy-to-use connection.

Another modularly interchangeable component is a device for introducing water or water vapor into the breathing gas. In particular, this can take place in the area of the air duct or in the air duct at or via a water surface, a water nozzle, a water nebulizer, a membrane that is preferably only permeable to one side, a Peltier element that generates condensation or a fuel cell.

Another modularly interchangeable component is a device for heating the water or the breathing gas that has already been humidified or still to be humidified

Additional elements can be inserted as required, for example in order to achieve optimized control of the breathing gas made available and its parameters by means of measured or entered data. Sensors on the user, environmental sensors, sensors on the device and its elements, as well as read data, for example via long-distance connections, for example via telemetry, are recorded, displayed, stored, processed and used for control processes, in a preferred embodiment in the form of a closed control loop which includes the respective changes in current values triggered by control processes in its control behavior. Automatic warning signals can also be generated, such as cleaning if the water supply is too low or if there is a risk of other limit violations.

Additional elements can also be used for supplementary or sole water production, such as fuel cells or Peltier elements, the advantage of which is that the water production is a side effect of another device function that is running simultaneously, for example a power generation or heating. Devices can also be present which make moisture from the ambient air usable in another way and, for example, introduce it into the flow of breathing gas through a membrane which is semi-permeable to water.

Additional components can also serve to simplify handling. Filling aids, handles, additional fastenings for different types of stands, cleaning aids, etc. can be provided so that the user - especially when traveling - has all useful tools within reach. The modular structure means that the device can be used with and without such elements. Furthermore, the power supply can be designed flexibly either by a power generator or by elements which allow access to alternative power sources, for example according to other standards, by inserting corresponding elements such as battery or battery components, fuel cells, transformers or converters if necessary. In particular, it is intended to enable the humidifier to be operated with all conceivable / common voltages, for example 6, 12, 14, 24, 48, 110, 220, 240 volts, direct and / or alternating current.

A particularly efficient form of moistening can be brought about by ultrasonic nebulization, whereby At the same time, the water supply remains separated by a filter barrier, thus ensuring that the humidified breathing gas is as pure as possible. This module can also be modularly expanded and / or exchanged.

The entire range of humidification of breathing air from ventilation of newborns to intensive ventilation (up to 120 1 / min or up to 120 mbar) can be made possible thanks to the variable modular design. This is made possible, among other things, by being adaptable to all commercial ventilators.

A compact device design is supported in that extension elements for a pressure measuring line are arranged both in the area of the supply connection and in the area of the hose connection.

A simple component geometry, in particular to support injection molding production, is achieved in that the extension elements of the pressure measuring line extend at least in regions along a main flow axis of the supply connection and the hose connection.

A load-bearing connection of the components to one another can be provided, for example, in that the supply connection and the hose connection are positively connected to one another by at least one pin and at least one recess.

In one embodiment, the supply connection is provided with a connection adapter which is used for connection to the breathing gas supply. The connection adapter is equipped with a locking device that engages when the respiratory gas humidifier and the respiratory gas supply are pushed together into a corresponding counter element of the respiratory gas supply. The locking device has an actuating element which, when pressed manually, releases the locking state, so that the respiratory gas humidifier can be disconnected from the respiratory gas supply in a simple manner.

A lateral boundary of the respiratory gas humidifier can have a contour which is adapted to a contour of the respiratory gas supply. As a result, a very compact overall construction is possible when the respiratory gas humidifier and the respiratory gas supply are joined together. In addition, the respiratory gas humidifier can have an electrical connection which can be coupled to a counter-connection of the respiratory gas supply. To fix the respiratory gas humidifier to the respiratory gas supply, a locking element is preferably provided which can be designed in the form of a click closure. The ventilation hose can also be coupled to the respiratory gas humidifier via such a connection. A flow space extends above the water supply. These modules are interchangeable and can be connected to each other using the interfaces described.

To avoid inadvertent leakage of water and to avoid excessive filling, it is provided that the supply connection and the hose connection are arranged on an elevated base of the cover.

A particularly functional geometric design is provided in that both the supply supply connection and the hose connection have an essentially angular design.

The manual handling when assembling and separating the individual module elements is facilitated in that at least one extension part for the pressure measuring line is arranged inside the cover.

A particularly easy to assemble construction can be achieved in that the extension part is designed as a plate-shaped connecting element.

A simplified geometry of the individual elements can be achieved in that the extension part has connecting piece-like connecting parts connected with a hose.

To support a favorable flow guidance, it is provided that the supply connection and the hose connection extend cylindrically at least in regions in the direction of the main flow axis.

A very simple handling when filling the respiratory gas humidifier can be provided in that the lid has a water supply.

In a state of use, a device is arranged such that the breathing gas supply is connected to the breathing gas hose via the hose connection and to the breathing gas supply via the supply connection.

A simple manual handling is also supported by the fact that the respiratory gas humidifier has a releasable locking device in the area of its extension that can be turned towards the respiratory gas supply. It is also provided that the hose connection can be connected to the breathing gas hose via a releasable locking device.

A high mechanical resilience is achieved in that the cover has a recess for fastening the hose connection.

In particular, it is contemplated that the hose connection engages in the recess with a mounting socket and is sealed off from the recess by a sealing ring.

In addition, the mechanical strength can be increased in that the cover has a recess for fastening the supply connection.

With regard to this constructive realization, too, it proves to be advantageous that the supply connection engages in the recess with a mounting socket and is sealed off from the recess by a sealing ring.

A formation of splash water within the respiratory gas humidifier can be avoided by arranging a baffle plate in the area where the supply connection opens into the lid.

According to one embodiment it is provided that the baffle plate is formed as part of the supply connection.

Alternatively, it is also possible for the baffle plate to be designed as part of the cover. Improved positioning reliability by providing a positive connection can be achieved in that the supply connection and the hose connection can be positively connected to one another by at least one positioning pin.

A simple assembly is supported in that the positioning pin is firmly inserted in one recess of one of the connections and engages in the other of the recesses with play.

Easy handling is achieved in that all modules can be connected to one another by means of tenons or tongue and groove mechanisms. So you can just plug them together.

A long humidification period without maintenance is achieved by the water supply modules being able to hold up to 5000 ml of liquid or by the fact that there is a continuous afterflow of water.

A low energy requirement of the device is achieved by partially using the device waste heat of the respective ventilator to heat the water.

To avoid condensation, a module contains a heated air supply and insulation.

The relative increase in air humidity is mainly dependent on the air and water temperature. The following table shows the saturation of the breathing air with water, the saturation depending on the temperature.

Temperature [° C] Water vapor pressure [mmHg] Water vapor pressure [kPa] 20 17.5 2.33 21 18.7 2.49 22 19.8 2.64 23 21.1 2.81 24 22.4 2.99 25 23.8 3.17 26 25.2 3.36 27 26.7 3.56 28 28.3 3.77 29 30, 0 4.00 30 31.8 4.24 31 33.7 4.49 32 35 .7 4.76 33 37.7 5.03 34 39.9 5.32 35 42.2 5.63 36 44.6 5.95 37 47.0 6.27

With another module, the device is operated on demand. A sensor system detects the ambient humidity and the ambient temperature and regulates the humidification output in the event of a change. The user can still freely control the degree of humidification and the temperature of the air. The device only implements the patient's settings within reasonable limits. For example, a minimum amount of humidification of the breathing air is always provided and one Avoid excessive condensation, especially in the hose.

With an additional module for the demand-controlled regulation of the respiratory gas humidifier, the respiratory gas humidifier output is regulated via a biofeedback of the patient. A sensor system records the patient's current need for humidification and regulates the respiratory gas humidifier output as required. You can choose between: Expiratory and / or inspiratory air humidity, expiratory and / or inspiratory air temperature, a measurement of the surface moisture on the mucous membranes of the upper respiratory tract or a combination of all. At the same time, the loss flow via a possibly existing mouth expiration or the loss flow via nose / mouth leakage can also be registered and the respiratory gas humidifier output can be adjusted accordingly.

The measurement data is preferably evaluated using fuzzy logic and / or neural networks.

The aforementioned modules are preferably combined in order to ensure ideal humidification and heating of the breathing gas at any time. The humidification output can be set permanently or regulated as required. This can be done in stages or continuously.

The moisture content and the temperature of the breathing gas are either ideally regulated in an automatic mode and / or fixed by the user and or within specified limits. The automatic function is part of a comparator, which also implements the user input. The device adjusts to the selected and / or required values. A sensor system detects the ambient humidity and / or the ambient temperature and / or the composition of the ambient air and / or the brightness and / or climatic parameters and / or the flow of breathing gas and / or the pressure of the breathing gas and / or any leakage and / or / or the current humidification requirement of the patient and / or the expiratory and / or inspiratory air humidity and / or the expiratory and / or inspiratory air temperature and / or the moisture on the mucous membranes of the upper respiratory tract and / or a temporal change in the measured variables and / or a change in the measured variables and regulates the degree of humidification and the temperature of the humidified breathing gas in the event of a change.

The measurement data is preferably evaluated by means of fuzzy logic and / or neural networks and / or by means of suitable algorithms by a comparator. This compares the actual with the target state. If the actual and target status differ for at least one measured parameter, the comparator sends a corresponding signal to the controller. This regulates the output until the actual state corresponds to the target state.

Suitable optical, electronic, mechanical, magnetic sensors can be used as sensors.

Alternatively, you can choose between wired or telemetric transmission of the measurement data from the patient to the respiratory gas humidifier.

Another modularly interchangeable component is a device for energy supply. The breathing gas humidification ter is typically operated together with a ventilator. In the event that the user desires a mobile unit, an energy supply with solar cells, accumulators, batteries, preferably rechargeable accumulators, fuel cells or miniaturized internal combustion engines is possible.

In the case of mobile use, the tipping safety of the stored water is important. Modularly replaceable components are located in the area of the water supply and enable tilt protection, for example by keeping the water in a porous component. Ideally, there is no more free liquid.

Easy filling is achieved by a funnel that folds up from the water supply for filling.

As an additional module, the level in the respiratory gas humidifier can be detected by sensors. Thus, if necessary, additional water can be supplied to the respiratory gas humidifier in a targeted manner, for example by means of a pump or an electrically operated valve. The resulting advantages: There is always very little water in the respiratory gas humidifier, so there is hardly any problem with tilting. In addition, there are constant conditions for moistening.

In another exemplary embodiment, the water level or the stored amount of water is recorded by means of a balance which is arranged in the area of the humidifier.

Possible embodiments of the sensor system: - Float that operates a switch, reed contact, etc. The float can also act directly on the feed valve.

- Measurement of the electrical conductivity of the water: If the water level drops below two electrodes in the respiratory gas humidifier, then no more current can flow between the electrodes. Optical sensors, e.g. reflections on the water surface). Additional modules enable users to communicate or inform themselves, for example, about current operating conditions. With a module to be selected, the current humidity and heat of the breathing gas and / or the set values for these parameters are displayed as a percentage or absolute value. With a further module, the user can adapt a display of the service life, a storage of the values for the service life and a setting of the service life. An optional cleaning indicator, which can be coupled with the "Service life" module, shows the user the recommended cleaning and / or maintenance dates. The communication can be expanded by a further module with speech recognition and / or speech output. The humidifier can thus, for example, enable bedridden patients to remotely control via voice recognition and to communicate possible error cases and / or current states / data via the voice output. Additional modules enable communication with intelligent technology and / or the sending and / or receiving and / or displaying messages. The humidifier can send / display current statuses via or telemetric and / or wired (display, displays, SMS, email, infrared, bluetooth) information transfer. The display can, for example, in Form of organic light emitting diodes (OLEDs). At the same time, communication also enables remote adjustment, remote maintenance and / or remote inquiry of humidifier parameters. For example, if there is only a little water left in the reservoir, the humidifier sends a message in good time.

The modules enable comprehensive monitoring of temperature and humidity, as well as important and informative function values. In addition, automatic warning signals for errors or deviations are generated and displayed or sent.

The design of the configured device is largely freely selectable. Interchangeable covers, facings and top covers are available for the device. These differ in shape, color and design and can preferably be based on the design of the respiratory gas supply used in each case. Alternatively, the customer's wishes can be met by providing a selection of different shapes, colors, designs and materials (especially customized). The user can replace the covers / upper shells himself, since the mechanism is simple and self-explanatory. Depending on the component, tongue and groove, rubber-mounted connectors or similar components are used, for example.

The user can choose different modules for the water supply according to his needs. In the field of domestic use, a continuous source of water can be realized, for example, by connecting the humidifier to the house water pipe. Here it is also possible to directly water flow to choose. This means that heating is no longer required.

An improvement in handling and a reduction in cleaning effort is provided by a module that supplies the humidifier with sterile water. The water is not filled into the humidifier. The sterile water supply, for example a plastic bottle, is replaced as soon as it is empty. This option is e.g. Suitable for bedridden patients, caregiving relatives therefore have to spend very little time on the maintenance of the technology and can fully devote themselves to the caregiver.

Heat loss can be avoided by insulating the walls of the water supply. Heating the water is more effective, faster and more energy efficient. As a result, an increased degree of moistening can be achieved with a constant supply of energy.

A longer humidification period for patients with an increased need for moisture, for example by breathing through the mouth, can be achieved by modules which allow condensation of atmospheric moisture.

In one embodiment, the use of a Peltier element will force the air humidity to condense by locally lowering the temperature. The condensate is collected in a region of the Peltier element in which the low temperatures are present and supplied to the water supply. Alternatively, the Peltier element can cool the chamber directly. At the same time, the warm side of the element is used to preheat the air before it blows through the humidifier and absorbs water. A longer humidification period in patients with an increased need for moisture, for example by breathing through the mouth, can also be achieved by using modules that provide hygroscopic materials. In one embodiment, the breathing tube is provided with a covering for this purpose, through which the patient's moist exhaled air passes. The wall between the breathing tube and the outer casing is made of a moisture-absorbing material. Coating the partition with HME-compatible materials increases moisture absorption. The ventilation air coming from the breathing gas source sweeps along this damp wall and absorbs the moisture and leads it to the patient. In an alternative module there is a hygroscopic material on the inside of the mask. In another adaptable variant, a silica gel is used. The silica gel extracts a large part of the moisture from the exhaled air. The SilicaGel is heated up periodically. As a result of the heating, the moisture is released again and fed to the water supply via a hose.

A module especially for the mobile application of a respirator with respiratory gas humidifier aims to practically not have to carry elemental water with it and also not to be energetically dependent on electricity, especially heavy batteries.

In one embodiment of this module, water is generated from elemental oxygen and hydrogen in a fuel cell. The energy generated is used to operate the device, the respiratory gas humidifier and, if necessary, the heating. Water can also be stored in another form of aggregate, for example ice. As a result, a tilting or leakage protection can be achieved and it is also possible to evaporate only the portion of the ice required for moistening in a targeted manner, for example with radiation. This module also provides for the evaporation of the ice using radiation to be carried out depending on the respiratory phase. The control algorithm is preferably set in such a way that evaporation is carried out shortly before inhalation by detecting the breathing phases. The pause between expiration and inspiration can serve as a trigger. As a result, the respiratory gas is only humidified if the patient - in a physiologically sensible manner - needs humidified respiratory gas. The water supply lasts longer.

In another module, the water is integrated in a gel, which results in a tilt or leakage protection, because the gel cannot flow or can only flow slowly if the respiratory gas humidifier is tilted. The gel can be warmed up like water and releases the moisture to the sweeping air, analogous to a water surface. In addition, a gel is preferably chosen which stores heat longer than water, which reduces the energy expenditure.

The water supply can also be designed in the form of a bird bath using an alternative module. In this case, only the amount of water currently to be humidified and / or heated is taken from the water supply. The water supply lasts longer and less energy is used to heat the water, for example by means of radiation. In a preferred embodiment of this module, water Depending on the respiratory phase, fed to the humidifier room. The control algorithm is preferably set in such a way that evaporation and / or heating of the water is carried out shortly before inhalation in each case by detecting the breathing phases. The pause between expiration and inspiration can serve as a trigger here. As a result, the respiratory gas is only humidified if the patient - in a physiologically sensible manner - needs humidified respiratory gas.

A water level flow in the respiratory gas humidifier is ensured by the water level compensation module. The water supply is always kept in an optimal position to the air flow via a spring. The spring gradually pushes the water supply upwards as the amount of water stored decreases. Regardless of the amount of water, the top edge of the water is always the same height. This ensures that the degree of moistening is kept constant. In addition, the sound development remains constant and does not change with decreasing water level and becomes louder.

The water supply is filled depending on the selected water supply module. For the continuous water supply, for example via a connection of the humidifier to the house water pipe, the water supply is self-filling, for example via valves, negative pressure, float switches or the like.

The humidification of the breathing air in the individual modules for storing the water often takes place in different ways, depending on the principle. In principle, however, it is envisaged that different humidification principles will also apply as part of the interchangeability of the modules use to be able to offer the optimal / desired solution.

In the case of membrane humidifiers, the air and water sides are separated from one another by a semipermeable membrane, for example GoreTex, Nafion membrane. The membrane allows water to pass in the direction of the humidification room. In this way, a large contact area between water and air can be realized, with optimal flow control and low noise emissions.

The water supply can preferably be implemented in the area of the ventilation hose. In the area of the ventilation tube, there are particularly preferably contact points between the semipermeable membrane and breathing gas in several areas, preferably three-dimensionally oriented in relation to one another. Ideally, a widely branched, fine capillary network is formed that provides a very large contact area with water-breathing gas. In the case of an additional module, the heating can be arranged in the area of the ventilation hose at the same time. The heater and the membrane are preferably designed such that the heated areas of the membrane allow increased passage of water through the membrane as a result of the heating. The heating can also be regulated very precisely as required. This avoids condensation of water vapor in the area of the membrane facing the ventilation air. In addition, the regulation can be carried out in such a way that the breathing gas is more or less moistened in accordance with the breathing phases.

For modules that work on the principle of a drip humidifier, the water supply is above of the water outlet arranged. The opening of the water outlet to the humidification room is designed so that no water drips out due to the surface tension of the water. By briefly heating the water outlet, the viscosity of the water is reduced, the surface tension drops and heated water drips from the tank. By cooling the opening, the critical surface tension is reached again, water no longer drips. A very dynamic and needs-based regulation of the amount of water withdrawn can be achieved by appropriate timing of the supply of water to the humidification room, in accordance with the breathing phases. Water is preferably supplied to the humidification chamber shortly before inhalation.

Alternatively, the drip humidifier can also be designed such that a heatable metal plate has small bores. The water supply is positioned on this plate. The water is thus directly on the metal plate. The size of the holes is selected so that no water flows out due to the capillary forces. If the plate is now heated, the water viscosity changes and water escapes. The water supply to the humidification room can thus be regulated by regulating the energy supply.

In another embodiment of the drip humidifier, several, for example, parallel tubes are filled with water. These tubes can extend along the breathing tube. The tubes have fine holes / openings. The openings can be opened / closed in a controlled manner. Here too, as with the drip humidifier, water only escapes when the tubes and or the openings are heated. Alternatively, in both modules the principle of a drip Humidifier, the openings are opened or closed electronically, mechanically, pneumatically or magnetically.

The heater can also heat the water indirectly. Alternatively, another module offers the option of directing heated air into the humidification room. Instead of the water, the air that is led into the respiratory gas humidifier is heated. This allows more moisture to be absorbed at low water temperatures.

Another module for heating the water is a thin, electrically conductive layer that is arranged in the area of the water supply.

The thin layer can preferably line the entire water supply. This creates a particularly large heat transfer area. The current-conducting layer can, for example, be vapor-deposited and consist of all suitable materials which have good heat transfer, in particular gold, silver, copper and similar metals. The interface to the water is preferably electrically insulated.

All non-electrically conductive materials with good thermal conductivity are suitable for insulation. The insulating layer is typically very thin, preferably in the range of a few μm and nm thick, and can be vapor-deposited, for example. The current-conducting layer is not only used to heat the water. In particular, it is intended to also determine the current water temperature via the current-conducting layer and also to determine the water level. For example, the temperature of the water can be determined in phases in which there is no heating in order to then adjust the heating output accordingly. The level of the water can also be determined in phases in which there is no heating. The heating power can thus be adapted to the decreasing water level.

For example, the warm "exhaust air" of the electronics can be used as an energy source for heating the air. It is also possible to use a heating spindle as used in hair dryers. Both sources are preferably used simultaneously. The breathing gas is continuously preheated by the warm exhaust air from the electronic components and additionally regulated to the desired temperature by suitable devices. The breathing air can be heated in a breath-controlled manner.

Another module provides the structure of an injection humidifier based on the principle of an inkjet printer (piezo or bubble jet). The fine outlet openings are preferably arranged in an elastomer part, so that, for example, limescale deposits can be removed by deforming the elastomer part. The injection can be diffuse into a humidification room and / or in the respirator on the motor, blower or fan wheel.

An alternative module provides a pump, which preferably applies the smallest amounts of water directly to the fan wheel or an upstream atomizing element. Due to the high speed of rotation and the small, pulsed quantity, the water is atomized immediately and mixed with the air flow. torn. The modules described enable fast and precisely controllable atomization.

By means of an additional module, the breathing air and / or the humidified breathing air can be heated to the desired temperature by at least one heating grill which is located in the airway. These modules are preferably used together with a non-continuous humidification of the breathing gas. In particular, it is contemplated to control the moistening in such a way that a higher level of moisture and / or temperature is provided to the patient in phases of inspiration than in phases of expiration. As a result, water and energy are used as needed and at the same time sparingly.

According to another embodiment, the water is pumped into the respiratory gas humidifier area by a circulation pump and runs back into the tank via one or more walls, lattice structures or similar devices. The best possible wetting of the walls with water is achieved by means of a distribution system, for example several nozzles or channel-shaped distribution channels. The breathing air flows over the walls and absorbs the moisture.

Conceivable embodiments of the pump: gear pump, piston pump, pump with turbine wheel, pump with pulsating elements, for example membranes. Valves for specifying the direction of delivery, peristaltic pumps, long-stroke elements on the hose, impeller, eccentric screw, side channel impeller or centrifugal pumps can be used.

According to a further embodiment, a partition with an opening can be arranged above the tank. Is the The opening is arranged at a distance from the outer wall of the tank, so that the separating wall protects the respiratory gas humidifier from tilting.

In general, it is conceivable to design the entire humidification area, including the partition, as a removable cover for the respiratory gas humidifier and thus to achieve easy cleaning.

Optionally, the water can be heated by a water heater for better respiratory gas humidifier performance.

The humidifier principle is explained in more detail below.

A module humidifies only a subset of the breathing gas in the sense of a bypass. This module can preferably be supplemented by a control unit, the humidity and temperature provided to the patient being able to be regulated by setting / regulating the mixing ratio between moistened and non-moistened breathing gas with a relatively constant heating output. The advantage of this module is the very fast regulation, which can be adjusted several times, especially in breaths.

It is preferably contemplated to control the moistening in such a way that a higher level of moisture and / or temperature is provided to the patient in phases of inspiration than in phases of expiration. It is also possible, for example, to moisten differently in the beginning and end inspirations within one breathing phase.

It is preferably contemplated to control the moistening in such a way that the patient is in phases of the beginning and ending inspiration is provided with less moisture than during periods of medium expiration. This results in less moisture in the dead space and the condensation in the hose can be effectively reduced.

It is particularly preferred to control the humidification in such a way that the patient needs the humidification and temperature control of the breathing air depending on the breathing phase and / or event. This can be synchronized with the detection of the breathing phases and / or the detection of events that influence the breathing of the patient, for example apneas, coughing, swallowing, by the ventilator.

With the "rewetting" module, various components such as a mask and / or hose are equipped as water and / or heat stores. The mask and / or the hose and / or the humidifier are lined from the inside with a suitable water-storing material (HME heat moisture exchanger), which binds the moisture in the exhaled air and releases it again into the breathing air the next time you inhale. A respiratory gas humidifier can also be integrated into the mask.

The HME principle described above is expanded in a supplementary module. The HME component is significantly larger and constructed in such a way that at least the air humidity and the temperature remain largely constant within the matrix and essentially correspond to the values of the exhaled air. This is ensured by a large surface of the matrix, which is interspersed with fine hollow capillaries. The Oxygen and carbon dioxide exchange takes place within the capillaries by diffusion. This module is elastic and can be moved mechanically, which results in ventilation. Alternatively, a conventional source of breathing gas can be connected.

In the following, the air inlet is explained in more detail, which is equipped with a return tilt protection - (bulkheads to prevent backflow, tilt protection). Water is retained by walls in the bottom area of the water storage container when the water container is tilted. For example, several walls can be designed concentrically to one another. In addition, the height of the walls towards the supply connection or towards the ventilation connection can increase, so that the necessary tilt angle for the water backflow into the device increases with each wall. The resulting chambers can also be connected through very small openings, so that the backflow is also extended in time. The central region can be designed such that the air hits the water surface through holes, preferably designed as nozzles, with the aim of increasing the respiratory gas humidifier output.

As a kind of very quick and effective way of heating the water, a module is provided that uses radiation for heating. Radiation types of different energy ranges and wavelengths are conceivable, for example infrared radiation, UV radiation, microwave radiation. Radiation types that have a disinfecting and a heat effect at the same time are preferably used. The radiation can particularly preferably act on small amounts of water, so that the water evaporates almost completely due to the action of the radiation. This means that ne heating and / or disinfection and / or humidification of the ventilation air can be achieved.

The actual heating device can be designed as a simple metal plate without electrical supply. The energy for heating the heating device is then supplied contactlessly by eddy current, induction.

The water is led from the water supply through a heatable line and then passed in small portions to an evaporation room. The advantage here is the low heating power required with high thermal dynamics, since only a small amount of water is heated at a time. By means of a suitable arrangement of a check valve, for example according to the principle of a coffee machine, the water can also be pumped to a higher level.

An alternative module that makes it possible to use the heat only for a small amount of water is the floating heating plate. The heating plate swims close to the surface of the water and primarily heats the part of the water above the heating plate. In particular, the portion of water that is in contact with the breathing gas in the humidification room is heated. In a module to be used with preference, the floating heating plate can at the same time contain and / or activate a sensor. The sensor reacts when the water supply runs low and sends a signal to a refill device and / or activates the refill to a desired water level. At this point too, the sensor integrated in the heating plate switches off the refill of water. A heat store can be used to supplement energy saving. By heating the respiratory gas humidifier container, for example during hot sterilization, cooking or rinsing in the dishwasher, a latent heat accumulator permanently installed in the area of the water supply is "charged" with thermal energy, for example by microspheres of a heat-storing material in the wall of the water supply. When the respiratory gas humidifier is used, the heat is released again and used to heat the water.

A further energy saving is provided by a module that enables the water supply to be heated up via the device waste heat. The waste heat from the device is used to heat the water. For example, the heat sink of the power supply unit is a heat sink and water heater at the same time. In addition, the heat sink could be tempered with a heater to guarantee an adjustable water temperature regardless of the device load. The water supply is advantageously positioned on the device transformer of the ventilator.

Modules for generating aerosols can also be used for the humidifier. The purpose of these modules is to supply substances such as medicines, fragrances, etc. directly into the airways. The advantage of these supplementary modules is that the patient can easily, quickly and safely convert his already existing device for administering breathing gas and humidifying the breathing gas and does not have to buy a second device that would only be needed for the production of aerosols. The following modules are specifically considered. a) Pressure nebulizer: An air flow generated by pressure nebulizes liquid through a nozzle. With the continuous use of a pressure nebulizer, more than half of the amount of an aerosol generated is lost during the patient's exhalation. By using an interrupter, the nebulization can be limited in particular to the area of inspiration, preferably the middle inspiration. This saves substance. The range of particles generated by a nozzle nebulizer and the amount of an aerosol atomized per time depends on the dimension of the nozzle and the pressure generated by the respiratory gas source. Flow. For this reason, the respiratory gas source and the nebulizer device must be matched to each other in a device-specific manner.

b) Ultrasonic nebulizer: By vibrations of e.g. An aerosol is generated in the piezoelectric crystal. Ultrasonic nebulizers produce aerosols, the diameter of which depends on the electrically generated vibration frequency. In particular, this module is constructed in such a way that aerosols are added to the respiratory gas flow, particularly in the area of inspiration, preferably for middle inspiration.

c) MDI: The pressure required for nebulization is generated by evaporation. So far, propellant gases have been used in metered dose aerosols, which only slowly decomposed after escaping into the environment and damaged the ozone layer. With the module provided here and the connection to a breathing gas source, it is possible to completely do without propellant gases. The substance is finely dosed only in the breathing phases, especially in the area of inspiration, preferably for the middle more inspiration, added to the breathing gas flow, which allow the patient to inhale the greatest possible amount of substance.

d) Powder nebulizer: The drug, which is in the form of a fine powder, is applied to the patient with the inspiratory flow. Dry powder inhalation assumes that the patient can generate an inhalation flow of 25-60 1 / min. This is not always the case in toddlers and adults with severe airway obstruction. The module provided here with the connection to a respiratory gas source makes it possible to add the substance to the respiratory gas flow in fine doses only in those respiratory phases, particularly in the area of inspiration, preferably for the middle inspiration, which make it possible for the patient to inhale the greatest possible amount of substance.

e) ballast

The fastest and largest, i.e. aerosol particles that are not suitable for deposition in the lower airways. In addition, when using an antechamber, the patient does not have to inhale the metered dose inhaler in synchronization with the activation, but can inhale the substance during a few calm breaths. This reduces the deposition of the substance in the upper airways and improves it in the lower airways.

The efficiency of aerosol therapy is improved by reducing the adhesion of the substances to the surface of the devices. For example, the modules have surfaces that reduce the adhesion of substances to the surface of the equipment, for example, reduce the electrostatic charge of plastic. Ideally, aerosols that are used for the treatment of lung diseases have a diameter between 0.1-10 μm. Droplets with a larger diameter do not get into the lower airways, smaller particles only contain small amounts of a drug and are also largely exhaled.

The choice of a specific aerosol form has to be made individually. It depends on various factors, not least the patient's preferences. For infants and young children, for patients who have difficulty operating a metered dose aerosol, types of aerosol generation are used that are independent of the cooperation.

Decisive for the compliance of aerosol therapy are not only technical aspects, but also the patient's preference for a certain nebulizer system.

Regardless of the choice of the type of aerosol administration, it is certain that certain substances can only be atomized by certain devices for aerosol generation. The corresponding module must be selected in accordance with these requirements.

With additional modules for the storage of accessories, devices are provided which provide the patient with needs-based, practical and simple help to facilitate the daily use of the devices according to the invention.

In particular, elements required for the therapy, such as a tube, mask, medication, are preserves. In addition, the clock, alarm clock and entertainment electronics are either integrated or adapted.

Another module for the alarm clock includes an alarm function that takes into account the patient's sleep phases. An analysis of the sleeping bunnies preferably identifies phases for waking up when the patient is not in deep sleep.

A supplementary module for time measurement enables the calculation of the useful life and the shaving time. A comparison with other device data and environmental data enables the typical need for water and energy to be determined, which enables appropriate planning and appropriate storage.

The duration of ventilation, humidification and administration of medication can be set via a timer function.

It can preferably be stored in or on a drawer, on a shelf or on a stand.

The mask is preferably stored in such a way that it is possible for the patient to grasp and put on the mask quickly and easily with one hand. The hose is stored in an orderly and space-saving manner so that it is easy to grip and unroll. Plug, clamp or locking devices are preferably used for this. The attachment is preferably in the area of the device or on the bed or on a bedside table or a shelf.

A roll-up mechanism is also provided for the hose and cable of the power supply. Exemplary embodiments of the invention are shown schematically in the drawing. Show it:

1: A perspective view of a humidifier that can be connected to an air supply,

2 is a perspective view of a breathing mask with breathing gas tube,

3 is a perspective view of a respiratory air humidifier with a water tank and lid and a supply connection for connection to a breathing gas supply and a hose connection for connection to a breathing gas hose,

4 shows a top view of the respiratory air humidifier according to FIG. 3,

5 is a longitudinal section according to section line V-V in Fig. 4,

6 is a partially sectioned view according to section line VI-VI in Fig. 5,

7 shows a construction of a respiratory air humidifier with an essentially flat cover surface,

8 is a plan view of the humidifier according to FIG. 7,

9 is a vertical section along section line IX-IX in Fig. 8, 10 is a cross section along section line XX in Fig. 9,

11 is a perspective view of the humidifier of FIG. 3 in a partially disassembled state,

12 is a perspective view of the humidifier according to viewing direction XII in Fig. 7,

13 shows a representation rotated by 180 ° in relation to the representation in FIG. 9 and modified in the region of the connection of the hose connection and the supply connection,

14 is an enlarged view of the detail XIV in Fig. 13,

15 shows a schematic representation of the modules from which a humidifier according to requirements can be put together,

16 is a schematic representation of the possible control and regulating processes,

17 shows a further exemplary embodiment for the interaction of the ventilator and humidifier,

18 shows another module of the humidifier, which adapts to a respirator,

19 shows a modification to the representation in FIG. 18, 20 shows a further modification for illustration in FIG. 18,

FIG. 21 shows another variation for the representation in FIG. 18,

22 shows a module that works with water-permeable membranes with a water supply in a tank,

23 shows a modification to FIG. 22, in which the water supply is in the ventilation hose, separated from the air flow by the membrane,

24 shows a module: device for filling the water supply in the ventilation hose

25 shows a module: "ink jet printer" with an elastic nozzle, in which water is brought into the airway / atomized,

26 shows a module: "water atomization" on the fan wheel with a heating grille in the air,

27 shows a module: “Peltier element” for heating the water supply and / or collecting condensed water,

28 a module: "fuel cell" for energy supply, water production and heating,

29 shows a module: "inductive heating", in which the water supply is heated inductively, 30 shows a module: "floating heating plate", in which only the amount of water located above the heating plate is heated. In addition, the sinking plate signals a low water supply,

31 shows a module: "Use of the device waste heat", in which the water supply is heated up via the device waste heat,

32 shows a module: "Circulation / instantaneous water heater", in which water is taken from the supply, heated and passed over a large surface, and

Fig. 33 a module: "tilt protection".

The interaction of the modules and the advantages of the modular structure are now to be described using several exemplary embodiments. A sleep apnea patient is prescribed CPAP therapy by his doctor to prevent nocturnal breathing interruptions. After the start of therapy, the patient notices that the respiratory tract dries out, causing infections to form. The doctor prescribes a humidifier for him. The patient chooses the modular respiratory gas humidifier that can be retrofitted, since his CPAP device does not have a respiratory gas humidifier. The respiratory gas humidifier consists of the basic modules that are required for the effective humidification of respiratory gas when operated together with a CPAP device: water tank, lid that shoots the water tank, filler neck for water in the lid, in particular with rubber stopper as a closure, supply connection and breathing hose connection. The perspective view in FIG. 1 shows a respiratory gas supply (1) which can be connected via a connection element (2) to a supply connection (3) of a respiratory gas humidifier (4). The connection element (2) is designed in the form of a socket and can accommodate the supply connection (3), which is likewise in the form of a socket, or can be enclosed in regions by the latter.

The breathing gas supply (1) has a display device (5) and operating elements (6). The respiratory gas supply (1) is also equipped with a conveyor (7) for the respiratory gas, an electric drive (8)

Conveyor (7) and a controller (9) for the electric drive (8).

The respiratory gas humidifier (4) is provided with a water tank (10), a filling opening (12) which can be sealed by a closure element (11) and a hose connection (13). The hose connection (13) is designed in the form of a socket and is used to connect a ventilation hose. To fix the respiratory gas humidifier (4) to the respiratory gas supply (1), a locking element (14) is provided which can be designed in the form of a click lock. The ventilation hose can also be coupled to the respiratory gas humidifier (4) via such a connection. A flow space (15) extends above the water tank (10).

From the illustration in Fig. 1 it can be seen that a lateral boundary (16) of the respiratory gas humidifier (4) is designed as an interchangeable veneer and here has a contour profile that is in line with a contour profile of the respiratory gas supply (1) Front is adjusted. This allows a very compact overall construction when the respiratory gas humidifier (4) and the respiratory gas supply (1) are joined together. It can also be seen from FIG. 1 that the respiratory gas humidifier (4) has an optional electrical connection (17) which can be coupled together with a counter-connection (18) of the respiratory gas supply (1). This way, both elements are put together easily and securely.

Fig. 1 also illustrates that the water tank (10) is connected by a cover (19) to the supply connection (3) and the hose connection (13). The filling opening (12) is arranged in the area of the lid (19).

Fig. 2 shows the breathing gas hose (20) for connection to the hose connector (13). In the exemplary embodiment shown, an optional pressure measuring line (21) runs next to the breathing gas hose (20), but in particular it is also intended to arrange the optional pressure measuring line (21) within the breathing gas hose (20). The breathing gas hose (20) is connected to a hose coupling (23) of a breathing mask (24) via an exhalation element (22). The breathing mask (24) essentially consists of a basic mask body (25) and a hood (26).

FIG. 3 shows a respiratory gas humidifier (4) modified from the embodiment in FIG. 1 in a further perspective illustration. It can be seen that the supply connection (3) and the hose connection (13) extend, at least in regions, in the shape of a tube along a main flow axis (27). The supply connection (3) and the hose connection (13) are with respect to a base plane (28) of the cover (19) arranged on an elevated base (29) which limits the flow space (15) in some areas. This achieves increased leakage protection and prevents the water tank (10) from overfilling.

From Fig. 3 it can also be seen that in the area of the hose connection (13) runs to the cylindrical outer wall of the hose connection (13) substantially coaxially arranged optional pressure connection (30) which is provided for connection to the optional pressure measuring line (21) in this embodiment runs inside the breathing gas tube (20).

The humidifier according to the invention in this exemplary embodiment is suitable in the basic module variant CPAP for ventilation pressures up to 18 bar. It is a cold air humidifier, without heating the water. At the specialist dealer, the respiratory gas humidifier according to the invention is equipped with the supply connection module that allows connection to the patient's CPAP device.

It can be seen from the illustration in FIG. 4 that the main flow axis (27) has a lateral offset relative to a device center line (31) of the respiratory gas humidifier (4). It can also be seen that the optional electrical connection (17) in the illustrated embodiment is implemented as a coaxial line arrangement. In principle, however, it is also conceivable to use, for example, two contact pins arranged next to one another.

In the embodiment shown in FIG. 4, the supply connection (3) is provided with a connection adapter (32) which is used for connection to the breathing gas supply (1) serves. The connection adapter (32) is provided with a locking device (33) which, when the respiratory gas humidifier (4) and the respiratory gas supply (1) are pushed together, snaps into a corresponding counter element of the respiratory gas supply (1). The locking device (33) has an actuating element (34) which, when pressed manually, releases the locking condition, so that the respiratory gas humidifier (4) can be disconnected from the breathing gas supply (1) in a simple manner.

After a while, the patient notices that the degree of humidification is not sufficient, he also feels the cold, humid air as unpleasant and attributes the frequent colds to it. The doctor prescribes a humidifier with heating. According to the state of the art, the patient would now have to buy a new device. The respiratory gas humidifier according to the invention is, however, simply upgraded by adding modules as required.

6 illustrates the construction of the respiratory gas humidifier in a vertical section. From this it can be seen that within the water tank (10) a heating element (52) connected to the electrical connection (17) is arranged, which can be implemented, for example, as a heating element which is directly enclosed by the liquid stored in the water tank (10). Flow guide elements (53) are arranged within the supply connection (3), which contribute to a uniform flow and prevent turbulence of the flowing breathing gas.

After a long time, the patient's health deteriorates. The normal CPAP device is no longer sufficient to treat the patient as needed breathe as a chronic obstructive disease of the lungs has been identified. The doctor prescribes a bi-level ventilator that is able to ventilate the patient's lungs through two different pressure levels between inspiration and expiration. The lower pressure value is 6 mbar and the upper pressure value is 30 mbar. Since this bilevel device is from a different manufacturer than the CPAP device and the ventilation pressure has also increased significantly, the respiratory gas humidifier is no longer suitable. According to the state of the art, a completely new respiratory gas humidifier would have to be bought. However, the humidifier according to the invention is adapted to the new bilevel device by three add-on modules. Due to the higher pressure, a different cover with a different closure of the filling opening is necessary, since these modules of the CPAP variant were only designed for pressures up to 18 mbar. A new supply connection module is necessary in order to be able to connect the humidifier to the bilevel device, since this had a different air outlet connection than the CPAP device. In addition, the new device regulates on the basis of measured pressure and / or flow values of the breathing gas, which is why a measuring line must also extend through the humidifier. In addition, a larger water tank is used because the higher pressure and longer ventilation made a larger water reserve necessary.

FIG. 5 shows the structure of the respiratory gas humidifier (4) according to FIG. 4 in a vertical section. It can be seen that the hose connection (13) coaxially surrounds the pressure connection (30) in some areas. The pressure connection (30) has an insertion cone (35) which is provided for a sealed connection to the pressure measurement line (21). Starting from the insertion cone (35), the pressure connection (30) extends essentially along the main flow axis (27) and then bends in the direction of the water tank (10). In the area of its extension facing the cover (19), the hose connection (13) has a necking connection (36) which engages in a recess (37) in the cover (19). The bracket (36) has a sealing ring (38) which is provided for sealing relative to the recess (37).

A connection element (39) is arranged inside the cover (19) and below the recess (37). In the exemplary embodiment shown, it is designed in the manner of a plate and is provided to transmit the pressure from the pressure connection (30) to the supply connection (3).

In order to provide a sealed coupling of the connecting element (39) to the hose connection (13), a hollow connecting pin (40), which has an insertion cone (41) that extends to, extends in the direction of the connecting element (39) as an extension of the pressure connection (30) a hollow connecting cone (42) of the connecting element (39) is adapted. When the hose connection (13) is inserted into the recess (37) of the cover (19), the breathing gas hose (20) is connected to the breathing gas humidifier (4) in one operation and the pressure connection for the pressure measuring line (21) is provided.

The supply connection (3) is similar to the hose connection (13). Within the supply connection (3), a pressure connection (43) initially runs essentially along the main flow axis (27), which in the area of its extension facing the hose connection (31) in the direction of a NEN hollow connecting pin (44) kinks. The connecting pin (44) has an insertion cone (45) which is adapted to a connecting cone (46) of the connecting element (39). The connecting pin (44) is surrounded in some areas by a mounting socket (47) of the supply connection (2) which can be inserted into a recess (48) in the cover (19) and is sealed off from the cover (19) by a sealing ring. With regard to the supply connection (3), both a connection to the respiratory gas humidifier (4) and a provision of the pressure connection can thus be carried out in one work step.

As an alternative to a plate-shaped construction of the connecting element (39), it is also possible, for example, to design the connecting cones (42, 46) as end pieces of pipe segments and to connect the pipe segments to one another by means of a separately attached hose. This means that an additional work step is required for assembly, but considerably simplified shapes can be used in injection molding production.

The water tank (10) is coupled to the lid (19) via a connection (50), which can be implemented, for example, as a thread or a bayonet lock. A seal (51) seals the water tank (10) relative to the lid (19).

FIG. 7 shows the perspective illustration of a respiratory gas humidifier (4) which is modified compared to the embodiment in FIG. 6. The supply connection (3) and the hose connection (13) are not arranged on a base (29) here, but together with the closure element (11) in the base plane (28). Otherwise the structural design speaks essentially the embodiments already explained.

FIG. 8 illustrates a top view of the respiratory gas humidifier (4) according to FIG. 7 and FIG. 9 shows a vertical section. In the embodiment according to FIG. 9, the supply connection (3) and the hose connection (13) have a constructional implementation which is modified compared to the previously described embodiments. This constructive implementation can also be used with a respiratory gas humidifier (4) which is provided in the area of the cover (19) with a base (29) for increased positioning of the supply connection (3) and the hose connection (13).

The pressure connection (30) of the hose connection (13) extends essentially completely along the main flow axis (27) and emerges again from the hose connection (13) in the area of a boundary facing the supply connection (3). A recess (54) is arranged in the area of this boundary, into which a pin (55) of the supply connection (3) engages, in the area of which the pressure connection (43) of the supply connection (3) ends. According to an alternative embodiment, it is also possible to arrange the depression in the area of the supply connection (3) and a peg-like projection in the area of the hose connection (13). The positive connection provided prevents the supply connection (3) and the hose connection (13) from rotating relative to one another.

A continuation element (56) for the pressure connection (43) is arranged in the area of the connection adapter (32). net to provide a continuous pressure connection to the breathing gas supply (1).

FIG. 10 shows a cross section for the embodiment according to FIG. 9. In particular, the guidance of the mounting socket (47) in the recess (48) of the cover (19) and the seal using the sealing ring (49) can be seen.

FIG. 11 shows again the embodiment according to FIG. 3 after the supply connection (3) and the hose connection (13) have been removed from the cover (19). A view into the interior of the respiratory gas humidifier (4) is possible through the recesses (37, 48) and the connecting element (39) can be seen.

FIG. 12 shows a further perspective illustration of the embodiment of the respiratory gas humidifier (4) corresponding to FIG. 7. With regard to FIG. 7, there is an oblique view from behind in FIG. In the area of the connection adapter (32), the extension element (57) for the pressure line can be seen from the selected viewing direction.

In order to avoid the formation of splashing water in the area of the water tank (10), it is advantageous not to let the breathing gas flow directly onto the amount of liquid contained in the water tank (10), but rather a baffle plate in the area where the supply connection (3) opens into the cover (19) to be arranged, which extends essentially transversely to the direction of flow. The baffle plate can be attached to the supply connection (3) via spacer elements, but it is also possible to design the baffle plate as part of the cover (19). In particular, the baffle plate and the To implement the cover (19) by injection molding as a single component.

13 shows a constructional implementation modified in the area of the connection of the pin (55) to the recess (54). In comparison to the representation in Fig. 9 it can be seen that the seal (56) along the pin (55) is positioned somewhat further in the direction of the hose connection (13) and thus in the direction of the main flow axis (27) in a central region of the pin (55) is arranged. In addition, the hose connection (13) is provided with a projection (58) which surrounds the pin (55) in a circle, which leads to an improved positive connection between the supply connection (3) and the hose connection (13) in an assembled state.

An additional positive connection between the supply connection (3) and the hose connection (13) is achieved by one or more positioning pins (59). The positioning pin (59) is arranged in the region of the mutually facing boundary surfaces of the supply connection (3) and the hose connection (13). A simple manufacture is supported in that the positioning pin (59) is designed as a separate component and is inserted in recesses (60, 61) of the supply connection (3) and the hose connection (13).

From the enlarged illustration in FIG. 14 it can be seen that the positioning pin (59) is firmly inserted into the recess (60) and engages in the recess (61) with play. This supports the assembly and separation of the connections (3, 13). Typically, the positioning pin (59) firmly connected to that of the connections (3, 13) which also carries the pin (55). In the illustrated embodiment, this is the supply connection (3).

15 schematically shows examples for the selection within the modules and for the variety of combinations. The actual number of different modules can be expanded practically indefinitely. There are many possible combinations. In particular, the abbreviations in Fig. 15 have the following meanings.

radiation

devices waste heat

energy

battery pack

Netzström

fuel cell

K. Hoses

25 cm hose, male / female

25 cm tube, male / female, with 0.8 micron membrane

25 cm hose, male / male

25 cm tube, male / male with 0.8 micron membrane

25 cm double-extruded, coaxially mounted hose, male / female

25 cm double-extruded, coaxially mounted hose male / female with 0.8 micron membrane

25 cm double-extruded, coaxially mounted hose, male / male

Internal hose, male

Internal hose, male, with 0.8 micron membrane

Internal hose, female

Internal hose, female, with 0.8 micron membrane

Internal 25 cm double extruded, coaxially mounted hose, male internal 25 cm double extruded, coaxially mounted hose, male, with 0.8 micron membrane

25 cm hose, male / male I. Connection to breathing mask

Conventional breathing mask for adults

Flexible articulated breathing mask for adults

Ball joint breathing mask for adults

II. Hygroscopic heat and moisture exchangers (HME)

HME filter between the contra-angle handpiece and the patient-side connector

HME / HEPA filter between the contra-angle handpiece and the patient-side connector

HME filter in the hose

HME filter in mask

X. Upper shells

Side cover CPAP-Basic blue

Side cover CPAP-Basic black

The table above shows examples for the selection within the modules and for the variety of combinations

The customer can select the desired modules from a catalog, similar to the one shown above.

In addition to the various modules shown, FIG. 15 also illustrates the interaction with a patient (62) and the interaction with an environment (63). 16 illustrates the interaction already explained between the respiratory air humidifier (4), the respiratory gas supply (1), the environment (63) and the patient (62). A comparator (64) for data evaluation and a controller (65) for controlling the respiratory gas humidifier (4) are shown.

In the exemplary embodiment shown in FIG. 17, the respiratory gas supply (1) and the respiratory gas humidifier (4) are assembled in a modular manner. The breathing gas supply (1) is provided with a filter (66) and a blower (67). A liquid supply (68) is arranged in the area of the respiratory gas humidifier (4), for which a minimum and a maximum fill level are provided. Immersed in the liquid supply (68) there is an evaporation element (69) which can be made of a porous or capillary material, for example. It is also possible to arrange a large number of outlet openings (70) in the area of the evaporation element (69).

18 shows an embodiment in which the respiratory gas humidifier (4) is arranged above the respiratory gas supply (1) and in which a lateral boundary of the respiratory gas humidifier has a contour profile which is adapted to a contour profile of the respiratory gas supply (1). The respiratory gas humidifier (4) is provided with its own control elements (71) and its own display (72).

According to the embodiment in FIG. 19, the respiratory gas humidifier (4) is positioned in regions below and in regions next to the respiratory gas supply (1). According to the embodiment in FIG. 20, the respiratory gas humidifier (4) can be inserted into an insert of the respiratory gas supply (1).

21 shows an embodiment in which the respiratory gas humidifier (4) is positioned in regions next to and in regions above the respiratory gas supply (1).

22 shows an embodiment in which the respiratory gas humidifier (4) is equipped with a waterproof but vapor-permeable membrane (73). The membrane (73) delimits a transition from the water tank (10) to an air flow (74). The large contact area already explained in the transition area from water to air is hereby realized.

According to the embodiment in FIG. 23, a membrane (73) is also used, which is also formed as part of the breathing gas hose. The breathing gas hose (20) is preferably provided with an expandable flexible outer shell (75). The heating element (52) is preferably arranged between the outer shell (75) and the membrane (73). A storage space (76) is delimited by the membrane (73) and the outer shell (75) and holds a water supply. The storage space (76) can be divided by partitions (77) in a longitudinal direction of the breathing gas hose (20). An adapter (78) connects the breathing gas hose (20) to components close to the patient.

24 shows a filling device (79) for filling the storage space (76), which is arranged in the region of the breathing gas hose (20). The filling device (79) has a funnel (80) which surrounds a centering element (81) and together with the centering element ment (51) delimits an essentially annular filling gap. The water reaches the area of the storage space (76) through the filling gap.

FIG. 24 also illustrates once again in a perspective view that the membrane (73) and the storage space (76) surround a flow path (82) essentially concentrically.

FIG. 25 shows an embodiment in which, as a modification to the embodiment in FIG. 22, the moisture is conducted via an elastic nozzle (83) into the area of the air flow (74). The nozzle (83) projects into an air duct (84). The nozzle (83) is connected to the water tank (10) via a drop generator (85). The drop generator (85) can be controlled via excitation connections (86).

According to the embodiment in FIG. 26, a nozzle (87) opens into the air channel (84) and is connected to the water tank (10) via the drop generator (85). The drop generator (85) has a drip control (88) here. A fan wheel (90) driven by a fan motor (89) is arranged in the area of the air duct (84). According to one embodiment, the drops emerging from the nozzle (87) reach the area of the fan wheel (90) and are distributed by the latter. Alternatively, it is also possible to arrange an upstream atomizer wheel (91) in the area of this fan wheel (90) in order to prevent moisture from penetrating into the area of the fan motor (89). An electrically controllable heating grill (92) can be used to control the temperature of the air flow within the air duct (84). According to the embodiment in FIG. 27, a Peltier element (93) is used which is connected to a voltage supply (94). The Peltier element (93) has a cold side (95) with condensation from the air and a warm side (96) with heat emission to the air. Air flow (97) is applied to both the cold side (95) and the warm side (96). A collecting trough (98) for condensate which forms is arranged in the vertical direction below the Peltier element (93).

According to the embodiment in FIG. 28, a fuel cell (99) is used, which is connected to an oxygen tank (100) and a hydrogen tank (101). The fuel cell (3) has an electrical connection (102) for energy supply. Water formed by the fuel cell (99) is collected in the area of a collecting device (103). The electrical connection (102) serves to supply energy to at least one connected electrical consumer, for example the respiratory gas humidifier (4) and / or the respiratory gas supply (1).

Fig. 29 illustrates a module designed as a heating element (52), which is arranged below the water tank (10). In this embodiment, the water tank (10) has an electrically conductive bottom (104). The heating element (52) consists of an electromagnet (105), the coil (106) of which is connected to an alternating voltage (107). The electromagnet (105) is separated from the water tank (10) by a housing wall (108).

30 illustrates an embodiment with a floating heating plate (109) as heating device (52). The heating plate (109) floats on a water supply (110) within the water tank (10). The heating plate (109) is supplied with energy by an electrical connection (111). The air flow (97) sweeps over a surface of the water reservoir (110). The heating plate (109) is constructed in such a way that it easily dips into the water reservoir (110), taking into account its specific weight, so that a thin film of water forms on a surface of the heating plate (109) facing away from the water reservoir (110), which evaporates is provided.

31 illustrates the use of waste heat from a

Power supply or transformers (112). The water tank (10) is arranged on a heat sink (113) of the power supply unit (112). Preferably, the power supply (112) from the heat sink (113) and the water tank (110) through the

Housing wall (108) separated.

According to the embodiment in FIG. 32, a plurality of partition walls (115) are arranged within an interior (114) of the water tank (10), which is arranged above the water reservoir (110), which are preferably arranged inclined to the horizontal. Water is removed from the water supply (110) using a pump (116) and heated via the heating element (52). The heated water is supplied to the interior (114) in a vertical direction from above and runs in stages along the partitions (115) arranged one above the other in the direction of the water supply (110). The partitions (115) thereby provide large-scale evaporation surfaces. The interior (114) is provided with an air inlet (117) and an air outlet (118). FIG. 33 shows an embodiment modified from FIG. 32. The air inlet (6) is lower and the air outlet (7) higher. As a result, an air flow in the counterflow principle is achieved relative to the water flowing in the vertical direction from top to bottom, which increases the moisture absorption of the air again.

Claims

Patent claims

1. Device for humidifying breathing gas, characterized in that the device contains at least one component that can be exchanged modularly for an alternative part.

2. Device according to claim 1, wherein the modularly interchangeable (or a modularly interchangeable) component is a device for the production and / or storage of water or contains it, in particular is a water container or contains it.

3. The device according to claim 1, wherein the modularly interchangeable (or a modularly interchangeable) component is a device for closing a water container or contains it, in particular is a lid or a filling opening closure or contains such parts.

4. The device according to claim 1, wherein the modularly interchangeable (or a modularly interchangeable) component is a device for introducing water or water vapor into breathing gas or contains it, in particular an air duct or an air duct on or via a water surface, a water nozzle Water nebulizer, a membrane (in particular only permeable to water on one side), a Peltier element that generates condensation or a fuel cell.

5. The device according to claim 1, wherein the modularly interchangeable (or a modularly interchangeable) component is a device for connecting a breathing gas tube or the component contains a device for connecting a breathing gas tube.

6. The device according to claim 1, wherein the modularly interchangeable (or a modularly interchangeable) component is a device for connecting a breathing gas supply or the component contains a device for connecting a breathing gas supply.

7. The device according to claim 1, wherein the modularly interchangeable (or a modularly interchangeable) component is a device for heating the water or the already humidified or still to be humidified breathing gas or a device for heating the water or the already humidified or still to be humidified breathing gas contains.

8. Device according to one of claims 1-7, in which groups of modularly interchangeable, substi tutieren or complementary components can be connected to each other by a uniform locking system, such as by a catch, by pin, by tongue and groove, by magnetic lock or by twist lock

9. A device for humidifying breathing gas, consisting of at least one device for introducing water or water vapor and a connection to a breathing gas supply, characterized in that one or more separate components with additional functions can be added to the functional basic unit.

10. The device according to claim 9, wherein the separate component is a measuring and or control device with which one or more measured physiological or medical measured values of the person to be ventilated (including data of the inhaled and exhaled air) or the change over time of one or more these values are recorded and / or processed and / or stored, and these data are displayed and / or used for manual or automatic control of the humidification process or its parameters (for example pressure, flow, temperature, humidity or their change over time).

11. The device according to claim 9, wherein the separate component is a measuring and / or control device with which one or more measured ambient measured values of the person to be ventilated, in particular air temperature, air pressure, air humidity, air composition, height, magnetic field strength, electric field strength, brightness or the change in time of one or more of these values is recorded and / or processed and / or stored, and this data is displayed and / or for manual or automatic control of the humidification process or its parameters (for example pressure, flow, temperature, humidity or their change over time) be used.

12. The apparatus of claim 9, wherein the separate component is a control device with which to be entered, stored or transmitted physiological or medical measured values or data of the person to be ventilated (including data of the inhaled or exhaled air) or the temporal change of one or more of these Values are recorded and / or processed and / or saved, and these data are displayed and / or used for manual or automatic control of the humidification process or its parameters (eg pressure, flow, temperature, humidity or their change over time).

13. The apparatus of claim 9, wherein the separate component is a control device with which to be entered, stored or transmitted environmental measurements or environmental data of the person to be ventilated, in particular air temperature, air pressure, humidity, air composition, height, magnetic field strength, electric field strength, brightness or the temporal Changes to one or more of these values are recorded and / or processed and / or saved, and these data are displayed and / or for manual or automatic control of the humidification process or its parameters. ter (e.g. pressure, flow, temperature, humidity or their change over time).

14. Device according to one of claims 9 to 13, wherein the control of the moistening process forms a control circuit.

15. The apparatus of claim 9, wherein the separate component is a Peltier element, which for heating. of the air flow and / or for generating condensed water from the ambient air.

16. The apparatus of claim 9, wherein the separate component is a measuring and / or control device with the data of the humidifier such as water level, spatial position of the device or the water supply, temperature, energy consumption or reserve, degree of calcification, degree of contamination mechanical, chemical, be made electrically, electronically, optically, magnetically or otherwise recognizable, readable, or displayed, or which are used for the automatic control or generation of advertisements or messages or warning signals.

17. The apparatus of claim 16, which is integrated in a further separate component, such as a housing cover, a base plate, a connection, a gas guide.

18. The apparatus according to claim 9, wherein the separate component, in particular an air duct, a connection or contains a cover, devices or devices for noise reduction.

19. The apparatus of claim 9, wherein the separate component, in particular an air duct, a connection, a lid, an element with a binder or an insert in the storage container, for example spongy or labyrinthine, devices or devices for preventing the water in the storage container from tipping over contains.

20. The apparatus of claim 9, wherein the separate component is a tool or aid for handling the base unit, in particular for its installation or fixation, water filling, cleaning or remote control.

21. The device according to claim 9, wherein the separate component contains a battery or a rechargeable battery or solar cells or a fuel cell or more of the aforementioned elements, for the mains-independent power supply of the device or an additional component, or by means of a transformer and / or converter for its power supply with a external power supply other data (such as voltage, frequency, type of current) serves as the basic unit.

22. The apparatus of claim 98, wherein the separate component includes a filter that serves to clean or reduce the bacterial load in the water before moistening.

23. The device according to claim 9, wherein the separate component storage or display or control elements of the device connects telemetrically with sensors or external data transmission devices.

24. A device for humidifying breathing gas, consisting of at least one device for introducing water or water vapor and a connection to a breathing gas supply, characterized in that the water required is provided in whole or in part by a fuel cell, which also serves to power the device or elements associated with it.

25. Device for humidifying breathing gas, consisting of at least one device for introducing water or water vapor and a connection to a breathing gas supply, characterized in that the water required in whole or in part, and / or the heating of the humidified or humidified breathing gas by a Peltier element is generated.

26. Device for humidifying breathing gas, consisting of at least one device for introducing water or water vapor and a connection to a breathing gas supply, characterized in that the heating of the water by an inductively heatable electrically conductive element in the water reservoir, which is done by an outside of the Container located device is excited.

27. A device for humidifying breathing gas, consisting of at least one device for introducing water or water vapor and a connection to a breathing gas supply, characterized in that a floating heating plate is located within the water storage container, which heats the water primarily on its surface.

28. A device for humidifying breathing gas, consisting of at least one device for introducing water or water vapor and a connection to a breathing gas supply, characterized in that the water storage container in spatial proximity to a heat-generating component or a heat-generating additional element of the device or the breathing gas supply such as a power supply, transformer or motor is attached and the water is heated, preheated or heated by this component or element.

29. Device for humidifying breathing gas, consisting of at least one device for introducing water or water vapor and a connection to a breathing gas supply, characterized in that the gas stream is moistened on a water-permeable membrane on a water-storing or water-generating element.

30. Device for humidifying breathing gas, consisting of at least one device for introducing water or water vapor and a connection to a breathing gas supply, characterized in that the gas stream is moistened through a nozzle opening into a gas channel.

31. Device for humidifying breathing gas, consisting of at least one device for introducing water or water vapor and a connection to a breathing gas supply, characterized in that the gas stream is moistened via a nozzle opening into a gas channel, which is connected upstream of a drop generator.

32. Device for humidifying breathing gas, consisting of at least one device for introducing water or water vapor and a connection to a breathing gas supply, characterized in that the water is introduced into the gas stream in the region of a motor-driven fan wheel.

33. Device for humidifying breathing gas, consisting of at least one device for introducing water or water vapor and a connection to a breathing gas supply, characterized in that the water in the area of a motor-driven fan wheel is introduced into the gas stream via a droplet control and is thereby atomized.

34. Device for humidifying breathing gas, consisting of at least one device for introducing water or water vapor and a connection to a breathing gas supply, characterized in that the device for generating and / or storing the water in the breathing gas supply, in particular in the breathing gas hose, located, preferably on the side or on the outer edge.

35. The apparatus of claim 34, wherein the moistening is carried out via a membrane permeable to water on one side.

36. Apparatus for humidifying breathing gas, consisting of at least one device for introducing water or water vapor and a connection to a breathing gas supply, characterized in that the humidification is effected by a water mist excited by ultrasound.

37. The apparatus of claim 36, wherein the water reservoir is separated from the area of ultrasonic nebulization by filters.

38. Device for humidifying breathing gas, consisting of at least one device for introducing water or steam and a connection to a breathing gas supply, characterized in that the water reservoir is separated from the area of humidification by a filter.

39. Device for humidifying breathing gas, consisting of at least one device for introducing water or water vapor and a connection to a breathing gas supply, characterized in that the water supply or the device for water production or the guidance of the humidified breathing gas with insulation to reduce temperature changes is provided.

40. Device for humidifying breathing gas, consisting at least of a device for introducing water or water vapor and a connection to a breathing gas supply, characterized in that moisture from the ambient air is supplied by hygroscopic materials on the breathing gas hose or in a separate component, alone or in addition to another source of humidification.

41. Device for humidifying breathing gas, consisting of at least one device for introducing water or water vapor and a connection to a breathing gas supply, characterized in that the water is heated via microwaves.

42. Apparatus for humidifying breathing gas, consisting of at least one device for introducing water or water vapor and a connection to a breathing gas supply, characterized in that only a separately separated part of the breathing gas supply is humidified and the breathing gas supplied to the person to be ventilated from one controllably composed mixture of humidified and non-humidified breathing gas.

43. Apparatus according to claim 8, wherein the separate component is a time measuring device and / or a measuring device for air pressure or air temperature or humidity, in connection with a display and an operating or control unit for setting, preselecting or regulating functions of the humidification.