DE102009014746A1 - Apparatus for optimal heating and humidification of inhaled gases for e.g. artificial respiration, of patient, has inhaled control current supplying device adjusting inhaled gas temperature - Google Patents

Abstract

The apparatus has an inhaled gas heating-humidification-device provided with tube connectors. Humidification elements are attached to inductively heat heat production elements. An external water dosing pump electronically regulates heat amount of the heat production elements and humidification amount of the humidification elements depending on quantity of an inhaled gas stream. A control current supplying device adjusts inhaled gas temperature, and the heat production elements made of copper, aluminum, stainless steel or electrically conducting plastics and heated by a heating band (6).

Description

The dry and cold inhaled air reaches physiologically over the Nasal membranes and optimizes the nasopharynx and moistens the trachea, the bronchi and finally for gas exchange the alveoli. An undisturbed Filtering and cleaning function of the bronchial mucosa allows only the elimination of Mucus and foreign bodies, but that is only possible with an optimal conditioning of the inhaled air with heat and Humidity. Physiologically, this is achieved by a stronger or weaker blood circulation the nasal mucosa with a resulting altered Release of moisture and heat to the breath. In artificial Ventilation and respiratory therapy need but these physiological functions are replaced. Marketable active Breathing air Anwärm-pre-wet devices use the principle of breathing over the surface of heated Water or over heated surfaces, which vaporizes the water to pass around with heat and vapor To condition moisture. These surfaces often become artificial enlarged by the extra Use of flow paper parts, dipping into the water. This can be an increase of effectiveness to reach. mention to find the completeness Half the now rarely used procedures such. B. the Conditioning of respiratory gases by porous hollow fibers through which warm water flows or the portioned dispensing of hot steam. A special position But still take devices that moisture as a heat-moisture exchanger of the exhaled air of the patient and heat Remove and then each of the dry inhaled air, however with certain losses, leave again. These exchangers have but only in special cases the artificial one Ventilation and spontaneous breathing limited applicability.

Problems with respiratory gas warm-up wetting devices

• 1. The production of optimally tempered and humidified Respiratory gases at different Atemgasfluß resp. Respiratory minute volumes such as B. in artificial Ventilation of infants, Children, adults and respiratory support such as mask ventilation, CPAP therapy u. a ..
• 2. Rapid operational readiness with avoidance of a "hot shot" (suddenly hot breathing gases) z. B. at the beginning of an artificial Ventilation therapy. This danger threatens especially in moistening-warming devices that larger amounts of water for your Need function. They require this preheating in emergency ventilation cases immediately to get enough conditioned respiratory gases.
• 3. rain out water by cooling the respiratory gases in the long Ventilation tubes with the need for water traps or expensive consuming electrical heated sterilizable breathing tubes.
• 4. Bacteriological-hygienic problems leading to breathing gas parts applied directly to the patient. Need to use sterile expensive disposables or laborious cleaning and steam sterilization the multiple article (tubes, Connectors, warm-up moistening devices).
• 5. Easy and safe use for the patient in everyday routine in economic terms acceptable loads for the budget and the environment.

With the invention described below, the new device for warming and moistening of respiratory gases, the problems mentioned are largely solved.

Three embodiments for single or multiple use are described below with reference to 1 - 6 described.

1 shows the heart of the device of 2 , the heated humidifier wrap for the respiratory gases. It consists of a corrugated paper strip 1 that by imprints 2 each at the beginning and end of a wave, with the underlying base paper strip 3 each in the places 4 connected is. These flow papers are used for water absorption for moistening and their described structure to form the largest possible surface. Rolled up to a wrap 5 In addition, multiple air channels are created, which increase the efficiency.

Wrappings of this type, but impregnated with hygroscopic chemicals, are used as known in today's HMEs (heat and moisture exchanger). The crucial feature of the invention, however, is that these known tile paper structures rolled up in closest connection with an electric heating tape as a heated winding 5 to be used. This electric heating tape 6 , preferably formed as a thin metal band of copper or stainless steel is at its beginning 7 with an electrical connection in tube form 8th connected. The overtemperature fuse element 9 is integrated in the wrap. The free end of the heating tape 6 with the electrical connection 20 (S. 2 and 3 ) connected.

device Description of the 1st embodiment

2 shows in perspective and transparent drawn the device for heating and humidifying respiratory gases separated in upper part 10 and lower part 11 , The upper part has a breathing gas off let lop 11 with an electrical contact plate 12 to control the here properly plugged breathing gas temperature sensor (not shown) on.

Into the lumen of the breathing gas outlet 11 protrudes in a bulge 13 arranged integrated flow sensor 14 with its coaxial connector 15 , In the center of the arched surface 16 of the top 10 is an implementing element 17 for the connecting piece with hose attached 18 attached for the supply of dampening water. Dashed, thin lined drawn you can see through the transparent top 10 the watering cross 19 connected to the connecting piece 18 , The lower part 11 shows the breathing gas inlet nozzle 24 , the respiratory gas warm-up moistening wrap used 5 with its electrical connections 7 u. 20 and the coaxial connectors 21 for the overtemperature sensor 9 in the wrap 5 and the flow sensor 14 and the associated coaxial connectors 22 u. 23 ,

3 shows in section, section plane I ... I, 2 The Breathing Gas Warm-Up Moisturizer Device. Her domed shell 10 shows the gas outlet 11 with the electrical contact plate 12 and the bulge 13 with integrated flow sensor 14 , Coaxial socket 15 and the sealing lip 28 , In the center of the arched surface 16 of the top 10 is the lead-through element 17 with the O-ring seal 26 for the neck 18 In the water distribution cross (pipe for the moistening water supply) 19 with its water distribution channels 27 and water outlet openings 28 is pressed. This water distribution element 19 becomes in direction, as by arrow 29 shown for further water distribution and delivery to the blotting paper perforated disc 30 and the underlying warm-up moistening wrap 5 pressed by support ribs 26 being held by the sloping ground 25 of the lower part 11 out. The sloping ground 25 also causes too much applied dampening water to drain into a (not shown water trap).

device function of the 1st embodiment

The dry, cold breathing gas flows over the inlet port 24 the warm-up wetting device over the base 11 , through the numerous air channels of the heated warm-up wipe wrap 5 , the wet rolled paper perforated disk pressed onto it 30 with attached water distribution cross 19 in the upper part 10 the device and from there via the flow sensor 14 to the outlet 11 and the plugged there, mandatory for the commissioning of the electronic control power supply unit of the moistening Anwärm device the breathing gas temperature signaling and monitoring temperature measuring unit and a short breathing gas connection hose with adapter (not shown), well-tempered and moistened, via a tracheal tube, a Tracheal cannula or breathing mask to the patient. Its spent exhaled air eventually reaches the outside via an exhalation valve via any measuring devices that are still switched on.

decisive for the outstanding function of this breathing gas wetting-warming device but are their wetting-warming wraps. Their heating elements have a very low heat storage capacity and thus Thermal inertia. In order to the possibility arises a very rapid electrical change in heat output and that in addition in a big one Control range, which means that z. B. when changing the breathing gas flow also the breathing gas temperature within narrow limits largely constant can be held.

Technically constructive this is achieved by the use of a thin metal strip as a direct, electrically heated heating element. This element is integrated into the wetting-warming coil of the Warming-Moisturizing Device (see fig. 1 ). The moistening elements applied to the metal heating tape also have a low heat storage capacity and thus thermal inertia, since their water absorption capacity is only small (a few milliliters). These moistening elements are formed of wavy blotting paper in strip form and to a winding (s. 1 ) rolled up. This results in a large surface area for the evaporation of water evaporation and intimate contact with the respiratory air, which flows through the multiple air channels formed in the winding. The water supply and distribution for moistening the moistening wraps via the applied, perforated blotting paper disc with its attached water distributor. An external simple dosing pump, preferably peristaltic pump, controlled by the electronic control power supply device ensures a precisely dosed sterile water supply depending on the preselected or measured respiratory gas flow or respiratory minute volume. The Anwärm-moistening wraps described in their function thus allow rapid detected by the temperature measuring unit already small respiratory gas temperature changes using the electronic control and power supply device via the electrical power supply to the heating element to correct. Unpleasant warm or even dangerous hot respiratory gases z. As a "hot shot" can be avoided with changes in the respiratory gas or respiratory minute volume. Likewise, a so-called "preheating" the Atemgas-Anwärm-moistening device with the danger of sudden hot gases of gases has become unnecessary by the possible fast but sensitive heating of Anwärm-moistening wraps such. B. in the emergency emergency ventilation of a patient required. The in the warm-up moisten Vorrich tion in Gasauslassstutzen existing flow sensor also prevents switching on the electric heater using the electronic control power supply device in a non-existent breathing gas flow. Due to the compact design and especially the sensitive fast breathing gas temperature regulation, a patient-near arrangement of the device is possible and thus only a short breathing gas hose as a link to the patient, which causes only a very small drop in temperature of the breathing gases with correspondingly very low condensation water loss. This eliminates electrically heated breathing gas hoses and usually water traps.

device Description of the second embodiment

4 shows in perspective schematized the Anwärm-moistening device with its upper part 31 , the breathing gas inlet nozzle 32 with his extension 33 and the breathing gas outlet 34 , as well as the water supply pipe next to it 35 , On the inside of the top 31 There are two gutters provided with gutters 36 u. 37 through the channels in the upper part (not shown) with the water supply pipe 35 connected and serve as a water distributor. In the gutters of the last 36 u. 37 each stuck with rows of perforation holes 40 . 41 provided ends of the legs 38 u. 39 the U-shaped, thin sheet 42 with his neckline 43 which is bridged by the metal dock 44 , The U-plate 42 is with a water absorbent paper 45 completely covered on the inside and outside, leaving only the metal bar 43 left out. This blotter serves to supply water and is the moistening element.

5 shows the top 31 inserted into the box-shaped base 46 with the sensor plate with feeler pin 47 for overtemperature signaling. As drawn schematically, the U-shaped transformer core 49 on the thigh 50 the primary winding 51 carries, with his thigh 52 through the in the lower part 46 gastight tunnel 48 introduced. With the I-shaped transformer core 53 can by advancing in the direction of the arrow 43 on the layer 44 the inserted cassette lower part 46 mechanically locked and thereby the transformer core connection can be achieved.

device function of the second embodiment

5 shows the warm-up wetting device cartridge schematically inserted into its control power supply device. The one leg 48 of the transformer core 49 is in the tunnel 48 of the cassette lower part 46 introduced and with the I part 53 mechanically locked and at the same time thereby the U-shaped transformer core 49 at its ends 50 u. 52 magnetically closed. That means the U-shaped plate 42 becomes the secondary short-circuit winding of the transformer and can thus be heated by induced current. With the applied thin water-soaked blotting paper 45 This creates a warm-up moistening element. Due to the special geometric shape of the thin heating plate 42 a minimization of the heat storage capacity is achieved and by the additional perforations 40 u. 41 at its upper ends, a transfer of heat to the moistening water in the water distributor 36 and 37 minimized. The resulting low heat capacity of the heating element (despite high heat output) in combination with the low water capacity and heat storage capacity of the humidifying element (thin blotting paper) causes a rapid, low-inertia adjustment of the respiratory gas temperature can be made to changing gas flow. This can largely solve the problems mentioned in the introduction.

device Description of the third embodiment

6 shows the 3rd example of the Atemgaswärwär- moistening device perspective, transparent and partially drawn schematically. The housing of the device consists of two halves of a shell 56 with gas outlet 57 and a lower part 58 with gas inlet 59 With the help of flanges and a seal (not visible) through the closure 60 be held together gas-tight. On the transparent drawn lid 61 you can clearly see the two electrical plug contacts 62 u. 63 attached, the inside of the housing respectively with the electrodes 64 u. 65 are connected, each at the longitudinal edges 66 u. 67 the longitudinally slotted, thin-walled cylinder jacket 68 continue until the beginning of the perforated cylinder jacket zone 69 and which are electrically and mechanically connected to this cylinder jacket. The upper end of the longitudinally slotted thin-walled cylinder 68 is guided in a circular groove (not shown) on the inside of the housing cover and thereby mechanically stabilized. The drawn gas distributor with baffle plate and outlet openings 70 serves for breathing gas inlet into the interior of the cylinder jacket, the longitudinal slot 71 in the cylinder jacket 68 to its exit (well-tempered and moistened). The lower end of the cylinder jacket is replaced by one in the bottom 72 of the lower housing part 58 molded circular groove 73 mechanically stabilized. The one on the ground 72 drawn hose nozzle 74 is used to supply sterile moisturizing water up to the visible max. Water level mark 75 on the outer wall of the housing base 58 , The thin-walled metal cylinder jacket 68 represents the heating element of the Anwärm-moistening and can, as shown schematically in the upper part of the drawing, z. B. by one on the two electrical plug contacts 62 u. 63 over the couplings 76 u. 77 composites NEN thick metal strap 78 , to the secondary short-circuit coil of a transformer. As shown schematically, this can be achieved by inserting an I-shaped transformer core part and the magnetic core closure obtained therewith in the case of a primary coil-provided U-core. An overtemperature shutdown is again as in embodiment no. 2 via a lid 61 built-in temperature sensing pin 80 and a temperature sensor mounted thereon with shutdown electronics, a portion of the electronic control power supply unit of the respiratory gas warm-up wetting device.

device function of the third embodiment

6 shows the Atemgas-warming-moistening device in perspective, drawn transparent. Cold breathing gas flows through the gas inlet 59 to the gas distributor with baffle plate and outlet openings 70 over the inner surface of the electrically heated cylinder jacket 68 which is covered with cylinder-rolled, thin blotter paper (not shown). This blotting paper cylinder stands with its lower end in the sterile moistening water, that over the neck 74 supplied from an external reservoir, the bottom 72 the respiratory gas warm-up moistening device covers up to the level of the water level mark 75 , Due to the intimate contact of the flux paper cylinder with the electrically heated, thin-walled, metal cylinder jacket 68 , which is the heating element of the device, the moistening water is evaporated or vaporized. The breathing gas stroking over this large surface is optimally warmed and moistened. It passes over the longitudinal slot of the cylinder jacket 71 finally to the gas outlet 57 , Finally, a short connecting tube to the patient connection piece via this connection piece and the respiratory gas temperature sensor (not shown) attached there. The respiratory gas temperature sensor controls via the electronic control power supply unit (s. 7 ) the power supply to the heating element of the respiratory gas warm-up moistening device. An over-temperature control of the heating element takes place via the temperature measuring pin (sensor) 80 through the downstream electronic control power supply device. About the electrical connector 62 . 63 the power supply takes place. It can most elegantly over the drawn thick, electrically good conductive metal bracket 78 be made, if this as shown schematically by the insertion of the transformer core 79 leads to the core of an associated transformer and thus becomes the secondary short-circuit winding of the same. Due to the low heat storage capacity of the thin-walled, metal, longitudinally slotted cylinder jacket 68 , which does not dive with its lower end in the Anfeuchtwasserreservoir, as an electric heating element in combination with the thin paper strand cylinder, as moistening with low water storage capacity, in turn, the favorable fast low-inertia regulations of Atemgastemperatur and moisture with the help of the connected control power supply device.

In 7 simplified are the functions of the electronic control power supply device for the Atemgas-warming-moistening device and associated metering pump for the humidifier water and the associated sterile water reservoir shown schematically simplified.

The respiratory gas warm-up moistening device, shown here in simplified form as a heating / humidifier device, shows the respiratory gas temperature measuring device which is plugged onto the outlet connection and is referred to schematically as the ° C sensor. It is connected to the operating thermostat with its setting and display elements. This thermostat communicates with the microprocessor of Heizstromregulators, both depending on the manually preselected respiratory gas temperature, the currently measured temperature and its rise or fall rate as well as on the currently determined by a flow meter or manually preselected values of the gas flow or respiratory minute volume, the heating current increases, decreases or switches off (switch S3), which is delivered to the heating elements of the Anwärm-moistening device. Likewise, the water metering pump for the adequate humidification of the respiratory gases is controlled by this regulator via an interval switch as a function of the respiratory minute volume or respiratory gas flow. The flow sensor, which is still integrated in the respiratory gas warm-up moistening device, causes the heating current to be switched off via switch S1 in the absence of a respiratory gas flow. The warm-up dampness wrap 5 integrated over-temperature sensor 9 (S. 2 ) triggers the over-temperature switch and cuts off the heating current via S2.

Claims (14)

Device for optimal heating and moistening of respiratory gases for artificial respiration and respiratory aid therapy with a respiratory gas Anwärm moistening device A in the patient circuit and an associated electric-electronic control and regulating device B, characterized in that the device A in a housing with hose nozzle is provided for breathing gas supply and -abfuhr and used for heat generation electrically or inductively heated heat generating elements in one or a plurality of low heat storage capacity in combination with humidification elements with low water storage and heat storage capacity in single or multiple, which on these heated heat generating elements are applied or in intimate contact and whose heating power and humidification with sterile water with the help of an electrically operated external Wasserdosierpumpe depending on the amount of the breathing gas flow and the breathing gas temperature inertial, electrically-electronically controlled by means of the control power supply device B. Heat-generating elements with low heat storage capacity according to claim 1 characterized in that they are preferably made of thin, band-shaped or thin, flat consist of electrically conductive materials, preferably metals, metal alloys (eg, copper, aluminum, stainless steel) or electrically conductive plastics. Heat-generating elements according to the claims 1 u. 2, characterized in that the flat-shaped elements have different sizes and have multiple recesses of different shape, shape, size and arrangement can. Heat-generating elements according to the claims 1-3 by characterized in that it comprises an inductively excited secondary short-circuit coil one with 50-60 Hz AC or electronically switched transformer represent. Heat-generating elements according to the claims 1-3 by characterized in that they are indirectly electrically connected via an intermediate transformer or are fed directly by the electric-electronic Control power supply device B by a continuous or pulsed discharged heating current and this as heat from the heat generating element inertia dispensable. Heat-generating elements according to the claims 1-5 by characterized in that it is provided with a corrosion-resistant and heat-resistant coating z. B. metal, metal oxide or plastic are provided. Heat-generating elements according to the claims 1-6 by in that moistening elements are applied to its surface with low water storage and thus heat storage capacity that out thin wassersaugfähigem Material consist, preferably papers made of cellulose or special Plastic fibers. Heat-generating elements according to the claims 1-7 by characterized in that to avoid too high surface temperatures recorded their temperature and when exceeding the safety limits by means of the electronic control power supply device B, the electric heating power supply interrupts and triggers an alarm. Heat generating elements according to claims 1-8, characterized in that the temperature measured at the surface of the heating elements and their rise and fall speed by means of the control power supply device B via the Heizstromregulator (s. 7 ) is used for Heizstromsteuerung. Wassersaugfähiges Material of the moistening elements according to claims 1 u. 7 characterized that it's a punched, absorbent paper in combination with a water distributor for moistening one underneath arranged heated humidifier used. Heat-generating elements with applied moistening elements according to claims 1-10 characterized in that the dampening water as sterile water, exactly dosed automatically or according to manually specified values, delivered is powered by an electrically powered external pump, or one container by gravity, or according to the principle of communicating tubes, respectively dependent on from the respiratory gas flow and the respiratory gas temperature. Heat-generating elements with applied moistening elements according to claims 1-9 in that the moistening water is applied precisely metered by spraying becomes dependent from the respiratory gas flow and the respiratory gas temperature. Heat-generating elements with applied moistening elements according to claims 1-7 characterized in that the moistening water for evaporation-evaporation is applied only by the suction power of absorbent papers, which comes from a small water reservoir, located on the ground of the housing the heat-moistening device located. Anwärm-pre-wet apparatus according to the claims 1-13 by in that the on or in the inlet or outlet nozzle of Anwärm-pre-wet apparatus arranged flow sensor over the electric-electronic control power supply unit the current flow for the or only releases the heating elements when it registers a flow of breathing gas.