HK1225323A - Ventilation method and ventilation device - Google Patents

Description

Ventilation method and ventilation device

The invention relates to a division of Chinese patent application with the application number of 2011800121797 and the application date of 2011, 2, month and 18, and the name of ventilation method and ventilation device.

Technical Field

The present invention relates to a method for ventilation (ventilation) of a living body, a ventilation device, and a valve control device.

In general, the present invention relates to the field of ventilation of patients with respiratory problems. COPD patients are taken as an example, in particular patients with hypercapnic respiratory insufficiency. In these patients, structural changes have occurred in the lungs due to various diseases, requiring increased work from the respiratory musculature in order to ensure sufficient gas exchange. As the disease progresses, the respiratory musculature becomes exhausted and therefore a lack of respiratory sensation occurs during breathing, even with very slight breathing. In the obvious case, particularly during night sleep, the respiratory musculature and respiratory driving force can no longer compensate for the structural changes of the lungs by increasing the depth of breathing and increasing the respiratory frequency.

Background

Ventilators for supporting such patients have been proposed, for example, as described in US6,105,575 or US6,240,919B1. Such devices provide ventilator-controlled inspiratory pressure supplied to the patient through a ventilation mask during Inspiration (IPAP), and ventilator-controlled expiratory pressure supplied during Expiration (EPAP). The ventilation device is automatically adjusted for the patient. For example, typical IPAP support pressures are 10 to 30mbar and EPAP support pressures are 4 to 10 mbar. The prevailing opinion is that in order to ensure the best possible respiratory support, the pressure should be as high as possible within the patient's acceptable range.

However, some studies of ventilation in COPD patients have shown that increased pressure amplitude (i.e. the difference between IPAP and EPAP) does not cause the desired relief of the respiratory musculature, but often leads to increased lung hyperinflation.

Disclosure of Invention

The object of the invention is to disclose a method for ventilating a living being and a ventilation device for this purpose, whereby an unfavourable lung hyperinflation can be avoided in the most possible way.

In a first aspect of the invention, a method for ventilating a living being (3) is provided, detecting a flow of breathing gas into the living being (3) and out of the living being (3)From detected respiratory airflow-determining whether an inhalation phase or an exhalation phase is present, -adjusting the air pressure (p) in the respiratory organ of the living being (3), -after identifying an inhalation phase, increasing the air pressure (p) in the respiratory organ at the beginning of the inhalation phase, -decreasing the air pressure (p) in the respiratory organ again as the breathing cycle progresses.

In another preferred embodiment, during the inspiration phase, the air pressure (p) in the respiratory organ is first increased and then decreased, wherein the slope decreases continuously.

In a further refinement, the air pressure (p) in the respiratory organ is reduced to an initial value in the inspiration phase before the end of the inspiration phase, the initial value serving as a starting value (p) at the beginning of the inspiration phase₀) And (4) setting.

In another preferred embodiment, during the inspiration phase, the respiratory airflow is reached when the respiratory airflow is reachedAt the maximum amount ofThe inspiratory phase reduces the air pressure (p) within the respiratory organ to the initial value.

In a second aspect of the invention, a method for ventilating a living being, in particular as described in the first aspect of the invention, a flow of breathing gas into and out of the living being (3) is detectedFrom detected respiratory airflowDetermining whether an inspiratory or an expiratory phase is present, in which the air pressure (p) in the respiratory organ of the living being (3) is adjusted as a function of the expiratory respiratory airflowAnd a parameter derived therefrom regulates the air pressure (p) in the respiratory organ such that the flow of respiratory gases out of the living being (3)A predetermined amount is reached.

In another preferred example, during the expiration phase the air pressure (p) in the breathing organ is increased to a maximum pressure which is reached half way before the duration of the average expiration phase of the living being (3).

In another preferred example, the air pressure (p) in the respiratory organ is reduced in an expiratory phase by a substantially exponential decay function at the end of the expiratory phase.

In another preferred example, after the expiration phase is identified, the air pressure (p) in the respiratory organ is increased at the beginning of the expiration phase.

In a further preferred embodiment, the air pressure in the breathing organ is adjusted only at the beginning of the expiration phase (b)p) so that the flow of respiratory gases out of the living being (3)A predetermined amount is reached.

In another preferred embodiment, during the expiratory phase, the respiratory gas flow with the expirationProportionally regulating air pressure (p) within the respiratory organ.

In another preferred embodiment, a breath volume is determined from the detected respiratory airflow, and if a breath volume increase is determined in a preceding breath cycle, the maximum value and/or the pressure level of the air pressure (p) within the respiratory organ is increased during the expiration phase, and/or a pressure curve is adjusted.

In another preferred example, the breathing frequency is determined, and if a reduction of the breathing frequency is determined in a preceding breathing cycle, the maximum value and/or the pressure level of the air pressure (p) in the breathing organ is increased in the expiration phase, or the pressure curve is adjusted.

In a further preferred embodiment, the air pressure (p) and/or the respiratory gas flow in the respiratory organ are monitoredIf superimposed oscillations are identified, the maximum value and/or the pressure level of the air pressure (p) in the respiratory organ is increased during the expiration phase or the pressure curve is adjusted.

In another preferred example, during the expiration phase, the maximum value of the air pressure (p) and/or the increase of the pressure level within the respiratory organ is limited to a maximum value.

In another preferred embodiment, at the end of the expiration phase, the air pressure (p) in the respiratory organ is reducedUntil the end of an expiration phase, in particular until an initial value of the air pressure (p) is reached, which is taken as a starting value (p) at the beginning of the inspiration phase₀) And (4) setting.

In another preferred embodiment, the respiratory airflow based on said detectionDetermining the intrinsic PEEP of the living body from the relationship between the pressure increase in the expiratory phase and the pressure increase in the expiratory phase, determining an initial value of the air pressure in the respiratory organ from the intrinsic PEEP, the initial value being set to a starting value (p) at the beginning of the inspiratory phase₀)。

In another preferred example, the initial value of the air pressure in the respiratory organ is used as a base pressure level (p)₀) At any time, the pressure level does not drop below the base pressure level, wherein the base pressure level (p) is determined₀) Equal to the intrinsic PEEP minus a given pressure difference.

In another preferred embodiment, the cycle of regulation of the air pressure (p) in the respiratory organ comprises at least two respiratory cycles, one respiratory cycle comprising an inspiration phase and an expiration phase directly connected to each other.

In a third aspect of the invention, a ventilation device is provided, said device having at least one controllable air delivery unit (6), at least one air flow meter (11), at least one pressure sensor (9), and having at least one programming unit (10), said programming unit (10) being arranged to carry out the method of at least one of the first and second aspects of the invention.

In a fourth aspect of the invention, a valve-regulated unit is provided, the unit having at least one pressure control valve, at least one air flow meter (11), at least one pressure sensor (9), and having at least one programming unit (10), the programming unit (10) being arranged to carry out the method of at least one of the first and second aspects of the invention.

It has been recognized that the additional air pumped in support of the ventilator cannot be fully exhaled again by the patient during the exhalation phase, and that increased residual air remains in the alveoli, resulting in adverse lung hyperinflation. In particular, typical ventilators supply excess pressure to the patient during the inspiratory phase to support inspiration, and reduce the pressure during the expiratory phase to support the expiratory phase with low expiratory resistance. However, for patients with severe lung diseases, this results in, on the one hand, a gradual pressurization of the air into the patient during the expiration phase, and, on the other hand, in the small airways damaged in all cases and the bronchi connecting them with the alveoli being constricted by the reduced pressure of the ventilation device, sufficient expiration (i.e. ventilation of the lungs) being difficult to perform.

The present invention counteracts this effect, on the one hand, by proposing a variable pressure curve that is reduced early in the inspiration phase. After identifying the inspiration phase, the air pressure in the breathing organ is increased at the beginning of the inspiration phase and then decreased as the breathing cycle progresses. In this context, an inhalation phase and an exhalation phase in succession are understood as a breathing cycle. According to a preferred development of the invention, the air pressure in the breathing apparatus is reduced again as the inspiration phase progresses. The reduction in pressure therefore already advantageously occurs as the inspiration phase progresses, rather than completely at the end of the inspiration phase as in the known devices. For exemplary purposes, the pressure curves 30-32 of FIG. 3 illustrate this.

According to the invention, the expiratory phase is supported as follows: during the expiration phase, the air pressure in the respiratory organ is adjusted in accordance with the respiratory gas flow or an expiration parameter derived therefrom such that the respiratory gas flow emitted from the living being reaches a predetermined amount. The predetermined pressure is therefore not set as in known ventilators, but the air pressure is dynamically adjusted according to the expiratory respiratory airflow so as to ensure a specific expiratory airflow. For this purpose, the air pressure is raised or lowered as required, and by adjusting the air pressure in accordance with the respiratory airflow, the corresponding minimum pressure in the respiratory organs can be maintained dynamically with varying counter-pressure, so that the small airways and the bronchi connecting them with the alveoli remain open. Thus, providing a certain dynamic resistance during exhalation, the patient is unexpectedly considered comfortable and helpful. As a result, the exsufflation is improved and adverse pulmonary hyperinflation is avoided. In particular, even short pressure pulsations during exhalation contribute to the opening of the airway.

According to a preferred development of the invention, the air pressure in the breathing apparatus is increased after the identification of the inspiration phase, and the air pressure is briefly reduced after the identification of the expiration phase, after which the air pressure in the breathing apparatus is increased again. In this way, exsufflation and thus pulmonary deflation is advantageously supported. For this purpose, the pressure curve of the patient's respiratory airflow is preferably made asymmetric and the pressure of the individual respiratory phases is dynamically changed. For this purpose, the dynamic variation of the pressure in the individual breathing phases is particularly advantageous, i.e. the air pressure is not constant over a longer period of time, unlike in known ventilators.

According to a preferred refinement of the invention, the air pressure is set at each time point to be greater than an initial value, which is set to a starting value at the beginning of the inspiration phase.

According to a preferred development of the invention, the pressure curve of the air pressure is continuously dynamically and inconsistently adjusted at the starting and ending points in time of the inspiration and expiration phases of the living being. The dynamic response has significant meaning to pathophysiology, and is fundamentally different from the prior ventilation device with a pressure curve platform.

According to a preferred development of the invention, the air pressure in the breathing apparatus is first increased and then decreased during the inspiration phase, wherein the slope decreases continuously. Before the end of the expiration phase, the air pressure in the respiratory organ can preferably be reduced during the inspiration phase to an initial value, which is set as a starting value at the beginning of the inspiration phase. In particular, considering the base pressure level as the starting value, it is preferably chosen to be slightly lower than the intrinsic PEEP (positive end expiratory pressure — pressure level at the end of the expiratory phase).

According to a preferred development of the invention, the air pressure in the breathing apparatus is first increased and then decreased during the inspiration phase, wherein the slope of the breathing gas flow decreases continuously.

According to a preferred development of the invention, the air pressure in the breathing apparatus decreases to an initial value during the inspiration phase when the inspiration phase reaches a maximum value of the breathing gas flow. This allows an early reduction in pressure during the inspiration phase, which also helps to avoid over-inflation.

According to a preferred development of the invention, the air pressure in the breathing apparatus is increased during the inhalation phase to a value such that the reduction in the breathing gas flow during the period after the maximum value of the breathing gas flow is reached is as slow as possible.

According to a preferred development of the invention, the air pressure in the breathing apparatus increases during the expiration phase to a maximum pressure, which is reached at the end of the expiration phase of the living organism. For example, as shown in pressure curves 37 and 38 of fig. 3.

According to a preferred development of the invention, during the expiration phase, the air pressure is increased in the breathing apparatus to a maximum pressure, which is reached before half the duration of the average expiration phase of the living being. In this way, the pressure curve of the expiratory phase can be approximated to the natural expiration of a healthy organism.

According to a preferred development of the invention, after the expiration phase is identified, the air pressure in the breathing apparatus increases at the beginning of the expiration phase. In this way it can be ensured that the airway remains unconstrained just at the beginning of the expiratory phase, so that the expiration can be particularly deep and efficient.

According to a preferred development of the invention, an adaptive self-learning function is provided, which can be further improved during respiratory support. According to a preferred refinement of the invention, a tidal volume (tidarvolume) is determined from the detected respiratory airflow. The amount of breath may be determined indirectly from the amount of inhaled air during the inspiration phase or indirectly from the amount of exhaled air during the expiration phase, or as an average or derivative of a parameter that is detectably changed by these amounts of air during a breathing cycle or cycles. If the increase in the volume of one breath in the previous breathing cycle can be determined, the maximum value and/or the pressure level of the air pressure in the breathing organ is increased during the expiration phase, or the pressure curve is adjusted. Thus, an optimal relaxation of the respiratory organ can be adaptively obtained. If no increase in the volume of one breath is determined, the maximum value of the air pressure and/or the pressure level in the breathing apparatus is maintained at the desired value during the expiration phase or is reduced slightly again.

According to a preferred refinement of the invention, the breathing frequency is determined. If a decrease in the breathing frequency in the preceding breathing cycle can be determined, the maximum value and/or the pressure level of the air pressure in the breathing organ is increased during the expiration phase, or the pressure curve is adjusted. This is based on the following findings: in certain ranges, a decrease in respiratory rate indicates improved ventilation. Respiratory anxiety (respiratory anxiety) that may result from increasing the maximum or pressure level of the air pressure can also be detected in this way. If respiratory anxiety is detected, the pressure increase may be re-limited or re-decreased.

According to a preferred development of the invention, it is monitored whether superimposed oscillations with a higher frequency than the breathing frequency occur in the time profile of the air pressure and/or the breathing gas flow in the breathing apparatus. Superimposed oscillations can be seen as a non-uniform expiratory performance after an increase in intrinsic PEEP. If the frequency of the superimposed oscillations is increased and/or the amplitude of the superimposed oscillations is reduced by a prior increase of the air pressure during the expiration phase, the expiration and thus the lung ventilation is improved. If no further improvement of the exhalation is shown in terms of superimposed oscillations, the maximum value of the air pressure or the pressure level does not increase during the exhalation phase. Instead, the maximum value or pressure level of the air pressure is reduced.

Of course, the maximum value of the air pressure or the pressure level is increased up to the existing limit value.

According to a preferred development of the invention, the air pressure in the breathing apparatus decreases at the end of the expiration phase until the expiration phase has ended. The initial value of the air pressure set as the starting value up to the beginning of the inspiration phase is preferably reduced.

According to a preferred refinement of the invention, the intrinsic PEEP of the living being is determined from the detected respiratory gas flow together with the increase in expiratory pressure. The initial value of the air pressure in the respiratory organ, which is set to the starting value at the beginning of the inspiration phase, is determined from the intrinsic PEEP. This advantageously allows a so-called automatic PEEP-controlled breathing support of the living being.

According to a preferred refinement of the invention, the initial value of the air pressure in the respiratory organ is used as a base pressure level, below which the pressure level does not fall at any time, wherein the base pressure level (p) is determined₀) Equal to the intrinsic PEEP minus a given pressure difference. This value is readjusted after the PEEP inherent during breathing changes.

According to a preferred development of the invention, the cycle of regulation of the air pressure in the breathing apparatus comprises at least two breathing cycles which are closely connected to one another.

The preferred ventilation device has at least one controllable air delivery unit, a pressure sensor for determining the air pressure in the respiratory organ of the living being, and a programming unit. The programming unit is arranged to perform the previously described method, for example by means of suitable software programming. Furthermore, the ventilation device preferably has one or more air flow meters, by means of which the air flow supplied to and discharged from the air delivery unit and regulated by the respiration of the patient can be detected. For example, the airflow meter can be used as a respiratory airflow tachometer (pneumotachodraph). The controllable air delivery unit can have a controllable turbine (turbine) or an air compressor, for example a reciprocating (piston) compressor. The air delivery unit may furthermore have a pressure control valve or a valve arrangement for controlling the quantity of output air.

A preferred valve control apparatus is also disclosed. The valve control device can be connected as an auxiliary unit between a conventional ventilator and the organism to be ventilated. The valve control device preferably has at least one air flow meter, such as a respiratory air flow rate meter, a pressure sensor for determining the air pressure in the respiratory organ of the living being, at least one pressure control valve and a programmable unit. The program control unit is preferably arranged to carry out the method of at least one of the preceding claims, for example by means of a corresponding software programming. Thus, if a ventilation means is provided, it can be supplemented with a more cost-effective producible valve control means. The valve control arrangement does not require a separate air transfer unit.

The invention is preferably applicable to both invasive and non-invasive ventilation.

The invention can dynamically adjust the external respiratory pressure adapting to the respiration of the organism. The base pressure level is preferably set approximately to those values that are slightly below the patient-related intrinsic PEEP. Respiratory support is administered during inspiration by an inspiratory controlled pressure increase (set as a function of the particular patient's condition and the resulting volumetric flow), for example, by an amount of 2 to 30 mbar. In a preferred embodiment, the pressure increase is adjusted back to the base pressure level as soon as the maximum inspiration speed is reached. In this way it is ensured that no over-inflation of the lungs occurs and that the pressure support represents the working support of the inspiratory musculature.

During the expiratory phase, a dynamic counter-pressure is applied, the aim of which is to prevent the "small airways" which are particularly strongly and frequently affected by the disease from collapsing as long as possible, leaving them open as far as possible, making them wide enough that as much air as possible can still be exhaled from these downstream alveoli. This results in better lung ventilation and thus better gas exchange. This in turn allows subsequent inspirations with a larger breath volume, which in turn is used as a regulating variable for future respiratory support.

Increasing the expiratory pressure until further increase in expiratory pressure no longer results in an increase in inspiratory breath volume

Detailed Description

The present invention is explained in detail based on exemplary embodiments using the drawings below.

In the drawings, there is shown in the drawings,

FIG. 1 shows a schematic view of a ventilation device;

FIG. 2 shows a first embodiment of a ventilation cycle;

FIG. 3 shows a further preferred embodiment of a ventilation cycle;

FIG. 4 shows a further preferred embodiment of a ventilation cycle; and

fig. 5 shows a ventilation cycle with superimposed oscillations.

Fig. 1 shows a ventilation device 1 connected to a breathing mask 2 or other suitable interface by a hose 8. The breathing mask 2 is connected to the mouth and/or nose of the living being 3, or to the deeper food airways. The breathing mask 2 has a discharge orifice 4 which is open to the atmosphere and is connected to a hose 8 via a throttle point 5. In this way, a specified leakage amount is provided within the breathing mask 2.

The gas exchange device 1 has a controllable turbine 6 (integrated with a complete gas flow rate measuring structure for volumetric flow measurement) and a pressure sensor 9, which is located on the output side of the turbine 6, connected to a compressed gas hose 8. Optionally or additionally, an air flow meter 11 is also provided for the integrated gas flow rate measurement structure, the pressure sensor 9, the air flow meter 11 and the turbine 6 are connected to the electronic control unit 10 by electrical wires. The electronic control unit 10 receives signals from the pressure sensor 9 and the turbine 6 which reflect the pressure in the compressed air hose 8 and signals from the gas flow rate measuring structure which reflect the gas flow pumped into the compressed air hose 8 through the turbine 6. The electronic control unit 10 can also receive a signal from an optional air flow meter 11 reflecting the volume flow through the compressed air hose 8. The electronic control unit 10 analyses the received signals and, on the basis of these signals, determines the air flow into the living being 3 and/or out of the living being 3 using the known flow resistance of the hose 8 and the known leakage of the breathing mask 2 from the electronic control unit 10. Furthermore, the electronic control unit 10 determines, on the basis of these signals, the pressure present in the respirator organ of the living being 3.

According to the previously described method, the electronic control unit 10 controls the turbine 6 and/or the respective pressure control valve. Air is sucked in via a turbine 6 through an air inlet 7 connected to the atmosphere, suitably compressed and fed via a hose 8 to the breathing mask 2 and thus to the living being 3.

FIG. 2 shows preferred gas flow times and volume flowsAnd a first embodiment of a pressure p-curve. In FIG. 2a, at t₁And t₃During the inspiration phase between the time points, inspiration occurs, as shown by the airflow curve 20. At t₃And t₄During the expiration phase between the time points, expiration takes place, as shown by the air flow curve 21. FIG. 2b shows the pressure curve 22 at t₁And t₃The time range of the time points approximates to an inverse parabola. At t₁And t₂Between the time points, the pressure p is from the intermediate level, the base pressure level p₀Increasing to a maximum value. At t₂And t₃Between the time points, the pressure p is adjusted back to the base pressure level. At t₃After the point in time, the pressure p rises according to the curve portion 23, reaching the maximum of the curve portion 23 early in the expiration phase, at t₄At the point in time, the pressure is reduced back to the base pressure level p₀。

Fig. 3 shows a pressure curve p (fig. 3b) for implementing a further preferred embodiment of the invention, shown in a back-and-forth order in relation to the breathing cycle (airflow v in fig. 3 a). The shaded area in fig. 3b indicates the range of possible variations of the curve portions 22 and 23 within which the invention is preferably implemented.

In the pressure curves 30 to 33, the air pressure increases from the initial value at a certain time of the respiration cycle during respiration of the living organism, and is reduced again as the respiration of the living organism progresses, so that the air pressure in the respiratory organ of the living organism is always higher than the initial value during exhalation of the living organism.

In the pressure curves 30 to 33, the air pressure in the ventilator organ of the living being is first raised to a predetermined amount during the inspiration phase and then changed over the breathing cycle curve between this predetermined amount and a starting value, the starting value being set as the starting value at the end of the expiration phase falling back to the beginning of the inspiration phase.

In fig. 3, the pressure curve 34 corresponds to fig. 2 and is shown for comparison only.

In the embodiments shown in the pressure curves 35 to 38, the air pressure in the respiratory organ of the living being first rises during the expiration phase, then changes over the breathing cycle curve between a predetermined amount and a starting value, and falls back during the inspiration phase to the starting value set as the starting value at the beginning of the expiration phase.

Furthermore, the pressure curve 30 shows an embodiment in which the air pressure inside the ventilator organ of the living being first rises to a predetermined amount during the inhalation phase, then remains on the inhalation curve, decreases continuously at the beginning of the exhalation phase, starts slowly, then more rapidly, at the end of the exhalation phase, falls to an initial value set as a starting value at the beginning of the inhalation phase.

The pressure curve 31 shows an embodiment in which the air pressure in the ventilator officer of the living being first rises to a predetermined amount during the inhalation phase, then remains on the inhalation curve, first decreases rapidly by a specific amount at the beginning of the exhalation phase, then decreases continuously, first slowly and then more rapidly, and at the end of the exhalation phase back down to the initial value set as the starting value at the beginning of the inhalation phase.

The pressure curve 32 shows an embodiment in which the air pressure in the ventilator officer of the living being is first increased to a predetermined amount during the inhalation phase, then maintained for the predetermined amount until the point in time of maximum inhalation air flow is reached, then decreased rapidly for the specific amount until the expiration phase begins, then decreased again continuously, first slowly and then more rapidly, at the end of the expiration phase back to the initial value set as the starting value at the beginning of the inspiration phase.

FIG. 4 shows a pressure curve spanning multiple respiratory cycles (FIG. 4b), again showing airflow relative to a normal respiratory cycleThe relationship (FIG. 4 a). As shown at curves 41 and 42, the ventilation cycle of the ventilation device includes two respiratory cycles of the living being. Curve 40 of fig. 4b shows a ventilation cycle of the ventilation device, which includes four respiratory cycles of the living being. Furthermore, it should be recognized that the air pressure in the respiratory organ of the living being rises at a predetermined point in time of a respiratory cycle, then changes between a predetermined amount and a starting value on the curve of one or more respiratory cycles, and then falls back during one or more respiratory cycles to the initial value set as the starting value at the beginning of the pressure increase.

FIG. 5 shows the air flow provided in a healthy organism over a time frame 50Curve 52 of (a). In the time range 51, a curve 53 is shown, in which the gas flow is present during the expiration phaseIn which superimposed, high frequency oscillations can be measured. This oscillation can be detected by the electronic control unit 10 and used as a control criterion for the controller of the ventilation.

Claims (10)

1. Method for ventilating a living being (3), detecting a respiratory gas flow into and out of the living being (3)From detected respiratory airflowDetermining whether an inhalation phase or an exhalation phase is present, regulating the air pressure in the respiratory organ of the living being (3)(p), characterized in that the air pressure (p) inside the respirator organ of the living being (3) is first increased from an initial value to a predetermined amount at the beginning of the inspiration phase; during a subsequent inhalation phase and upon entering an exhalation phase, the air pressure is maintained substantially at the predetermined amount; and at the end of the expiration phase the air pressure drops back to the initial value.

2. Method according to claim 1, wherein during the inspiration phase the air pressure (p) in the breathing organ is first increased and then decreased, wherein the slope decreases continuously.

3. Method according to claim 2, characterized in that the air pressure (p) in the respiratory organ is reduced to an initial value during the inspiration phase before the end of the inspiration phase, the initial value being taken as a starting value (p) at the beginning of the inspiration phase₀) And (4) setting.

4. The method of claim 3, wherein during the inspiratory phase, when the flow of breathing gas is achievedIs increased, the air pressure (p) within the respiratory organ is reduced to the initial value during the inspiration phase.

5. Method according to at least one of the preceding claims, characterized in that, in the expiration phase, the respiratory gas flow according to the expiration is determinedAnd a parameter derived therefrom regulates the air pressure (p) in the respiratory organ such that the flow of respiratory gases out of the living being (3)A predetermined amount is reached.

6. The method according to at least one of the preceding claims, characterized in that during the expiration phase the air pressure (p) in the breathing organ is increased to a maximum pressure which is reached before half the duration of the average expiration phase of the living being (3).

7. Method according to at least one of the preceding claims, characterized in that the air pressure (p) in the respiratory organ is reduced in an essentially exponential decay function at the end of the expiration phase.

8. Method according to at least one of the preceding claims, characterized in that after the identification of an expiration phase, the air pressure (p) in the breathing organ is increased at the beginning of the expiration phase.

9. The method according to claim 8, characterized in that the air pressure (p) in the respiratory organ is adjusted only at the beginning of the expiration phase, so that the respiratory gas flow out of the living being (3)A predetermined amount is reached.

10. A device which is a ventilation device with at least one controllable air delivery unit (6) or a valve control unit with at least one pressure control valve, having at least one air flow meter (11), at least one pressure sensor (9) and having at least one programming unit (10), the programming unit (10) being provided to carry out the method of at least one of claims 1 to 9.