WO2011054438A1

WO2011054438A1 - Respiratory-gas warming/humidifying devices

Info

Publication number: WO2011054438A1
Application number: PCT/EP2010/006319
Authority: WO
Inventors: Volker Lang
Original assignee: Volker Lang
Priority date: 2009-11-04
Filing date: 2010-10-15
Publication date: 2011-05-12
Also published as: DE102009052542A1

Abstract

The invention relates to two embodiment examples of two simple devices for warming and humidifying respiratory gases according to the evaporator/vaporizer principle, which can be produced at low cost and which operate using novel heating and humidifying elements that can be controlled quickly and that have high electrical efficiency. The first device embodiment is very small, compact, and lightweight, operates in a substantially position-independent manner, and is intended above all for mobile use. The second device embodiment is bottle-shaped and lightweight, operates in a substantially position-independent manner without an external pump or humidification water reservoir, and is optimized above all for use in the home care sector. Said respiratory-gas warming/humidifying devices are monitored by an electric/electronic control current supply and monitoring device according to the prior art.

Description

Respiratory Gas Warm-Up Moisturizer Devices

The invention relates to a device for heating and humidifying breathing gases according to the preamble of claim 1.

The dry and cold inhaled air reaches physiologically optimal temperature via the nasal mucous membranes and the nasopharynx and humidifies the trachea, the bronchi and finally for the gas exchange the alveoli. However, only an undisturbed filtering and cleaning function of the bronchial mucous membrane allows the elimination of mucus and foreign bodies, which is only possible with an optimal conditioning of the inhaled air with heat and moisture.

Physiologically, this is achieved by a stronger or weaker perfusion of the nasal mucosa with a resulting change in the delivery of moisture and heat to the respiratory air. In artificial respiration and respiratory therapy these physiological functions must be replaced.

Commercially available active air-heating-humidifying devices use the principle of breathing air over the surface of heated water or over heated upper surfaces that evaporate or evaporate the water, in order to condition them with heat and moisture. These surfaces are often artificially enlarged by the additional use of float paper parts that dip into the water. This can achieve an increase in effectiveness. For the sake of completeness, mention should also be made of the less frequently used methods today, such as: B. the conditioning of the respiratory gases by warm water flowing through porous hollow fibers or the portioned dispensing of hot water vapor.

A special position still take devices that extract moisture and heat as a heat-moisture exchanger of the exhaled air of the patient and then each of the dry inhaled air, but with certain losses, again. However, these exchangers have limited applicability only to special cases of artificial respiration and spontaneous breathing.

The following practical problems with breathing gas warm-up wetting devices must be solved:

1. The generation of optimally tempered and humidified respiratory gases at different Atemgasfluß or respiratory minute volumes such. B. in artificial respiration of infants, children, adults and respiratory aid in mask ventilation, CPAP therapy u. al.,

2. Rapid operational readiness with avoidance of an "emergency shot" (eg sudden breathing gases), eg at the beginning of an artificial respiration therapy.This danger threatens especially with moistening-warming devices, which require larger amounts of water for their function Preheat to immediately receive adequately conditioned respiratory gases in emergency ventilation cases.

3. Rain water by cooling the respiratory gases in the long breathing tubes with the need for water traps or expensive elaborately electrically heated sterilizable breathing tubes. 4. Bacteriological-hygienic problems with breathing-gas-conducting parts connected directly to the patient lead to the necessity of using sterile, usually expensive disposables or labor-intensive cleaning, disinfection and steam sterilization of the multiple items (hoses, connectors, heating-moistening devices).

5. Simple and safe use in the patient in everyday routine with economically justifiable strains on the budget and the environment.

With the device defined in claim 1 for heating and humidifying respiratory gases mentioned problems are solved. Preferred embodiments will become apparent from the dependent claims appended to the main claim.

The invention will be described below with reference to FIGS. 1-7 in two exemplary embodiments for multiple use, especially in the field of home care.

Fig. 1 shows the heart of the device according to FIG. 2, namely the heatable humidifier for the respiratory gases. It consists of a corrugated, thin metal heating strip 1 (preferably made of stainless steel), with an overlapping paper strip 2. This heating tape 1 is connected with its beginning 4 on the winding body 5 with the central electrical, tubular contact 6. The free end 7 of the heating tape 1 is connected to the electrical connector 36 (see Fig. 4 and Fig. 5). Heating tape 1 and paper strips 2 rolled up form the winding 3 with its multiple air channels and thus large surfaces for the cold and dry, flowing air. Wrappings of a similar type but impregnated with hygroscopic chemicals are used, as is known, in HMEs (heat and moisture exchangers). The crucial peculiarity of the invention, however, is that smooth flow paper strips in close connection with an electrically heated, corrugated heating tape, rolled up as a coil 3 can be used.

Device description of the first embodiment

Fig. 2 shows in perspective and transparent drawn the device for heating and humidifying respiratory gases separated in upper part 8 and lower part 9. The upper part has a breathing gas outlet 10, to which the Atemgas- temperature sensor piece 11 is plugged, which is used to connect a patient with a Connecting piece 12 is provided and has a connecting cable for the electric-electronic control power supply device.

By the curved surface 13 of the upper part 8 can be seen in dashed lines the upper moistening Anwärm winding 14 and in the center of the formed as a pipe electrical contact 15. On the outer surface of the upper part 8 of the electrical contact plug 16 which is connected to the end 7 of Winding heating tape is connected, attached. The lower part 9 has the gas inlet pipe 17 and at its curved bottom 18 the water outlet pipe 19, and on its outside the electrical connector 20. In addition, you can see in the lower part 9, the lower Anwärm-moistening winding 21 with its central, electrical contact tube 22, in that the electrical connector 23 is inserted. The arranged between the upper part 8 and lower part 9 flat-cylindrical central part 24 has at its top a tightly welded, fine-meshed network (sieve) 25 and a fine mesh (sieve) 26 on its underside. These sieves (nets) 25 and 26 together with the cylinder wall of the central part 24 a chamber through which the inflowing Wasserbeführstutzen 27 dampening water is evenly distributed to the upper roll 14 and the lower roll 21 with flowing breathing gas.

3 shows in section of the sectional plane I I in FIG. 2 the respiratory gas heating

Humidifying device. Her domed upper part 13 shows the gas outlet 10 with the plugged-on breathing gas temperature sensor piece with connecting cable 11th and Patient connection piece 12. In the cylindrically shaped part of the upper part 8, the winding 14 is electrically connected to the electrical contact tube 15 and the electrical contact switch 16. The lower part 9 shows the gas inlet port 17 and the curved bottom 18 (with support rib for the winding) and the water outlet port 19. In the cylindrical part of the lower part 9 is the lower coil 21, which is electrically connected to its central electrical contact tube 22, as well as with the contact plug 20. The middle part 24 has in the upper part of a dense mesh (screen) 25 on a net (wire) 26 in the lower part. The nets are each shown dotted. The nets 25 and 26 form with the cylindrical wall of the central piece 24 a closed humidification chamber, which is penetrated centrally by the electrical contact pin 23 and into which the water feed nozzle 27 opens. This pin connects, as indicated by dashed lines, in the assembled state, electrically the upper and lower Anwärm-moistening-winding the Atemgas-Anwärm-moistening device.

Device function of the first embodiment

The dry, cold breathing gas flows through the inlet port 17 of the Anwärm- moistening device on the lower part 9, through the numerous air channels of the heated Anwärm-moistening roll 21, the distributor moistening chamber 24 pressed thereon with their welded nets (sieves) 25 and 26, in the pressed-up shell 8 with the heated Anwärm-moistening winding 14 with its numerous air channels, over the domed lid 13 to the outlet 10 and the plugged temperature sensor piece 11 with the connection piece 12 and a short breathing gas connection hose with adapter ( not drawn), well-tempered and moistened, via a tracheal tube, a tracheal cannula or breathing mask to the patient. If the temperature sensor piece 11 is not attached to the socket 10, then prevents the electronic control power supply unit commissioning of the moistening Anwärm device. Decisive for the outstanding function of this respiratory gas moistening-warming device but are their moistening warm-up wraps. Their heating elements have a very low heat storage capacity and thus thermal inertia. There- with the possibility of a very rapid electrical change in heat dissipation performance and in addition in a large control range, which means that z. B. when changing the breathing gas flow and the breathing gas temperature can be kept largely constant within narrow limits.

Technically constructive this is achieved by the use of a thin metal strip as a direct, electrically heated heating element. This element is integrated in the wetting-warming coil of the heating-moistening device (see Fig. 1). The moistening elements applied to the corrugated 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 from strip paper in strip form and rolled up into a roll (see FIG , 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 the moistening of the moistening reel via the pressed-networks (sieves) of the water distributor moistening chamber. An external simple metering pump, preferably a peristaltic pump, controlled by the electronic control power supply device, ensures a metered supply of sterile water as a function of the preselected respiratory gas flow or respiratory minute volume. The Anwärm-moistening wraps described in their function thus also allow quickly detected by the temperature measuring unit even small Atemgastemperaturänderung using the electronic control and power supply device via the electrical power supply to the heating element to correct. Unpleasantly warm or even dangerously hot respiratory gases (eg a "hot shot") can be avoided with changes in the respiratory gas flow or respiratory minute volume, as well as a so-called "preheating" of the respiratory gas warm-up moistening device with the danger suddenly hotter Respiratory gases have become unnecessary due to the possible rapid but sensitive heating of warm-up moistening wraps, as they are eg. B. in the emergency emergency ventilation of a patient is required. 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 respiratory gases with correspondingly very low condensation loss. This eliminates electrically heated breathing gas hoses and usually water traps.

Device description of the second embodiment

Fig. 4 shows the second embodiment of the respiratory gas Anwärm-moistening device in perspective, transparent and partially schematically. The housing of the device consists of two halves, a bottle-shaped cylindrical upper part 28 with curved cover 29, gas outlet port 30 with screwed-on sensor piece 31 with patient port 32, sensor port 33 and sensor connection cable 34 and the lower part of the inserted and welded bottom 35th , With the electrical connector 36, the breathing gas inlet nozzle 37 with breathing gas manifold 38 and the moistening water supply port 39. Through the transparent top drawn you can see the thin, meander-shaped heating plate 40 with its interstices 41 to a cylinder shell formed by two (at the top and bottom The attached to these bands 42 and 43 spacers 44 and 45, formed between the Heizblechzylinder 40 and the cylindrical wall of the upper part 28 inside abutting blanks 46, a wide gap around 48 (see Fig. 5).

Clearly shows in section of the wall of the upper part 28 and on this inside tightly fitting the outer blotter paper 46 and below the outer gap 48, which by spacers (44, 45 on the belts 42, 43, see Fig. 4) is formed. This gap space 48 is bounded by the heating meander cylinder 40 with its interstices 49 and the underlying inner blotter paper 47 with circulation openings at its lower end (not shown) for moistening water and Breathing gas. Further inward follow the wide inner gap 50 into which the Atemgasverteiler 38 projects with its outlet openings 51.

Fig. 6 shows in perspective, the lower part, the bottom plate 35 with the electrical connector 36 (associated with the ports 52 and 53 for the heating meander cylinder), the breathing gas inlet port 37 and the Befeuchtungswasser- supply port 39th

Fig. 7 shows schematically and simplifies the simple realization of the described Mänder heating cylinder. On the two temperature-resistant plastic bands 42 and 43 of the thin, stainless steel stamped heating meander 40 is placed and firmly connected to the marked attachment points 54 with these bands (eg, with rivets, brackets). In the case of a very thin sheet metal thickness, the edges of the meanders 55 are bent or folded at right angles, especially in the interspaces 41 (marked as a double line), for mechanical stiffening.

To produce the heating meander cylinder, the two plastic strips are bent with the heating meander fixed thereto in each case to a circle and their ends connected by welding. The welded plastic tape 43 thereby represents the lower edge of the heating cylinder, on which also the electric current supply takes place via the beginning 56 and the end 57 of the heating meander sheet. The welded band 42 forms the upper edge of the heating cylinder.

Device function of the second embodiment

Fig. 4, Fig. 5 and Fig. 6 show the Atemgas-warming-moistening device both in perspective, viewed drawn as well as in section. Cold breathing gas flows through the gas inlet port 37 to the gas distributor 38 with baffle plate and outlet openings and from there, both over the inner surface of the electrically heated heating meander cylinder jacket 40 which is covered with the tight-fitting inner blotter paper 47 (not shown), as well as on the Outer surface of the heating Meandering cylinder 40 through a gap 48 formed outwardly by the outer blotter paper 46 (the top 28 of the device is tight). If the Anwärm moistening device as drawn in Fig. 4, operated in a vertical position, then these paper cylinders are with their lower ends in germ-free moistening, which is supplied via the nozzle 39 from an external reservoir, the bottom 35 of Atemgas-warming Moistening device covered. However, this Anwärm-moistening device can be operated just as horizontally or inclined by 45 degrees to both sides. In this case, the side surfaces of the paper cylinders are dipped strip-shaped into the dampening water. This water rises in the flow papers up, moisturizes them completely and is then heated by the heat emitted by the thin-walled meander meander cylinder 40 inside and outside heat and evaporates or evaporated. The over this large surface stroking breathing gas is optimally warmed and moistened and leaves the device via the gas outlet 30 with screwed-temperature sensor piece 31 with patient connector 32. The measured breathing gas temperature controls the power supply via the electronic control power supply and monitoring device to the heating element of the respiratory gas warm-up moistening device. An over-temperature control of the heating element is detected via an electronically registered decrease in the heating current with increasing temperature of the heating element and leads to exceeding the permissible limit of the switching off of the heating current and triggering of a warning signal. About the electrical connector 36, the power supply takes place. Due to the low heat storage capacity of the thin-walled, metal heating-meander cylinder jacket which dips only a very small part in the moistening water reservoir, as an electric heating element in combination with the thin paper cylinders, as humidification with low water storage capacity, turn the cheap, fast, Low-inertia control of the temperature and humidity of the breathing gas with the aid of the connected control power supply device.

Claims

Respiratory Gas Warm-Up Moisture Devices Claims

1. An apparatus for heating and humidifying respiratory gases for artificial ordnance and respiratory aid therapies according to the hygienic principle of a separation into a respiratory gas Anwärm-moistening device (A) in the patient hose system and an associated control and power supply device (B), characterized in that the Atemgas-Anwärm-moistening device (A) is arranged in a special housing with hose nozzle for Atemgaszu- and -abfuhr and uses for generating heat electrically heated heat generating elements ^' in combination with humidification with the lowest possible heat storage capacity, wherein the moistening applied to these heated heat generating elements or in close contact with the sen and whose heating power and humidification with sterile water by means of a water distribution element and an electrically operated external water metering pump or a metering valve depending on the amount of breathing gas flow and the breathing gas temperature with low inertia by means of the control and power supply device (B) is adjustable, wherein in the Control and Power Supply Device (B) Safety precautions are taken to shut off the control and power supply device (B) when the warm-up wetting device (A) is overheating, as well as when there is no flow of breathing gas to or from the device (A).

2. Apparatus according to claim 1, characterized in that they consist of a thin, band-shaped, corrugated metal sheet, preferably made of stainless steel.

3. Apparatus according to claim 1 or 2, characterized in that flat-shaped elements with a meander-shaped structure, preferably made of thin stainless steel sheet, are used as electrical heating resistors for heat generation.

4. Device according to one of the preceding claims, characterized in that the thin provided with meandering, rectangular stainless steel sheet is fixed with its longitudinal edges on each a narrow, temperature-resistant plastic tape and is formed by the circular bending of these bands and connecting their ends to a cylinder jacket and so represents the heat generating element.

5. Device according to one of claims 1, 3 or 4, characterized in that the provided with the meandering thin stainless steel sheet is folded or folded for mechanical stiffening at the edges of the meander.

6. Device according to one of claims 1-5, characterized in that on its surface moistening with low water storage and so that heat storage capacity are applied, which consist of thin water-absorbent material, preferably papers made of cellulose or special plastic fibers which are impregnated with metallic silver.

7. Device according to one of claims 1-6, characterized in that a current limiting device is provided as overheating protection.

8. Device according to one of claims 1-7, characterized in that the moistening water as sterile water by an electrically operated external pump with reservoir or from a container via a controlled valve by gravity or according to the principle of communicating tubes depending on the Atemgasfluß and the respiratory gas temperature dispensed accurately.

9. Device according to one of claims 1-8, characterized in that they are designed in the form of two blasting paper cylinder jackets and that the inner cylinder jacket on the meander heating cylinder element lies tightly against the inside and at the bottom with perforations for Anfeuchtwasser- and breathing gas circulation is provided and the outer cylinder shell of the housing outer wall rests tightly inside and exploits the radiation heat emitted to the outside in addition to heating and humidifying the respiratory gases.

10. A device with water distribution element according to claim 1, characterized in that it is formed as a chamber, preferably in flat-cylindrical shape, in which a water supply nozzle opens and their tightly welded lid consists of a close mesh or finely perforated sieve and their tight welded soil is also designed as a fine mesh or finely perforated sieve and that these nets or sieves made of metal, plastic or ceramic.