DE102017005803A1 - Respirator and procedure - Google Patents

Abstract

The present invention relates to a method and a ventilator (1) with a ventilation device (2). The ventilation device (2) comprises a blower device (3) for generating a breathing gas flow for the ventilation and a coupling device (4) for connecting a tube device (5), via which the breathing gas flow can be supplied to at least one breathing opening of a user. In this case, the respiration device (2) comprises a detection device (6) for detecting different types of tube devices (5). The detection device (6) is suitable and designed to detect a characteristic size of the respiratory gas flow and to recognize the type of connected hose device (5) on the basis of the detected variable.

Description

The present invention relates to a ventilator and a method for operating a ventilator with at least one fan device and with at least one coupling device for connecting at least one hose device.

Ventilation of patients usually requires a high level of expertise and manual adjustment. Ventilation experts not only have to make the adjustment of the ventilation parameters individually for each patient, but also have to select and configure the appropriate tubing system with the appropriate exhalation system and the correct ventilation access.

As a rule, single-tube systems are used with a corresponding exhalation system. Two-hose systems are required, for example, when the expiratory volume must be determined safely. In addition, it is usually possible to choose between tube systems with open outlet systems or leakage ventilation and controlled exhalation valves.

A change between the types of hose systems usually requires a complex adaptation of the device configuration. Otherwise, the quality of the ventilation may be adversely affected. In addition, the device sensors and the algorithms can not usually bring the desired performance without a corresponding adaptation to the type of tube system used. For example, alarms can be triggered too early or too late.

It is therefore the object of the present invention to provide a ventilator and a method for operating such a ventilator, which allow a particularly comfortable and user-friendly use of different types of tube devices. In particular, different types of hose devices should be usable without the user or the caregiver having to make elaborate adjustments to the ventilator.

This object is achieved with a respirator of claim 1 and with the method according to claim 21. Further developments and advantageous embodiments are the subject of the dependent claims. Further advantages and features will become apparent from the general description and the description of the embodiments.

The ventilator according to the invention comprises at least one respiration device with at least one fan device for generating at least one respiratory gas flow for the respiration. The ventilation device comprises at least one coupling device for connecting at least one hose device. The breathing gas flow can be supplied to at least one breathing opening of a user via the hose device. In this case, the ventilation device comprises at least one detection device for detecting different types of hose devices. The detection device is suitable and designed to detect at least one characteristic variable of the respiratory gas flow. The detection device is suitable and designed to recognize the type of the connected hose device based on the detected size and in particular set.

The ventilator according to the invention has many advantages. A significant advantage may be that by means of the detection device, an automatic detection of the connected hose device is possible. The ventilator according to the invention thus allows a particularly comfortable use, since after an exchange of the hose means an automatic detection of the connected type takes place. For example, the ventilator can be operated with different types of tubing without requiring users or caregivers to make changes or new adjustments to the device configuration. With knowledge of the respective type of hose, the detection device or a control device operatively connected thereto can then automatically make the appropriate settings for the ventilation, for example.

For example, the user can simply connect the respective hose device to the ventilator and then no longer have to worry about its configuration. This is particularly advantageous because it is of secondary importance for the therapist in ventilation, with which exhalation system the patient is ventilated, if the quality of ventilation is right. Since the ventilator recognizes the tube device itself and in particular can automatically make the right technical conclusions for a desired ventilation quality, the therapist is relieved of a task that binds time and attention and which is usually purely technically motivated.

Another significant advantage, for example, that the detection is based on detection of a characteristic size for the respiratory gas flow. This allows a particularly reliable detection of the connected hose type. In addition, the sensors required for the detection can be implemented in a constructive manner in the ventilator.

It is particularly preferred that the detection device can be suitable and designed to recognize a hose device for leakage ventilation and a hose device for valve ventilation as different types of the connected hose device. The hose device for valve ventilation comprises in particular at least one patient valve. The patient valve is particularly suitable and designed to control the inhalation and / or from breathing. The hose device for leakage ventilation comprises in particular at least one defined opening in the flow connection between the respiratory device and the respiratory interface, through which the exhaled air can be discharged. Since these two types of hose assemblies require very individual settings for ventilation, automatic detection is particularly helpful.

Preferably, the detection device may be suitable and designed to recognize a tube device with at least one breathing tube and with at least one exhalation tube and a tube device without exhalation tube as different types. It is possible that the respiratory tube and / or the exhalation tube comprise at least one measuring tube and / or at least one control tube. The tube device with breathing tube and exhalation tube is preferably designed as a double tube system. The exhaled air can preferably be discharged back to the ventilation device via the exhalation tube. The patient valve is preferably located on the exhalation tube in the case of the double-tube system.

In particular, the coupling device according to the invention may comprise at least one first coupling for the breathing tube and at least one second coupling for the exhalation tube. It is possible that the coupling device comprises further couplings, for example for at least one measuring hose and / or control hose. The detection device is particularly suitable and designed to detect the characteristic size of the respiratory gas flow at least at the second clutch. Since the exhalation tube is connected to the second coupling, so a particularly reliable and inexpensive detection of a two-hose system is possible. It is possible for the flow connection to the second coupling to be closed by at least one valve and / or closure element, in particular if no exhalation tube is connected.

The detection device may preferably be suitable and designed to recognize the exhalation system of the connected hose device on the basis of the detected variable. The identification device can also be suitable and designed to recognize a diameter and / or a length of at least one hose of the hose device.

Particularly preferably, the detection device is suitable and designed to recognize on the basis of the detected size a hose device with at least one measuring hose and a hose device without a measuring hose as different types. In particular, the measuring tube is provided for near-patient pressure detection and / or flower holder. By automatically detecting the measuring tube, the ventilation can therefore be monitored particularly reliably without the need for additional operator inputs.

The coupling device may additionally or alternatively comprise in particular at least one inlet connection for coupling at least one measuring tube. The detection device is particularly suitable and designed to detect the characteristic size of the breathing gas flow for the measuring tube at least at the inlet nozzle. In addition, the detection device is particularly suitable and designed to detect the characteristic size of the breathing gas flow also on the first coupling for the breathing tube and / or on the second coupling for the exhalation tube. For this purpose, for the detection at the inlet nozzle and at the first and second clutch each separate sensor means such. B. pressure sensors and / or flow sensors can be provided. Preferably, a common sensor means could be provided.

The identification device may preferably be suitable and designed to compare a characteristic variable of the respiratory gas flow detected for the measuring tube with at least one threshold value and / or with a characteristic variable of the respiratory gas flow detected for a respiratory tube and / or exhalation tube. The detection device is particularly suitable and designed to recognize the type of the connected hose device based on the comparison.

For example, at a detected for the measuring hose at the inlet nozzle size, z. As a pressure above a threshold, a hose device detected with a connected measuring hose. The pressure detected for the measuring tube can also be compared with the pressure detected in the breathing tube and / or exhalation tube. The result of the comparison is preferably subjected to a plausibility check. Is z. B. a plausible deviation or coincidence of each detected size Before, in particular, a connected measuring hose is assumed.

It is also possible for the detection device to be suitable and designed to use a characteristic variable of the respiratory gas flow detected for the measuring hose for monitoring the function of the measuring hose. In particular, the function can be checked on the basis of a comparison with at least one threshold value and / or with a characteristic variable recorded for the breathing tube and / or exhalation tube. So z. B. a kinked or jammed measuring tube can be reliably detected.

In all embodiments, it is particularly preferred that the respiratory gas flow can be provided by at least one defined flow of breathing gas to identify the type of connected hose device. In particular, the defined respiratory gas flow is not the respiratory gas flow used for ventilation. For example, the defined respiratory gas flow has a different pressure and / or a different flow than the respiratory gas flow intended for ventilation. In particular, the respiratory gas flow for ventilation and the defined respiratory gas flow are not acted upon at the same time.

Such a defined breathing gas flow allows a particularly reliable evaluation of the detected characteristic size and thus a particularly reliable detection of the connected tube type. For example, the flow of breathing gas is defined so that depending on the connected type of hose a certain value of the detected size of the respiratory gas flow can be expected.

Particularly preferably, the detection device could be suitable and designed to generate the defined breathing gas flow by means of the blower device. In particular, the detection device is suitable and designed to generate a pressure build-up in at least one flow connection and / or in the hose device by means of the defined respiratory gas flow. It is possible that the defined breathing gas flow is not guided into the hose device. This is the case, for example, if the defined respiratory gas flow is established in a flow connection of the second clutch and no exhalation hose is connected there.

The detection device is preferably suitable and designed to generate the defined respiratory gas flow by means of a specific rotational speed of the fan device. It is also possible to generate a defined flow of breathing gas by means of a specific power setting of the blower device, for example a torque and / or an electric power consumption. It may also be provided that a different blower device is provided for generating the defined respiratory gas flow than for generating the respiratory gas flow for the respiration. Preferably, the defined breathing gas flow is generated by the same fan device as well as the respiratory gas flow used for ventilation. In particular, the speed for generating the defined respiratory gas flow is less than for generating the respiratory gas flow for ventilation. This has the advantage that a particularly low-noise detection of the hose type is possible.

In particular, the detection device may be suitable and designed to generate the defined respiratory gas flow while taking into account a specific desired pressure and / or desired flow. The target pressure may be, for example, a minimum pressure and / or a maximum pressure. The desired flow can be, for example, a minimum flow and / or maximum flow. It is also possible that a certain mean pressure and / or average flow are set with a certain value. It is also possible that another characteristic size of the respiratory gas flow is specifically set to a defined setpoint. It is also possible that the detection device is suitable and designed to adjust a pressure change and / or a flow change over a specified period of time. For example, an increase of the pressure can take place up to a defined value. The values for the desired pressure and / or desired flow are preferably stored in the identification device.

The detection device may be suitable and designed to generate the defined respiratory gas flow as at least one pressure pulse and / or flow pulse. Such a pulse is characterized in particular by a short-term, increasing pressure rise and / or flow increase up to a defined value. It is possible that the recognition device is suitable and designed to set a recognition scheme comprising a plurality of pressure pulses and / or flow pulses. By means of such pulses, particularly characteristic pressure changes or flow changes can be achieved as a function of the particular type of hose connected, so that reliable detection is possible.

The detection device may preferably be suitable and designed to generate the defined respiratory gas flow during a detection phase. The detection phase is preferably preceded by a ventilation phase with a breathing gas flow intended for ventilating the user. Ventilation phase and detection phase are preferably not simultaneous and in particular spaced in time. The detection phase can be carried out, for example, during startup and / or during a hose change.

Particularly preferably, the detection phase could take place during a power-consuming idle mode and in particular during a standby of the ventilator. In particular, the blower device and other actuators and / or sensors can be activated and / or read during the standby of the ventilator. The detection phase preferably takes place cyclically.

For example, the detection phase takes place in a clock of a few seconds or a minute or a few minutes or more. Also possible are shorter timings. For example, the detection phase occurs every 15 seconds. A detection phase during standby has the advantage that in a subsequent ventilation phase the ventilation is already set to the recognized type of tube.

It could also be possible that detection is also carried out during a ventilation phase. Then, the detection device is particularly suitable and designed to make the detection of the tube type based on the respiratory gas flow used for ventilation.

In particular, the detection device may be suitable and designed to detect the pressure and / or flow of the defined respiratory gas flow as a characteristic variable of the respiratory gas flow. In particular, the detected size of the respiratory gas flow is a pressure and / or flow of the defined respiratory gas flow. For example, it is detected on the basis of a characteristic pressure and / or flow on the second coupling for the exhalation tube, whether an exhalation hose is connected or not.

The detection device is particularly suitable and designed to determine the type of the connected hose device on the basis of the detected pressure and / or flow. Reference values can be used for this purpose, for example, which were previously determined using known tube devices. It is also possible to assign the type of hose device to a reference value, for example based on a threshold value and / or a characteristic field and / or on the basis of at least one assignment function and, for example, a polynomial.

Particularly preferably, the detected pressure may be an EPAP control pressure (Expiratory Positive Airway Pressure) and / or a PEEP control pressure (Positive End-Expiratory Pressure). In this case, the control pressure is in particular the pressure that is applied to the patient valve by the application of the defined respiratory gas flow. It is possible that, depending on the valve position of the patient valve, this pressure assumes a different value. It is possible that a characteristic control pressure change is detected and used to determine the type. For example, at a detected control pressure above a threshold, a hose device is detected with a valve ventilation. With no or a control pressure below a threshold value, a hose device with leakage ventilation is preferably detected.

The detection device may be suitable and designed to determine a deviation of the detected pressure and / or flow from the desired pressure and / or desired flow of the defined respiratory gas flow. The detection device is particularly suitable and designed to determine the type of the connected hose device based on the deviation. It is possible that the deviation is also considered as a function of time. A use of the deviation between the desired pressure and the detected pressure can be used particularly reliably for the determination of open and valve-controlled exhalation systems.

Preferably, the detection device may be suitable and designed to detect and evaluate at least one time profile of the pressure and / or flow of the defined respiratory gas flow, in particular to determine the type of the connected hose device based on the time profile. In particular, the pressure and / or the flow are detected as a function of time. For example, a defined pressure and / or flow is applied and recorded its temporal change. Depending on how quickly the pressure builds up or degrades again, it can then be closed to the connected hose device.

The identification device may be suitable and designed to detect a rotational speed and / or power setting of the fan device necessary for achieving the desired pressure and / or desired flow. Based on the speed and / or power setting the type of the connected hose device is set. For example, to achieve a desired pressure in an open system, a higher fan speed is required than in a valve system. It is possible that the time until reaching the target pressure and / or desired flow is detected and the type of hose device is determined based on the time.

In all embodiments, it is particularly preferred that the detection device can be suitable and designed to at least specify a user input in determining the type of the connected hose device consider. For example, the recognized hose device is communicated or displayed to the user and the final determination is made by the user input. It is also possible that regardless of the user input, the type of hose device is specified. It can also be provided that at least one plausibility check is carried out for the recognized hose device and the user input. Due to the user input and / or the plausibility check, at least one further recognition phase can be carried out and / or a further user input can be requested.

The identification device may preferably be suitable and designed to recognize a coupling and / or uncoupling of the hose device from the coupling device and then perform a recognition of the type of the connected hose device. In particular, the detection phase is thereby started and the defined respiratory gas flow is generated. Recognition of the type of hose means may also be started by at least one user input. By such embodiments, it can be ensured that after replacement of the hose device recognition takes place and thus the necessary device configurations are set automatically.

In particular, the detection device may be suitable and designed to make at least one adjustment of at least one ventilation parameter and / or at least one device configuration depending on the specified type of the connected hose device. This has the advantage that without manual inputs, a ventilation adapted to the type of hose device can be ensured. The user or caregiver therefore only has to concentrate on the selection of the optimal tube device, while the necessary settings are made automatically by the ventilator.

In particular, the recognized type of hose device is provided to at least one control device. The control device is suitable and designed to operate and adjust the ventilation device taking into account the recognized hose device.

In addition, the detection device may be suitable and designed to determine at least one mode identifier and / or at least the minimum of the setting value for the PEEP control pressure and / or EPAP control pressure, and / or a technical alarm and / or depending on the detected type of connected hose device to set an algorithm of volume calculation.

The ventilator may be operable with various types of tube devices. But it is also possible that the ventilator is operable only with a certain type of hose device. Then the detection device serves in particular to detect the correct type of hose. Preferably, in the case of an improper hose type, an error message is issued.

It is possible that the detection device for detecting the size comprises at least one sensor device with at least one pressure sensor and / or flow sensor. In this case, the sensor device can also be provided for monitoring and setting ventilation parameters during ventilation. It is also possible that the detection device has its own or separate sensor device, which is provided only for detecting the type of the connected hose device.

The method according to the invention serves to operate a respirator with at least one respiration device. The ventilation device comprises at least one fan device for generating at least one respiratory gas flow for the respiration and at least one coupling device for connecting at least one tube device. By means of the hose device, the respiratory gas flow can be supplied to at least one respiratory opening of a user. In this case, different types of connected hose devices are detected by means of at least one detection device. For this purpose, at least one characteristic variable of the respiratory gas flow is detected by the detection device. On the basis of the detected size, the type of the connected hose device is detected and determined.

The inventive method also offers a comfortable and user-friendly use of different types of hose devices, since an automatic detection of the connected type takes place.

In particular, as a result of the recognized hose device, at least one ventilation parameter and / or at least one device configuration can be adapted. As a result, the user or caregiver can select and connect the desired hose device, and ventilation automatically takes place, which is optimally adapted to the hose device used. The device does not need to be reconfigured.

Further advantages and features of the present invention will become apparent from the description of the embodiments, which will be explained with reference to the accompanying figures below.

In the figures show:

1 a schematic representation of a ventilator according to the invention with different types of hose means in a perspective view;

2 the ventilator with a connected hose device for leakage ventilation in a perspective view;

3 the ventilator with a connected hose device for valve ventilation in a perspective view;

4 the ventilator with a connected hose device with breathing tube and exhalation tube in a perspective view; and

5 a highly schematic representation of a ventilator according to the invention.

The 1 shows a ventilator according to the invention 1 which acts as a home ventilator 100 or sleep therapy device is formed. The ventilator 1 Can also be used as a clinical ventilator 1 be used. The ventilator 1 serves to carry out the method according to the invention. In addition, the shows 1 three different types of hose assemblies 5 connected to the ventilator 1 can be connected.

The ventilator 1 includes a ventilation device 2 with a blower device 3 for generating a breathing gas flow for ventilation. For controlling or regulating the ventilation device 2 and in particular the blower device 3 here is a control device 16 intended. Operation and adjustment of the ventilator 1 via an operating device 103 with a display device 104 ,

The control device 16 is also operatively connected to a sensor device not shown here. The sensor device comprises one or more sensors for the detection of ventilation parameters and preferably of characteristic variables of the respiratory gas flow.

The control device 16 represents z. B. provides a necessary minimum pressure and compensates for pressure fluctuations that are caused by the respiratory activity of the user. For example, the control device detects 16 Based on the sensor device, the current pressure and flow of ventilation and regulates the performance of the blower device 3 according to, until a desired ventilation pressure or flow is applied.

The for setting the ventilation device 2 or the blower device 3 required ventilation parameters and the device configuration and / or device software are in a memory device of the control device 16 deposited.

The ventilator shown here 1 can be configured as a fix level device or as an automatic level device. In particular, in this case takes place by the control device 16 a control to target ventilation parameters, which have been previously calculated and determined individually based on the characteristic breathing of a user.

It is also possible that the ventilation device 100 is adjusted dynamically and in particular according to the breathing phase of the user. For example, by means of the control device 16 a respiratory phase change can be detected so that a higher or lower pressure can be provided depending on the respiratory phase. For example, the ventilator 1 be designed as a CPAP or APAP device. The ventilator 1 can also be designed as a bilevel device. For example, the ventilator responds 1 to certain respiratory events, such. As snoring, Atemabflachungen and / or obstructive pressure peaks with appropriate settings of the ventilation parameters.

In order to supply the respiratory gas flow to a respiratory orifice of the user during respiration, a breathing interface shown here in a highly schematic manner is shown 102 , intended. The respiratory interface 102 is preferably designed as a patient interface and may be configured, for example, as a full-face mask, as a nasal pillow, as a tube or as a laryngeal mask. The respiratory interface 102 can also be designed as a nasal mask breathing mask 105 be. For fixing the breathing mask 105 a hood can be provided.

To connect the respiratory interface 102 with the ventilation device 2 can use different types of hose assemblies 5 be used. To automatically detect the with the ventilator 1 connected hose device 5 to enable is a recognizer 6 intended. The recognition device 6 is here in the controller 16 integrated. For detecting the hose device 5 detects the recognition device 6 at least one characteristic size of the respiratory gas flow. On the basis of the recorded values, an assignment of a certain type of hose device takes place 5 , The characteristic size of the respiratory gas flow is in particular a physical quantity for a fluid flow.

The desired hose device 5 is via a coupling device 4 at the ventilation device 2 tethered. So will one Flow connection between blower device 3 and respiratory interface 102 provided. The hose device 5 has coupling elements at the respective ends to connect to the respiratory interface 102 and at the coupling device 4 to be connected.

In the 1 are hose devices 5 shown, each representing different types. At the top left is a hose device 5 shown for leakage ventilation. The hose device 5 for leakage ventilation points in the breathing tube 501 or in the respiratory interface 102 and for example in the breathing mask 105 a defined opening. Through this opening, the exhaled air and especially the expiratory carbon dioxide are washed out.

The ventilator 1 with a connected hose device 5 for leakage ventilation is in the 2 shown. The breathing tube 501 is at a first clutch 14 the coupling device 4 with the ventilation device 2 flow-connected.

To the right and below are two hose assemblies 5 shown, which serve for valve ventilation. The recognition device 6 is able, the hose device 5 for leakage ventilation as a type other than the tube devices 5 to detect valve ventilation.

The in the 1 Hose assemblies shown above 5 are so-called single hose systems. In this case, the hose devices include 5 one respiratory tube each 501 but no exhalation tube 502 , Below is in the 1 a hose device 5 shown which a breathing tube 501 and an exhalation hose 502 includes, a so-called two-hose system. The recognition device 6 is capable of a single tube system with a breathing tube 501 as another type of hose device 5 as a two-hose system with a breathing tube 501 and an exhalation tube 502 to recognize.

For monitoring at least one characteristic size of the respiratory gas flow, the hose means comprise 5 here in each case a measuring hose 110 , The measuring hose 110 is via an inlet pipe 111 with the ventilation device 2 flow-connected. Thus, a characteristic size and, for example, the pressure and / or the flow of the respiratory gas flow can be detected close to the patient. For this purpose, at least one pressure sensor and / or at least one flow sensor, which is connected to the inlet nozzle, is located in the respiration device 111 fluidly connected. The measuring hose 110 or the inlet nozzle 111 can be used both to monitor the ventilation and to detect the hose device 5 be used. The recognition device 6 can detect automatically whether a measuring hose 110 connected or not.

The in the 1 top hose shown on the right 5 for valve ventilation here includes a controllable patient valve 101 , To the patient valve 101 becomes the respiratory interface 102 and for example the breathing mask 105 connected. The control of the patient valve 101 via a control hose 109 which is fluidly connected to the patient valve 101 as well as at a taxpipe 119 the ventilation device 2 connected.

The control hose 109 is through the ventilation device 2 subjected to a targeted control pressure and applied, for example, with an EPAP or PEEP control pressure. This allows the patient valve 101 be opened or closed at the desired time.

A respirator 1 with a connected hose device 5 for valve ventilation is in the 3 shown. The breathing tube 501 this hose device 5 is also connected to the first clutch 14 the ventilation device 2 connected. The detection of the characteristic size of the respiratory gas flow takes place in the region of the patient valve 101 near the patient via a measuring tube 110 , which at the entrance neck 111 is coupled.

The lower in the 1 shown hose device 5 is also a hose device 5 for valve ventilation. In contrast to the hose device described above 5 has this hose device 5 but an exhalation hose 502 and thus represents a two-hose system. The patient valve provided for valve ventilation 101 is here on the exhalation hose 502 arranged. The control of the patient valve 101 also takes place via a control hose 109 , which at the taxpipe 119 the ventilation device 2 connected.

The exhalation hose 502 is via a second clutch 24 the coupling device 4 connected to the ventilator. The breathing tube 501 will be at the first clutch 14 tethered. Via a Y adapter 112 be the two hoses 501 . 502 with the respiratory interface 102 flow-connected. The detection of a characteristic variable takes place via the measuring hose 110 , which here in the range of the Y-adapter 112 is connected.

A respirator 1 with a connected two-hose system is in the 4 shown. Such a two-hose system is used, for example, when the expiratory volume has to be determined particularly reliably.

The 5 shows a very schematic view of the ventilator 1 , The active compounds between the individual components are here highly schematic and simplified represented as arrows.

The ventilation device 2 includes a blower device 3 for generating the breathing gas flow. The breathing gas flow becomes the first clutch 14 guided and from there via a breathing tube, not shown here 501 continue to the breathing interface, also not shown 102 directed.

To detect a characteristic size of the breathing gas flow, here are a flow sensor 15 and a pressure sensor 25 intended. The characteristic size of the respiratory gas flow is thus here the pressure and the flow. The flow sensor 15 and the pressure sensor 25 are here with the entrance neck 111 flow-connected, so that the pressure or flow via a connected measuring hose 110 is detectable. The sensed values for pressure and flow become the controller 16 provided so that these the blower device 3 can control or regulate accordingly.

The flow sensor 15 and the pressure sensor 25 Here, too, they are preferably used to detect the pressure or flow in the coupled breathing tube 501 and / or exhalation hose 502 , This is especially the case when a hose device 5 without measuring hose 110 is used, for. B. a leakage system. However, additional or separate sensor means for detecting the pressure or flow in the coupled breathing tube can also be used 501 and / or exhalation hose 502 be provided.

For controlling the blower device 3 by the control device 16 here is a driver device 13 intended. The control device 16 takes into account at least one device configuration as well as specifications for the setting of certain ventilation parameters.

To make settings for the device configuration and / or to set ventilation parameters here is a user interface 36 with an operating device 103 and a display device 104 intended. The entries are made via a user interface controller 26 the control device 16 made available.

In addition, that of the blower device 3 generated breathing gas flow as a control pressure for a patient valve 101 be used. For this purpose, the breathing gas flow through the control neck 119 and a control hose connected to it 109 led to the patient valve. In order to be able to set the control pressure specifically, here is an actuator 23 intended. This sets, for example, the desired EPA or PEEP control pressure. The actor 23 is in particular with the control device 16 operatively connected.

The ventilation device 2 here also includes a second clutch 24 for an exhalation hose 502 , The exhaled air entering there is passed through the ventilation device 2 released into the environment.

For the automatic detection of a connected hose device 5 controls the recognition device 6 the blower device 3 Here accordingly, to produce a defined flow of breathing gas. For this purpose, in particular a certain speed for the blower device 3 set. It is also possible to set a predetermined desired pressure and / or a predetermined desired flow. The recognition device 6 can the blower device 3 Also control so that a defined flow of breathing gas is constructed with targeted pressure pulses and / or flow pulses.

The defined breathing gas flow is here, for example, every 15 seconds in a standby of the ventilator 1 generated. In standby, preferably the necessary actuators 3 . 13 . 23 . 101 controllable and the corresponding sensors 15 . 25 read. Also, the detection and determination of the connected hose device 5 takes place here during standby.

If the user then switches from standby to the ventilation phase, the inserted tube device is 5 already detected and the desired ventilation can start immediately. In addition, the controller has 16 that of the recognizer 6 fixed hose device 5 already considered for the settings of ventilation. The control device 16 takes settings in the device configuration or adjustments of the ventilation parameters, taking into account the hose device used 5 in front.

To detect a characteristic variable of the defined respiratory gas flow, the flow sensor is used here 15 , the flow sensor 35 and / or the pressure sensor 25 used. Thus, pressure and flow are detected as characteristic quantities of the respiratory gas flow.

For the automatic detection of a connected hose device 5 in terms of leakage or valve system takes place here an admission of the hose device 5 with the defined breathing gas flow. In particular, an intelligent test scheme is provided which sets predefined pressure pulses and / or flow pulses. On the basis of the detected pressure and / or flow changes can then be concluded that there is a leakage or valve system.

In the case of leakage ventilation, in particular a single-tube system with a permanently open exhalation gap is used. A corresponding pressure pulse in the breathing tube 501 thus breaks down rapidly over the exhalation gap. In the case of valve ventilation, on the other hand, exhalation is usually achieved by the switchable patient valve 101 locked until released. With a locked patient valve 101 the pressure pulse of the defined respiratory gas flow remains in the breathing tube 501 thus exist over a much longer period.

A distinction between leakage or valve system can therefore be made according to a characteristic pressure drop per unit time. The recognition device 6 detects the pressure and / or the flow as a function of time.

For example, the blower device 3 at a connected hose device 5 turned on low speed and the pressure across the pressure sensor 25 measured. Alternatively or additionally, the flow can also be measured. It is particularly advantageous that the flow sensor 15 or the pressure sensor 25 here correspondingly close to the coupling device 4 are arranged. This allows the sensors sizes in the breathing tube 501 capture very well.

Is a hose device 5 with a valve system 101 connected, after the application of the defined respiratory gas flow no pressure build-up or a correspondingly low pressure build-up is measured. The recognition device 6 then preferably sets a hose device 5 for leakage ventilation.

Is, however, a hose device 5 with a valve system 101 connected, it comes through the application of the defined flow of breathing gas to a characteristic pressure build-up. Then by the recognizer 6 a hose device 5 set for valve ventilation, z. When the pressure reaches a threshold.

It can be provided that typical measured values for the common leakage or valve systems are determined in advance and these in the detection device 6 be deposited. Accordingly, reference values can also be stored for single-hose systems and two-hose systems. Then, preferably, a comparison of the detected variable with the stored reference values takes place. In addition, it can be provided that an additional user preselection of the hose device 5 is provided, for. B. as user input via the operating device 103 , Such a user prefix is particularly preferably provided when the recognition device 6 can not make a sufficiently secure determination of the type or an error occurs.

Another example of an automatic detection of the connected hose device 5 Regarding leakage or valve system can be over the control pressure of the patient valve 101 respectively. Is a hose device 5 for valve ventilation with a valve 101 Connected via the pressure sensor 25 a corresponding control pressure and in particular an EPAP or PEEP control pressure is measured. The recognition device 6 then recognizes a hose device 5 for valve ventilation. If, however, an open ventilation system is connected, the pressure sensor 25 no corresponding EPAP or PEEP control pressure measured. The recognition device 6 thus goes from a hose device 5 with leakage ventilation off.

An automatic detection of a connected hose device 5 in terms of Einschlauchsystem or double hose system takes place here z. B. on the detection of the flow at the second clutch 24 for the exhalation hose 502 , This can be a separate flow sensor 35 be provided. It is also possible that the flow sensor 15 for detecting the flow at the second clutch 24 is used. In a corresponding manner, a detection of the pressure by means of a pressure sensor on the second clutch 24 be provided.

Is a hose device 5 with an exhalation hose 502 connected, the exhaled air is in the ventilation device 2 returned and discharged from there into the ambient air. For a connected single hose system, the second clutch is 24 however, in particular locked or closed. Depending on the hose device 5 This results in different values for the flow or the pressure at the second clutch 24 ,

For differentiation between single or double hose system is therefore the fan 3 rotated at a correspondingly low speed and generates the defined flow of breathing gas. About the flow sensor 35 is the flow of defined breathing gas flow at the second clutch 24 measured. Is a hose device 5 without an exhalation hose 502 connected, no Flow through the sensor 35 registered. The recognition device 6 then goes from a hose device without an exhalation hose 502 out. On the other hand, is a hose device with a breathing tube 501 and an exhalation tube 502 connected, a corresponding flow through the sensor 35 registered. The recognition device 6 then recognizes a hose device 5 of the double hose system type.

Here, too, it is preferably provided that a supplementary user preselection of the hose device 5 via a user input on the operating device 103 can be made.

An automatic detection of a connected measuring tube 110 takes place here via the at the inlet 111 recorded pressure. Is z. B. a leakage system without measuring hose 110 connected, is at the entrance port 111 no plausible pressure value determined. For example, the pressure is above a threshold when the inlet port 111 without measuring hose 110 z. B. is closed by a valve. Is the inlet nozzle 111 without connected measuring hose 110 open, too low a pressure is detected. For the connected breathing tube 501 deliver the sensors 15 . 25 . 35 however, plausible values for the size recorded in each case.

Is z. B. a valve system with a measuring tube 110 connected, is at the entrance port 111 a plausible pressure value determined. This pressure value is then preferably with the detected pressure values for the breathing tube 501 and / or exhalation hose 502 compared. If the comparison also gives a plausible result, the measuring tube becomes 110 recognized. Then the ventilation is preferably also based on the measuring tube 110 monitored and this used for near-patient or proximal detection of pressure, flow and / or other sizes.

In particular, the airway pressure over the measuring tube 110 detected. Ventilation is then regulated to a desired airway pressure. It is preferably by the detection device 6 evaluated continuously during ventilation during operation, whether a measuring hose 110 connected to the proximal pressure measurement. Will the at the inlet nozzle 111 detected size is considered plausible, the over the measuring tube 110 measured airway pressure used directly to control.

Shows continuous monitoring of the inlet nozzle 111 However, if the detected quantity has implausible values, the recognition device passes 6 from a non-connected or non-functional measuring tube 110 out. To regulate ventilation, the airway pressure is then preferably calculated on the basis of other variables. In particular, that for the breathing tube 501 at the first clutch 14 and / or for the exhalation hose 502 at the second clutch 24 recorded pressure and / or flow used.

The calculated airway pressure is preferably based on the pressure and the flow-dependent pressure drop in the breathing tube 501 and / or exhalation hose 502 determined. The flow-dependent pressure drop is calculated in particular on the basis of measured characteristic curves. At the beginning of ventilation or before detection of a measuring tube 110 Preferably, the calculated airway pressure is used first.

The steps presented here for the detection of the connected hose device 5 are preferably carried out as part of a ventilation upstream detection phase. For example, the detection phase is in standby. According to the recognized hose device is then by the detection device 6 a configuration of the ventilation parameters made. In addition, the detection device 6 also an automatic setting of technical alarms and / or an optimization of the volume calculation including the hose compliance for the respective hose devices 5 make. For example, an adaptation of the ventilation pressure to the recognized hose device 5 be made.

For example, in a hose device with a leakage ventilation correspondingly more breathing gas through the hose 501 be encouraged. This is particularly advantageous because in the leakage ventilation usually respiratory gas escapes. Such leakage compensation is particularly preferred as a result of a detected type of hose automatically by the control device 16 performed. This saves the user or caregiver often a very high configuration effort after replacing the hose device.

The leakage compensation may include, for example, an adaptation of the ventilation volume and / or the ventilation pressure. In particular, the leakage is taken into account in the case of an applied tidal volume. Thus, the patient almost always receives the specified and required volume of breathing gas.

It is also possible to continuously adapt flow triggers and / or termination criteria as a consequence of a recognized leakage system. In addition, during ventilation with a recognized leakage system, irrelevant alarms that are necessary during valve ventilation can be suppressed. It is also possible to deactivate unnecessary alarm settings.

LIST OF REFERENCE NUMBERS

1

ventilator

2

ventilator

3

blower

4

coupling device

5

hose means

6

recognizer

13

driving means

14

clutch

15

flow sensor

16

control device

23

actuator

24

clutch

25

pressure sensor

26

User interface controller

35

flow sensor

36

User interface

100

Home ventilator

101

patient valve

102

Respiratory interface

103

operating device

104

display

105

oxygen mask

109

control hose

110

measuring tube

111

inlet connection

112

Y-adapter

119

control socket

501

breathing tube

502

exhalation

Claims (21)

Ventilator ( 1 ) with at least one ventilation device ( 2 ) comprising at least one blower device ( 3 ) for generating at least one breathing gas flow for the ventilation and at least one coupling device ( 4 ) for connecting at least one hose device ( 5 ), via which the respiratory gas flow can be supplied to at least one respiratory opening of a user, characterized in that the respiration device ( 2 ) at least one recognition device ( 6 ) for detecting different types of hose assemblies ( 5 ) and that the recognition device ( 6 ) is adapted and designed to detect at least one characteristic size of the respiratory gas flow and, based on the detected size, to determine the type of the connected hose device ( 5 ) to recognize. Ventilator ( 1 ) according to the preceding claim, wherein the recognition device ( 6 ) is suitable and designed, a hose device ( 5 ) for leakage ventilation and a hose device ( 5 ) for valve ventilation as various types of connected hose device ( 5 ) to recognize. Ventilator ( 1 ) according to one of the preceding claims, wherein the recognition device ( 6 ) is suitable and designed, a hose device ( 5 ) with at least one breathing tube ( 501 ) and with at least one exhalation tube ( 502 ) and a hose device ( 5 ) without exhalation tube as different types ( 5 ) to recognize. Ventilator ( 1 ) according to the preceding claim, wherein the coupling device ( 4 ) at least one first clutch ( 14 ) for the breathing tube ( 501 ) and at least one second clutch ( 24 ) for the exhalation hose ( 502 ) and wherein the recognition device ( 6 ) is adapted and adapted to the characteristic size of the respiratory gas flow at least at the second clutch ( 24 ) capture. Ventilator ( 1 ) according to one of the preceding claims, wherein the recognition device ( 6 ) is suitable and designed, based on the detected size, a hose device ( 5 ) with at least one measuring hose ( 110 ) and a hose device ( 5 ) without measuring hose ( 110 ) as different types ( 5 ) to recognize. Ventilator ( 1 ) according to the preceding claim, wherein the coupling device ( 4 ) at least one inlet nozzle ( 111 ) for coupling the measuring tube ( 110 ) and wherein the recognition device ( 6 ) is suitable and designed to measure the characteristic size of the respiratory gas flow for the measuring tube ( 110 ) at least at the inlet nozzle ( 111 ) capture. Ventilator ( 1 ) according to one of the two preceding claims, wherein the recognition device ( 6 ) is suitable and designed for the measuring hose ( 110 ) detected characteristic size of the respiratory gas flow with at least one threshold value and / or with one for a breathing tube ( 501 ) and / or exhalation hose ( 502 ) to compare the characteristic size of the respiratory gas flow and compare the type of connected hose device ( 5 ) to recognize. Ventilator ( 1 ) according to one of the preceding claims, wherein the respiratory gas flow has a defined respiratory gas flow for the detection of the type of connected hose device ( 5 ). Ventilator ( 1 ) according to the preceding claim, wherein the recognition device ( 6 ) is suitable and designed for generating the defined respiratory gas flow by means of a specific speed and / or or power setting of the blower device ( 3 ) to create. Ventilator ( 1 ) according to one of the two preceding claims, wherein the recognition device ( 6 ) is suitable and designed to generate the defined flow of breathing gas, taking into account a specific desired pressure and / or desired flow. Ventilator ( 1 ) according to one of the three preceding claims, wherein the recognition device ( 6 ) is adapted and designed to generate the defined respiratory gas flow as at least one pressure pulse and / or flow pulse. Ventilator ( 1 ) according to one of the four preceding claims, wherein the recognition device ( 6 ) is adapted and designed to generate the defined respiratory gas flow during a detection phase, which precedes a ventilation phase with a breathing gas flow intended for the ventilation of the user. Ventilator ( 1 ) according to one of the five preceding claims, wherein the recognition device ( 6 ) is suitable and designed to detect a pressure and / or flow of the defined respiratory gas flow as a characteristic variable of the respiratory gas flow and, based on the detected pressure and / or flow, the type of connected hose device ( 5 ). Ventilator ( 1 ) according to the preceding claim, wherein the pressure is an EPAP control pressure and / or a PEEP control pressure. Ventilator ( 1 ) according to one of the two preceding claims, wherein the recognition device ( 6 ) is adapted and designed to determine a deviation of the detected pressure and / or flow from the desired pressure and / or desired flow of the defined respiratory gas flow and based on the deviation, the type of the connected hose device ( 5 ). Ventilator ( 1 ) according to one of the three preceding claims, wherein the recognition device ( 6 ) is adapted and designed to detect and evaluate a time profile of the pressure and / or flow of the defined respiratory gas flow and based on the time course, the type of the connected hose device ( 5 ). Ventilator ( 1 ) according to one of the seven preceding claims, wherein the recognition device ( 6 ) is suitable and designed for applying a rotational speed and / or power setting of the blower device to achieve the desired pressure and / or desired flow of the defined respiratory gas flow ( 3 ) and, based on the speed and / or power setting, the type of connected hose device ( 5 ). Ventilator ( 1 ) according to one of the preceding claims, wherein the recognition device ( 6 ) is suitable and designed in determining the type of the connected hose device ( 5 ) to consider at least one user input. Ventilator ( 1 ) according to one of the preceding claims, wherein the recognition device ( 6 ) is suitable and designed, a coupling and / or uncoupling of the hose device ( 5 ) of the coupling device ( 4 ) and then a recognition of the type of connected hose device ( 5 ). Ventilator ( 1 ) according to one of the preceding claims, wherein the recognition device ( 6 ) is suitable and designed, depending on the specified type of the connected hose device ( 5 ) at least make an adjustment of at least one device configuration and / or at least one ventilation parameter. Method for operating a ventilator ( 1 ) with at least one ventilation device ( 2 ) comprising at least one blower device ( 3 ) for generating at least one breathing gas flow for the ventilation and at least one coupling device ( 4 ) for connecting at least one hose device ( 5 ), via which the respiratory gas flow can be supplied to at least one breathing opening of a user, characterized in that by means of at least one detection device ( 6 ) different types of hose assemblies ( 5 ) and that the detection device ( 6 ) is detected at least one characteristic size of the respiratory gas flow and that on the basis of the detected size of the type of the connected hose device ( 5 ) is recognized and determined.

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