阅读说明：本技术 随吸入性物质的输送来提供气体以人工呼吸和氧合的系统 (System for providing gas for artificial respiration and oxygenation with delivery of an inhalable substance ) 是由 H·格尔德 C·布伦德尔 M·莫尼希 于 2021-05-13 设计创作，主要内容包括：本发明涉及一种伴随人工呼吸和氧合用于将物质输送给病人(30)的系统(1000)。所述系统(1000)具有至少一个人工呼吸系统(1)、带计量系统(7)的用于吸入镇静的系统(17)、氧合系统(2)、呼吸气体计量路径(3)、冲洗气体计量路径(4)、呼吸气体连接元件(5)、靠近病人的连接元件(25)、氧合连接系统(6)和转换单元(8)。转换单元(8)构造用于在靠近病人的连接元件(25)和氧合系统(2)之间分发或分配借助计量系统(7)计量到气体混合物中的大量吸入性物质。至少一个管控单元(9、10、11、12)构造用于管控转换单元(8)和/或系统(1000)。(The invention relates to a system (1000) for delivering a substance to a patient (30) with artificial respiration and oxygenation. The system (1000) has at least one artificial respiration system (1), a system for inhalation sedation (17) with a metering system (7), an oxygenation system (2), a respiratory gas metering path (3), an irrigation gas metering path (4), a respiratory gas connection element (5), a connection element (25) near the patient, an oxygenation connection system (6) and a switching unit (8). The switching unit (8) is designed to dispense or distribute a quantity of an inhalable substance, which is metered into the gas mixture by means of the metering system (7), between a connecting element (25) close to the patient and the oxygenation system (2). At least one control unit (9, 10, 11, 12) is designed to control the conversion unit (8) and/or the system (1000).)

1. System (1000) for artificial respiration and oxygenation of a patient (30), having:

-an artificial respiration apparatus (1) with

An artificial respiration system (1),

a respiratory gas connection system (5),

and a connecting element (25) adjacent to the patient,

an oxygenation system (2) with an oxygenation connection system (6),

-a system (17) for inhalation sedation with

A metering system (7) with a gas extraction joint (16),

a reflection unit (18) and a gas return connection (24),

-a conversion unit (8),

a respiratory gas metering path (3),

a flushing gas metering path (4),

-at least one regulating unit (9),

wherein the artificial respiration system (1) is designed with means (27, 60, 67) for supplying respiratory gas to a patient (30),

wherein the breathing gas connection system (5) is designed for gas-conducting connection for the concomitant delivery and entrainment of breathing gas to the patient,

wherein the breathing gas connection system (5) is designed to deliver a portion of the breathing gas enriched with an inhalable substance from the conversion unit (8) to a patient (30) via a connection element (25) close to the patient,

wherein the breathing gas connection system (5) is designed to deliver a further portion of breathing gas which is not enriched with inhalant substances from the artificial respiration system (1) to the patient (30) via a connection element (25) which is close to the patient,

wherein the system (SIS) (17) for inhalation sedation is designed with a metering system (7) for metering an inhalable substance (100),

wherein the conversion unit (8) is designed to distribute and/or dispense a gas quantity enriched with an inhalant substance (100) into the breathing gas metering path (3) and the flushing gas metering path (4),

wherein the conversion unit (8) is designed to,

part of the respiratory gas enriched with the inhalable substance is delivered and supplied to the respiratory tract of a patient (30) by means of a respiratory gas metering path (3) and by means of a connecting element (25) close to the patient,

wherein the switching unit (8) is designed to deliver and supply the inhalation substance-enriched partial breathing gas to the oxygenation system (2) by means of the flushing gas metering path (4),

wherein the oxygenation system (2) has a membrane (35) for gas exchange with the blood circulation of the patient (30) and for removal of carbon dioxide from the blood circulation of the patient (30) with delivery of a quantity of oxygen and a quantity of an inhaled and/or volatile substance (100) into the blood circulation of the patient (30),

wherein the oxygenation system (2) has means (34, 36, 37) for conveying and/or supplying a large amount of flushing gas to the membrane (35),

wherein the oxygenation system (6) makes it possible to use a volatile-rich substance (100) and oxygen (O)₂) Supplies the patient (30) with blood and makes it possible to carry away carbon dioxide (CO) enriched with CO₂) The amount of blood in the blood vessel is,

wherein the at least one control unit (9) is designed to control the conversion unit (8).

2. The system (1000, 2000, 3000) according to claim 1, wherein the metering system (7) is configured for metering an inhalable and/or volatile substance or volatile anesthetic agent (100).

3. The system (1000, 2000, 3000) according to claim 1 or claim 2, wherein the gas return connection (24), the reflection unit (18) and the patient-near connection element (25) are constructed as a structural unit.

4. A system (1000, 2000, 3000) according to any of the claims 1 to 3, wherein a filter element (28) is arranged at the reflection unit (18).

5. The system (1000, 2000, 3000) according to claim 4, wherein the filter element (28) is designed as an HME filter for absorbing and expelling moisture, or wherein the filter element (28) is designed as a filter for retaining germs, viruses or bacteria in the breathing gas.

6. System (1000, 2000, 3000) according to claim 4 or claim 5, wherein the gas extraction connection (16), the gas return connection (24) are constructed in a common structural unit with the reflection unit (18) and/or the breathing gas connection system (5) and/or the patient-near connection element (25) and/or the filter element (28).

7. System (1000, 2000, 3000) according to claim 4 or claim 5, wherein the gas extraction connection (16) and the gas return connection (24) are constructed in a common structural unit with the reflection unit (18) and/or the patient-near inhalation valve and/or the breathing gas connection system (5) and/or the patient-near connection element (25) and/or the filter element (28).

8. The system (1000, 2000, 3000) according to any one of the preceding claims, wherein the regulating unit (9) is configured for regulating the dosing of the inhalable substance based on the concentration of the inhalable substance determined at the patient-proximate connecting element (25), at the breathing gas connecting system (5) or at the reflecting unit (18).

9. The system (1000, 2000, 3000) according to claim 8, wherein the administration unit (9) is configured for administering the measure of the inhalable substance based on an end-tidal concentration of the at least one inhalable substance or the at least one anesthetic.

10. The system (1000, 2000, 3000) according to any one of the preceding claims, wherein the metering system (7) is configured to

-of the System for Inhalation Sedation (SIS) (17),

-of the artificial respiration apparatus (1) or of the artificial respiration system (1),

-of the breathing gas connection system (5)

And (4) forming a component.

11. The system (1000, 2000, 3000) according to any one of the preceding claims, wherein the conversion unit (8) is configured to

-of the System for Inhalation Sedation (SIS) (17),

-of the artificial respiration apparatus (1) or of the artificial respiration system (1),

-of the breathing gas connection system (5),

-of the oxygenation connection system (6),

-of the respiratory gas metering path (3),

-of the flushing gas metering path (4),

-of the metering system (7)

And (4) forming a component.

12. The system (1000, 2000, 3000) according to any one of the preceding claims, wherein a blood transport unit (36) for transporting blood volume towards and/or away from the patient (30) is arranged in or at the oxygenation connection system (6) and/or the oxygenation system (2).

13. Gas distribution unit (3, 7, 8, 9, 18, 24, 25) for a system (1000, 2000, 3000) for artificial respiration and oxygenation of a patient (30), formed by a conversion unit (8), a respiratory gas metering path (3), a connection element (25) close to the patient, a gas extraction connection (16) for extracting part of the respiratory gas from the inhaled gas, a gas return connection (24) for the inhaled gas and an irrigation gas metering path (4),

wherein at least the switching unit (8), the respiratory gas metering path (3), the connection element (25) close to the patient, the gas extraction connection (16) and the gas return connection (24) form a common structural unit.

14. Gas distribution unit (3, 7, 8, 9, 18, 24, 25) according to claim 13, wherein the gas distribution unit comprises a reflection unit (18) and/or an HME filter (28) and/or a further filter element (28) in a common structural unit.

15. The system (2000, 3000) according to any of the claims 1 to 12 and the system (2000, 3000) with a gas distribution unit (3, 7, 8, 9, 18, 24, 25) according to claim 13 or claim 14,

wherein a gas transport unit (38) for transporting a purge gas is arranged in the gas distribution unit, in the purge gas metering path (4) or in the oxygenation system (2).

16. The system (2000, 3000) according to any one of claims 1 to 12 or 15 and the system (2000, 3000) with a gas distribution unit (3, 7, 8, 9, 18, 24, 25) according to claim 13 or 14, wherein a flush gas absorption unit (39) for removing carbon dioxide from flush gas is arranged in the flush gas metering path (4) or the oxygenation system (2).

17. The gas distribution unit (3, 7, 8, 9, 18, 24, 25) according to claim 13 or claim 14 and the system (3000) according to any one of claims 1 to 12 and any one of claims 15 to 16,

wherein an exhaust gas line (29) is arranged in the system (3000) from the artificial respiration system (1) to the gas distribution unit (3, 7, 8, 9, 18, 24, 25) or to the conversion unit (8), which exhaust gas line enables the transport of exhalation gases from the artificial respiration system (1) to a mixing chamber (19) arranged in or at the conversion unit (8) or in or at the gas distribution unit (3, 7, 8, 9, 18, 19, 24, 25) and the removal of carbon dioxide from the exhalation gases.

18. The gas distribution unit (3, 7, 8, 9, 18, 24, 25) according to claim 13 or claim 14 and the system (1000, 2000, 3000) according to any one of claims 1 to 12 and any one of claims 15 to 17, wherein the at least one regulating unit (9, 10, 11, 12, 15) is configured as a central regulating system or as a central regulating unit.

19. The gas distribution unit (3, 7, 8, 9, 18, 24, 25) according to claim 13 or claim 14 and the system (1000, 2000, 3000) according to any one of claims 1 to 12 and any one of claims 15 to 18,

wherein each control unit (9) forms a decentralized control system, wherein at least one control unit (9, 10) is arranged in the oxygenation system (2) and in the artificial respiration system (1).

20. The gas distribution unit (3, 7, 8, 9, 18, 24, 25) according to claim 19 and the system (1000, 2000, 3000) according to claim 19, wherein in the decentralized management system there are arranged individual management units (9) in the conversion unit (8) and/or individual management units (12) in the metering system (7) and/or external management units (15), wherein one of the individual management units (8, 9, 12) and/or an external management unit (15) is configured for managing the conversion unit (8) and/or the metering system (7).

21. The gas distribution unit (3, 7, 8, 9, 18, 24, 25) according to claim 13 or claim 14 and the system (2000, 3000) according to any one of claims 1 to 12 and any one of claims 15 to 20, wherein at least one of the regulating units (9, 10, 11, 12, 15) takes into account the provided data of the artificial respiration system (1) and/or of the oxygenation system (2), respectively, when regulating the conversion unit (8).

22. The gas distribution unit (3, 7, 8, 9, 18, 24, 25) according to claim 13 or claim 14 and the system (2000, 3000) according to any one of claims 1 to 12 and any one of claims 15 to 21, wherein a process gas analysis unit (21) for analysis is arranged in or at the oxygenation system (2), in or at the oxygenation connection system (4), or is assigned to the oxygenation system (2), in or at the oxygenation connection system (4), and wherein the process gas analysis unit (21) is configured for providing the determined data to the system (2000, 3000) and/or at least one of the management units (9, 10, 11, 12, 15) based on the analysis.

23. The gas distribution unit (3, 7, 8, 9, 18, 24, 25) according to claim 13 or claim 14 and the system (2000, 3000) according to any one of claims 1 to 12 and any one of claims 15 to 22, wherein the process gas analysis unit (23) for analyzing: is arranged in or at the patient-near connection element (25) or is connected to the gas distribution unit (3, 7, 8, 9, 18, 24, 25) or the patient-near connection element (25) by means of a measurement gas line (26); arranged in or at the System for Inhalation Sedation (SIS) (17) or assigned to the System for Inhalation Sedation (SIS) (17);

and wherein the process gas analysis unit (23) is designed to provide the determined data for at least one of the System for Inhalation Sedation (SIS) (17), the system (2000, 3000) and/or the control unit (9, 10, 11, 12, 15) on the basis of the analysis.

24. Gas distribution unit (3, 7, 8, 9, 18, 24, 25) according to claim 23 and system (2000, 3000) according to claim 23, wherein a central process gas analysis unit is arranged in the system (1000, 2000, 3000) or is assigned to the system (2000, 3000),

wherein a central process gas analysis unit together with a switching and dispensing regulation unit is designed to carry out an analysis of gas samples of the System for Inhalation Sedation (SIS) (17), of the connection elements (25) of the breathing gas connection system (5) close to the patient, of the oxygenation system (2), of the oxygenation connection system (4), of the metering system (7) or of the switching unit (8) and to provide the determined data to the system (2000, 3000) and/or to at least one of the regulation units (9, 10, 11, 12, 15) on the basis of the analysis.

25. Gas distribution unit (3, 7, 8, 9, 18, 24, 25) according to claim 23 or claim 24 and a system (2000, 3000) according to claim 23 or claim 24,

wherein a blood gas analysis unit (22) for analysis is arranged in or at the oxygenation system (2) or the oxygenation connection system (4) or is assigned to the oxygenation system (2) or the oxygenation connection system (4) and

wherein the blood gas analysis unit (22) is configured to provide the determined data to at least one of the oxygenation system (2), the system (2000, 3000) and/or the regulating unit (9, 10, 11, 12, 15) based on the analysis.

26. The gas distribution unit (3, 7, 8, 9, 18, 24, 25) according to claim 23 to claim 25 and the system (2000, 3000) according to claim 23 to claim 25, wherein a process gas analysis unit (23) for analysis is arranged or provided in or at the conversion unit (8) or the metering system (7), and wherein the process gas analysis unit (23) is configured to provide the determined data to the conversion unit (8), the metering system (7), the system (2000, 3000) and/or at least one of the regulating units (9, 10, 11, 12, 15) on the basis of the analysis.

27. The gas distribution unit (3, 7, 8, 9, 18, 24, 25) according to claim 13 to 26 and the system (2000, 3000) according to any one of claims 1 to 12 and any one of claims 15 to 26,

wherein a moistening/heating system (75) for the breathing gas for heating the breathing gas is arranged in or at the gas distribution unit (68), in or at the conversion unit (8), in or at the connection element (25) near the patient, in or at the breathing gas connection system (5).

28. The gas distribution unit (3, 7, 8, 9, 18, 24, 25) according to claim 13 to 27 and the system (1000, 2000, 3000) according to any one of claims 1 to 12 and any one of claims 15 to 27,

wherein a data network (212) is arranged in or at the system (1000, 2000, 3000) or is assigned to the system (1000, 2000, 3000),

wherein the data network (212) is designed to provide data in the system (1000, 2000, 3000), the or each administration unit (9, 10, 11, 12, 15), the blood gas analysis unit (22), the process gas analysis unit (20, 21, 23), the artificial respiration system (1), the oxygenation system (2), the conversion unit (8), the metering system (7), the System for Inhalation Sedation (SIS) (17) or a further component, and

the or each control unit (9, 10, 11, 12, 15) of the system (1000, 2000, 3000) is thus provided with the ability to control and/or coordinate the conversion unit (8) and/or the metering unit (7).

29. The gas distribution unit (3, 7, 8, 9, 18, 24, 25) according to claim 13 to 28 and the system (2000, 3000) according to any one of claims 1 to 12 and any one of claims 15 to 28, wherein a system (40) for monitoring the physiology (PPM) of a patient is arranged in or at the system (2000, 3000) or the system (1000, 2000, 3000) is provided with a system (40) for monitoring the physiology (PPM) of a patient,

wherein the system (40) for monitoring Patient Physiology (PPM) is configured to provide data to the data network (212) or to at least one of the system (2000, 3000), the respiratory system (1), the oxygenation system (2), the metering system (7) or the conversion unit (8), and/or the regulating unit (9, 10, 11, 12, 13, 15).

30. The gas distribution unit (3, 7, 8, 9, 18, 24, 25) according to claim 13 to 29 and the system (2000, 3000) according to any one of claims 1 to 12 and any one of claims 15 to 29, wherein a system (50) for cardiopulmonary imaging and diagnosis is arranged in or at the system (2000, 3000) or the system (1000, 2000, 3000) is provided with a system (50) for cardiopulmonary imaging and diagnosis,

wherein the system (50) for cardiopulmonary imaging and diagnosis is configured to provide data to at least one of the system (2000, 3000), the artificial respiration system (1), the oxygenation system (2), the metering system (7), the conversion unit (8) or the system for monitoring Patient Physiology (PPM) and/or the administration unit (9, 10, 11, 12, 15) or the data network (212).

31. The gas distribution unit (3, 7, 8, 9, 18, 24, 25) according to any of claims 13 to 30 and the system (1000, 2000, 3000) according to any of claims 1 to 12 and any of claims 15 to 30, wherein the system (2000, 3000) is designed for providing data with the data network (212) in a data exchange (210, 211, 212, 213).

32. The gas distribution unit (3, 7, 8, 9, 18, 24, 25) according to claim 13 to 31 and the system (1000, 2000, 3000) according to any one of claims 1 to 12 and 15 to 31, wherein the regulating unit (9) in the metering system (7) is configured to regulate the mass of the inhalable substance (1000) according to data provided in the data network (212) and/or according to data provided by one of the regulating units (9, 10, 11, 12, 15).

33. The gas distribution unit (3, 7, 8, 9, 18, 24, 25) according to claim 13 to 32 and the system (2000, 3000) according to any one of claims 1 to 12 and 15 to 32, wherein the administration unit (9) in the conversion unit (8) is configured to administer the distribution and/or distribution of a volume of inhalable substance (100) into the flushing gas metering path (4) towards the oxygenation system (2) and into the breathing gas metering path (3) towards the patient-near connecting element (25) or towards the reflection unit (18) according to data provided in the data network (212) and/or according to data provided by one of the administration units (9, 10, 11, 12, 15).

Technical Field

The present invention relates to a system for providing gas for artificial respiration (Beatmung) and oxygenation with delivery of an inhalable substance. A combined system is described with means for providing a breathing gas, gas or gas mixture for artificial respiration and oxygenation of a patient with the gas or gas mixture and with means for extracorporeal membrane lung oxygenation of the patient. The system according to the invention with a device for artificial respiration and extracorporeal membrane oxygenation enables the delivery of An inhalant substance or anesthetic agent (An ä sthesiemtel) by means of a gas or gas mixture supplied to the patient. Substances are, for example and preferably, gases which are dissolved in the gas or vapour phase, such as anaesthetic (An ä sesimeittel), anaesthetic (An ä sesiegas), anaesthetic (Narkotikum) or anaesthetic (narkosemititel), pharmaceutically effective substances which are dissolved in the gas or vapour phase or drugs which are suitable for inhalation administration into respiratory gases. The term "breathing gas" is to be understood in accordance with the invention next as a generic term for the amount of gas delivered to or removed from a patient and thus as inhalation gas, exhalation gas, a plurality of breathing gases, a plurality of inhalation gases, a plurality of exhalation gases and a breathing gas, a plurality of breathing gases.

Background

The use of traditional artificial respiration in intensive care units and during the performance of surgery often leads to undesirable accompanying symptoms such as barotrauma and aspiration which can cause local lung injury and can lead to complications such as pneumonia or sepsis. To avoid further injury and as a treatment when the heart or lungs are damaged, there are several methods for oxygenation and circulatory support, such as venous-venous extracorporeal membrane pulmonary oxygenation (v.v. ecmo), pumpless extracorporeal lung assist (pECLA) for carbon dioxide removal, and arteriovenous extracorporeal membrane pulmonary oxygenation (v.a. ecmo).

From the prior art, artificial respiration and anesthesia apparatuses are known which can be used for artificial respiration in Intensive Care Units (ICU) OR for performing surgical interventions in an Operating Room (OR).

US 2016067434 AA shows a breathing apparatus for use in an intensive care unit for artificially breathing a patient. The shown artificial respiration apparatus should be aimed at avoiding complications during the administration of artificial respiration.

US 4148312 a shows a combination of an anesthesia apparatus and a respiration apparatus. In order to perform artificial respiration during surgical intervention, unconsciousness, absence of pain and muscle relaxation of the patient are important. For this purpose, different volatile anesthetics (An ä styretikum) (anesthetic An ä styremititel) (halothane, isoflurane, desflurane, sevoflurane, ether) and laughing gas, which have different hypnotic, analgesic and muscle-relaxing properties, are delivered to the patient by inhalation by means of An anesthesia apparatus, for example by means of An endotracheal tube, in combination with air and oxygen. Most additionally administer drugs into the blood circulation in a traumatic manner. The metered administration of volatile anesthetic (An ä sthetikum) or anesthetic (narkosemititel) into the breathing gas or into the breathing gas mixture can be carried out, for example, by means of atomization with An anesthetic evaporator (also referred to as An anesthetic atomizer or vaporizer (nebulizer)).

US 2016008567 AA shows a system for metering narcotics (Narkosemittel) or volatile narcotics (An ä sesieemititel).

WO 09033462 a1 shows an anesthetic vaporizer with a storage container and a delivery and metering device, wherein the vapor pressure of the anesthetic is generated by increasing the temperature and a saturated anesthetic vapor is generated.

So-called heart-lung machines (HLM) are used in particular when performing heart surgery. Such heart-lung machines (HLM) assume the function of heart and lungs during surgical interventions at the heart, that is to say the delivery of oxygen into the patient's blood circulation and the removal of carbon dioxide from the patient's blood circulation and the letting blood flow into the blood vessels. Thus, for example, GB 2568813 a1 shows a heart-lung machine for extracorporeal gas exchange and oxygenation.

A device for supplying anesthetic gas (Narkosegas) is known from WO 2009033462 a 1. The device is capable of providing saturated anesthetic vapors and delivering them to a patient without the need for external fresh or carrier gas.

US 2020038564 AA shows a blood pump suitable for extracorporeal blood transport.

US 9901885 BB shows a membrane constructed and arranged for blood-gas and gas-blood exchange.

US 6174728 BA, US 4279775 a and US 2003064525 AA show devices for determining the composition and blood gas in biological blood.

Disclosure of Invention

With the above prior art in mind, it is the object of the present invention to provide a system which makes it possible to deliver substances in gaseous form to the respiratory cycle of a patient and to deliver substances in gaseous form extracorporeally to the blood cycle of a patient.

Another object of the present invention is to provide a device which makes it possible to dispense and/or distribute a portion of the respiratory gas into the respiratory and blood circulation of the patient.

The aforementioned object is solved by the independent claims 1 and 13.

The object of a system for gaseous delivery of a substance is achieved by a system for supplying gas for artificial respiration and oxygenation of a patient with delivery of a substance having the features of claim 1.

The object of an apparatus for dispensing and/or distributing a portion of breathing gas into the respiratory and blood circulation of a patient is solved by a gas dispensing unit having the features of claim 13.

Advantageous embodiments of the invention emerge from the dependent claims and are explained in more detail in the following description with partial reference to the figures.

A first inventive aspect is formed by a system for delivering a substance in conjunction with gaseous delivery to the respiratory and blood circulation of a patient. The system according to the invention for delivering substances achieves gaseous delivery of substances into the respiratory cycle of a patient and gaseous delivery of substances extracorporeally into the blood cycle of a patient. For example, for clinical use in Intensive Care Units (ICU), coordinated operation is thus achieved simultaneously and/or in parallel with the delivery of substances for inhalation sedation into the blood circulation and into the respiratory circulation. The delivery of the substance for inhalation sedation can be accomplished by means of the simultaneous and/or parallel coordinated operation through the patient's respiratory access and through the air/blood exchange system (membrane lung oxygenation, ECMO, oxygenator, oxygenation system). With the system according to the invention, it is likewise possible to administer substances for inhalation sedation into the cardiac circulatory system via the lungs of the patient and to administer such substances into the blood circulation of the patient via the gas/blood exchange system (extracorporeal circulation).

The system according to the invention comprises:

-an artificial respiration apparatus with an artificial respiration system (BS) and

-with a breathing gas connection system,

with connecting elements close to the patient (Y-shaped piece)

An Oxygenation System (OS) with an oxygenation connection system,

a System for Inhalation Sedation (SIS) with a metering system (DS),

with a gas extraction connection for the suction of gas,

-with a reflection unit (CR),

with a gas return connection for the suction of gas,

-a conversion unit for converting the data received from the first and second input units,

-a respiratory gas metering path,

-a purge gas metering path, and

-at least one regulating unit.

The artificial respiration system is configured to provide a respiratory gas to a patient. The breathing gas connection system is configured for being connected in a gas-conducting manner to supply a large amount of breathing gas to a patient with concomitant delivery and entrainment. A System for Inhalation Sedation (SIS) is formed by a metering system, a gas extraction junction for extracting a portion of the breathing gas from the inhaled gas, a reflection unit, and a gas return junction for returning the portion of the breathing gas from the metering system toward the conversion unit.

System for Inhalation Sedation (SIS) is configured with a metering system for metering an inhalable substance. A portion of the breathing gas is provided by a respiratory prosthesis or system and delivered to a System for Inhalation Sedation (SIS).

The inhalant-rich partial breathing gas is delivered and provided to the conversion unit by a System for Inhalation Sedation (SIS) via a gas extraction connector and a breathing gas connection system.

According to the invention, the conversion unit enables the distribution and/or distribution of the inhaled substance-rich gas quantity into the breathing gas metering path and the flushing gas metering path.

The partial respiratory gas enriched with the inhalant substance is supplied by the switching unit to the respiratory tract of the patient by means of the respiratory gas metering path and by means of a connecting element close to the patient.

The portion of the respiratory gas enriched with the inhalant substance is conveyed and supplied to the oxygenation system by the switching unit by means of the flushing gas metering path.

The partial respiratory gas enriched with the inhalant substance is supplied to the patient by the switching unit via a connecting element close to the patient by means of the respiratory gas connection system.

A further portion of the breathing gas, which is not enriched with inhalant substances, is delivered and supplied to the patient by the artificial respiration system by means of the breathing gas connection via the connection element close to the patient.

A volume of blood enriched with an inhalable substance is delivered by an oxygenation system to a patient through an oxygenation connection system by means of a flush gas flowing in a flush gas metering path. For this purpose, the qi and blood exchange and the blood and blood exchange are carried out in an oxygenation system, whereinSupplied and enriched with oxygen O₂And the amount of gas of the inhalant substance from the oxygenation connection system through the surrounding flushing of the membrane into the patient's blood circulation and at the same time a large amount of carbon dioxide CO generated in the patient's metabolism₂From the patient's blood circulation into the flush gas metering path. These processes of qi and blood exchange and qi and blood exchange are called oxygenation and called decarboxylation.

The oxygenation connection system is configured for fluid communication with the blood circulation to deliver and carry away large volumes of blood from the patient. The blood which is supplied by the oxygenation system and is enriched with oxygen is supplied to the patient in a traumatic manner by means of the oxygenation connection system as a fresh and enriched blood volume with the supply line.

The volume of carbon dioxide-enriched blood leaving the patient is returned to the oxygenation system by means of an oxygenation connection system. The oxygenation connection system can thus be used with volatile-rich substances and oxygen (O)₂) The amount of blood supplied to the patient and the amount of carbon dioxide (CO) enriched in the blood₂) The amount of blood is taken away.

The artificial respiration system is part of an artificial respiration system in a common design. A breathing system for a breathing apparatus generally has suitable means for supplying, delivering and removing breathing gases and substances to and from a patient, such as means for mixing gases and means for conveying gases, such as at least one gas conveying unit (fan, blower, piston drive, valve arrangement), and a breathing gas connection system having means for guiding gases, such as in the form of a breathing tube and a connecting element for connecting the breathing tube to an endotracheal tube, breathing mask or tracheostoma, so-called Y-piece. Also known are connection elements which comprise an exhalation valve close to the patient. In addition to the artificial respiration system, the artificial respiration apparatus also comprises elements, in particular sensors, for detecting in a measurement technique given and/or adjusted pressures, flows and other operating parameters of the mechanical artificial respiration accompanying the delivery of the gas and gas mixture. For mechanical artificial respiration, at least the following parameters are adjusted and/or monitored, such as inspirationAnd artificial respiration pressure for expiration, artificial respiration frequency, inspiratory-expiratory time ratio, upper and lower pressure limits, upper and lower flow limits, upper and lower volume limits, and gas concentration. According to the invention, the artificial respiration apparatus and the artificial respiration system support a system which ensures ventilation of the lungs, that is to say ensures substance transport in the event of collapse of the lungs or individual lung regions (alveoli), during the task and function. Furthermore, the artificial respiration system carries out O in the lungs₂/CO₂The patient is supported while the gas is exchanged. The system for delivering a substance has suitable elements for carrying away, delivering and/or reintroducing large quantities of breathing gas. The breathing gas supplied by the artificial respiration system is supplied to the patient as fresh breathing gas by means of the inspiration path of the breathing gas connection as an inspiratory artificial respiration hose. The breathing gas or breathing gas mixture exhaled by the patient is then conducted back or carried away by means of the breathing gas connection.

The inspiration and expiration paths of the breathing gas connection system are mostly combined close to the patient by means of a connection element close to the patient, the so-called Y-piece, at the patient. The air exhaled by the patient is passed from the patient via the exhalation path of the breathing gas connection system into the surroundings or into a suitable system for absorbing the consumed gas quantity by means of an exhalation valve, the so-called exhalation valve, often referred to as EX valve. Depending on the design of the respirator, the exhalation valve can be arranged in the respirator itself, so that the exhaled breathing gas can be discharged to the surroundings by means of a tracheostoma, an endotracheal tube or a nasal mask via a connecting element (Y-piece) and an exhalation artificial breathing tube and the exhalation valve. In an alternative embodiment, the exhalation valve is arranged outside the respirator close to the patient, so that the exhaled breathing gas can flow out directly via the exhalation valve into the surroundings by means of a tracheostoma, an endotracheal tube or a nasal mask. In this embodiment, there is no provision for an expiratory breathing tube for breathing gas to be fed back into the breathing apparatus via the breathing gas connection.

The System for Inhalation Sedation (SIS) enables the provision of inhaled substances, such as substances with hypnotic (narcotic Narkotikum), analgesic or muscle-relaxing properties or effects. A System for Inhalation Sedation (SIS) enables metered or metered input of an inhalant substance into an artificial respiration system and/or an oxygenation system via a conversion unit and in this way provides an inhalant substance-rich gas volume into the patient's respiratory cycle and lungs and/or into the patient's blood cycle via an oxygenation system.

The connection between the switching unit and the connection element close to the patient takes place by means of a breathing gas metering path with the delivery of a portion of the breathing gas enriched with the inhalable substance to the patient.

The connection between the conversion unit and the oxygenation system is made by means of a flushing gas metering path with the delivery of the inhalant-rich partial respiratory gas to the oxygenation system.

According to the invention, at least one control unit is designed to control the conversion unit. Regulating here comprises coordinating the distribution and/or distribution of the amount of gas provided and/or led by the metering system between the metering paths, i.e. between the flushing gas metering path and the breathing gas metering path. The regulating unit implements to some extent the management of the gas or gas mixture between the two metering paths. The amount of gas provided and/or directed by a System for Inhalation Sedation (SIS) and/or a metering system is enriched with a large amount of a substance, a large amount of a volatile substance, or saturated with a large amount of a volatile anesthetic (An ä sthetikum) or a large amount of a substance, a large amount of a volatile substance, or a large amount of a volatile anesthetic. With the regulation and/or coordination of the gas or gas mixture management, it is appropriately predetermined by the at least one regulating unit which amount of substance, volatile substance or volatile anesthetic (An ä sthetikum) is delivered with the delivered amount of breathing gas into the respiratory cycle and lungs of the patient via the breathing gas connection system, or into the oxygenation system and thus from the oxygenation system into the blood cycle of the patient via the oxygenation connection system with the delivered or exchanged amount of blood.

By controlling and coordinating the conversion unit by means of at least one control unit, in particular a control unit in the conversion unit, a balance can be established between inhalation anesthesia and external anesthesia, for example, during the delivery of the inhalation substance, or also be cancelled during the treatment from a medical point of view. The at least one control unit thus enables the user to put the desired settings or changes in the center of gravity of the treatment into practice in terms of a balance between extracorporeal sedation by means of an oxygenation system or inhalation sedation by means of a System for Inhalation Sedation (SIS) during operation of the system according to the invention which enables gaseous delivery of substances into the respiratory cycle and gaseous delivery of substances extracorporeally into the blood cycle of the patient.

Systems for Inhalation Sedation (SIS) have, for example, a gas extraction connection for inhalation air for extracting a portion of the inhaled gas from the inspiratory path of the breathing gas connection system as a suitable element for delivering a large amount of breathing gas towards a metering system.

Systems for Inhalation Sedation (SIS) have, for example, a gas return connection for the inhaled gas for returning part of the inhaled gas from the switching unit into the inspiration path of the breathing gas connection system and/or back to a connection element (Y-piece) close to the patient as a suitable element for delivering large quantities of breathing gas to the patient. A System for Inhalation Sedation (SIS) has suitable elements for storing and/or providing a volume of exhaled breathing gas or breathing gas mix of a patient. For this purpose, the System for Inhalation Sedation (SIS) has, for example, a reflection unit or anesthetic gas reflector (Narkosegasreflektor) as a suitable element. Most anesthetic gases (Narkosegas) are stored or buffered in a reflex unit or reflector upon exhalation and are reused upon subsequent inhalation. The reflector may, for example, be configured as a carbon reflector configured to store or buffer the inhalation substance over a period of multiple days. One exemplary construction of the reflection unit has a chamber in the flow of breathing gas with a reflection agent, such as, for example, appropriately impregnated activated carbon particles. The activated carbon enables the inhalation substance from the patient's exhaled gas to be absorbed, buffered and temporarily bound thereto during patient exhalation and released back into the inhaled gas in the breathing gas connection system with the immediate subsequent inhalation following delivery to the patient.

Such a reflection unit is arranged in or at the breathing gas connection system, preferably at or near the connection element (wye). The reflection unit can alternatively be constructed as part of a connection element (Y-piece) of the breathing gas connection system. The connection element (Y-piece) may alternatively be constructed as part of a reflection unit in the breathing gas connection system. The reflection unit has elements for filtering and/or buffering gas components and/or substances in the breathing gas, in particular inhalative and/or volatile substances. The reflector unit is sometimes also referred to as a reflector, a gas reflector or a anesthetic gas reflector (narkosegas reflektor) or An anesthetic gas reflector (An ä stepiegasreflektor).

In a preferred embodiment of the system, the metering system can be designed for metering inhalant substances and/or volatile substances or volatile anesthetics (An ä styretikum).

In a preferred embodiment, a further chamber can be arranged in the gas flow in the reflection unit, which further chamber absorbs moisture present in the exhalation gas during exhalation, temporarily buffers and binds moisture present in the exhalation gas and then enables the moistened inhalation gas to be delivered to the patient during a subsequent inhalation. Such a further chamber arranged in the gas flow therefore has the function of a filter element in the design of a so-called HME filter (heat moisture exchange).

In a further preferred embodiment, a further filter element can be arranged in the reflection unit or in the further chamber or in a further additional chamber, which further filter element is designed for filtering with germs, viruses or bacteria in the trapped breathing gas.

The gas return fitting may be configured as a component of the connection element that is proximal to the patient. The gas return connection can be configured as a component of the reflection unit.

In a preferred embodiment, the gas return connection, the reflection unit and the connection element near the patient are constructed as a structural unit. In a preferred embodiment, the gas return connection, the patient-side connection element and the reflection unit are constructed as a structural unit in combination with a further filter element and/or an HME filter.

In a preferred embodiment, the gas extraction connection and the gas return connection for the inhaled gas are formed in a common structural unit with a reflection unit and/or a breathing gas connection system and/or a connection element (Y-piece) close to the patient and/or a further filter element and/or an HME filter. In a preferred embodiment, the gas extraction connection and the gas return connection for the inhaled gas can be formed in a common structural unit with a reflection unit with an exhalation valve close to the patient and/or a breathing gas connection system and/or a connection element close to the patient (Y-piece) and/or a further filter element and/or an HME filter.

For the purpose of providing a System for Inhalation Sedation (SIS), a metering system is provided with a correspondingly configured element for metering an inhalable substance. A suitably designed element for metering the inhalation substance is, for example, a valve or a valve arrangement in the form of a controlled, that is to say for example electrically or electronically controlled or regulated valve for metering the inhalation substance into the gas mixture. For example, magnetic or electromagnetic control valves, as well as piezoelectric valves or piezoelectric actuators are used for this purpose. A suitably configured element for metering an inhalable substance is, for example, a device for evaporating or atomizing an inhalable substance. Suitable devices for evaporating or atomizing inhalable, preferably volatile substances are constructed, for example, from anesthetic atomizers (narkosemitellverdus). These anesthetic gas nebulizers (narkosegas verdunters), mostly known as vaporizers, enrich the gas stream with volatile substances suitable for biological inhalation sedation or sedation, for example with volatile anesthetic agents (An ä styremetitel) in adjustable concentrations, for example desflurane, halothane, isoflurane, sevoflurane, diethyl ether. The evaporator operates according to the metering principle which changes the ratio of the flow quantities between the main flow and the partial flow. The main flow and the partial flow converge at the output of the evaporator. The supplied gas is therefore saturated with volatile substances in the partial flow, and the degree of metering and thus also the concentration of the substances at the output of the evaporator can be adjusted by adjusting or regulating the flow rate ratio between the main flow and the partial flow. The delivered gas flow is thus enriched in substances suitable for biological inhalation sedation or sedation in the metering system.

For example, a suitable possibility for metering an inhalable substance by means of a metering system in a System for Inhalation Sedation (SIS) is obtained by branching off a portion of the inhaled gas from the total amount at the breathing gas connection system, at the connection element close to the patient, at the reflection unit or at the artificial respiration system by means of a gas extraction connection and then metering into this portion of the inhaled gas a quantity of inhalable substance determined in the metering system. Such metering can be accomplished, for example, by means of a metering valve which meters the inhalation substance into the branched off portion of the inhalation gas in time pulses.

The portion of the inhalation gas which has been branched off and is now enriched with the inhalant substance is then introduced into the breathing gas connection via the gas return connection, preferably or reintroduced into the gas flow, for example at the reflector or at the connection element (Y-piece), and delivered to the patient. The delivery of the volatile substances is performed as a metered input into the inhalation gas. The supplied gas mixture consisting of air and oxygen reaches the patient as breathing gas from the artificial respiration device or system via the inspiration path of the breathing gas connection system for performing a pressure profile, flow, volume with respect to pressure, time artificial respiration therapy. This portion of the intake air is conducted to the metering system by means of the gas extraction connection via a connecting element, which is usually designed as a hose line. The inhalant or volatile substance is metered into the metering system for further use in the treatment of a patient via the lungs and/or via the blood pressure cycle. The inhalant substance is supplied to the breathing gas by means of a metering system for inhalation sedation, for example in the form of a volatile anesthetic (An ä styretikum) or another substance, and reaches the switching unit via a connecting element, which is usually likewise designed as a hose line.

In an alternative embodiment, the metering of the inhalation substance by the metering system is preferably effected by controlling a variable branched-off portion from the total amount of inhalation gas, preferably in conjunction with a constant metering input by the metering valve or a variable metering input by a regulating valve, for example a proportional valve. In Systems for Inhalation Sedation (SIS) when the inhalation substance is present in the liquid state, a device for heating, for example a heating device, is provided which effects a conversion of the inhalation substance from the liquid phase into the gas phase, so that the inhalation substance can be metered into the inhalation gas in the gaseous state by means of a regulating or metering valve.

In a preferred embodiment, the control unit can be designed to control the metering of the inhalant substance, i.e. to a time-pulsed metering input or to a constant or variable metering input and/or to control the amount of the branched-off portion passing through the metering system, on the basis of the concentration of the inhalant substance determined at the connection element (Y piece), at the breathing gas connection system or at the reflection unit.

For determining the concentration of An inhalant substance in the inhalant gas, the gas concentration, in particular the gas concentration of the inhalant substance or the anesthetic gas concentration in the exhaled gas (An ä sesiegaaskonzenation) can be determined, for example, using a measurement system for Process Gas Analysis (PGA), which can be arranged as a separate measurement system in the system for delivering a substance, can be assigned to the system for delivering a substance or can be designed as An element of the System for Inhalant Sedation (SIS) or of a metering system. Such a measuring system (PGA) is designed to determine the concentration of inhaled substances, in particular the anesthetic concentration (An ä sthesiematitedlkonzenation) or laughing gas (nitrous oxide, N), on the basis of a large quantity of breathing gas from a breathing gas connection or connection provided with suction and by means of a measuring gas line₂O) and carbon dioxide CO₂Or oxygen (O)₂) Is analyzed for respiratory gases. In this case, the suction phase is preferably preceded byDuring which the inhalant substance is metered into the inhalation gas by means of a metering system, while during the exhalation phase the concentration of the inhalant, volatile substance, in particular the anesthetic concentration (An ä styremetiteekkonzenation) or laughing gas (nitrous oxide, N) is preferably present in the exhalation gas₂O) and carbon dioxide CO₂Or oxygen (O)₂) And (5) determining the concentration. Here, the concentration at the end of the expiration phase, the so-called end-tidal carbon dioxide concentration (etCO 2) of the at least one inhalable substance or the end-tidal concentration (etVA) of the at least one anesthetic (An ä stiliemittel), is important for controlling the metering of artificial respiration and/or inhalable substances in the system for delivering substances.

In a preferred embodiment, the metering system is designed to meter the inhalant substance on the basis of the end-tidal concentration of at least one inhalant substance or of at least one anesthetic agent (An ä stheemititel).

In a preferred embodiment, the metering system is designed to carry out a time-pulsed metered feed of the inhalant substance through the metering valve on the basis of or as a function of the end-tidal concentration of the at least one inhalant substance or of the at least one anesthetic (An ä sthesiemittel).

In a preferred embodiment, the metering system is configured to control the variable branched portion of inhaled gas from the total amount of inhaled gas by adjusting a valve based on or in accordance with the end-tidal concentration of the anesthetic agent (An ä sthesiementtel).

The metering system is designed for metering volatile or inhalant substances and/or for metering volatile anesthetics (An ä dhetikum). On the one hand, this offers the advantage that the delivery of volatile media with the system for delivering substances takes place by means of a respiration system and a system for inhalation sedation, so that, for example, inhalation anesthesia (inhalarsankose) can be performed. But also large amounts of volatile drugs can be delivered inhalatively by means of artificial respiration systems and systems for inhalation sedation. The metering system is thus configured for metering volatile substances, such as drugs. The following list includes possible examples, also substances which are pharmaceutically effective and which can be dissolved in the gas or vapour phase, such as substances or media which influence the circulatory system of the heart, for example, which influence blood pressure and heart rate, drugs which influence the metabolism, fluid balance or hormonal state of the patient, and drugs which can be delivered inhalable in the gas or vapour phase in terms of function and/or therapy or rehabilitation or pain therapy as a therapeutic measure for organs, such as the lung, heart, kidney, pancreas, liver, stomach, intestine, sex organs, sensory organs, brain, nervous system, bronchi, bone, skin and muscle tissue, thyroid gland, gall bladder.

In a particular embodiment, the metering system can also be designed as a component of a System for Inhalation Sedation (SIS), in a further particular embodiment as a component of an artificial respiration system or in a further particular embodiment as a component of a breathing gas connection system.

The advantage is obtained that volatile media can be administered into the blood circulation by means of the oxygenation system with the system for delivering substances, for example volatile anesthetics (An ä stheemititel) or volatile medicaments with hypnotic (Narkotikum), analgesic or muscle-relaxing properties can be administered into the blood circulation.

According to the invention, the switching unit enables switching, dispensing or distributing of a gas quantity and/or An inhalant substance for sedation, such as a volatile anesthetic (An ä sthesiemittel) or a drug. According to the invention, the gas quantity of the gas is converted, distributed or dispensed by means of a conversion unit between a respiratory gas connection system and a connection element (Y-piece) with a reflection unit at one end and an oxygenation system at the other end. With the switching, dispensing or dispensing of the gas quantity, also indirectly An inhalant or volatile substance, An anesthetic (An ä dhetikum) or another substance is delivered concomitantly with the dispensing or dispensing by the metering system into the breathing gas connection with the connection element close to the patient and/or toward the oxygenation system.

Suitable means for switching and dispensing of the switching unit are, for example, a valve or a valve arrangement, an 3/2 diverter valve or two 2/2 diverter valves arranged in parallel in the gas flow, in combination with corresponding state control mechanisms for dispensing and dispensing by the metering system in components towards the respiratory system by means of a respiratory gas metering path or towards the oxygenation system by means of a flushing gas metering path.

The switching unit is designed to switch between the two metering paths and, in cooperation with the two metering paths, is designed to dispense and distribute an enriched gas quantity for the breathing gas to the connection element of the oxygenation system to the patient. The inhaled or volatile substances are supplied to the breathing gas by means of the metering system of the conversion unit and the System for Inhalation Sedation (SIS) and are passed from the conversion unit either by means of a gas return connection and via a breathing gas metering path and a breathing gas connection system, mostly also via a connection element (Y-piece) close to the patient, into the breathing gas and into the bronchi and lungs of the patient by means of an endotracheal tube, a tracheostoma or a nasal mask, or from the conversion unit via a flushing gas metering path to the oxygenation system and from the oxygenation system by means of an oxygenation connection system and then into the blood circulation of the patient.

In the design of a system for delivering substances in the intensive care or emergency medicine field, a switching unit is connected downstream of a metering system in the gas flow. In a particular embodiment, the switching unit can also be designed as a component of a System for Inhalation Sedation (SIS), and in a particular embodiment, the switching unit can also be designed as a component of an artificial respiration system.

In a particular embodiment, the conversion unit can be designed as a component of the breathing gas connection system, i.e. as a component, or as a component of the oxygenation connection system. In a particular embodiment, the switching unit can be designed as a component of the breathing gas metering path or as a component of the flushing gas metering path. In a special embodiment, the conversion unit can also be designed as a component of the metering system.

The oxygenation system is configured to provide oxygen to the patient during the blood circulation and to remove carbon dioxide from the blood circulation. The oxygenation system has a membrane for gas/blood exchange. By means of this membrane, a large amount of oxygen is delivered by the flushing gas into the blood volume of the patient's blood circulation and a large amount of carbon dioxide is removed from the patient's blood circulation. The purge gas is provided to the oxygenation system by the conversion unit via a purge gas connection path.

In a preferred embodiment, the blood volume can be delivered to and from the patient by means for delivering blood, for example by a blood delivery unit (pump). Such a blood transport unit (pump) is preferably arranged in or at the oxygenation connection system or in or at the oxygenation system and serves to transport a blood volume to and from the patient. Such pumps may be coupled intravenously (VV-ECMO) or arterially-intravenously (VA-ECMO) by means of suitable infusion needles and hoses having an outer diameter typically in the range of about 3.0 mm to 12.0 mm. The pump here conveys the blood to the oxygenation system at a flow rate in the range from 0.2L/min to 10L/min and back again. Here too, the patient enters the blood circuit, for example, via the femoral artery and the femoral vein, alternatively also via the femoral artery and the external jugular vein. In particular, in one embodiment of the blood transport unit, which can be adjusted in terms of transport volume, the extracorporeal blood-gas exchange with regard to the removal of carbon dioxide and the delivery of oxygen can be carried out in a manner that is individually adapted to the situation and to the patient.

In a special embodiment of the oxygenation system without external blood transport, the transport of the blood volume to and from the patient is effected, for example, by a pump. In this particular design, the transport of blood volume to and from the patient is accomplished by the pumping capacity of the patient's heart itself. This is called pumpless extracorporeal membrane lung oxygenation or pumpless extracorporeal lung assist (pECLA). The arterial-venous coupling of the pump-less extracorporeal membrane lung oxygenation is effected, for example, via the femoral artery and the femoral vein by means of infusion needles and hoses with an inner diameter typically in the range of about 3 mm to 7 mm, so that the heart transports the blood extracorporeally to the oxygenation system, typically at a flow rate in the range of 2L/min to 2.5L/min, and back again.

Preferred embodiments of the system according to the invention for delivering substances can have a control unit as a central control system or have a central control unit. These further preferred embodiments provide the advantage that a large amount of information can be centrally processed, referenced to each other and then centrally coordinated and regulated with the management, control and/or regulation of artificial respiration, extracorporeal blood gas exchange or therapy execution. In this case, it is possible to advantageously focus on the change of the coordinated operating mode or therapy, for example to adjust the equilibrium between inhalation anesthesia (inhalation Narkose) and external anesthesia (external Narkose), or also to cancel this equilibrium during therapy from the pharmaceutical point of view with the new center of gravity of the therapy being set, for example, substantially at the time of the external or inhalation delivery of the drug or sedative substance.

However, a preferred embodiment of the system according to the invention for transporting substances can also be designed with a plurality of individual control units which, in combination and in cooperation with one another, form a common control of the system. Although the control of the system can be implemented as a so-called "master-slave" device by means of a plurality of control units (slaves) interacting with a central control unit (master). The administration unit may be arranged in an artificial respiration system, in a System for Inhalation Sedation (SIS), in a metering system, in an oxygenation system, in a switching unit or in a module also external.

These preferred embodiments of the system provide the advantage that the information of different systems can be combined with each other, which also enables the combination of devices of different manufacturers and enables existing devices to be extended with further devices or modules. The coordination and cooperation between each other is achieved by a protocol for coordination adaptation in the data exchange, for example in the data network (LAN, WLAN).

In a further preferred embodiment of the system, at least individual control units in the conversion unit and/or individual control units in the metering system and/or in the artificial respiration system and/or external control units can be arranged in the decentralized control system.

One or more of the individual control units and/or external control units can be designed to control the conversion unit and/or the metering system. The regulation may here, for example, comprise coordinating the distribution and/or distribution of the amount of gas provided and/or guided by the metering system between the metering paths, i.e. between the flushing gas metering path and the breathing gas metering path, by means of the conversion unit. Furthermore, the control may also include the manner and method of metering by means of the metering unit, as well as combined control of the conversion unit and the metering system in coordination with the operation of the system for providing gas or gas mixture with the delivery of the substance, for example for carrying out inhalation anesthesia (Inhalationsnarkose) with the combined delivery of anesthetic gas (An ä sesiegas) into the respiratory and blood circulation of the patient.

These further preferred embodiments provide several advantages when coordinating and governing the system with respect to the requirements in terms of computing power, storage requirements and reaction time given for the respective functions.

The embodiment is implemented such that the adjustment process can be carried out directly in a control unit in the metering system with temporal performance requirements for the metered height, for example, but the gas quantity can be converted into the oxygenation system and the distribution to the system for inhalation sedation with moderate temporal performance requirements, for example, by means of an external control unit. Such a change of the quantity allocation can also be done, for example, by a wirelessly connected mobile terminal as a special design variant of an external control unit, such as a tablet, a smartphone, a mobile phone.

In a further preferred embodiment of the system for delivering a substance, at least one of the regulating units may take into account provided data of the System for Inhalation Sedation (SIS), of the artificial respiration system (BS) and/or of the Oxygenation System (OS), respectively, when regulating the switching unit. Such a further preferred embodiment offers the advantage that, for example, when the switching unit is controlled, information can be taken into account that a change in the manner of the user, for example, of the artificial respiration at the artificial respiration device, is carried out or activated shortly before, so that the practice of the change carried out is awaited before the state change is carried out by the switching unit. A similar situation applies to changes to the oxygenation system drive in terms of the management of the conversion unit. Furthermore, possible alarms of the artificial respiration system, of the artificial respiration system (BS), of the System for Inhalation Sedation (SIS) and of the oxygenation system can be taken into account for the control of the switching unit, for example in such a way that only certain changes to the operating state of the switching unit are effected when an alarm is present.

The or each control unit is configured to control the conversion unit and the metering system. The administration unit may furthermore be configured for administering artificial respiration apparatus, artificial respiration systems, systems for inhalation sedation, metering systems and oxygenation systems. The control unit can be arranged as a functional element or control module in or on the artificial respiration device, the artificial respiration system, the system for inhalation sedation, the metering system, the system for inhalation sedation, the oxygenation system or can be assigned to the artificial respiration device, the artificial respiration system, the system for inhalation sedation, the metering system, the oxygenation system.

The control unit and the individual control units provide the most different functions for operating the system according to the invention as functional elements. In the control unit, data memories (RAM, ROM) are usually provided, which are designed to store program code. The execution of the program code is coordinated by other designs of the microcontroller or of the computing elements (FPGA, ASIC, μ P, μ C, GAL) which are arranged as essential elements in the control unit. The control unit and/or the individual control units are designed, prepared and set up to coordinate the operation of the system and/or the interaction of the artificial respiration system, the system for inhalation sedation, the metering system, the oxygenation system and the conversion unit and further components and systems and to carry out the comparison operations, the calculation operations, the storage and organization of data quantities, the actuation of actuators and sensors, the detection of measured values by meters and sensors, the processing of data and information and the provision of information and data to components within the system and to components outside the system, which are required for the procedure.

According to the invention, according to a first aspect of the invention, the conversion, distribution or dispensing of the gas quantity is carried out by means of a conversion unit between a respiratory gas connection system, in particular a connection element (Y-piece) close to the patient, and an oxygenation system. The conversion unit, by conversion, distribution or dispensing of the gas quantity, enables the substance provided for inhalation sedation to be conducted together with the breathing gas both into the lungs of the patient and into the blood circulation of the patient via the oxygenation system. This provides advantages, for example, when it is desired to administer inhalation therapy with large amounts of volatile, inhaled drugs or substances by means of a respiratory device or by means of a respiratory system in combination with a system for inhalation sedation and, if desired, also simultaneously or alternatively by means of an oxygenation system.

A further inventive aspect is formed by a gas distribution unit according to the invention as a structural unit at the connection element close to the patient. A compact, space-saving arrangement of small volume close to the entrance to the respiratory tract of the patient is thus obtained. The gas distribution unit according to the invention forms a device for distributing and/or distributing a portion of the breathing gas into the breathing circuit and the blood circuit of a patient and is formed from a common structural unit with at least one switching unit, a breathing gas metering path, a connecting element close to the patient, a gas extraction connection for extracting a portion of the breathing gas from the inhaled gas, and a gas return connection for the inhaled gas. The switching unit, the breathing gas metering path, the connection element close to the patient, the gas return connection for the inhaled gas and the gas extraction connection are constructed and designed as described in the context of the system according to the invention for gaseous delivery of a substance according to the first inventive aspect. The common structural unit has connections for connection to an oxygenation system and a metering system, to an artificial respiration system and to a patient. The breathing gas metering path and the gas return connection can be preferably embodied in the gas distribution unit and can be designed, for example, as an internal line. The flushing gas metering path, the breathing gas connection system, can be preferably and for example constructed by the gas distribution unit as a line, for example in the form of a breathing tube or a hose line to an oxygenation system or to a patient and a breathing system. The supply line of the gas extraction connection to the metering system or to the inhalation sedation system (SIS) is preferably and for example designed as a hose line.

An important advantage of the invention with the first inventive aspect and with the further inventive aspects is thus obtained in its entirety that the distribution of the inhalable substance via the lungs of the patient and extracorporeally administered into the blood circulation of the patient can be performed with the system for substance delivery in combination with the artificial respiration system, the System for Inhalation Sedation (SIS) and the oxygenation system.

In a preferred embodiment, the gas distribution unit may comprise a reflection unit and/or an HME filter and/or further filter elements in a common structural unit. The reflection unit and/or the HME filter are designed and embodied as described in the context of the system according to the invention for the gaseous transport of substances according to the first inventive aspect.

In a preferred embodiment, the gas distribution unit and/or the connection element near the patient has a connection for a measurement gas line, which is provided for connection to a process gas analysis unit.

In a further preferred embodiment, a moistening/heating system for the breathing gas, which is provided for heating the breathing gas, can be arranged in or at the gas distribution unit, in or at the switching unit, in or at the connection unit near the patient, in or at the breathing gas connection system.

In a further preferred embodiment, a mixing chamber can be arranged in or at the gas distribution unit, which mixing chamber is provided for conveying the exhalation gases of the patient by means of an exhaust line for the exhalation gases. The possibility arises with the exhaust line that at least part of the large amount of the inhalation substance in the exhalation gas does not have to be continuously conveyed for purging, but instead the possibility arises of re-evaluating this part of the inhalation substance. This results in savings of inhalation substances, which brings cost advantages and reduces the transport of climatically harmful gases to the environment.

In a further preferred embodiment, the waste gas line for the exhaled air, the gas distribution unit or the mixing chamber has a further absorption unit which is provided for removing carbon dioxide from the exhaled air from the patient. Such a further absorption unit makes it possible to remove carbon dioxide from the exhalation gas and thus also to continuously re-evaluate the remaining amount of the back-introduced inhalation substance in the exhalation gas independently of the breathing phase or independently of the corresponding adjustment of the switching unit for the distribution to the breathing gas metering path and the flushing gas metering path that is present during operation.

In a further preferred embodiment of the system, which also comprises a gas distribution unit according to the further inventive aspect, a device with a flushing gas absorption unit and/or a further gas carrying unit, for example a fan (blower) configured for transporting flushing gas, may be arranged and provided in the oxygenation system or in the flushing gas metering path. The flushing gas absorption unit removes the carbon dioxide component from the exhaled breathing gas, so that the part of the inhaled substance or volatile anesthetic (anesthetic agent) that is not absorbed by the patient can be reused for treatment in the cycle after the removal of the carbon dioxide. The flushing gas absorption unit contains a special type of lime particles (soda lime) as the most part calcium hydroxide (ca (oh))₂) And/or soda lime composed of sodium hydroxide (NaOH) are well known. The carbon dioxide component is removed from the exhaled breath by a chemical reaction with the release of heat and water. In artificial breathing systems, an exhaust gas outlet (waste) is provided, via which the used part of the exhaled breathing gas can be conveyed for disposal. This further preferred embodiment offers the advantage that the flushing gas prepared by means of the flushing gas absorption unit is introduced back into the flushing gas metering path and can subsequently be passed at the membrane into the patient's blood circulation again by means of the oxygenation connection system. Such a device for back-guiding can be referred to as a so-called loop system. The flushing gas absorbing unit removes carbon dioxide component supplied from the patient's blood circulation from the flushing gas, and thus the portion of the inhalable substance or substance not absorbed by the patientVolatile anesthetics (anesthetic agents) can be reused in the circulation for treatment. The further gas carrying unit achieves a reversal of the flushing gas in a circular flow. It is thus possible to avoid that flushing gas enriched with inhalant substances or volatile anesthetics (anesthetic agents) must be conducted through the membrane directly after the first flow as used gas via the waste gas outlet and therefore that substances which are valuable for further treatment cannot be reused. The further gas carrying unit may be arranged in the oxygenation system as a module, for example as an insert module, in combination with the further flush gas absorption unit. The further gas carrying unit and the flushing gas absorption unit may be configured jointly or also separately as separate units or modules, which may be connected to the oxygenation system, for example as external modules.

The flushing gas absorption unit is therefore advantageously designed to remove carbon dioxide constituents from the flushing gas, so that, at the membrane, large amounts of inhalant substances or volatile anesthetics (anesthetic agents) which are not introduced into the blood circuit can be used again in the circuit after the removal of carbon dioxide when the oxygenation system is in operation. The purge gas absorption unit of the oxygenation system comprises lime particles (soda lime), mostly calcium hydroxide (ca (oh)₂) And/or sodium hydroxide (NaOH). The carbon dioxide component is removed from the flush gas by a chemical reaction with the release of heat and water. In the oxygenation system, an exhaust gas outlet (waste) is provided, via which the amount of used flushing gas can be conveyed for disposal. All used gas quantities are mostly introduced into the hospital infrastructure by means of an anesthetic gas discharge system (AGS) and are correspondingly removed professionally. The gas quantity supplied to the process gas analysis unit is mostly introduced into the hospital infrastructure after the analysis and is purged. In some cases, however, these analyzed gas quantities can also be reused and recycled. An embodiment with an open anesthetic gas discharge device (ORS) is also possible, in which the used exhalation gases are filtered or trapped by means of an activated charcoal trap andthe filtered exhaled air is then delivered to the room air.

In a particularly preferred embodiment of the system or of the gas distribution unit, a mixing chamber is arranged in or at the switching unit or in or at the gas distribution unit, which mixing chamber is designed in cooperation with a supply line for the exhalation gases from the respirator to the switching unit for repeated use of a large amount or part of the inhalable substances in the exhalation gases which are supplied for removal in the normal operation of the system for the purpose of supplying the substances via the exhalation valve (exhalation valve) and the exhaust gas outlet of the respirator during the further operation of the system and the course of the therapy. The exhaled gas has a carbon dioxide component which can be removed from the exhaled gas by means of the flush gas absorption unit in a preferred embodiment of the oxygenation system.

In this way, at least in a defined period of time, part of the exhaled air can be introduced into the patient's blood circuit together with any portion of the inhalant substance after removal of the carbon dioxide component via the membrane of the oxygenation system during the course of the artificial respiration therapy and therefore does not have to be conveyed for cleaning.

In a preferred embodiment of the system, in addition to the design already described above as a preferred embodiment for a Process Gas Analysis (PGA) for determining a gas concentration measurement system, a further process gas analysis unit or units (PGA) for analyzing a gas, gas mixture, liquid and/or blood volume is/are arranged in the system or associated with the system which also contains a gas distribution unit according to further inventive aspects. These process gas analysis units may provide the determined data and/or information to the governing unit and/or governing system or to the respective governing unit based on the analysis. These further preferred embodiments provide the advantage that the functional monitoring of the metering of the inhalant, volatile substance or anesthetic agent can be carried out continuously during operation and the influence of the quantity and/or metering change on the patient or on the patient state can be estimated on the basis of this evaluation. Some exemplary possibilities for arranging, deploying and using a process gas analysis cell (PGA) in the system are explained in more detail below.

In a particular embodiment, a process gas analysis unit (PGA) can be arranged in the system at the individual components and can therefore be used independently of one another for the analysis. However, it is also possible and encompassed by the invention as an alternative further embodiment that the process gas analysis unit (PGA-Z) arranged centrally in the system forms an analysis center together with additional switching and distribution control units, for example, designed as controllable and/or managed valve devices. In this case, the respective gas samples are supplied from the artificial respiration system, the oxygenation system and, if appropriate, the system for inhalation sedation or the metering system or the switching unit to the central process gas analysis unit (PGA-Z) by means of a switching and distribution control unit and then analyzed in sequence, one after the other as required, by the central process gas analysis unit (PGA-Z).

The switching and dispensing administration unit delivers gas samples of the various components within the system, in particular by a System for Inhalation Sedation (SIS), an oxygenation system, an oxygenation connection system, a metering system, a switching unit, a gas distribution unit, connection elements near the patient, to a central process gas analysis unit (PGA-Z) and provides for analysis and coordination of the delivery of the gas samples with means for switching, dispensing and delivering. This further preferred embodiment offers the advantage that a process gas analysis unit (PGA) does not have to be arranged separately at each unit or at each module of the system. This can reduce the structural and operational complexity of the components, such as the sensor system, the power supply, the interfaces and the operating software, and simplify the function and cooperation, in particular in the case of a design with a central control unit. The results of the analysis can then be provided in a decentralized or centralized manner to the individual control units or to a central control unit. In a special embodiment, the blood gas analysis unit can also be integrated into a process gas analysis unit (PGA-Z) arranged centrally in the system. A further such process gas analysis unit can be arranged in or at the oxygenation system or in or at the oxygenation connection system or assigned to the oxygenation system or to the oxygenation connection system for the analysis of the flushing gas. Such a further process gas analysis unit (PGA-OS) may provide the determined data to the regulating unit and/or the respective regulating unit on the basis of the analysis. In order to perform extracorporeal membrane lung oxygenation, knowledge about the concentration of carbon dioxide and/or oxygen in the flush gas is very important.

A special design of the process gas analysis unit can be designed in a preferred embodiment as a design of a blood gas analysis unit (BGA) for analyzing blood volume. Such a blood gas analysis unit according to this preferred embodiment can be arranged in or at the oxygenation system or in or at the oxygenation connection system or assigned to the oxygenation system or to the oxygenation connection system. The blood gas analysis unit (BGA) enables analysis of a gas or gas mixture dissolved in the patient's blood, whereby the blood gas analysis unit (BGA) provides, for example, information about O in the blood₂(oxygen), CO₂(carbon dioxide) gas distribution (partial pressure) and knowledge of pH and acid-base equilibrium. The blood gas analysis unit may provide the determined data to the administration unit and/or the respective administration unit based on the analysis.

Knowledge of these values may often be beneficial or important in assessing the effects of anesthesia, artificial respiration, and/or extracorporeal membrane lung oxygenation. This further preferred embodiment offers the advantage that the use of para-O₂(oxygen), CO₂Knowledge of the gas distribution (partial pressure) of (carbon dioxide) monitors the regulation of the oxygenation system. Furthermore, the values obtained regarding the acid-base balance and the pH value in the blood can be used to provide the user with reasonable information about the patient's general condition and the performance of the treatment involved. Furthermore, such a blood gas analysis unit (BGA) can also check and/or monitor the function of the oxygenation system (oxygenator quality) during use. The user can then be given a prompt in time about the current state, such as a possible future state change or performance change of the oxygenator or membrane. The function of the oxygenation system may be hampered, for example, by coagulation effects (coagulation ). Such a blood gas analysis unitThe (BGA) can be arranged in the oxygenation system as a module, for example as a plug-in module, in combination with a process gas analysis unit (PGA-OS). The blood gas analysis unit (BGA) and the process gas analysis unit (PGA-OS) can be designed jointly or individually as separate units or modules, which can be connected to an oxygenation system, for example, as external modules. Such a combination and embodiment as a module, in particular and for example as a plug-in module, offers the advantage that the oxygenation system can be equipped with the module selectively and condition-matched, so that a module for Blood Gas Analysis (BGA) and/or process gas analysis can be provided accordingly before the use of the oxygenation system. Such a process gas analysis unit can therefore be arranged in or at the System for Inhalation Sedation (SIS) or in or at the breathing gas connection system or assigned to the System for Inhalation Sedation (SIS) or the breathing gas connection system for the analysis of breathing gas. Such a process gas analysis unit (PGA-SIS) can correspond to the measuring system for process gas analysis for determining the gas concentration mentioned above in the context of the description of the metering system, or can be designed identically and functionally. Such a process gas analysis unit (PGA-SIS) may provide the determined data to the management and control unit and/or the respective management and control units based on the analysis. In the breathing gas, the determined concentration of the gas, which is important for carrying out artificial respiration or anesthesia, can be known by means of a process gas analysis unit.

For performing artificial respiration, and for performing anesthesia, knowledge about the concentration of carbon dioxide and oxygen in the breathing gas is very important. Furthermore, knowledge about the concentration of gases or inhaled substances, substances used for inhalation sedation or narcotics (narcotics) such as halothane, isoflurane, desflurane, sevoflurane or ether may be of great importance.

In a preferred embodiment of the system, a process gas analysis unit for analysis is arranged in or on the metering system or is assigned to the metering system. Such a process gas analysis unit (PGA-DS) can correspond to the use mentioned above in the context of the description of the metering systemMeasurement systems for the analysis of process gases for determining the gas concentration, or are likewise designed identically and functionally. Such a process gas analysis unit (PGA-DS) can carry out a gas analysis with regard to the determined concentration of the gas in a similar manner to a process gas analysis unit arranged for analysis at an artificial respiration system. In this way, gases (oxygen, laughing gas) or inhalant substances, substances for inhalation of sedation or narcotics (narcotics) such as halothane, isoflurane, desflurane, sevoflurane or diethyl ether, as well as oxygen, nitrous oxide (N), can be determined₂O), laughing gas, heliox, nitric oxide concentration and such a process gas analysis unit (PGA-DS) can thus provide the regulating unit and/or the respective regulating unit with determined data on the basis of such an analysis. This further preferred embodiment offers the advantage that the concentrations of the components and substances in the breathing gas, anesthetic agent, oxygen, laughing gas and further gases together are continuously known during operation and that a regulation and monitoring and regulation of the metering of the gases is effected by a control unit in the metering system itself or in a central control unit.

In a preferred embodiment of the system, a process gas analysis unit for analysis is arranged in or on the conversion unit or associated with the conversion unit. Such a process gas analysis unit (PGA-US) can, in a similar manner to the process gas analysis units arranged for analysis at the metering system, be informed about the gas or inhaled substances, the substances for inhalation of sedation or narcotics (narcotics) such as halothane, isoflurane, desflurane, sevoflurane or diethyl ether, and the concentration of oxygen, and can provide the central control unit and/or the individual control units with determined data on the basis of such an analysis.

Such a further preferred embodiment offers the advantage that the constituents in the breathing gas are known in the operation of the system for delivering substances and allow for a controlled distribution of the gas enriched with the inhalation substance to the breathing gas and flush gas metering paths, together with a specification of the concentration in the conversion unit, in a control unit in the metering system or in a central control unit.

Data and/or information can be provided in the system between the process gas analysis units, the control units, for example, the individual control units designed as control modules, by means of data lines or data connections. The data lines or data connection means are preferably designed as a wired or wireless data network (ethernet, LAN, WLAN, bluetooth, PAN) or bus system (CAN, LON) having data nodes (converters, hubs, routers) for coordinating data and components (databases, servers, routers, access points) for storing and distributing data. A database system for managing patient data, for example in the form of a patient data management system (PMS), can thus be connected to a data network which, in addition to diagnostic and therapeutic information pertaining to the patient, also receives data and/or measured values relating to this patient from the process gas analysis unit, stores them as data records and manages access to them. The data network or bus system may also manage the interaction of the individual control units with the central control unit as a central element of the system, so that at least some components of the system, such as the artificial respiration system, the System for Inhalation Sedation (SIS), the oxygenation system, the metering system, the switching unit, the control units, the individual control units, the control module, the process gas analysis unit, are connected to one another by means of the data network or bus system and can interact in a coordinated manner. Changes in the execution of therapy with artificial respiration, extracorporeal oxygenation and decarboxylation can then be shown in an advantageous manner in combination with patient data, diagnostic data such as EKG, EIT, laboratory data such as blood, urine, cerebrospinal fluid, liquid, respiratory gas or blood gas in a display unit connected to the data network, which enables the user to immediately see and check the effect of the therapy change.

Further preferred embodiments of the data network and/or network connection system CAN be formed by data lines or data connection means, wired or wireless data networks (ethernet, LAN, WLAN, bluetooth, PAN) or bus systems (CAN, LON), data nodes (switches, hubs, routers) for coordinating data, means (databases, servers, routers, access points) for storing data, distributing data, the data network and/or network connection system being designed and arranged to provide and coordinate data in the system, the control unit or individual control units, the blood gas analysis unit, the process gas analysis unit, the artificial respiration system, the System for Inhalation Sedation (SIS), the oxygenation system, the conversion unit, the metering system or further components.

In a preferred embodiment of the system, which also comprises a gas distribution unit according to the further inventive aspect, a system for monitoring the physiology (PPM) of a patient can be arranged in or assigned to the system for delivering a substance. This further preferred embodiment offers the advantage that the influence of the administration of the inhalant and/or of the drug and/or of the anesthetic on the state of the patient, such as the blood oxygen Saturation (SPO), is monitored by means of physiological measurement variables in a measurement technique₂) Carbon dioxide concentration during and at the end of the expiratory phase (end-tidal carbon dioxide concentration, etCO)₂) Heart rate, blood pressure, body temperature. From these measured variables, the user can deduce the current treatment situation of the blood-gas exchange in the lungs, such as the extracorporeal blood-gas exchange, with regard to the removal of carbon dioxide and the delivery of oxygen. It is also possible to use the blood oxygen Saturation (SPO)₂) As a regulating variable for the metering of oxygen in the metering system, it is therefore also possible to manage the distribution of the gas quantity in the switching unit to the artificial respiration system or to the System for Inhalation Sedation (SIS) and oxygenation systems. The carbon dioxide concentration may be used as a basis for governing the extracorporeal blood gas exchange through the oxygenation system, which may be done, for example, by means of matching of the transport volume at the blood transport unit and/or the flow rate of the flushing gas.

In a preferred embodiment of the system for transporting substances, which also comprises a gas distribution unit according to the further inventive aspect, the system for cardiopulmonary imaging and diagnosis can be arranged in or assigned to the system.

This further preferred embodiment offers the advantage that the state of the lungs, and in particular also the change in the condition of the lungs (improvement, healing, deterioration) during the treatment can be tracked during the treatment. Suitable imaging systems are, for example, ultrasound diagnostics, Electrical Impedance Tomography (EIT), Computed Tomography (CT), X-ray examination (X-ray), magnetic resonance imaging (MRT). In particular, electrical impedance imaging is to be emphasized here, since, in contrast to the remaining four systems described, the possibility of continuous imaging of the lungs, chest and heart is provided. Global and/or local changes in the pulmonary state, accompanied by possibly local stretching and collapsing of the lungs, can thus be made visible. The change in the manner of artificial respiration by means of an artificial respiration system and the change in the manner and method of extracorporeal blood gas exchange in combination with an oxygenation system can therefore be made visually and checked quickly in effect by the user.

A particularly preferred embodiment of the system, which also comprises a gas distribution unit according to the further inventive aspects, enables data exchange within the system with components of the system and with a data network or a network-connected system by means of the provision of data. In this case, data exchange between the artificial respiration system, the oxygenation system, the system for inhalation sedation, the metering system, the conversion unit, the administration unit, the process gas analysis unit, the blood gas analysis unit, the system for cardiopulmonary imaging and diagnosis or the system for monitoring the physiology (PPM) of a patient or with a data network or network connection system can be carried out. The regulating unit of the conversion unit, the regulating unit of the metering system or the respective regulating unit in the system thus has the ability to regulate and/or coordinate the conversion unit and/or the metering system. This further preferred embodiment provides the advantage that the previously described advantages of the manageability possibilities and the inspectability of the interaction and interaction of the artificial respiration system, the system for inhalation sedation, the metering system, the switching unit, the oxygenation system can be provided to the user in combination with each other. The data exchange enables the data to be balanced and combined with one another in a time-dependent manner and to show and record trends in the treatment in an overall manner.

In a further preferred embodiment, the regulating unit in the metering system may be configured for regulating the amount of the inhalable substance in dependence on data provided in the data network or network connection system and/or in dependence on data provided by one of the regulating units. The metered input of the metered inhalation substance by the metering system can thus be effected, for example, on the basis of determined blood gas measurements, for example the partial pressure of oxygen or carbon dioxide in the blood, the acid-base equilibrium or the pH value of the blood, which are known from the blood gas analysis unit (BGA), on the basis of measurements from the process gas analysis unit (PGA), such as the concentration of oxygen and carbon dioxide in the respiratory gas, or on the basis of measurements from physiological monitoring (PPM) of the patient, which measurements indicate the state or condition of the circulatory system of the heart, such as blood pressure, heart rate, EKG.

In a further preferred embodiment of the system or of the gas distribution unit, the regulating unit in the conversion unit is configured for regulating the distribution and/or distribution of the volume of inhalation substance into the flushing gas metering path towards the oxygenation system and into the connecting element close to the patient or into the breathing gas metering path towards the reflection unit, depending on data provided in the data network or network connection system and/or depending on data provided by the regulating unit. The administration unit may, inter alia, coordinate or administer the distribution and allocation of the inhalant-rich partial breathing gas into the lungs of the patient or into the blood circulation of the patient via the oxygenation system based on data which are indicative of the current lung condition of the patient and which are provided, for example, by the system for cardiopulmonary imaging and diagnosis in a data network or network connection system. Possible changes in the pulmonary status can thus be made visible continuously and rapidly during treatment with the system of EIT diagnostics (EIT system). The effect of artificial respiration and the manner of use in combination with the oxygenation system can thus be made quickly visible and checked by the user. If data indicating the current state of the ventilation condition of the patient's lungs or a change or trend of the ventilation condition of the patient's lungs is provided in the network, for example by the EIT system, the administration unit of the conversion unit can administer the distribution of a large amount of inhalable substance and/or a large amount of oxygen into the patient's blood circulation or breathing circulation on the basis thereof.

Thus, for example, when the ventilation situation deteriorates, that is to say when it is known from the EIT system that the lung region is either no longer sufficiently ventilated (ventilated) or no longer sufficiently fed (perfused) or neither sufficiently ventilated nor sufficiently fed, the control unit causes the switching unit to dispense a respiratory gas enriched with inhalant substance and optionally oxygen between the respiratory gas metering path and the irrigation gas metering path with an increase in the component of the respiratory gas into the irrigation gas metering path. When it is known by means of the EIT system that the condition of the patient's lungs is improved during the course of a treatment due to a recovery or healing of the patient's lungs, the control unit can cause the conversion unit to distribute a respiratory gas enriched with an inhalable substance and, if necessary, oxygen between the respiratory gas metering path and the flushing gas metering path with an increase in the component of the respiratory gas into the respiratory gas metering path.

Drawings

The invention will now be explained in more detail without limiting the general inventive idea by means of the following figures and the associated description of the figures. In the drawings:

FIG. 1 is a first schematic view of a system for delivering an inhalable substance;

FIG. 2 is a second schematic view of a system for delivering an inhalable substance;

figure 3 is a third schematic view of a system for delivering an inhalable substance.

Detailed Description

Fig. 1 shows in a schematic diagram a patient 30 and a system 1000 for artificial respiration with oxygenation and decarboxylation with the following main components: the artificial respiration device as the artificial respiration system 1, the oxygenation system 2, the breathing gas metering path 3, the flushing gas metering path 4, the breathing gas connecting system 5, the oxygenation connecting system 6, the metering system 7, the switching unit 8, the gas extraction connector 16, the gas return connector 24, the connecting element 25 close to the patient, the reflection unit 18, the delivery line 103 and at least one control unit 9 which is provided and configured for controlling the metering system 7.

The patient 30 is in fluid communication with the artificial respiration system 1 by means of the breathing gas connection system 5 and the connection element 25 near the patient, by means of the endotracheal tube 33 and the respiratory tract inlet 32 for delivering and carrying away breathing gas. Alternatively to the endotracheal tube 33, a nasal mask or tracheostoma may be used. System for Inhalation Sedation (SIS) 17 is essentially composed of a metering system 7, a gas extraction junction 16 for extracting a portion of the respiratory gas from the inhaled gas, a reflection unit 18, and a gas return junction 24 for returning a portion of the respiratory gas from conversion unit 8 to reflection unit 18. Part of the breathing gas is supplied from the breathing prosthesis 1 and delivered to a System for Inhalation Sedation (SIS) 17 by means of the breathing gas connection system 5 and the gas extraction connection 16. By means of a further component/further path of the breathing gas connection system 5, a further portion of the breathing gas quantity which is not enriched with inhalant substances is delivered by the artificial respiration system 1 via the connection element 25 close to the patient directly to the respiratory tract 32 of the patient 30 via the endotracheal tube 33, the nasal mask or the tracheostoma. The portion of the respiratory gas enriched with inhalant substance is passed from the metering system 7 to the conversion unit 8 by means of the delivery line 103. A portion of the breathing gas enriched with the inhalant substance is supplied by the switching unit 8 via the breathing gas metering path 3 to the respiratory tract 32 of the patient 30 via the gas return connection 24 at the connection element 25 close to the patient. Part of the gas enriched with the inhalation substance is supplied to the oxygenation system 2 by the switching unit 8 by means of the flushing gas metering path 4. The conversion unit 8 enables the distribution and/or distribution of the inhalation substance-rich gas quantity to the breathing gas metering path 3 and the flushing gas metering path 4. A large amount of blood enriched with an inhalable substance is delivered by the oxygenation system 2 to the blood circulation of the patient 30 via the oxygenation connection system 6 and the traumatic fluid inlet 31 by means of the flush gas flowing in the flush gas metering path 4. At the membrane 35 arranged in the oxygenation system 2, a qi-blood exchange as well as a qi-blood exchange takes place in the oxygenation system 2. Rich in oxygen O₂And the amount of inspired substance from the oxygenation connection 6 through the surrounding irrigation of the membrane 35 into the blood circulation of the patient 30 and at the same time with a large amount of carbon dioxide CO₂Blood from the patient 30 circulates into the flush gas metering path 4. Artificial respiration systemThe system 1 is configured to provide a breathing gas to a patient 30.

The artificial respiration system 1 is part of an artificial respiration apparatus in a common embodiment. The artificial respiration system 1 for a respiration apparatus generally has means for supplying, delivering and removing respiratory gases and substances to and from a patient, for example a means 67 for mixing gases and a means 27 for conveying gases, such as a gas mixer and at least one gas conveying unit (fan, blower, piston drive, valve arrangement), as well as means for conveying gases, such as a gas connection 60 for conveying gases, such as air and oxygen, a respiratory gas connection 5, which has a form of an artificial respiration tube, for example designed as an inspiratory tube, and often also as an expiratory tube, and a patient-adjacent connection 25, a so-called Y-piece, for connecting the artificial respiration tube to an endotracheal tube 33, a breathing mask or a tracheostoma. Furthermore, the artificial respiration system 1 has an exhalation valve (exhalation valve) 20, via which the exhalation gas which is returned to the artificial respiration device 1 via an exhalation-type artificial respiration hose of the respiration gas connection system 5 can then pass into the surroundings via an exhaust gas outlet 300 as the patient 30 exhales outwards or can be trapped or removed by means of a system for collecting and removing the used gas volume. Furthermore, alternative patient-proximal connection elements 25 are also known, which comprise an exhalation valve close to the patient. In addition to the artificial respiration system 1, the artificial respiration system in a conventional embodiment also has elements, in particular sensors, for detecting, in a measurement technique, the predetermined and/or set pressure, flow and further operating parameters of the mechanical artificial respiration that accompany the delivery of the gas and gas mixture. For the mechanical artificial respiration process, at least the following parameters, such as inspiratory and expiratory artificial respiration pressures, artificial respiration frequency, inspiratory-expiratory ratio, upper and lower pressure limits, upper and lower flow limits, upper and lower volume limits and gas concentration, are adjusted by the control unit 10 and/or monitored by means of the sensing device. Such sensing devices are not shown in this illustration 1000 of fig. 1 for clarity. The metering system 7 is designed for automatic metering by means of the control unit 12 and the metering element 101, and a predetermined quantity of a substance and/or volatile anesthetic (An ä styresieitel) which is dispensed to a portion of the inhalation gas is metered into the delivery line 103 from a reservoir 100 with the inhalation substance and/or volatile anesthetic.

The anesthetic heating device 102 (narkosemitlerw ä rmung) may be activated by the regulating unit 12 in order to transform the inhalant substance present in liquid form in the reservoir 100 into a gaseous state. An alternative embodiment for manual metering or gas mixing is the arrangement of a so-called flow tube which can be used in conjunction with a needle valve and a suspension flowmeter arranged in the riser to achieve gas mixing and/or metering of the inhalation substance or anesthetic agent (An ä stohesiemitttel). The switching unit 8 is configured by means of the regulating unit 9 for dispensing or distributing a quantity of the inhalable substance-rich gas into a delivery line 103 leading to the oxygenation system 2 or towards the connecting element 25 close to the patient. The metering system 7 and the conversion unit 8 are shown in this fig. 1 as individual units, but the conversion unit 8 can also be designed as a component of the metering system 7 in a practical embodiment. The connection element 25 and the reflection unit 18 close to the patient are shown in this fig. 1 as a common unit together with the gas return connection 24. In a practical embodiment, the connection element 25 close to the patient, the reflection unit 18 and the gas return connection 24 can also be designed as individual units. The connection element 25, the reflection unit 18 and the gas return connection 24 close to the patient are shown separately from the gas extraction connection 16 in this fig. 1. In a practical embodiment, the patient-side connecting element 25, the reflection unit 18, the gas return connection 24 and the gas extraction connection 16 can be designed as a common structural unit, for example integrated into the patient-side connecting element 25. The control units 9, 10, 11, 12 can be constructed in a modular manner or as a common control unit and a central control unit 15 (fig. 2) of the system 1000 or 2000 (fig. 2) can be constructed. In the artificial respiration system 1, the mixing of the gases supplied through the gas connection 60 is accomplished by means of a gas mixer 67. The gases, i.e. oxygen and medical air, are mostly supplied to the gas connection 60 by means of a central gas supply unit (ZV). The total amount of breathing gas reaches the patient 30 from the artificial respiration system 1 via the breathing gas connection 5. Part of the breathing gas is extracted from the breathing gas connection system 5 via a gas extraction connection 16 and fed to the metering system 7.

In the artificial respiration system 1, the gas delivery unit 27 or alternatively a piston drive is controlled by means of the control unit 10 in order to deliver breathing gas to the patient 30 and to remove used breathing gas from the patient 30. The administration unit 10 administers the flow of artificial respiration with inspiratory and expiratory artificial respiration pressures, tidal volumes, flows and further artificial respiration adjustments by means of an expiratory valve (expiratory valve) 20 and a gas delivery unit 27. The breathing gas connection 5 is formed by an inspiratory breathing tube for delivering breathing gas and an expiratory breathing tube for removing used exhalation gases of the patient 30, which are connected to one another by means of a patient-adjacent connecting element 25, a so-called Y-piece, for connecting the patient 30. The adjustment and display elements required to administer the artificial respiration system 1 and to perform artificial respiration, sensors for pressure and flow measurement, valves, check valves and further components, which are not shown in this fig. 1 for the sake of clarity. The patient 30 is connected to the oxygenation system 2 by means of an oxygenation connection system 6 for the concomitant transport and entrainment of blood volume into the blood circulation via the traumatic fluid inlet 31. The connection of the patient 30 to the oxygenation system 2 may be accomplished by a fluid connection 37 designed for pumpless extracorporeal membrane lung oxygenation. The transport of the blood volume to and from the patient 30 is accomplished in this embodiment by the pumping capacity of the patient's heart itself. This embodiment is referred to as pumpless extracorporeal membrane pulmonary oxygenation or pumpless extracorporeal lung assist (pECLA). However, the connection of the patient 30 to the oxygenation system 2 is usually carried out by means of a blood transport unit 36, which is usually designed as a pump. Gas enriched with inhalant or volatile substances or anesthetic agents (An ä sthesiementtel) is passed as flushing gas from the switching unit 8 via the flushing gas metering path 4 to the gas connection 34 at the oxygenation system 2. The oxygenation system 2 regulates the flow rate and flow rate of the flush gas into the membrane 35 by means of the regulating unit 11. The membrane is configured to introduce oxygen from the flush gas into the blood and to carry carbon dioxide away from the blood into the flush gas. In this way, blood-gas exchange takes place outside the body (outside the body).

The adjustment and display elements required to further govern the oxygenation system 7 and perform the extracorporeal enrichment (oxygenation) and removal (decarboxylation) of oxygen, the sensors for pressure and flow measurements, valves and further components are not shown in this fig. 1 for clarity. A process gas analysis unit 21 (PGA) assigned to the oxidation system 2 for analyzing the gas composition of the flushing gas is shown as a further important component of the system 1000. The process gas analysis unit 21 has, in addition to the elements of the measurement technique for determining the gas concentration, also elements for display and illustration, which are not shown in this fig. 1, such as operating elements enabling the user to read and operate. The process gas analysis unit 21 assigned to the oxidation system 2 is designed to analyze the gas composition of the flushing gas. The flush gas is fed to the process gas analysis unit 21 and analyzed in the process gas analysis unit 21 in order to monitor the ratio of carbon dioxide and oxygen at the membrane 35, thus determining the gas exchange and transmission rate between the blood circulation and the flush gas and providing patient-adapted regulation of oxygenation and decarboxylation by means of the regulating unit 11. The amount of used gas is removed from the system 1000 by the oxygenation system 2 and by the artificial respiration system 1 via a valve arrangement provided in each case and not shown in this fig. 1 via an exhaust gas outlet (waste) 300. These used gas quantities are mostly introduced from An anesthesia apparatus (An ä sthesieger ä t) into the hospital infrastructure by means of An anesthesia gas discharge system (narkosegas for tuneingssystem) and are correspondingly removed professionally in the infrastructure. Depending on the breathing cycle or the distribution to the blood cycle, the oxygenation and decarboxylation is performed inhalatively with the system 1000 for delivering substances, while artificial respiration is performed with blood gas exchange in the lungs of the patient 30 and/or extracorporeally with blood gas exchange at the membrane 35 of the oxygenation system 2. The user can adjust the ratio between the inhalation administration of the inhalable substance and the external administration of the inhalable substance by means of the switching unit 8. As a support, the measured values and the status values of the process gas analysis unit (PGA) 21 of the oxygenation system 2 are provided to the user.

A data interface 211 may be provided at the artificial respiration system 1, the oxygenation system 2, the metering system 7, the conversion unit 8, which enables unidirectional and/or bidirectional data exchange between the artificial respiration system 1, the oxygenation system 2, the metering system 7, the conversion unit 8 and the System for Inhalation Sedation (SIS) 17. This data exchange preferably manages, facilitates or coordinates the coordination and communication of the administration units 9, 10, 11, 12 in the artificial respiration system 1, the oxygenation system 2, the System for Inhalation Sedation (SIS) 17, the metering system 7, the transformation unit 8. The data interfaces are connected to one another by means of data lines 210 (fig. 2), which are not illustrated in this fig. 1 for the sake of clarity of the illustration, in a wired or wireless manner. A further central control unit 15 (fig. 2), which is not shown in fig. 1, can also be arranged in system 1000 and in systems 2000 (fig. 2) and 3000 (fig. 3) and is provided for coordinating the interaction of artificial respiration system 1, oxygenation system 2, System for Inhalation Sedation (SIS) 17, metering system 7, switching unit 8 in system 1000 via data line 210 (fig. 2), if appropriate also with further components 212, 213 (fig. 2) (database, server, router, access point, hub) in data network 212 (fig. 2) (LAN, WLAN, bluetooth, PAN, ethernet) or network connection system.

Fig. 2 shows a system 2000 with the possibility of expanding the design of a system 1000 for artificial respiration with oxygenation and decarboxylation according to fig. 1.

Like parts in fig. 1 and 2 are denoted by like reference numerals in fig. 1 and 2.

In addition to the elements and components 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 16, 17, 18, 20, 21, 24, 25, 27, 30, 31, 32, 33, 34, 35, 36, 37, 60, 67, 100, 101, 102, 103, 211, 300 shown and described in fig. 1 for the system 1000 (fig. 1), further features and components 15, 19, 22, 23, 26, 28, 38, 39, 70, 75, 210, 212, 213 are also present in the expanded system 2000 according to fig. 2.

The expanded system 2000 thus has an additional gas carrying unit (fan, blower) 38 and a flush gas absorbing unit (carbon dioxide absorber) 39 in the oxygenation system 2. Such a further gas carrying unit 38 may be arranged in the oxygenation system 2 as a module, for example as an insert module, in combination with the flush gas absorption unit 39.

The further gas supply unit 38 and the flushing gas absorption unit 39 can be designed, jointly or individually, as separate units or modules, which can be connected to the oxygenation system 2, for example, as external modules. The expanded system 2000 thus shows a measurement gas line (sample line) 26 which can be connected to the patient-side connecting element 25 or can be connected thereto and via which a sample of the breathing gas obtained at the patient 30 can be fed to the further process gas analysis unit 23 or the blood gas analysis unit 23, so that the process gas analysis unit 23 or the blood gas analysis unit 23 has the measurement-technical ability to determine the concentration of oxygen, carbon dioxide or inhalation substances such as the anesthetic agent An ä dhetikum (anesthetic agent An ä dheimititel) and to know the measured values which indicate these concentrations and to provide a control system 2000. For further analysis, the expanded system 2000 also has a blood gas analysis unit (BGA) 22 in the oxygenation system 2 for analyzing blood gas in the blood of the patient 30. Blood gas analysis for example provides the relevant O₂(oxygen), CO₂(carbon dioxide) gas distribution (partial pressure) and information of the pH and the degree of acid-base equilibrium in the blood of the patient 30. Such a blood gas analysis unit 22 (BGA) can be arranged in the oxygenation system 2 as a module, for example as a plug-in module, in combination with a process gas analysis unit (PGA) 21. The blood gas analysis unit 22 (BGA) and the process gas analysis unit (PGA) 21 can be designed jointly or individually as separate units or modules, which can be connected to the oxygenation system 2, for example as external modules. The conversion unit 8 and the metering unit 7 can also be designed in a common structural unit, so that the process gas analysis unit 23 or the blood gas analysis unitThe evaluation unit 22 can then be arranged both in or on the metering unit 7 and in or on the conversion unit 8 in a common structural unit. The design of the common structural unit, in which the process gas analysis unit or the blood gas analysis unit is arranged, is not shown in this fig. 2 for the sake of clarity. The expanded system 2000 also shows a wetting and/or heating system 75 for tempering the breathing gas in the breathing gas connection system 5 as a further component.

Fig. 3 shows a system 3000 with an extension of the design of the system 1000, 2000 for artificial respiration with oxygenation and decarboxylation according to fig. 1 or 2. Like parts in fig. 1, 2 and 3 are denoted by like reference numerals in fig. 1, 2 and 3.

In addition to the elements and components 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 60, 67, 70, 75, 100, 101, 102, 103, 210, 211, 212, 213, 300 shown and described in fig. 2 for the system 2000 (fig. 2), further components 19, 29 are also present in the expanded system 3000 according to fig. 3. The conversion unit 8 thus has a mixing chamber 19. This mixing chamber 19 is designed and provided to accommodate at least part of the exhaled gas of the patient 30 in this mixing chamber 19 of the conversion unit 8 by means of the exhaust line 29 instead of being able to flow from the exhaust gas outlet 300 into the surroundings, as is shown in the embodiment according to fig. 1 and 2. This portion of the exhaled gas can then be conducted by the mixing chamber 19 of the conversion unit 8 together with the portion of the breathing gas which is delivered by the metering system 7 by means of the delivery line 103 and is enriched with the inhalant substance to the conversion unit 8 and then to the oxygenation system 2 via the flushing gas connection 4. The concentration of carbon dioxide in the gas mixture is reduced in the oxygenation system 2 by the flush gas absorption unit 39 and the portion of the inhalable substance remaining after the patient exhales can be delivered via the oxygenation system 2 again by means of the oxygenation connection system 6. Depending on the selected distribution of the quantity of gas with the inhalation substance between the oxygenation system 2 and the artificial respiration system 1 by the conversion unit 8, the portion of the inhalation substance still present in the exhalation air of the patient 30 can be replaced in the oxygenation system for extracorporeal gas exchange, at least during a defined period of time, during the course of artificial respiration by the artificial respiration apparatus 1, either by flowing into the surroundings via the exhaust air outlet or by having to be purged by means of a discharge or collection system (AGS: anesthetic gas purging device, ORS: open reservoir purging device). The possibility is thus obtained, at least in part, via the exhaust line 29, that the portion of the inhalation substance in the exhalation gas does not have to be continuously supplied for purging, but instead that the portion of the inhalation substance is re-evaluated. When the switching unit 8 is adjusted in such a way that the distribution of the inhalation gas enriched with inhalation substances flows into the oxygenation system 2 substantially via the flushing gas metering path, in particular a considerable share of the remaining amount of inhalation substances in the exhalation gas that are returned to the artificial respiration apparatus in the exhalation gas can be reevaluated in the oxygenation system 2.

If the optional additional absorption unit 68 is introduced into the exhaust gas line 29, into the conversion unit 8 or into the mixing chamber 19 in the conversion unit 8, then carbon dioxide can be removed from the exhalation gas, so that the CO can also be removed independently of the breathing phase or independently of the corresponding adjustment of the distribution to the breathing gas metering path 3 and the flushing gas metering path 4 that is present during operation₂The possibility of the remaining amount of the inhalable substance being reintroduced with the expired gas being provided to the artificial respiration apparatus in the oxygenation system 2 is then continuously re-evaluated.

In the expanded systems 2000, 3000 according to fig. 2 and 3, furthermore, a further process gas analysis unit (PGA) 23 for analyzing the gas 103, which is arranged, for example, at the switching unit 8 or at the metering unit 7, can be provided in the oxygenation system metering path and/or the breathing gas metering path 3, in the flushing gas metering path 4 or from the metering unit 7. Information about the metering and adjustment of the anesthetic dosing (narkosemidose) 100, 101, 102 can therefore be checked in the gas 103 by means of concentration determination in a measurement technique. Depending on the adjusted distribution of gas 103 to conversion unit 8 in the breathing cycle or in the blood cycle, the gas has different oxygen concentrations in breathing gas metering path 3 and in flushing gas metering path 4. A further process gas analysis unit (PGA) 23 can be used to monitor this difference in measurement technology. In this mode of operation, anesthesia is performed with the artificial respiration system 1 by inhalative indirect delivery of volatile anesthetic drugs (anesthetic agents) and of further substances, preferably volatile substances, to the lungs of the patient 30 and indirect delivery of the substances 6, 31 to the blood circulation of the patient 30, with different oxygen concentrations in the breathing gas, depending on the user's wishes, while performing artificial respiration with the exchange of qi and blood directly in the lungs of the patient 30 or ex vivo at the membrane 35 of the oxygenation system 2.

The systems 1000, 2000, 3000 shown in fig. 1 to 3 can be connected for cooperation and for common system operation by means of the data interface 211, the data lines 210 in the data network 212 to further medical devices or systems, for example to the process gas analysis units (PGA) 20, 21, 23, the blood gas analysis unit (BGA) 22, the system 40 for monitoring the physiology (PPM) of the patient and the system 50 for imaging and diagnosis of the heart and lung 50.

Thus the system 1000 and the extended systems 2000, 3000 may have a system 40 for monitoring Patient Physiology (PPM). Such a system 40 for monitoring the physiology of a patient has a display and a graphical representation of detected, determined, analyzed or calculated physiological measurement data and/or parameters. For this purpose, for example, EKG measurement techniques using EKG electrodes and EKG cables on the upper body of the patient, for example, the oxygen Saturation (SPO) in the fingers of the patient 30₂) Detection of non-invasive blood pressure measurements by means of a bandage for measuring blood pressure at the upper arm of the patient 30, detection of invasive blood pressure measurements by means of invasive access points at the hands of the patient 30 and detection of a body temperature of the patient 30, such as skin temperature or body core temperature. Via an optional connection for aspirating off gas and/or a further measurement gas line at the Y-piece 25, a gas sample can be conducted to a system for monitoring the physiology of a patient, which is not shown in detail in fig. 2 and 3System 40 and within the system performs gas analysis, such as analysis of the concentration of carbon dioxide, methane, or other components, such as alcohol (ethanol) of exhaled breath. The regulating unit 12 in the dosing system 7 is thus configured to regulate the amount of the inhalable substance 100 in accordance with data provided in the data network 212 or the network-connected system and/or in accordance with data provided by one of the regulating units 9, 10, 11, 15. The metered input of the metered inhalation substance by the metering system 7 can thus be effected, for example, as a function of the partial pressure of oxygen or carbon dioxide in the blood, the acid-base equilibrium or the pH value of the blood, the concentration of oxygen and carbon dioxide in the respiratory gas or the blood pressure, the heart rate, the EKG. The system 1000 and the expanded systems 2000, 3000 may also have a system 50 for cardiopulmonary imaging and diagnosis which is not shown in detail in fig. 2 and 3. The system 50 for cardiopulmonary imaging and diagnosis is designed, for example, as a device for computed tomography (CT diagnostics), a device for magnetic resonance imaging (MRT diagnostics), an X-ray device (X-ray diagnostics), a device for electrical impedance imaging (EIT diagnostics, EIT systems) or a device for ultrasound diagnostics (US diagnostics, medical ultrasound, doppler medical ultrasound). The system 50 for cardiopulmonary imaging and diagnosis may provide value-laden information to the user, i.e., what disease or rehabilitation state the lungs of the patient 30 are in.

Based on this, the user may configure the systems 1000, 2000, 3000 such that the center of gravity for inhalational delivery of oxygen to the patient 30 is placed on the path through the lungs or invasively placed on the path through the blood circulation via extracorporeal membrane oxygenation (ECMO). An apparatus for electrical impedance imaging (EIT diagnostics) enables continuous imaging of the lungs, chest and heart, unlike CT diagnostics, X-ray diagnostics, MRT diagnostics, US diagnostics. The system 50 with EIT diagnostics (EIT system) can thus continuously and rapidly make possible changes in the lung status visible during treatment. The effect of artificial respiration and the manner of use in combination with the oxygenation system can thus be made quickly visible and checked by the user. If data are provided in the data network 212, for example by the EIT system 50, which data indicate the current state of the ventilation condition of the lungs or a change or trend of the ventilation condition of the lungs of the patient 30, the administration unit 9 of the conversion unit 8 can administer the distribution of the amount of inhalable substance 100 and/or oxygen into the blood circulation or into the respiratory circulation of the patient 30 on the basis thereof. It is thus possible, for example, that when the ventilation situation deteriorates, that is to say when it is known with the EIT system 50 that the lung region is either no longer sufficiently ventilated (ventilated) or no longer sufficiently fed (perfused) or neither sufficiently ventilated nor sufficiently fed, the control unit 9 causes the switching unit 8 to distribute the respiratory gas enriched with the inhalable substance 100 between the respiratory gas metering path 3 and the flushing gas metering path 4 with an increase in the component of the respiratory gas into the flushing gas metering path 4. When it is known by means of the EIT system 50 that the condition of the lungs of the patient 30 has improved during the course of the treatment due to a recovery or healing of the lungs of the patient 30, the control unit 9 can cause the conversion unit 8 to distribute the respiratory gas enriched with the inhalable substance 100 between the respiratory gas metering path 3 and the flushing gas metering path 4 with an increase in the component of the respiratory gas into the respiratory gas metering path 3.

List of reference numerals

1 Artificial respiration System (BS), Artificial respiration apparatus

2 Oxygenation System (OS) (oxygenator)

3 respiratory gas metering path

4 purge gas metering path

5 breathing gas connection system

6 oxygenation connection system

7 metering system (DS)

8 conversion unit

9 management and control unit, management and control module (μ C) of conversion unit₁）

10 management and control unit, artificial respiration equipment/management and control module (mu C) of artificial respiration system₂）

11 management and control unit, management and control module (μ C) of Oxygenation System (OS)₃）

12 management and control unit, management and control module (μ C) of metering system (DS)₄）

15 external management unit, external management module (μ C)_M）

16 gas extraction connection for inhaled breathing gas, i.e. inhalation gas

17 System for Inhalation Sedation (SIS)

18-reflecting unit (CR), element for recovery of anesthetic gases, anesthetic gas reflector

19 mixing chamber at the switching unit

20 inhalation valve of artificial respiration equipment

21 Process gas analysis of oxygenation System (PGA, PGA-OS)

22 blood gas analysis of the oxygenation System (BGA)

23 Process gas analysis of a metering System (PGA, PGA-DS, PGA-SIS)

24 gas return connection for inhaled breathing gas, i.e. inhalation gas

25 connecting element near patient (Y-shaped piece)

26 measurement gas line

27 gas delivery unit (fan, blower, piston drive) in an artificial respiration system

28 Filter element for moisture recovery (HME filter)

29 waste gas line for exhaled air

30 patients and living things

31 traumatic fluid inlet to the blood circulation of a patient

32 respiratory tract entrance, entrance to the respiratory tract of a patient

33 endotracheal tube, alternative nasal mask or tracheostoma

34 gas connection at oxygenation System

35 film, blood-gas exchange film and oxygenator film

36 fluid connector with blood conveying unit (pump)

37 fluid connection in pump-free extracorporeal membrane oxygenation

38 additional gas carrying unit (fan, blower) in or at the oxygenation system

39 flushing a carbon dioxide absorber (CO) in a gas absorption unit, oxygenation system₂Clearing away)

40 System for monitoring Patient Physiology (PPM)

50 System for cardiopulmonary imaging and diagnosis

60 gas connector for delivering gas (oxygen, air) to an artificial respiration apparatus

67 gas mixer for mixing gases (oxygen, air) in an artificial respiration apparatus

68 additional absorption unit

Heating system for blood volume at oxygenation connection system 70

75 humidification/heating system for respiratory gases at a respiratory gas connection system

100 reservoir for inhalant substances or narcotics (Narkosemitel) (narcotic bin)

101 metering element

102 anesthetic heating device

103 for supplying the gas mixture to the switching unit 8

210 data line, data connector, data node

211 data interface, data node, data coordination (converter, hub, router)

212 network connection System, data network (LAN, WLAN, Bluetooth, PAN, Ethernet)

213 Components in a data network (database, Server, Router, Access Point, hub)

300 waste gas outlet (waste)

1000 System (fig. 1)

2000 extended system (fig. 2)

3000 extended system (fig. 3).