SYSTEM FOR SUPPLYING GASES OR GAS MIXTURES WITH FEEDING OF SUBSTANCES

Abstract

A system (1000) for a feeding of substances to a patient (30) with ventilation and oxygenation of the patient. The system (1000) includes a ventilation system (1), an oxygenation system (2), a breathing gas dispensing path (3), a purge gas dispensing path (4), a breathing gas connection system (5), an oxygenation connection system (6), a dispensing system (7), a switching unit (8), and at least one control unit (9). The switching unit (8) is configured for a distribution or splitting of a quantity of a drug or anesthetic active ingredient, which quantity was dispensed into a gas mixture by means of the dispensing system (7), between the ventilation system (1) and the oxygenation system (2). The at least one control unit (9) is configured to control the switching unit (8).

Claims

1. A system for ventilating and oxygenating a patient, the system comprising: a ventilation system with a breathing gas dispensing path, the ventilation system being configured with devices to supply, feed and remove breathing gas mixtures and substances to and from the patient; an oxygenation system with a purge gas dispensing path; a breathing gas connection system connected to the ventilation system, the breathing gas connection system being configured for a gas-carrying connection for supplying, feeding and removing quantities of breathing gas mixtures and substances to and from the patient; an oxygenation connection system connected to the oxygenation system; a dispensing system configured for a dispensing of one or more substances; a switching unit connected to the dispensing system and configured to switch the dispensing of substances of the dispensing system between the breathing gas dispensing path and the purge gas dispensing path wherein: the purge gas dispensing path is configured for connection of the oxygenation system to the dispensing system or to the switching unit and a quantity of a fresh gas mixture, enriched with a quantity of the one or more substance, is supplied as a purge gas from the dispensing system and the switching unit to the oxygenation system by means of the purge gas dispensing path; the oxygenation system comprises a membrane for a gas exchange with a blood circulation of the patient with a feeding of a quantity of oxygen and of a quantity of a volatile substance of the one or more substances into the blood circulation of the patient and a removal of carbon dioxide from the blood circulation of the patient, the oxygenation system comprising devices configured to feed and/or supplying a quantity of the purge gas to the membrane and to supply the patient with quantities of blood enriched with the volatile substance and remove carbon dioxide from the blood circulation of the patient; and the breathing gas dispensing path is configured for connection of the ventilation system to the dispensing system or to the switching unit and a quantity of a fresh gas mixture enriched with a quantity of a volatile substance of the one or more substances is supplied as a breathing gas mixture from the dispensing system and the switching unit to the ventilation system by means of the breathing gas dispensing path; and a controller, comprising at least one control unit, configured to control the switching unit.

2. A system in accordance with claim 1, wherein the dispensing system is configured for a dispensing of volatile substances and/or for a dispensing of volatile anesthetics as the one or more substance.

3. A system in accordance with claim 1, further comprising a blood feed unit arranged in or at the oxygenation connection system and/or at the oxygenation system for transport of quantities of blood to the patient and/or away from the patient.

4. A system in accordance with claim 1, further comprising a gas feed unit arranged in the purge gas dispensing path and/or in the oxygenation system for a transport of gas.

5. A system in accordance with claim 1 or in accordance with claim 4, wherein an absorber unit is arranged in the purge gas dispensing path and/or in the oxygenation system for a removal of carbon dioxide from the purge gas.

6. A system in accordance with claim 1, wherein the controller is configured as a central control system or as a central control unit.

7. A system in accordance with claim 1, wherein: the controller comprises individual control units and the at least one control unit is one of the individual control units forming a non-central control system; and the at least one control unit is arranged as a part of the oxygenation system and/or as a part of the ventilation system.

8. A system in accordance with claim 1, wherein: the controller comprises individual control units and the at least one control unit is one of the individual control units forming a non-central control system; and the non-central control system comprises the at least one control unit as a single control unit in the switching unit and/or a single control unit in the dispensing system and/or an external control unit; wherein one of the single control units and/or the external control unit is configured for a control of the switching unit and/or of the dispensing system.

9. A system in accordance with claim 8, wherein at least one of the control units takes into consideration data provided from the respective ventilation system and/or the oxygenation system in controlling the switching unit.

10. A system in accordance with claim 1, further comprising a process gas analysis unit arranged in or at the ventilation system or in or at the breathing gas connection system or associated with the ventilation system or with the breathing gas connection system and configured for an analysis, wherein the process gas analysis unit is configured to provide data determined on the basis of the analysis to the ventilation system to the system and/or to the at least one control unit.

11. A system in accordance with claim 1, further comprising a process gas analysis unit arranged in or at the oxygenation system, arranged in or at the oxygenation connection system, associated with the oxygenation system, or arranged in or at the oxygenation connection system, wherein the process gas analysis unit is configured to provide analysis data to the system and/or to the at least one control unit.

12. A system in accordance with claim 1, further comprising a central process gas analysis unit, wherein the central process gas analysis together with a switching unit and distribution control unit is configured to carry out analyses of gas samples of the ventilation system, of the breathing gas connection system, of the oxygenation system, of the oxygenation connection system, of the dispensing system or of the switching unit and to provide analysis data determined on the basis of the analysis to the system and/or to the at least one control unit.

13. A system in accordance with claim 1, further comprising a blood gas analysis unit arranged in or at the oxygenation system or in or at the oxygenation connection system or associated with the oxygenation system or with the oxygenation connection system for an analysis, wherein the blood gas analysis unit is configured to provide data determined on the basis of the analysis to the oxygenation system to the system and/or to the at least one control unit.

14. A system in accordance with claim 1, further comprising a process gas analysis unit arranged in or at the switching unit or in or at the dispensing system or associated with the switching unit or with the dispensing system for an analysis, wherein the process gas analysis unit is configured to provide analysis data determined based on analysis to the switching unit, to the dispensing system, to the system and/or to the at least one of the control unit.

15. A system in accordance with claim 1, further comprising an absorber unit arranged in the breathing gas connection system and/or in the ventilation system for a removal of carbon dioxide from the breathing gases.

16. A system in accordance with claim 1, further comprising a data network arranged in or at the system or associated with the system, wherein the data network is configured to provide data to the system, to the at least one control unit, to the ventilation system, to the oxygenation system, to the switching unit, or to the dispensing system to enable therewith the controller to control and/or coordinate the switching unit and/or the dispensing unit.

17. A system in accordance with claim 1, further comprising a physiological patient monitoring system configured to provide data to the system, to the ventilation system, to the oxygenation system, to the dispensing system or to the switching unit and/or to the at least one control unit.

18. A system in accordance with claim 1, further comprising a heart and lung imaging and diagnostic system configured to provide data to the system, to the ventilation system, to the oxygenation system, to the dispensing system, to the switching unit and/or to the at least one control unit.

19. A system in accordance with claim 16, wherein the system is configured to provide data in a data exchange with the data network.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0075] In the drawings:

[0076] FIG. 1 is a first schematic view of a system for ventilation with oxygenation and decarboxylation; and

[0077] FIG. 2 is a schematic view of a second, expanded system for ventilation with oxygenation and decarboxylation.

DESCRIPTION OF PREFERRED EMBODIMENTS

[0078] Referring to the drawings, FIG. 1 shows in a schematic view a patient 30 and a system 1000 for ventilation with oxygenation and decarboxylation with essential principal components: Ventilation system 1, oxygenation system 2, breathing gas dispensing path 3, purge gas dispensing path 4, breathing gas connection system 5, oxygenation connection system 6, dispensing system 7, switching unit 8 and a controller comprising at least one control unit 9 intended and configured for the control of the dispensing system 7. The patient is connected fluidically to the ventilation system 1 by means of the breathing gas connection system 5 for the feeding and removal of breathing gases or breathing gas mixtures. The dispensing system 7 is configured, by means of a control unit 12 of an adjusting element, for an automatic dispensing 101, e.g., in the configuration of an electronic mixer and/or active, usually electronically controlled anesthetic dispenser (electronic vaporizer) or by means of a passive anesthetic dispenser (vaporizer) 102, which may have, for example, a manually actuatable setting element (hand wheel), to dispense a quantity of volatile anesthetic into the fresh gas mixture (FG) 103 from a reservoir 100 containing volatile anesthetic. An alternative embodiment variant for a manual dispensing or mixing of gas would be an arrangement of so-called flow tubes, which can make possible a mixing of gas and/or dispensing of substances or anesthetics in interaction with needle valves and with floating body flowmeters arranged in a rising pipe. The switching unit 8 is configured by means of the control unit 9 for a distribution or splitting of the quantity of the fresh gas 103 enriched with volatile anesthetic to the ventilation system 1 or to the oxygenation system 2.

[0079] The dispensing system 7 and the switching unit 8 are shown as separate units in FIG. 1; however, the switching unit 8 may also be configured as an assembly unit (7) of the dispensing system 7 in embodiments that are used in practice.

[0080] The controller, comprising the control unit 9 and the control unit 12, may have a modular configuration or may be configured as a common control unit and may also form a central control unit 15 of the system 1000. In the dispensing system 7, the fresh gas 103 is prepared by means of a gas mixer (not shown in this schematic overview) of gases supplied by means of a gas port 60. The gases oxygen, nitrous oxide and medical air are fed to the gas port 60—usually by means of a central gas supply unit (GS). A total quantity of enriched fresh gas 103 enters the switching unit from the dispensing system 7 and from there as a respective partial quantity via the purge gas dispensing path 4 to the oxygenation system 2 and as another partial quantity via the breathing gas dispensing path 3 to the ventilation system 1. In the ventilation system 1, a gas feed unit 27 or an alternative usable piston drive 28 is controlled by means of a control unit 10 in order to regulate the feeding of fresh gas (FG) 103 enriched with anesthetic as a breathing gas mixture to the patient 30, as well as the removal of used breathing gases or breathing gas mixtures from the patient 30 and the subsequent removal of carbon dioxide by means of an absorber unit (carbon dioxide absorber) 29 and the subsequent return to the fresh gas (FG) 103.

[0081] The breathing gas connection system 5 is comprised of an inhalation ventilation tube for the feed of the fresh gas (FG) 103 enriched with anesthetic as breathing gas mixture and an exhalation ventilation tube for the removal of the used exhaled gases or breathing gas mixtures of the patient 30, which are connected to one another for the connection of the patient 30 by means of a port and patient connection element 25 located close to the patient, a so-called Y-piece. Setting and display elements, sensors for pressure and flow rates, valves, an APL (adjustable pressure-limiting) valve, a manual ventilation bag, nonreturn valves and other components necessary for the control of the ventilation system 1 and for carrying out the ventilation are not shown in this FIG. 1 for the sake of clarity.

[0082] The patient 30 is connected to the oxygenation system 2 by means of the oxygenation connection system 6 for a supply with feeding and removal of quantities of blood into the blood circulation via an invasive fluid access 31. The patient 30 may be connected to the oxygenation system 2 via a fluid port 37, which is configured for a pumpless extracorporeal membrane oxygenation. In this case, the quantities of blood are transported towards the patient 30 and away from the patient 30 in such an embodiment by the pumping capacity of the heart of the patient themself.

[0083] This process is called pumpless extracorporeal membrane oxygenation or pumpless extracorporeal lung assist (pECLA). However, the patient 30 is connected to the oxygenation system 2 usually by means of a blood feed unit 36, which is usually configured as a pump.

[0084] The fresh gas (FG) 103 enriched with anesthetic enters a gas port 34 at the oxygenation system 2 from the switching unit 8 as purge gas by means of the purge gas dispensing path 4. By means of a control unit 11, the oxygenation system 2 controls a flow quantity and flow rate of purge gas at the membrane 35. The membrane is configured to introduce oxygen from the purge gas into the blood and to scavenge carbon dioxide from the blood into the purge gas. In this manner, a blood-to-gas exchange takes place outside of the body (extracorporeally).

[0085] The setting and display elements, sensors for pressure and flow rates, valves and other components necessary, furthermore, for the control of the oxygenation system 7 and for the carrying out of the extracorporeal enrichment with oxygen (oxygenation) and removal of carbon dioxide (decarboxylation) are not shown in this FIG. 1 for the sake of clarity.

[0086] A process gas analysis unit 20 associated with the ventilation system 1 for an analysis of the gas composition of the breathing gas or of the breathing gas mixture and another process gas analysis unit 21 associated with the oxygenation system 2 for an analysis of the gas composition of the purge gas are shown as other essential components of the system 1000. The process gas analysis units 20, 21 also have elements for display and visualization, as well as operating elements, which enable the user to read and operate, in addition to the measurement-based elements for the determination of gas concentrations. A measured gas line (sample line) 26, through which samples of the breathing gas mixture fed to the patient 30 can be fed to the process gas analysis unit 20, can be connected to the port and connection element 25 located close to the patient, so that the process gas analysis unit 20 is capable of determining by measurement the concentrations of oxygen, carbon dioxide, nitrous oxide or anesthetics and of determining and providing measured values, which indicate these concentrations.

[0087] The other process gas analysis unit 21 associated with the oxygenation system 2 is configured for an analysis of the gas composition of the purge gas. The purge gas is fed to the process gas analysis unit 21 and is analyzed in the process gas analysis unit 21 in order to monitor the ratios of carbon dioxide and oxygen at the membrane 35, so as to determine the gas exchange and the transfer rate between the blood circulation and purge gas and then to provide by means of the control unit 11 a control of oxygenation and decarboxylation that is adequate for the patient. Used gas quantities are removed from the system 1000 by the oxygenation system 2 and the ventilation system 1 via valve arrays, correspondingly provided for this purpose and not shown in FIG. 1, via a waste gas outlet (waste) 300. These used gas quantities are usually introduced from the anesthesia device into the infrastructure of the hospital by means of an anesthesia gas scavenging system and then disposed of therein correspondingly in a timely manner. Depending on the splitting of the fresh gas (FG) 103 in the breathing circuit or in the blood circulation, the carrying out of the anesthesia with substances, preferably volatile substances, especially anesthetics, takes place by inhalation with the ventilation system 1 at the same time as the carrying out of the ventilation with a gas-to-blood exchange in the lungs of the patient 30 or extracorporeally with a gas-to-blood exchange at the membrane 35 of the oxygenation system 2.

[0088] The ratio of the administration of anesthetics by inhalation and extracorporeally and thus the ratio of the anesthesia produced by inhalation to the extracorporeal anesthesia can be set for the user via the switching unit 8. The measured values of the process gas analysis unit (PGA) 20 of the ventilation system, as well as the measured values and status values of the process gas analysis unit (PGA) 21 of the oxygenation system 2 are available to the user as support.

[0089] Data interfaces, which can make possible the unidirectional and/or bidirectional exchange of data between the ventilation system 1, the oxygenation system 2, the dispensing system 7, and the switching unit 8, may be provided at the ventilation system 1, at the oxygenation system 2, at the dispensing system 7, and at the switching unit 8. Such an exchange of data is preferably organized, initiated or coordinated in interaction and communication with the control units 9, 10, 11, 12 in the ventilation system 1, the oxygenation system 2, the dispensing system 7, and the switching unit 8. The data interfaces are connected to one another in a wired or wireless manner by means of data lines 210 (FIG. 2) and data nodes 211 (FIG. 2). An additional central control unit 15 (FIG. 2), not shown in this FIG. 1, may also be arranged in the system 1000, as well as in the system 2000 (FIG. 2) and intended to coordinate via data lines 210 (FIG. 2) the interaction of the ventilation system 1, the oxygenation system 2, the dispensing system 7, and the switching unit 8 in the system 1000, and possibly also with other components 210, 211, 212, 213, 214 (FIG. 2) (database, server, router, access point, hub) in a data network 212 (FIG. 2) (LAN, WLAN, Bluetooth, PAN, Ethernet) or network linking system (214).

[0090] FIG. 2 shows with a system 2000 additional possibilities for expansions and embodiments of the system 1000 according to the present invention for ventilation with oxygenation and decarboxylation according to FIG. 1.

[0091] Identical components in FIG. 1 and in FIG. 2 are designated with the same reference numbers in FIGS. 1 and 2.

[0092] In addition to the elements and components shown in FIG. 1 and described in regard to the system 1000 (FIG. 1) 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 15, 21, 25, 26, 27, 28, 30, 31, 32, 33, 34, 35, 36, 37, 100, 101, 102, 103, 210, 211, 300, other features and components 13, 14, 22, 23, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 50, 57, 61, 212, 213, 214 are present in the expanded system 2000 according to FIG. 2.

[0093] Thus, the expanded system 2000 has optional additional gas ports 61, 62, an additional gas feed unit (blower) 38 and an additional absorber unit (carbon dioxide absorber) 39 in the oxygenation system 2. Such an additional gas feed unit 38 may be arranged in the oxygenation system 2 combined with the other absorber unit 39 as a module, for example, as a type of plug-in module. The additional gas feed unit 38, as well as the additional absorber unit 39, may be configured together or separately also as independent units or modules, which can be connected to the oxygenation system 2, for example, as external modules.

[0094] The expanded system 2000 thus includes a physiological patient monitoring system 40. The physiological patient monitoring system 40 has displays 47 and visualizations of acquired, determined, analyzed or calculated physiological measured data and/or parameters. These include, for example, measurement-based determinations of ECG 44 by means of ECG electrodes on the upper body of the patient 30 and ECG cable 44′, detection of an oxygen saturation (SPO.sub.2) 41′, for example, on a finger 41 of the patient 30, detection of a non-invasive blood pressure measured value 42′ by means of a blood pressure cuff 42 on the upper arm of the patient 30, detection of an invasive blood pressure measured value 46′ by means of an invasive access point on the hand 46 of the patient 30, as well as of a body temperature, for example, of a skin temperature or of a body core temperature of the patient 30.

[0095] Via an optional port for gas suction at the Y-piece 25 and an additional measured gas line 43, gas samples can be sent to the physiological patient monitoring system 40 and gas analyses can be carried out therein, for example, concentrations of carbon dioxide, methane or analyses on other components, for example, alcohols (ethanol) of the exhaled gas or breathing gas mixture.

[0096] The expanded system 2000 has a heart and lung imaging and diagnostic system 50. Heart and lung imaging and diagnostic systems 50 are configured, for example, as devices for computer tomography (CT diagnostics), magnetic resonance imaging (MRI diagnostics), X-ray devices (X-ray diagnostics), devices for electrical impedance tomography (EIT diagnostics) or devices for ultrasound diagnostics (US diagnostic sonography, Doppler sonography). The heart and lung imaging and diagnostic system 50 can provide to the user valuable information about what state of disease or recovery the lungs of the patient 30 are in. Based on this, the user can configure the system 2000 to that effect in order to place the focus of the feed of oxygen to the patient 30 by inhalation on the path via the lungs or by means of the extracorporeal membrane oxygenation invasively on the path via the blood circulation. Unlike CT diagnostics, X-ray diagnostics, MRI diagnostics, US diagnostics, electrical impedance tomography devices 50 (EIT diagnostics) especially make possible a continuous imaging of the lungs, thorax and heart. Possible changes in the state of the lungs can thus be made visible with the EIT diagnostics continuously and in a timely manner during the treatment.

[0097] Effects of the ventilation and of the manner of the combined use with the oxygenation system are thus visible and can be checked in a timely manner. In addition, in the expanded system 2000 it may have an additional process gas analysis unit (PGA) 23, for example, arranged at the switching unit 8 or at the dispensing unit 7 for the analysis of the fresh gas (FG) 103 in the oxygenation dispensing path and/or in the breathing gas dispensing path 3, the purge gas dispensing path 4 or starting from the dispensing unit 7. Thus, information with regard to the dispensing and setting of the anesthetic vaporizer 101, 102 can thus be checked by means of measurement-based concentration determination in the fresh gas 103. Depending on the set splitting of the fresh gas (FG) 103 in the breathing circuit or in the blood circulation and depending on the quantity of additional feeding of oxygen at the additional gas port 61 to the switching unit 8, the gas in the breathing gas dispensing path 3 and the gas in the purge gas dispensing path 4 have different oxygen concentrations. The additional process gas analysis unit (PGA) 23 may be useful to monitor this difference based on measurement. In such a mode of operation, the anesthesia is carried out with the ventilation system 1 with the feeding of volatile anesthetic as well as with the feeding of other substances, preferably volatile substances, by inhalation at the same time as the ventilation is carried out with a gas-to-blood exchange at the membrane 35 of the oxygenation system 2, as desired by the user, with different concentrations of oxygen in the breathing gas or breathing gas mixture indirectly 5, 32, 33 to the lungs of the patient 30 and indirectly 6, 31 into the blood circulation of the patient 30.

[0098] For further analysis, the expanded system 2000 may have, in addition, a blood gas analysis unit (BGA) 22 for the analysis of blood gases in the blood of the patient 30 in the oxygenation system 2. A blood gas analysis provides, for example, information with regard to a gas distribution (partial pressure) of O.sub.2 (oxygen), CO.sub.2 (carbon dioxide) as well as the pH value and the acid-base balance in the blood of the patient 30. Such a blood gas analysis unit 22 (BGA) may be arranged combined with the process gas analysis unit (PGA) 21 as a module, for example, as a type of plug-in module in the oxygenation system 2. The blood gas analysis unit (BGA) 22 and the process gas analysis unit (PGA) 21 may be configured together or separately also as independent units or modules, which can be connected to the oxygenation system 2, for example, as external modules.

[0099] In addition to dispensing of volatile anesthetics 100 by means of anesthetic evaporation 101, 102, feeding of other substances, for example, drugs by drug nebulization, feeding of other gases or gas mixtures, for example, nitrogen monoxide, helium, Heliox may be carried out by means of the additional gas port 62 at the dispensing system 7.

[0100] The systems 1000, 2000 shown in FIGS. 1 and 2 may be connected to the other medical devices or systems, for example, to process gas analysis units 20, 21, 23, blood gas analysis units (BGA) 22, to the physiological patient monitoring (PPM) system 40 as well as to the heart and lung imaging and diagnostic system 50 for an interaction and for a common system operation by means of the data nodes 211, data lines 210 in the data network 212.

[0101] While specific embodiments of the invention have been shown and described in detail to illustrate the application of the principles of the invention, it will be understood that the invention may be embodied otherwise without departing from such principles.

LIST OF REFERENCE NUMBERS

[0102] 1 Ventilation system [0103] 2 Oxygenation system (oxygenator) [0104] 3 Breathing gas dispensing path [0105] 4 Purge gas dispensing path [0106] 5 Breathing gas connection system [0107] 6 Oxygenation connection system [0108] 7 Dispensing system [0109] 8 Switching unit [0110] 9 Control unit, control module (μC1) of the switching unit [0111] 10 Control unit, control module (μC2) of the ventilation system [0112] 11 Control unit, control module (μC3) of the oxygenation system [0113] 12 Control unit, control module (μC4) of the dispensing system [0114] 13 Control unit, control module (μC5) of the imaging system [0115] 14 Control unit, control module (μC6) of the physiological patient monitoring (PPM) system [0116] 15 External control unit, external control module (μCM) [0117] 20 Process gas analysis (PGA, PGA-VS) of the ventilation system [0118] 21 Process gas analysis (PGA, PGA-OS) of the oxygenation system [0119] 22 Blood gas analysis (BGA) of the oxygenation system [0120] 23 Process gas analysis (PGA, PGA-DS) at the dispensing system/switching unit [0121] 25 Port and connection element (Y-piece) of the breathing gas connection system located close to the patient [0122] 26 Measured gas line for connection of the port and connection element located close to the patient to the process gas analysis of the ventilation system [0123] 27 Gas feed unit (blower) in the ventilation system [0124] 28 Alternative gas feed unit (piston drive) in the ventilation system [0125] 29 Absorber unit, carbon dioxide absorber (CO.sub.2 remove) in the ventilation system [0126] 30 Patient, living being [0127] 31 Invasive fluid access to the blood circulation of the patient [0128] 32 Access to the airways of the patient [0129] 33 Endotracheal tube, alternative nasal mask or tracheostoma [0130] 34 Gas port at the oxygenation system [0131] 35 Membrane, blood<->gas exchange membrane, oxygenator membrane [0132] 36 Fluid port with blood feed unit (pump) for feeding quantities of blood between the patient and the membrane [0133] 37 Fluid port in case of pumpless extracorporeal membrane oxygenation [0134] 38 Gas port with additional gas feed unit (blower) in or at the oxygenation system, (possibly as plug-in module) [0135] 39 Absorber unit, carbon dioxide absorber (CO.sub.2 remove) in the oxygenation system [0136] 40 Physiological patient monitoring (PPM) system [0137] 41 Oxygen saturation (SPO.sub.2) measuring point (hand, finger) [0138] 41′ Oxygen saturation (SPO.sub.2) measuring line [0139] 42 Non-invasive blood pressure (NIBP) measurement, blood pressure cuff [0140] 42′ Connecting line to the blood pressure cuff [0141] 43 Port for process gas analysis of breathing gases of the patient [0142] 44 ECG measurement, arrangement of ECG electrodes on the patient [0143] 44′ ECG connection cable [0144] 45 Invasive blood pressure (IBP) measurement [0145] 46 Invasive access point (back of hand) at the patient [0146] 46′ Invasive access line [0147] 47 Display of physiological measured values (NIBP, IBP, ECG, CO.sub.2, SPO.sub.2, HR, temperature) in the form of numerical values, diagrams, graphs [0148] 50 Heart and lung imaging and diagnostic system (EIT, CT, MRI, X-ray, ultrasound) [0149] 57 Display of images, diagrams, graphs, numerical values [0150] 60 Gas port for feeding oxygen, nitrous oxide, air to the dispensing system [0151] 61 Additional gas port at the switching unit [0152] 62 Additional gas port at the dispensing system for feeding an additional other gas, e.g., oxygen to the dispensing system [0153] 70 Heating system for quantities of blood at the oxygenation connection system [0154] 75 Humidification and/or heating system for breathing as at the breathing gas connection system [0155] 100 Reservoir (tank) containing volatile substances, volatile anesthetics [0156] 101 Anesthetic dispenser (vaporizer) with adjusting element for the automated feed of quantities of volatile anesthetics into the fresh gas (FG) mixture [0157] 102 Anesthetic dispenser (vaporizer) with manually actuatable setting element (hand wheel) for dispensing of volatile anesthetics into the fresh gas (FG) mixture [0158] 103 Supply of the fresh gas mixture to the switching unit 8 [0159] 210 Data lines, data links, data nodes [0160] 211 Data nodes, data coordination (switch, hub, router) [0161] 212 Data network (LAN, WLAN, Bluetooth, PAN, Ethernet) [0162] 213 Components in the data network (database, server, router, access point, hub) [0163] 214 Network linking system [0164] 300 Waste gas outlet (waste) [0165] 1000 System (FIG. 1) [0166] 2000 Expanded system (FIG. 2)