Device and method for providing a breathing gas stream

Abstract

A device 10 for providing a breathing gas stream, which contains a therapeutically active substance, for the mechanical respiration and/or mechanical breathing assistance of a patient, wherein the device 10 has at least one first line 21, through which a first gas stream 31 flows during the operation of the device, and wherein the device 10 has at least one second line 22, wherein the first line 21 and the second line 22 have a common section 13, and wherein the first line 21 and the second line 22 are connected to one another by a water vapor-permeable membrane 24 in the area of the common flow section 13, the present invention provides for a second gas stream 32 to flow through the second line 22 during the operation of the device.

Claims

1. A device for providing a breathing gas stream, which contains a therapeutically active substance, for the mechanical respiration and/or mechanical breathing assistance of a patient, the device comprising: a water vapor-permeable membrane; a first line through which a first gas stream flows during the operation of the device, wherein a therapeutically active substance is delivered to the first gas stream; a second line through which a second gas stream flows during the operation of the device, the second gas stream comprising a humidified gas stream, wherein the first line and the second line have a common flow section and the first line and the second line are connected to one another in the area of the common flow section by the water vapor-permeable membrane; an adapter connected to, and being in flow connection with, the first line and the second line, the adapter establishing a flow connection between the first and second lines and an airway of the patient, the adapter including a mixing chamber to mix together the first and second gas streams.

2. The device in accordance with claim 1, wherein the first and second lines are arranged coaxially to one another in the area of the common flow section.

3. The device in accordance with claim 1, wherein the therapeutic substance is to be administered in the form of a respirable aerosol.

4. The device in accordance with claim 1, wherein the first line or the second line comprises a flexible tube.

5. The device in accordance with claim 1, wherein the first line and the second line have a common flexible tube wall, which is formed by the water vapor-permeable membrane in the area of the common flow section.

6. The device in accordance with claim 1, wherein the first line is arranged within the second line in the area of the common flow section.

7. The device in accordance with claim 1, wherein the residence time of the first gas stream, in the area of the common flow section, during the operation of the device is at least 1 sec.

8. The device in accordance with claim 1, wherein the first gas stream is a laminar gas stream.

9. The device in accordance with claim 1, wherein the second gas stream has a principal direction of flow that corresponds to the direction in which the first gas stream also flows, in the area of the common flow section.

10. A method for providing a breathing gas stream, which contains a therapeutically active substance, for the mechanical respiration and/or mechanical breathing assistance of a patient, the method comprising the steps of: providing a device comprising a water vapor-permeable membrane, a first line through which a first gas stream flows during the operation of the device and a second line through which a second gas stream flows during the operation of the device, wherein the first line and the second line have a common flow section and the first line and the second line are connected to one another in the area of the common flow section by the water vapor-permeable membrane; feeding of the therapeutically active substance to the first gas stream; humidifying the second gas stream such that the second gas stream is a humidified second gas stream, said humidifying being performed before inhalation of the second gas stream by the patient; and humidifying the first gas stream, which contains the therapeutically active substance, by means of the humidified second gas stream, wherein the humidification of the first gas stream is carried out by the humidified second gas stream and the first gas stream, which contains the therapeutically active substance, being sent simultaneously along the water vapor-permeable membrane, which separates the first gas stream and the second gas stream from each other, the first gas stream comprising an average flow velocity of less than 3 m/s, wherein a residence time of the first gas stream in the common flow section is at least one second and at most 120 seconds, where the first and second gas streams are mixed prior to inhalation by the patient.

11. The method in accordance with claim 10, wherein: the first gas stream contains the therapeutic substance to be administered in the form of a respirable aerosol.

12. The device in accordance with claim 1, wherein the first line has a diameter of eight to twenty-five millimeters, the second line comprising a second line diameter, the second line diameter being equal to at least the diameter of the first line, wherein a length of the common flow sections is equal to 0.5 m and 3.5 m.

13. A method for mechanically assisting breathing of a patient, the method comprising the steps of: providing a breathing gas stream for mechanical inspiration of the patient; dividing the breathing gas stream into a first gas stream and a separate second gas stream before inspiration by the patient; adding a therapeutically active substance to the first gas stream after said dividing; humidifying the second gas stream after said dividing, and before the inspiration of the second gas stream by the patient; providing a common flow section with a first line and a second line, said first line and said second line in said common flow section each being defined, at least in part, by a water vapor-permeable membrane; flowing the first gas stream through said first line of said common flow section after said step of adding the therapeutically active substance and before inspiration by the patient; feeding the first and second gas streams to the patient for the mechanical inspiration of the patient, said step of feeding being performed after said step of adding the active substance, and after said step of humidifying the second gas stream.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

(1) In the drawings:

(2) FIG. 1 is a schematic view of a device according to the present invention in a co-flow arrangement; and

(3) FIG. 2 is a schematic view of a device according to the present invention in the counterflow arrangement.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

(4) Referring to the drawings in particular, it is recognized in FIG. 1 that a patient 16 is connected to a device 10 according to the present invention via an adapter 15, 15.

(5) Device 10 has a breathing assistance device 4, a humidifying device 11, a control unit 5, a regulating device 8 as well as a device 9 for admixing aerosol particles.

(6) The breathing assistance device 4 has a gas inlet 2 and a gas outlet 1. The breathing assistance device 4 is connected, in addition, to a flexible inspiration tube 20 and to an optionally present flexible expiration tube 17.

(7) A first line 21, which leads to the regulating device 8, branches off from the flexible inspiration tube 20. The first line 21 leads from the regulating device 8 further to the device 9 for admixing aerosol particles. The first line 21 leads from the device 9 for admixing aerosol particles to the adapter 15.

(8) The flexible inspiration tube 20 connects, in addition, the breathing assistance device 4 to the humidifying device 11. The humidifying device 11 comprises, just as the humidifying device 11 shown in FIG. 2, a heating device 113, a water reservoir 112 and a flow chamber 111. The flexible inspiration tube 20 leads as a second line 22 from the humidifying device 11 to the adapter 15. The second line 22 is thus part of the flexible inspiration tube 20.

(9) It is recognized that the first line 21 and the second line 22 have a common flow section 13. This common flow section 13 is formed between the humidifying device 11 or the device 9 for admixing aerosol particles and the adapter 15. In other words, the common flow section 13 is formed downstream of the device 9 for admixing aerosol particles. The common flow section 13 is formed, in particular, in the area of the flexible inspiration tube 20. The first line 21 extends in the area of this common flow section 13 within the second line 22. The first line 21 and the second line 22 are arranged coaxially to one another, i.e., they have a common axis of rotation.

(10) The breathing assistance device 4 is connected, furthermore, to the adapter 15 via the optionally present flexible expiration tube 17. The expired air 34 is sent back from the patient to the breathing assistance device 4 through the flexible expiration tube 17. Just like the expiration line 17 shown in FIG. 2, the expiration line 17 is provided with a filter 6.

(11) It is recognized in FIG. 1 that the breathing assistance device 4 releases a breathing gas stream 30, which flows through the inspiration line 20. If a flexible expiration tube 17 is present, the expired air 34 flows back to the breathing assistance device 4 through the flexible expiration tube 17 in this example.

(12) A first gas stream 31 is branched off from the breathing gas stream 30 in the area in which the first line 21 branches off from the inspiration line 20. The first gas stream 31 thus flows through the first line 21.

(13) The first gas stream 31 is sent in this case from the first line 21 to the regulating device 8 and from there further to the device 9 for admixing aerosol particles.

(14) FIG. 1 shows, furthermore, that a further, assisting gas stream 33 can be fed to the device 9 for admixing aerosol particles from an optionally present pressurized gas supply unit 3 via the control unit 5. Regardless of this feed of another gas stream 33, a therapeutically active substance is added to the first gas stream 31 in the device 9 for admixing aerosol particles 9. The device 9 for admixing aerosol particles 9 is preferably an atomizer. The first gas stream 31 is a therapeutic first gas stream 31, i.e., a gas stream 31, which contains a therapeutically active substance, after admixing the aerosol particles. This gas stream 31 is sent from the device 9 for admixing aerosol particles to the adapter 15, 15. The first gas stream 31 is sent now along the common flow section 13.

(15) The breathing gas stream, which remains after branching off the first gas stream 31 and flows further in the inspiration line 20 to the humidifying chamber 11, forms a second gas stream 32. This second gas stream 32 flows through the humidifying chamber 11 and can be humidified in the process. The second gas stream 32 enters from the humidifying chamber 11 the second line 22. Thus, the second gas stream 32, which arrives as a humidified gas stream from the humidifying chamber 11, consequently flows through the second line 22.

(16) It is recognized in FIG. 1 that the humidified second gas stream 32 flows around the first line 21 extending within the second line 22 in the area of the common flow section 13. The humidified gas stream 32 of the second line 22 thus flows around the therapeutic breathing gas stream, i.e., the first gas stream 31, in the first line 21. A membrane 24 is arranged between the flow of the first line 21 and the second line 22 in the area of the common flow section 13. This membrane 24 separates the first gas stream 31 and the second gas stream 32 from each other. The membrane 24 forms, in this case, the wall (the full circumference of the tubular wall) of the first line 21 in the area of the common flow section 13. Membrane 24 is permeable to water vapor, so that moisture can pass over from the second gas stream 32 of the second line 22 into the therapeutic first gas stream 31 in the first line 21 in the area of the common flow section 13. The water vapor permeable membrane 24 may be, for example, Gore-Tex (PTFE or-Teflon, respectively) or a pervaporation membrane, e.g., a membrane made of PBT (Polybutylenterephthalat) or the like.

(17) It is recognized that the first gas stream 31 and the second gas stream 32 enter the common flow section 13 with different moisture contents. The moisture content of the first gas stream 31 will then become equalized with the moisture content of the second gas stream 32 over the course of the common flow section 13 due to moisture diffusing through the water vapor-permeable membrane 24. However, it is not necessary in the sense of the present invention at all for the two gas streams 31, 32 to reach an identical moisture content at the end. The first and second gas streams 31, 32 flow in the same direction as co-flows in the area of the common flow section 13. The device 10 is therefore in a co-flow arrangement.

(18) The device 10 according to the present invention in FIG. 1 has, furthermore, just like the device 10 shown in FIG. 2, a heater 12, which heats the second line 22. It is, for example, a resistance wire, a heating coil or a heating foil. Any other tube heater is likewise suitable in the sense of the present invention. The device shown in FIG. 1 has, furthermore, a temperature sensor 14 to check the temperature of the breathing gas stream. This preferably detects the temperature in the area of the adapter 15, 15. It is possible in this manner to check, above all, whether the breathing gas stream flowing directly into the airways of the patient 16 has the desired physiological temperature.

(19) A design according to the present invention of a device in a counterflow arrangement is recognized in FIG. 2. A patient 16 is connected to a device 10, according to the present invention, via an adapter 15 in this case as well. As was already described in reference to FIG. 1, adapter 15 is preferably a breathing mask. The device 10 has a breathing assistance device 4 with a gas inlet 2 and with a gas outlet 1, a humidifying device 11, a control unit 5, a regulating device 6 as well as a device 9 for admixing aerosol particles in this case as well.

(20) The breathing assistance device 4 is connected to the humidifying device 11 via a flexible inspiration tube 20 in the example shown in FIG. 2 as well. The first line 21, which connects the breathing assistance device 4 to the regulating device 8 and leads from the regulating device 8 further to the device 9 for admixing aerosol particles, branches off from the flexible inspiration tube 20.

(21) The flexible inspiration tube 20 leads in this example directly from the humidifying device 11 to the adapter 15. A flexible expiration tube 17 leads from the adapter 15 back to the breathing assistance device 4. The flexible expiration tube 17 represents the second line 22 in this exemplary embodiment. The first line 21 is arranged in this case in the area of the common flow section 13 in the flexible expiration tube 17. In other words, the second line 22 is part of the flexible expiration tube 17 in this case. The common flow section 13 is consequently also formed in the area of the flexible expiration tube 17, namely, between the adapter 15 and the device 9 for admixing aerosol particles or the breathing assistance device 4, in this exemplary embodiment.

(22) It is thus recognized on the basis of FIGS. 1 and 2 that the common flow section 13 comprises in any case a section of the first line 21 that is formed between the device 9 for admixing aerosol particles and the adapter 15. In particular, the flow section 13 is formed downstream of the device 9 for admixing aerosol particles in reference to the first gas stream 31.

(23) The first gas stream 31 is a gas stream that is branched off from the breathing gas stream 30 in the example shown in FIG. 2 as well. The second gas stream 32 is now the part of the breathing gas stream 30 that is humidified in the humidifying chamber 11. The second gas stream 32 is then inspired at first by the patient and flows as a humidified expiratory (expired) gas stream 32 through the expiration line 17, i.e., consequently through the second line 22. In the area of the common flow section 13, the principal direction of flow of the second gas stream 32 in the second line 22 is opposite the direction of flow of the first gas stream 31 in the first line 21. The first gas stream 31 and the second gas stream 32 are consequently led in a counterflow arrangement.

(24) The present invention is not limited to one of the above-described embodiments, but may be varied in many different ways.

(25) Adapter 15 is preferably a breathing mask. As an alternative, adapter 15 may also be an adapter 15 that is suitable for tracheal gas insufflation instead of a breathing mask.

(26) Thus, the second line 22 may extend within the first line 21 in an alternative embodiment.

(27) All the features and advantages appearing from the claims, the specification and the drawings, including design details, arrangements in space and method steps, may be essential for the present invention both in themselves and in a great variety of combinations.

(28) It is recognized that it is advantageous in a device 10 for providing a breathing gas stream, which contains a therapeutically active substance, for the mechanical respiration and/or mechanical breathing assistance of a patient, wherein the device 10 has at least one first line 21, through which a first gas stream 31 flows during the operation of the device, wherein the first line 21 and the second line 22 have a common flow section 13, and wherein the first line 21 and the second line 22 are connected to one another by a water vapor-permeable membrane 24 (that forms the full circumference of the tubular wall) in the area of the common flow section 13, if a second gas stream 32 flows through the second line 22 during the operation of the device, wherein the first and second lines 21, 22 are arranged coaxially to one another in the area of the common flow section 13. It is favorable in this case, furthermore, if the first or second gas stream 31, 32 contains the therapeutic substance to be administered, wherein the substance is preferably an aerosol, especially preferably a respirable aerosol. It is advantageous, in addition, if the first or second gas stream 31, 32 is a humidified gas stream. It is favorable in this case if the first line 21 is arranged within the second line 22 in the area of the common flow section 13. It is advantageous, in particular, if the first line 21 and/or the second line 22 is designed as a flexible tube. Both lines 21, 22 are preferably in the form of a flexible tube in this case.

(29) It is favorable in any case if the first line 21 and/or second line 22 has a wall, preferably a tube wall, which is formed by the water vapor-permeable membrane 24 in the area of the common flow section 13. It is advantageous in such a device if the first gas stream 31 has a mean velocity of flow of less than 3 m/sec, preferably 2.5 m/sec or less, especially preferably 2.2 m/sec or less, and especially preferably 2 m/sec or less during the operation of the device, if the residence time of the first gas stream 31 in the area of the common flow section 13 is at least 1 sec or more, preferably at least 2 sec or more and especially preferably at least 3 sec or more during the operation of the device, and/or if the residence time of the first gas stream 31 in the area of the common flow section 13 is at most 120 sec or less, preferably at most 90 sec or less and especially preferably at most 60 sec or less during the operation of the device. The first line 21 (the inner tube) may have a preferred diameter of 4 to 10 mm in case the device is used for neonates. The first line 21 (the inner tube) may have a preferred tube diameter of 8 to 25 mm in case the device is used for adults. The second line 22 (the outer tube) may have a tube diameter that is the size of the first line 21 and an additional 6 to 20 mm. The length of the common flow section 13 may be between 1 and 3 m in a preferred embodiment. It is possible for the length to vary between 0.5 and 3.5 m. The tube diameter of the inner tube 21 and the outer tube 22 is of course not restricted to the mentioned dimensions but can vary between 4 to 25 mm or even 3 to 30 mm. Also the outer diameter may be not only 6-20 mm larger than the inner diameter but may be larger in a range of 4-30-mm or about 3-25 mm larger than the Inner diameter.

(30) It is recognized in this connection that it is favorable if the first gas stream 31 is a laminar gas stream. It may be advantageous now if the second gas stream 32 has a principal direction of flow that corresponds to the direction in which the first gas stream 31 is also flows in the area of the common flow section 13. However, it may also be advantageous if the second gas stream 32 has a principal direction of flow that is opposite the direction in which the first gas stream 31 flows in the area of the common flow section 13.

(31) It is recognized, furthermore, that it is favorable in a method for providing a breathing gas stream that contains a therapeutically active substance for the mechanical respiration and/or mechanical breathing assistance of a patient if the method comprises the following steps:

(32) a) Provision of a first gas stream 31,

(33) b) Feeding of the therapeutically active substance to the first gas stream 31,

(34) c) Provision of a second gas stream 32,

(35) d) Humidification of the first gas stream 31, which contains the therapeutically active substance, by means of the humidified second gas stream 32, wherein the humidification of the first gas stream 31 in step e) is carried out by the humidified second gas stream 32 and the first gas stream 31, which contains the therapeutically active substance, being sent simultaneously along a water vapor-permeable membrane 24, which separates the first gas stream 31 and the second gas stream 32 from one another.

(36) It is especially advantageous if the method comprises as a further step f) the mixing of the humidified first gas stream 31 with the humidified second gas stream 32. The great advantage of the use of a device 10 according to the present invention for carrying out such a method is recognized in this connection.

(37) 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.

APPENDIX

(38) TABLE-US-00001 LIST OF REFERENCE NUMBERS 1 Gas outlet 2 Gas inlet 3 Pressurized gas supply unit 4 Breathing assistance device 5 Control unit 6 Filter 8 Regulating device 9 Device for admixing aerosol particles 10 Device 11 Humidifying device 111 Flow chamber 112 Water reservoir 113 Heating device 12 Heater 13 Common flow section 14 Temperature sensor 15, 15 Adapter 16 Patient 17 Flexible expiration tube 21 First line 22 Second line 24 Membrane 30 Breathing gas stream 31 First gas stream 32 Second gas stream 33 Gas stream 34 Expired air