DE1566675C - Medical ventilator - Google Patents

Description

The invention relates to medical ventilation that is guaranteed if the patient does not make any attempts at canceling an anesthesia and treatment of unsatisfactory breathing, or if one is already breathing, consisting of an inhalation bellows. interrupts initiated natural breathing,
for the supply of anesthetic gas and / or other Patient-controlled valve drives with which the inhaled gas and an exhalation control breathing valve and the exhalation valve from a valve for the control of the exhalation periods, inhalation period in an exhalation period and the operation of the valves can be reversed with the help of the io, that a time control switch Control determining inhalation and exhalation periods is provided, the controllable control resistors device is adjustable and the device has for setting the breathing periods and a spontaneous attempt at breathing by the patient is connected to the switches in order to ensure that breathing is ongoing ungs period in the other possible valve drives to periodically control that a full breathing period can be reversed. "\ 15 lumen-eating device is provided, which is

Known medical ventilators this development of a set limit value for the patient Type can be gas or gas in or out of the patient based on a time cycle Volume cycle or with a pressure cycle responds to the volume and thereby the time control circuit work. When operating on the basis of the time cycle to initiate a new breathing period according to that from the USA.- controls that a gas pressure measuring device pre-patent 3 101708 known embodiment will be seen that when determining a fixed pressure the Ventilator alone with the help of an electrical limit value of the patient received or niche control regulated ", i.e. the control adjusts the gas coming from the patient and responds the device in. previously determinable periods of the time control circuit to initiate a an inhalation period reverses into an exhalation period 25 new breathing period that the end of each and vice versa by analogous control of the inhalation and exhalation period in dependence Valves around to artificially relieve the patient of the respective setting of the control reluctance to breathe. levels can be determined and that the volumetric

In other known devices with a device and the pressure measuring device with the

Pressure or volume cycle can work, 30 time control circuit is optionally available individually or in Kbmbi-

the pressure or the volume of the patient's nation can be put into operation with the help of switches

incoming gas and coming from the patient.

determined, wherein the ventilator is reversed by an atomic The principle and advantages of this ventilation Mung period to the other, as soon as the device is based essentially on the fact '■ that the undas in spontaneous respiration attempts by the gas pressure and 35 time control circuit constantly in operation gas volume a particular The limit value depends on whether the pressure or volume measurement has reached. Other devices also offer the possibility of setting the device, or whether the set speed, either with a pressure cycle or a limit value for reversing the time control circuit, volume cycle or with both cycles simultaneously or not, always ensures that it is operated so that the fixed pressure 40 the patient at least one time-regulated loading or volume limit value, the z. B. in the case of a respiratory cycle, that is, ventilation on which the patient is first to be mentioned, the Um- ten time cycle basis, is offered.
Control of the device in the other respiratory period. If the volume or pressure measuring device requires. ', is working or is set, which is expedient

It will be understood that doctors or anesthetists 45 would be the case with the patient breathing naturally

If necessary, one of these three above-mentioned is, then the measuring devices or the

Will prefer working methods. In addition, the measuring device currently in operation is included

Doctors also often find different determinations of the volume or pressure limit value

view which working method of the device time control circuit to initiate a new at-

Under certain circumstances, the most favorable is where to adjust and override the mation period so that

with it must still be taken into account that the respiratory period alone differs from the natural

during an operation it can be found that the patient's mood is being determined. But should be about working with a print cycle better, "the patient does not breathe ^naturally: then takes over

than with a volume cycle. the time control circuit alone controls the system

The ventilators known to date offer 55 advises. The same is true if the patient is after

However, the anesthetist does not have the option of producing natural breathing from any

with a single device optionally with time, reason suddenly stops breathing because in this

To work pressure or volume cycles, so that the At-

these devices are automatically relevant again with regard to their possible uses,

are limited and therefore for the doctor and pa- 60 so that the set with the control resistors

did not provide the best possible level of safety when breathing periods were never exceeded

Represent operation. can be.

Accordingly, the object of the invention consists in The invention is based on one in the drawing

the creation of a medical ventilator, the embodiment shown in more detail

that clarifies all three mentioned operational 65 to the anesthetist,

offers possibilities in one device and in which it shows

it is guaranteed that when working with pressure or F i g 1 a scheme of the gas cycle of the beat volume cycles even then a faultless ventilator according to the invention,

5 6

Fig. 2 a simplified representation of the electrical system by actuating a hand bellows 26 as a gas reserve

tric control of the ventilator, 'voir is controlled.

Fig. 3 is a circuit diagram for a remote monitor. The gas circuit according to Fig. 1 has seven gas connections

unit for a device according to Fig. 1, - 'conclusions, namely a first closed

Fig. 4 is a circuit diagram of part of Fig. 2 with 5 terminal 27, a second closed terminal

another switch arrangement. . 28, a connection 29 for the driving gas, a

According to FIG. 1, the ventilator consists of a connection 30 for the gas for the patient, a substantially cubic frame of connection 31 for the hand bellows 26, an inhalation metal profile 1, 2, 3, 4, 5, 6 and 7. The surfaces Anschluss32 and an exhalation connection 33 for the frame are clad with panels made of sheet metal in order to form the patient, who via tubes with the bellows with a device housing, and these panels have the help of eight poppet valves Vl to F8 (the Besse openings and Openings to accommodate the ren overview because shown in the open position) control devices, display devices and inlet and a distribution valve 34 for the gas and outlets for the gas. Two back that are upright. This valve 34 and the eight valves Vl parts 2 and 7 of the frame each carry bearings 8 15 to V 8 form a valve control and are with and 9, in which a rod 10 is freely rotatable. operated by a common control shaft, to which a control button is attached to the rod, two arms parallel to each other, with which the selection of 11 and 12 is rigidly attached, at the ends of which two bearings operating mode is carried out by hand, ie, the 13 and 14 are located, which carry a platform 15. A manual mode and the modes with offe coil spring 16 surrounds most of the 20 nem and closed circle. The valves Vl up to the length of the rod 10, with one end of the spring V 8 being in the closed position against the arm 11 and the other end against a worm wheel 17, not shown, by an outer helical spring, the center of which is the. held, which surrounds the valve rod and runs from rod 10, which is mounted on the upright part 7. the valve housing protrudes, and the valves who-a shaft 18 is in engagement with the worm gear 25 according to the selected mode of operation by eight wheels 17 and is also attached to the part 7, and the cams on the control shaft open,; which rotation of the shaft 18 rotates the worm wheel 17 actuate pivot arms which rest against the valve rods on its / storage and acts on the spring 16. The valves F1 to F8 have Anmit a torsional force. A platform indicated by the broken keys, B, C, D, E, F, G, H, .I, K, L and M, line 19 is supported within the frame and carries three cylindrical ones, some of which are for two valves at the same time Bellows, are seen. ..,.
namely a first bellows as exhalation bellows 20, the gas distribution valve 34 has the shape of a second bellows as central bellows 21 and a cylindrical bore 35 with a rotor 36 therein, third bellows as auxiliary bellows 22, the upper ends of which is coupled to the control shaft and from one of the platform 15 are attached. The rotation 35 of a fixed cylinder of suitable diameter and suitable worm wheel 17 will consist of such a length. The two parallel holes ensure that the torsional stress 37 and 38 pass through two diameters of the rotor, the platform 15 can sink and the bellows are also removed or collapsed over its length. The amount of this rotation is therefore back-turned, by two diametrically opposed to control the force which the bellows collapse 40 form lying flat surfaces 39 and 40, which admit, while due to the length of the other and are parallel to the rotor axis. Four AnFeder this force can be precisely selected and the conclusions S, P, R and N enter the cylindrical essentially over the entire movement bore 35 and are in a position of the rotor area of the arms 11 and 12 is constant. arranged and located so that the connections 5

The exhalation bellows 20 has an internal front 45 and P through the hole 37 and the. Connections R jump in the manner of an inverted hat shape, which are connected to and N through the hole 38 so that their upper surface is suspended or gas hangs down between the connections S and P and R and N , as indicated by the broken line 23 can flow. A rotation of the rotor in the watch is so that when it is folded up, it first brings the bellows, clockwise or in the opposite direction, the remaining volume is very small. The 50 holes and connections out of alignment, covers the maximum stroke volume of the exhalation bellows 20 then the connections and finally gives the request 2000 ecm, while the other two bellows locks again, with a gas passage between 21 and 22 each having a maximum stroke volume of see the connections S and R through part of the 1400 ecm, so that a negative (under-hole 35 and an area. 39 or 40 and an atmospheric) pressure can build up. 55 different gas passage through another part of the

The ventilator can supply one bore 35 and the other surface 40 or 39 patients with gas on the basis of an open or create. Such gas passages will not closed gas circuit or one formed by hand only when the surfaces 39, 40 directly the drifted circle can be used, with the out connections opposite, but they are Choice of application method only by a 60 also before if an edge is one of these faces Control process is carried out on the device. In which a pair of connections opens, and the gas passages only in both cases will the device either exist with one until the corresponding edge of the Time, pressure or volume cycle or with a surface39 or 40 covering the connections, i.e. it Combination of these operated, with a considerable angular range for the Dre aid of two alternately operated, electrically 65 hung of the rotor "before, in which the gas connections actuatable valves, namely an inhalation-effective. With the control button the three valve 24 and an exhalation valve 25, are set during possible operating positions, woim last mentioned case the ventilation circuit with itself the wave between each position by 120 °

turns. This rotation by 120 ° between the positions results in an additional advantage in that the cams actuating the valves Vl to V 8 can have a lower stroke than if a rotation of 90 ° between the positions were used.

When the device is in operation, the patient connected to the device inhales and exhales via a connection 41 and is connected to the inhalation connection 32 and the exhalation connection 33 of the device via flexible hoses 42 and 43, the connection of these hoses being an overflow valve 44 having. This valve 44 is slightly biased towards the closed position by means of a spring 45 and enables the gas present in the hoses to escape to the atmosphere via a connection 44 a when the pressure in the circuit exceeds a fixed adjustable level. By means not shown, provisions have been made to ensure that the spill valve 44 can be locked in the closed position to prevent the discharge of gas to the atmosphere. The gas supply for the patient is connected to the connection 30, wherein a gas source with a flow control or control for a pressure of z. B. 0.2 to 0.7 kg / cm ^{2 is} provided if the ventilator works like a minute-volume divider.

During manual operation of the ventilator, the distributor valve 34 is in the position shown, while the valves Vl and V3, V6 and Vl are open and the hand bellows 26 is connected to the connection 31, the overflow valve 44 being operationally in the unlocked position. The opening of the valves Vb and Vl enables, when the inhalation valve 24 is either not operated or periodically not operated and open, that the gas in the bellows 21 and 22 can escape into the atmosphere as soon as the bellows contract under the influence of the spring 16, whereby the gas in the bellows 20 passes through the port 28 into the atmosphere.

Gas flows from connection 30 to connection P via line 46, through the passage between P and N in distributor valve 34, out of connection N to connection G of open valve V 6 via line 47, from connection /? of the valve V 6 for connection of the open valve Vl via the line 48 and from the connection B of the valve Vl to inflate the hand bellows 26 via the line 49 and the connection 31. Gas also flows from port C of the open valve Vl via line 50 to a gas pressure test device 51 with zero center position and to port 32 via line 52, from where it passes through hose 42 to overflow valve 44 and to port 41 for the patient. The gas is not in the hose 43 and via the connection 33 in the line 53, through a stroke volume meter 54, the line 55, the exhalation valve 25 (which is either fully or periodically open and operated) and the line 56 to connection B of the Valve VS get because this valve is not open. The gas will also not pass from connection C via line 57, through control valve 58 for the flow rate, line 59, diaphragm valve 60 and line 61 to connection M , since neither valve V 4 nor valve F 8 is open . By compressing the inflated hand bellows 26 by pressure exerted by hand, gas will flow into the patient, some of the gas escaping into atmosphere via the valve 44 and the pressure used for the flow being displayed on the pressure testing device 51. The subsequent release of the pressure on the hand bellows 26 can be filled again, whereby the gas in the patient's lungs is pushed out by the elastic resilience of the chest wall and a smaller part of the expelled gas returns via the flexible hose 42, whereby an unavoidable Amount of re-inhaled gas is given, but most of the gas is released through the overflow valve 44 to the atmosphere. ·

The electrical supply of the device does not need to be switched on during manual operation.

ao switched to be. But if one of the two other previously mentioned modes of operation is used, however, electrical power must be used for an electronic Control means are available which alternately operate the electrically operated solenoid valves 24 and 25 operates, which sets the ventilation rhythm with an inspiration period and a subsequent one Control the exhalation period. If electrical voltage is applied to the electronic control device during manual operation, then the valves 24 and 25 are operated alternately, but this has no adverse effect. If necessary an electrical lock could be placed to prevent the supply of electrical power, if the. Operation of the device by hand was chosen, but also without this simplification it is possible to change over from manual operation to another operating mode, which, by the control device controlled without interrupting the ventilation rhythm.

When the above-mentioned closed gas circuit is used, the rotor 36 of the valve 34 is rotated so that the hole 37 is aligned with the ports S and P and the hole 38 is aligned with the ports R and N , while the overflow valve 44 is blocked, so that no gas escapes into the atmosphere. Valves V2 and V3, VS and V 8 are open, and ports 27 and 28 are through a pipe respectively; a hose 62 is connected, one branch 63 of which feeds a gas cleaner 64 (CO., - absorber) to which a gas storage container or reservoir 65 is connected via a

. Tube 66 is connected. '). The container 65 has flexible walls and can expand when it absorbs gas, the gas pressure essentially not increasing due to the expansion of the container walls. A propellant such as B. compressed air is supplied to port 29 and gas is supplied to the patient. brought to connection 30 for manual operation. The current of the driving force. Gas is also controlled by external devices, not shown, and. the ventilator initially fills the patient gas and then eliminates any gas losses that may occur due to patient absorption or leakage.

The driving gas runs from the connection 29 via the line 67 to the connection R of the distributor valve 34, from the connection N via the line 47 to the connection of the open valve V 2, from the connection

309 623,207

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Circuit F via line 68 to inlet 69 of the respond to pressure changes. This switch bellows 21 and from the outlet 70 of the bellows 21 via the membrane and work as Gasdruckmeßvorrich-line 71 to the inhalation valve 24. During the device, the detection of a fixed pressure-exhalation period, the inhalation valve 24 is in the limit of reaching the patient or operating and closed , and the bellows 21 is responded by the gas coming from the patient and the propelling gas is expanded, whereby the platform 15 is raised in a manner to be explained later and the other two bellows expand to initiate a new breathing period. During the following inhalation reversal. . : ^
period, the inhalation valve 24 is not operated. It has already been established that the stroke and open, whereby gas from the bellows 21 over the 10 volume of the exhalation bellows 20 is greater than the line 72 to opening I and from there via the other the other two and that during the exclusion L of the open valve V3 and the line 73 breathing stroke a negative (subatmospheric) can get into the atmosphere. During this pressure, the inhalation period generated with the system described, the spring 16 pushes the three would. So that this process from a negative bellows into the contracted position .. 15 maximum down to zero (atmospheric pressure)

Patient gas. runs from connection 30 through which control can be carried out, a control valve 91 is connected to line 46, connection P, hole 37, connection S, Lei. The inlet of the valve 91 is via lines 74 and 75 to the connection 27 and from there device 92 to the line 86 and the outlet: the via the hose 62, branch 63, gas cleaner 64 and. Valve 91 via a line 92 A with a one-Leitung66 to the filling of the container 65. The 20-way valve 93 of a second inlet 94 of the bellows - remaining part of the gas system can be connected to gas overall 20th The valve 91 works in the manner of filling, for example by removing the hose 62 from the variable tap and enclosing a valve 91 ^ 4, removing the connector 28 and thus allowing the machine which is biased in the closed position to light, a few Circuits with the valve 91 removed in the bypass and so angeord-end of the hose 62 to perform, which is with 25 net, that an excessive negative pressure, which is covered by the hand of the operator and could be dangerous for the patient, then again with the Connection 28 connected valve 91.4 opens. Will be used during operation. On the other hand, the flow rate for the closed circuit can be selected to be large, if the additional gas device is first used, in order to quickly expel the air that is desired to remove the negative pressure from the gas circuit. 30 is required, which is above the desired negative pressure is applied for the following description, therefore removed from the container 65 that such a loading and filling assumed. If negative pressure is not required, the system is already there. . is the control valve 91 under these conditions

During the exhalation period, the fully open, the one-way valve 93 is also expanding, as an inhalation bellows serving bellows 22 35 opens what is required to the bellows 20 gas To supply gas from the container 65 through the described, so that the difference in relation to the hub connections, thus also via the line 76 and the volume of the bellows 20 and 22 are canceled a one-way valve 67 into an inlet 78 to the bellows 22.

The control valve 58 is similar to the control finder Gas is built up in the expanding exhalation valve 91 but has no bypass bellows 20 via line 43, connection 33, line valve like this one.

device 53, spirometer 54 (which indicates the stroke volume of the exhaled gas if negative pressure is used), line 55, not only the patient, but also the driven and open exhalation valve 25, line hose 42 and the to the terminal 32 in comparison 56, terminals!) and e open valve VS, line 45 bond lines projecting supplied. The mem-79 and the unlimited inlet 80 of the bellows 20. The branch valve 60 closes under these conditions, during the inhalation stroke movement of the three bellows, so that the valve 81 does not open as soon as the platform 15 descends in the bellows 22 bellows 22 expands, and thus the gas volume of verbefindliche gas is reduced by a one-way valve 81, which can be drawn in the direction of the bellows 20 outlet 82 of the bellows 22, through the line 83, 5 ° Exhalation through ports K and M of the open valve F8, applied negative pressure is thus displayed on line 61, diaphragm valve 60, control valve 58, wel test device 51 and the switches 89 this the speed or the volume of and 90. The reduction of the volume of gas flow to the patient is regulated, lines 57, 50 of the bellows 20 through the inner projection, which and 52, connection 32 and hose 42 in the patient 55 by the broken line 23 indicate is light, th is passed, which is connected to the terminal 41 used to quickly the required negaist. The gas does not run through the hose 43, since tive working pressure build up. , _: ..-. ■ v
During the inhalation period the exhalation Per middle bellows 21 has not operated on its upper surface valve 25 and is therefore closed. an outlet valve 95. The rod 96 of this valve. At this time the gas in the exhalation bellows 20 60 passes through the platform 15 and by a spring through a one-way valve 84 of an outlet 85 of the 97 which connects with the rod 96 and the plate 15 to the bellows 20 via a line 86 led out to cooperate to keep the valve closed, the container 65 through the connection 28 to fill again. A stop disc 98 is adjustable on the outside to fill. During this inhalation period, the end of the valve rod 96 is attached and located so that the positive (superatmospheric) pressure at the 65 is indicated that the expansion of the bellows is indicated by a desired measuring device 51 and is also bordered by the disc 98 part of the yard lines 87 and 88 two switches 89 and 90 can be touched, such as B. the parts 3 and 5 or flows, which are operated by diaphragms which have a part attached thereto, and the valve 95 itself

can open, whereby Äntriebsgas can escape and change the period, as will be explained later

another expansion preventing the three bellows. :; .

will. ~ . ■. \ .. For operating the device with an open gas circuit

A tube or hose 62 from the connection stop rail 100 is attached to the platform 15 via a handlebar 99 and can move vertically in 5 28 and preferably also away from the connection 27 , guides not shown. The gas for the patient is carried as before to the on-pointer 101 is carried by the rail 100 , and port 30, and the _; Port 29 is not a part of the pointer is supplied in an opening 102 in a drive gas. The 'distribution valve 34 benn _r Frontpiatte. des: frame; visible. A pole: det itself in, shown. Position in which the check 100 Å, which is fixed to the stop rail projects Schlüsse5 io and R as well as the connections / N ¹ and by the upper surface of the device housing and · are connected to each other. The valves V2, V 4, V 5 allow an easily readable. Display of the off. and Vl are open and the rest of the valves are expansion and contraction of the bellows. By closed. Patient gas, which also acts as two control heads (not shown), flows via line 46, Ankaler direction in the frame, an upper cover plate 15, P and N, line 47, connections G and F 103 and a lower cover plate 104 set becomes open valve V2, line 68 and via the one lying in a plane behind pointer 101 inlet 69 to bellows 21. During exhalation and width such that they are the sides of the period the inhalation valve 24 is in operation and Overlap opening 102 , being closed by adjustment, and the middle bellows 21 expands because of the position of the plates 103 and 104 by their control ao, whereby the platform 15 is raised button a selected area of the opening 102 and the bellows 20 and 22 be stretched. While being uncovered. On the upper end of the upper of this expansion is in the bellows 22 air through the plate 103 are two microswitches, an upper inlet 78 and the Ehiwegeventil 77 of the An.-volume microswitch 105 and an upper over- connections 27 and 29, while gas from the monitoring switch 106 in such a way that, as soon as the patient is coming to the bellows 20 via the hose stop rail 100 under the influence of the expanding bellows 43, the connection 33 and the pipes, a surface 107 rises against the bellows the spirometer 54 are articulated, and further-actuator of the volume microswitch 105 to the - through the non-operated, and open off-system arrives and closes it. Should the breathing valve 25, ports D and Zs of the open stop rail 100 move fractionally by a small 30 valve VS to the inlet 80. It can raise a distance further, so an area 108 of negative pressure as in operation for the closed rail against the actuator of the open circuit is used to draw gas from the monitoring microswitch 106 to the patient's lungs or around the and open this. In the same way are to be assisted in the discharge of the gas therefrom .. In ren end of the lower cover plate 104 another two 35 this case, the control valve 91 enables the air microswitch attached, namely a lower passage from the connection 28 to the bellows 20. During Volume switch 109 and a lower monitoring of the following inhalation period are the switches 110, which are respectively closed and opened by the surfaces 111 and valves 24 and 25 in the open and closed 112 , when the position and the bellows are through the Spring 16 rod or rail 100 descends as soon as the 40 contracts, which is followed by the next period. Bellows together from the expanded position _; The gas in the bellows 20 will pull through a. The position of the plates 103 and 104 controls the one-way valve 84, the outlet 85, the line 86 and, in addition to the size of the opening, thus also the point / the connection 28 released to the atmosphere. The in which the switches 105, 106, 109 and 110, while during the Ausatmungsperipde in the bellows eingedes stretching or contraction of the bellows 45 coated air volume will be operated again to the atmosphere. The orders of magnitude are given in such a way, via a one-way valve 81, dedicated, that when one of the microswitches 105 or outlet 82, the line 83, the connections X and L 109 is first actuated by the stop rail, the valve is open V 7 and the line 73. That is aligned with the end of the associated device operating mode in the cover plate 103 or 104 at the indicator 107 , which is located in the bellows 21 serving 50 runs from the outlet opening 102 is visible. The switches 106 and 110 70 via the line 71, valve 24, line 72, work off when the indicator 107 partially covers the closures / and M of the open valve V 4 and also a free end of the plates 103 and 104. via line 61 and the path to the patient,

The volume switches 105 and 109 are thus already explained in the description of the operation for the circle closed by the stop rail 100 at an upper and 55. : -? ' - ^; ~ ■ lower limit position actuated, and this limit position. The exhaust valve 95 opens as before at lungeri or the timings of actuation of a predetermined expansion limit, and the pressure switches 105 and 109 provide a direct statement test device 51 shows the positive / used over the respective limits of the or negative to the patient pressure at , the switch 89 volume actuated in each case to the gas pressure limit values 60 which are correct or which come from the patient. Thus, the switches 105 and 109 and 90 of the pressure measuring device acts, while as well as the rail 100, the position of which from the eye diaphragm valve 60 allows gas to flow from the line 61 into the visual position of the three bellows or the flat line 59 and a withdrawal of form 15 depends, a volume measuring and volume gas through the line 59 is prevented. In order to be able to carry out this radio display device, the gas volume limit values established for the closed and also open guests by pressing the circle, the diaphragm valve has to respond to switch 105 or 109 and thus the time connection 60/1 (to which the Tube 59 is regulated to initiate a new breathing circuit) through the front surface of a

13 14

flexible membrane 605 is covered, with the device on the head, the spring can be compressed-line oil gas in a compartment, in which the presses, which is thus the valve in the closed position connection 6OA and which holds through the walls. The gas located in the upper compartment of the valve and the membrane 60S is delimited. its pressure can be below the pressure of the gas located in the lower section in this section from the line 61, the all-occurring and pressurized gas deflects the membrane common at or around atmospheric pressure, lays the connection 60 Λ free and leaves, and when this pressure difference the spring pressure thus gas enter the line 59. If it exceeds the value, the valve will lift, but the negative pressure supplied to line 59 is used to reduce the pressure difference. The adjustment only for closing, i.e. for better and more secure io the position of the nut, controls the pressure difference, closing the connection 60 Λ, because on the back where the bypass valve works,
side of the diaphragm due to the opening 6OC in which, when the valve wall is actuated at a positive pressure limit, atmospheric pressure acts. bare pressure switch 90 consists of a short cylindrical

The control valve 58 consists of a body with a three-dimensional compartment with a flexible metal mem-cylinder bore with an upper and lower flange as a circular wall. The inside of the department is over. Inside the bore lies a hollow cylinder in communication with the conduit 88, and the drical rotor with a shaft which is rotatable through the outer center of the diaphragm is arranged so that the body protrudes, the interior of which makes a first electrical contact a cylindrical rotor is open to the bore and moves the spring leaf. A second to the first contact has the lower connection and with a part 20 aligned electrical contact lies on one of the cylinder wall of the rotor, the upper rigid blade, the position of which is closed by twisting, while seals prevent a control shaft can be changed with a button , Gas leaks occur between the connections and around the distance between the contacts to varider surrounding atmosphere. In align. The contacts are arranged so that a device with the upper connection penetrates a 25 increase in pressure within the department group of radially arranged holes another above atmospheric pressure the contacts part of the rotor wall, which can close when twisted. The control button carries Eichmarkie rotors through the shaft one after the other, struggling more and more for the positive pressures at which the holes to the upper connection are exposed. The through-closing of the contacts takes place, so z. B. at 0 knife the holes in the rotor wall is 30 to 50 centimeters water column. The pressure switch flow rate, which can be actuated in accordance with the desired law of rotation / negative pressure limit value, varies, and on the shaft is a 89. The gas pressure measuring device is fitted with the off control button, with which the flow rate is constructed similarly to the pressure switch 90, amount by hand can be adjusted. This <* a ^ß a negative (subatmospheric) pressure structure enables a much easier process of closing the switch contacts within the department than the more common structure. The control button carries calibration markings that either have a specially shaped connection for the negative pressures at which the contacts or a rotor opening or a combination of close, so z. B. at 0 to 30 centimeters of water both used. pillar.

In the control valve 58 the connections are at 4 ° The inhalation valve 24 and the exhalation direct connection with the associated lines valve 25 are similar, solenoid-operated valves 57 and 59, while in the control valve 91 each and every valve consists of two compartments, namely connection Leads to a separate department, the borrowed an upper department and a lower wall is common to both. The lines are divided with a common partition. Each 92 and 92A communicate. with the lower and 45 compartment has an outlet, on the pipes upper compartments, which can be brought to the upper and. The gas flow is lead from lower connections, and the common of the upper to the lower compartment. The partition wall of the compartments is broken through by an opening and an opposite wall in the upper one, which has an insert as a valve seat. Department are perforated to accommodate a valve, the head of which, in the upper department 5 ° valve seat or a valve rod, as is and can suitably close the opening, which is also the case with the bypass valve 91Λ, jelpers with the valve rod through the The lower wall, however, is the valve rod directly on the movable one of the lower compartment, with provided sealing fittings of the solenoid-actuated coil preventing the escape of gas. The closed and not loaded by a spring, since the wall of the compartment through which the valve rod 55 runs to reset the valve in the open position, is relatively thick, and the hole in it gravity is used. The valves are internally threaded to accommodate an external ventilator so that the valve stem threaded and flanged valve guide bearings are vertical, but they will accommodate conventional ones. The sealant consists of an open and close manner, even then, flexible washer, e.g. B. made of neoprene, which should be inclined at 60 when the device is thirty degrees from the vertical 'the outer surface of the valve guide flange'.

clamped and with its inner edge in one The wall of the upper compartment through which the

Groove of the valve rod is embedded. The outer valve rod runs, is relatively thick, and that

End of valve rod is threaded and hole therein is threaded to

carries a nut between which and the compartment 65 an externally threaded and flange-mounted

wall through which the rod runs to accommodate one of the guide bearings. The sealants

The coil spring surrounding the rod is located. Due to the consist of a flexible washer like

Movement of the nut on the valve rod in close proximity to the bypass valve 91 A. The solenoid lies

15 16

concentric to the valve rod, and the valve guide collectively circles the solenoid-actuating coils

serves as a bearing for the valve rod and the moves 24 A and 25 Λ as drives for the two valves 24

borrowed armature of the solenoid. When the valve is up and 25.

is closed, there is thus a possibility to send gas. This trapped gas prevents a symmetrical multidert-type circuit that the valve opens immediately as soon as vibrators are created, whereby a capacitor is no longer operated, the solenoid is no longer operated, and in order to achieve the emitter resistances of the two transistors, a helical groove is used in io binds. In such a circuit, the time controls the valve stem, which creates a constant of the capacitance and an emitter resistance through which gas can flow freely between the upper stapdes for the length of a period, and the other compartment and the enclosed space, which can control the emitter resistance and capacitor , determined by the area of the valve guide and the duration of the subsequent period, the sum of which is limited by the washer. The closing · 15 of the two periods the time of a cycle of the valve is also tuned somewhat faster. In order to avoid the use of very large condensers, since little force acts on the gas, if generators avoid the above-mentioned enclosed space by a time constants in the cross connections neglecting upward bending of the seal in order to achieve the required length, directly coupled amplifiers are also used disk is enlarged. In the lower compartment, each cross-branch is built in, each of the club's externally adjustable stop provided, which also rests more closely on the output with lower impulse against the valve head and creates the valve on it, which prevents one directly from driving itself so far to open that the magnetic closed transistor is suitable and desirable. Circle is affected. The movable central As shown in Fig. 2, the battery iron armature supply the solenoid is shorter than the latter, 25 113 and / or the charger 114 the circuit over and when the valve is closed there is a two-pole on-off switch The lower ends of the armature and the solenoid switch 115, which is shown in the switched-on position and the coil in the vicinity of the valve is almost in alignment, and which in the switched-off position provides a resistance to the Charger 114 and the load 116 at the upper end is partially attached to the battery with a metal 3 ° to prevent excessive gassing of the piece, which can be moved outside inside the tube with an adjusting screw of the battery due to overcharging, around that when the ventilator is not in operation.The size of an air gap in the magnetic circuit to pnp transistors T1 and T2 are controlled by a control when the solenoid is operating *. To the capacitor TC connected to its emitter. To reduce the losses and to create a fast working 35 emitter of the transistor Tl is to the positive Verdes valve, there is at least a partial supply by a control resistor REl ahgedes the magnetic circuit, the central armature, from a closed, which consists of a series connection of a material with high permeability, for example from the resistance Rl, a set resistance R 2 known under the trademark "Radio Metal" and a potentiometer R 3, which is the material. . 40 variable resistor is connected. The emitter of

The electrical and electronic parts of the T2 are similarly equipped with a control resistor.

rätes receive their supply in the form of Niederstand RE2 wired from a resistor

voltage, e.g. B. from a 6.5 V battery 113 with R 4, a set resistor RS and a

Nickel-iron secondary cells, which is made up of a sufficient potentiometer R6 . A directly coupled one

Has capacity to supply the ventilator for longer than 45 transistor amplifiers 117 with npn transistors

Operate 24 hours. A charger 114 for this between the collector of Tl ' and the base of

The battery is also provided in the device, and the T2, where the resistor Rl represents the load on Tl-

The output of the charger is automatically controlled and the resistor R 8 with low resistance

and designed in such a way that the battery 113 takes the greater part of the load on the charge

A fully charged state of 5 ° more 117 in about 3 hours. A similar amplifier 118

can be, whereby a slow automatically connects the output of T.2 with the input

Very low speed charging possible from Tl, and the resistors R 9 and R 10 have

will, if this.by the battery condition requires the same functions as the resistors Rl

should be defensive. / \. . and R 8. Resistors R 11 and R 12 are both

Since the output of the charger is controlled, 55 amplifiers share emitter resistors, this can be used to operate the ventilator at 'The output "of the amplifier 117 forms the on-non-existence of the battery Also the charger 114 pnp transistors Γ3 and TA, in whose collectors can be easily removed for maintenance purposes, the coil 2AA of the inhalation valve 24 is located, since plug-in and socket ^{connections simplify such an expansion,} which is connected according to a Darlington circuit _.; Transistors Γ5 and Γ 6, also from pnp-Polari-

A simplified circuit diagram of the electronic tat, are driven in the same way by an amplifier control device for the valves 24 and 25, the 118 shows and have F i g in their collector circuit. 2. The control consists of a transistorized astable oscillating oscillator, the actuating coil 2SA of the exhalation valve, which is directly connected to ⁶ S 25. The output stages of the amplifiers 117 and 118 are driver and power transistors (as switches give off a maximum output voltage when turning) Connected, which are like a Darlington- their inputs are at a minimum, and are interconnected by switching and reversed in their, that is, if Tl does not conduct, the output

17 18

output stage of the amplifier 117 strong, whereby T 2 is influenced, which is set by the inhalation control wave and the pair of transistors Γ3 and Γ 4 turned on by R 6 . The display shown is the Bewird to operate the coil 24.4 and. the degree of inhalation is only applicable when the ventilator valve 24 operates on the basis of time cycles to close the ventilator during the exhalation period. If T 2 does not conduct, the resistors R 16 and RlS low Liehe, the exhalation valve 25 is on ahn- 5 is closed, resistance value are connected so that they erforderindem its spool 25.4 during the inspiratory and handy if by switches parallel to REl RE2 is operated for a period. ,. can be switched. Such a use

When Γ2 conducts, a voltage drops across RE2 , in a circuit through which the charging current of and a charging current for the capacitor TC flows io capacitor TC shortens the time available through RE1, whereby a voltage of such constant and switches quickly, e.g. is built up in less than polarity that the emitter is biased by Tl a tenth of a second, from one phase of being beyond its blocking limit, breathing cycle to the other.
while the base of Γ1 is at a potential. The coils 24.4 and 25.4 are respectively located by which is determined by the current flow through the conventional potentiometer, not shown, which is shunted from the resistors to produce the inductive effect when switching from stands and R13 AlO and out of the reducing tHE SET these coils, while the resistance R is disgusted fourteenth Since the charging current is ex-. If R was 10 and the decoupling capacitor 119 decreases in potential with time, the emitter switching settling processes are prevented, which could also affect the time voltage at Π until T1 begins to circle. These switching means can conduct, and because of the positive feedback, they are arranged or used in such a way that the coupling slows down an increasing influence and opening of the valves 24 and 25 in order to have an effect that switches off Γ 2, while Γ1 for the required amount for the temporal overlap leads a further time period. The time that is necessary to reach the valve operation, ie both valves so that the emitter voltage from T1 to the value is closed at the same time, if this is necessary - "., Which is necessary to initiate the switching action Hch. The resistors Ä20, R21, R 22 and R 23 is the time which is determined by the value of the control resistors are emitter resistors of the transistor pairs Γ3, status REl , and this can be set with Γ4 and TS, T6, some of these resistors with the help of a button which are assigned in 0.5 to more than one transistor. A one-5 seconds is calibrated to the setting of the potentiometer 30 pole single toggle switch and trigger selector switch tiometer R 3 and the duration of the exhalation period 120 can be closed to R 17. In the same way, a similar REl controls to switch when the contacts 89,4 of the button, the potentiometer R 6 and the inhalation pressure switch 89 are closed the resistance 2? 15, the patient should make a resistance R 16 during an exhalation period and the resistance R 8 should try to inhale and thus control a negative potential at the base of Γ2. Nominally tive pressure should generate that is below the equal pressure resistors Rl and R4 and set limit value , which is set by the calibrated control resistors R 2 and R 5 in conjunction with the one button of the pressure switch 89, then set resistors R 14 and R 16 enable the exhalation period to end immediately and the correct setting of the correct times in relation to an inhalation period is initiated,
, regardless of the comparison A two-pole single switch or pressure changes in the choice of parameters of the transistors Tl and switch 121 can be closed to the Knopfeichung, whereby the Γ 2 and the capacity of contacts TC 89.4 or 90 Λ of the pressure switch 90

After all, it follows that the operation of the two resistors R17 or R18 in parallel to valves 24, 25 can switch regulated 45 REl or RE 2 with a control device in order to extract the breathing and inhalation periods from the transistors acting as switches in the pressure cycle Γ3 to Γ6 controlled to end as coils 24A, 25A. Depending on the settings, it has valve drives with which both the time control potentiometers R 3 and R 6 are regulated from an inhalation period to an expression pressure that is reversed by the control process at the breathing period and vice versa 5 ° the pressure switches 89 and 90 are set are, and can. The duration of the breathing periods is determined as a function of the control valve 91 by a time control circuit, which consists of the breathing device with a time cycle or push cycle, transistors T1, T2, the control resistors RE1, or a combination of both, where RE2 and the capacitance TC . the inhalation and exhalation periods through the

Through an opening in the panel, which controls the set time, if the on-controls of the potentiometers R3 and R6 are not activated, the positive and negative pressures set are first visible as a display for the ventilation rate. This will suffice .. If no negative pressure has been used while the same basic principles of the pressure cycle are used, then the will be the. shown in British patent specification 914 352, thus the exhalation phase can be timed,
are, and one works with overlapping plates, 60 A two-pole single changeover switch or volume that lie in sliders or sliding guides and selector switch 122 can be closed, with one of the control shafts of the potentiometers R 3 and R 6 via the pole of the switch normally closing the Gear rack and pinion driven open contacts of microswitches 105 and 109 of the be. A lock is arranged in such a way that the out volume measuring device enables the inhalation period to never be less than the set 65 switch of the resistors J? 17 and R 18 through-inhalation period, although the previous one through. The operation of the buttons that control the operation of the shaft, which controls the plates 103 and 104, changes the position of these A3 controls, without changing the time period microswitches relative to the stop rail 100, the

19 20

According to the expansion and contraction of the wrong function, the rail 100 is moved over one of the bellows, and provided that the emergency volume switch can wander out and the maneuverable limit values of the volume to close one or the other of the monitor switches 106 and 110 of the microswitches before the set times - Press, if you are enough with time and pressure cycles, the machine works as a ventilation 5 works. Due to the relatively narrow operating control device with volume cycles, the closing of the lungs of the volume and monitor switch pairs (the switches 105 the exhalation stroke and the closing of the relative positions of the actuating surfaces Ben of the switch 109 ends the inhalation stroke. 107, 108, 101, 112 In a manner similar to describing the fact that in some medical pressure circuits, any combination of time and volume cycles may be desired for an inspiratory bladder to completely deflate the corresponding for a short period of time , can control periods of the ventilation circuit. Closing both switches 121 and 122 creates a monitor switch during the normal volume cycle. To a. Such an open state in which either the time to prevent the what an immediate indication of a pressure or volume gives delay the initial inspiratory and i _5, a capacitor SC, may terminate the respiratory periods is. Under these conditions, in series with a resistor R 24 , the set times will drive the device second pole of the switch 122 into the circuit, if either the set limit is not set. .

values for volume or pressures in shorter A two pole double changeover switch 123 will be reached like time. ... ao used in British patent 970 626 to switch on or off the control of the ventilator by the monitor unit and the electronic time control circuit , the momentary closing of a single-pole changeover switch will cause the device and its pulls to function incorrectly to the open switch position impaired compounds to the patient or is biased off, is used a akustinormes behavior during ventilation or sawn 25 see indicators in the monitor unit turn off, the patient's respiratory system in an expansion an indicator lamp 125 lights up when the monitoring or contraction of the bellows over their normal gate unit is in operation, and this lamp remains beyond the range of motion, and this will burn when the audible indicator is turned off by the switch 124 on a remote monitor unit. To operate a resistor R 25, which has a visible and / or audible 30, prevents the destruction and / or a quick display in the event of such an incorrect function of the battery 113, if on the remote advice. th monitor unit or on the connecting wires During the operation of the ventilator, a state should occur that in the absence of the time and / or pressure cycles, the monitor resistance R 25 will have a low resistance through the stop rail 100 in operation Battery should represent. Lines that are used to connect one of the series-connected and normal monitor units to the ventilator have closed contacts on the monitor microphone ends in a plug or pin that opens into switches 106 and 110. In the circuit that matches terminals 128, 129, 130, 131 and 132 . Monitor unit is a rectifier bridge circuit. Two further lamps 126 and 127 indicate when viewed in conjunction with a relay, which light up like 40, that the ventilator is supplied with electrical power according to the circuit according to the British patent and that the battery 970 626 is usually in Operation is maintained. The device is fully charged. Monitor switches 106 or 110 are shown either by FIG. 3, in which all relays in the deenergized state 108 or 112 of rail 100 are open, shows the circuit of the escape switch arm of the associated monitor switch 45 remote monitor units, with the touches 106 or 110 leading to him. Since the position of these scarfs broken lines are intended to represent the lines to the beater relative to the rail 100 by controlling the measurement device. The buttons described above, which operate the panels 103 and 104 , components of the monitor circuit are also changeable, the extent of the expansion left area of the circuit can be shown. A two-poli-drying and contraction of the bellows for the purpose of loading 50 ger on-off switch 133 in the off position separates an actuation of the monitor unit by the Steuereinrich- pole 134 of the negative power supply are set by the device refunds for the cover plate. Under battery 113 via the terminal 132 and the protection such conditions in which the monitor unit. resistance i? 29 and continues to disconnect from one not operated, the indicator 101 will remove the negative voltage from a bridge area of the opening 102 via a pole 135 , which is equal to or 55 rectifier 136 if the supply voltage at is less than that exposed by the cover plates -, the primary winding of a transformer 137 is placed rich, with an on is through the monitor unit, the secondary winding of which is given to the bridge tally when the indicator an end of lights 136 feeds. If the switch 133 is closed to the cover plate, which is visible in the opening 102 and voltage is applied to the fuse 138 , partially covers it or is also connected to the primary winding, a relay Z / 2 should be operated. ben. The contact Zl moves out of the illustrated position. When the ventilator is in the rest position, the voltage of the device battery volume cycles set by the switch 122 is disconnected from the conductor 139 and replaced by the same, the control of the expansion and trimmed Voltage. Assuming now that the contraction of the bellows is energized by means of the micro 65, a monitor relay X12, which is inert to a switch 105 and 109 , whereby the paths allow slow fall, the bellows and the pointer 101 are the contact Xl is closed by the plates 103 , and the relays X / 2 and 104 are controlled. Any deviation or receives voltage from the negative terminal of the battery

21 22

terie on the closed microswitches 110 and 128 and 129 reversed, and the current flow through

106, one pole of switch 123, resistor R 25, the relay, which is facing in the same direction. goes

Terminal 129, a test pressure switch 140, which was described in FIG. 4 as previously described, runs through the

Closed position is biased, a contact Xl diodes D 3 and DS. Because the relay X / 2 is slow

and a diode Dl. The other circuit drops to the positive 5, is the interval when the PoIa-

Terminal of the battery runs through the diode D 2, the rität when the switch 123 is released, too

Terminal 128 and the second pole of switch 123. short for the opening of contact Xl, and the

The contact X 2 is operated and connects the subsequently re-established normal polarity holds

Conductor 139 with conductor 141, the relay is attracted to the lamp 142, as previously described

light up via the closed contact Z2 to OK.

It can also be another form of monitor

voltage is applied and that the unit can be used normally wirelessly, as it is e.g. B. in the British

tioned. > 'Patent application 46 661/65 is shown, and this

If the supply is interrupted, the monitor can either drop directly into the ventilation relay Z / 2, the battery voltage is applied to the device, as in FIG. 1 through the line 139, and the lamp 142 is through with the broken line 141 indicated tube on the opening contact Z2 deleted. Should this be shown, or negative voltage can be arranged between the terminal 32 to the relay X12 through the opening and the hose 42, as indicated by the broken line 150 for one of the switches 110, 106 or 140. If they are broken, the contact Xl will open 20 remote monitor unit and parts of the monitor and the subsequent closing of the open circuit according to FIGS. 1 and 2 are then prevented by a switch that operates the relay X / 2. - *
and the contact X2 will put voltage on the line so that the devices for the control of the duration device 143 to let an indicator lamp 144 light up the inhalation and exhalation periods only one and to over the conductor 147 A and 25 of the three possible device work cycles (Time, VoIueinen closed contact Yl of a non-excited men or pressure) are ready for operation at any time, relay 171 'a ^ buzzer 145, operate. While working with Vojumenzyklu.s, another switch arrangement can also be used, and F i g. 4 shows the associated parts of the delay ring capacitor SC via the relay X / 2 F i g. 2, the unloading suitable to achieve this goal, changed to this after opening the switch 106 30.

or 110 to keep it energized for a period of time, six switches 151, 152, 153, 154, 155 and 156

the resistance of the discharge path with four positions, those of a common

is correct, in order to have an immediate display under- Control shaft can be operated with control button

.to press. . used, whereby the following positions Off, Time,

The resistor R 24. allows both the resistor 35 to mean volume and pressure cycle. The switch of the discharge resistance increases and serves 151 and 152 take the place of the poles of the switch to protect the battery 113, if a short circuit ters 115, the switch 151 the connection in the capacitor SC should occur. This capacitor to line 116 in the illustrated off position, the resistor R 24 and the second pole of the manufactures. In the other three positions switch 122 can be omitted if 4 ° this switch voltage from the battery 113 and / the surfaces of the stop rail, which supplies or from the charger 114 to the ventilator. Put the different microswitches in operation, the switch 153 lies in the emitter circuit of the transistor Tl correct and suitable distance from one another and completes this circuit by having. The following can also be selected at the TT terminals: in the time cycle position the additional,. Warning devices are connected to 45 stands R 2 and the potentiometer R 3, in the VoIuden. Voltage is also supplied via a protective fuse cycle setting of the resistor Λ 26, whereby a longer time constant than the maximum for lamp 125 in the device is supplied to the connection 146 and J-terminal 130 of a lighting. Which is created in operation of the time cycle setting, and in the. set buzzer can be switched off and a potentiometer R 27 at the pressure cycle position. The missing monitor unit can be brought to rest, 50 switch 154 is in the emitter circuit of Γ2 and switch 147 is briefly actuated, which in tet either the resistor RS and the potentio Direction is biased to the position shown, meter R 6 for working with time cycles or the whereby voltage is applied from the line 143 to the loading resistor R 28 for working with volume drive of the relay YIl. The contact Yl 'cycle and print cycle on. The switch 155 then switches to the voltage from the buzzer 55 to take the place of the second pole of the switch 122 and 145 and to apply it to the relay YJ1 put the resistor R 24 and the capacitor SC, which thus remains attracted when the switch 147 is released to take effect as before for the volume cycle. ... .... was described. The switch 156 takes the

When the switch 147 is not operated, both the second pole of the switch 121 and the a spring-loaded switch 124 on ventilator 60 also the first pole of switch 122 on. In the

performs a similar function by setting the switch 156 to the off and time cycle position during operation

an electrical circuit between conductors 143 do not connect, but it allows the Yil and the relay via the fuse 146 and volume of cycle position, the microswitch 109

Terminals 130 and 131 close. . ... and 105 the resistors R 18 and R 17 in the

To energize relay XI2 or not switch on 65 circuit. In the case of the pressure cycle control, that is, to switch the monitor unit on or off, it enables the pressure switch contacts 90 to switch on, the switch 123 is actuated briefly. Insert resistor R 18 into the circuit

The polarity of the terminals will vary during operation. If while working with pressure

23 24

cycles no negative pressure is used, so will be gen to this department via connector and

the exhalation cycle performed with the potentiometer R 27 sleeves, and the entire department

timed, and the resistor in the circuit can easily be removed from the device for

is set with a calibrated control knob. Maintenance purposes or for replacement. The switching

If negative pressure is used, the 5 circles that are not in the closed compartment

Contact 89 A of the pressure switch are assigned by the trigger contained switches, ie the

switch 120 can be taken into use, with switches S9A, 90A, 105, 109, 106 and 110 being

the corresponding settings of the control device at low voltage and have a relatively high

pressure switch 89. and potentiometer resistor to reduce the risk of explosions in the event of

R 27 determine when the exhalation period ends. io use to reduce explosive gases while for

If explosive anesthetic gases are used, the gas circuits, bellows, hoses and lines are anti-

all parts are used in the static rubber for safety reasons, whereby the assigned

Fig. 2 and 4 - with the exception of parts 89Λ, 90/4, belonging metal parts connected to the frame

105, 109, 106, 110, 113, 114, 24 A, 25 A and 128 which stands on metal.

up to 132 enclosed within a compartment, 15 in addition to valve 95 in the middle bellows 21,

one wall of which has a control and display panel through which the build-up of excessive pressure

forms, on which the associated control and display kes is prevented, are safety valves that

facilities for operating the device. take off at a specified adjustable pressure,

are brought. This panel forms part of the connections in connections 29 and 30 and in line 66

clothing of the frame. The electrical connections to the hand bellows 65 are arranged.

For this purpose 2 sheets of drawings

Claims (9)

Patent claims: 1. Medical ventilator for anesthesia and treatment of insufficient breathing, consisting of an inhalation bellows for the supply of anesthetic gas and / or other gas to a patient, an inhalation control valve for controlling the inhalation periods, an exhalation bellows for evacuating the gas exhaled by the patient and an exhalation control valve the control of the exhalation periods, whereby the operation of the valves can be regulated with the help of a control device which determines the inhalation and exhalation periods and the device can be switched from one breathing period to the other possible breathing period in the event of a spontaneous breathing attempt by the patient that the control device of switches (T 3, T 4; Γ5, Γ6) controlled valve ao drives (24 A, 25A) with which the inhalation valve (24) and the exhalation valve (25) are reversible from an inhalation period to an exhalation period and vice versa, that a time control circuit (ΓΙ, Γ2, REl; RE 2, as TC) is provided, which has controllable control resistors (REl, RE 2) for setting the breathing periods and with the Switches (Γ3, T 4; TS, T6) is in connection to control the valve drives (24 A, 25A) periodically that a volume measuring device (100,105,109) is provided, which when determining a fixed limit value of the patient coming to or from the patient responds to the coming gas volume and thereby reverses the timer UHIg (Tl, T 2, RE 2, TC) to initiate a new breathing period that a gas pressure measuring device (89, 90) is provided which, when determining a specified pressure limit value of the patient coming to or from Responds to the patient coming gas and thereby reverses the time control circuit (Tl, T2, RE2, TC) to initiate a new breathing period so that the end of each inhalation and exhalation ngs period depending on the respective setting of the control resistors (REl, RE 2) can be determined and that the volume measuring device (100, 105, 109) and the pressure measuring device (89, 90) with the time control circuit (Tl, 72, REl, RE2, TC) can be put into operation either individually or in combination with the aid of switches (120, 121, 122).
. 2. Apparatus according to claim 1, characterized in that it comprises three mechanically interconnected bellows (20, 21, 22) which are expandable and contractible in the same mode in a known manner, that a first bellows (20) as exhalation bellows and a second bellows (21 ) serves to take up a drive gas for the common expansion of all three bellows and that the gas is supplied to the bellows via a valve control (34, Vl to V 8), which, when the gas circuit is closed, transfers the gas for the patient to the second bellows (21). , with the open circuit the third bellows (22) or a manually controllable gas reservoir to enable a manually controlled gas circuit (26) feed. 3. Device according to claim 2, characterized in that the valves of the valve control (34, Vl to V 8) can be brought into three selection positions with the aid of a common control shaft, the gas supplied to the device in the first selection position to the second bellows (21) , in the second selection position the two other bellows (20, 22) and in the third selection position the gas reservoir (26) designed as a compressible hand bellows and that in the first and second selection position the gas . reservoir (26) is separated from the gas circuit in the device. 4. Apparatus according to claim 3, characterized in that the gas for the patient or the drive gas in the first and second selection positions of the valves (34, Vl to VS) can be fed to the second bellows (21) as a drive bellows in order to allow the inhalation valve to be closed ( 24) to expand all bellows (20, 21, 22). 5. Apparatus according to claim 3 or 4, characterized in that the three bellows (20, 21, 22) are connected to a platform (15) on which a spring (16) acts so that they the bellows seeks to push into the contracted position and with the inhalation valve (24) open returns the bellows from the expanded to the contracted state. 6. Apparatus according to claims 4 and 5, characterized in that the gas for the patient in the first selection position of the valves (34, Vl to V 8) from the second bellows (21) and in the second valve selection position from the third bellows ( 22) flows to a device such as a face mask, via which the patient is supplied with gas, and that in this case from the patient - Exhaled gas can be discharged through the exhalation valve (25) and the first bellows (20).
, 7. Apparatus according to claim 6, characterized in that the first and second. Selective position of the valves (34, Vl to VS) can be switched on with the help of switches (120, 121, 122) contacts (105, 109, 89 Λ, 90 A) , each of which is set to the aforementioned limit values of the volume and the pressure of the to and responding gas flowing from the patient, wherein the closing of at least one of the contacts (105, 109, 99A, 90A) the effective resistance of one of two chains of resistance (R 1, R2, R3 and R4, R5, R 6; R1, R26 and A4, R 28 ; R1, R 27 and R4, R 28) reduced in order to reverse the timing control circuit (ΓΙ, Γ2, REl; RE2, TC) to end the current breathing period and to initiate the other breathing period. 8. Apparatus according to one or more of claims 1 to 7, characterized in that the first bellows (20) for generating a negative, the extraction of gas from the lungs of the patient-supporting pressure has a larger stroke volume than the other two bellows (21, 22) and that a variable opening (91) is provided for setting the negative pressure within desired limits. 9. Apparatus according to claim 8, characterized in that a safety valve (91 A) is provided for limiting the negative gas pressure.