Process for supporting blood gas exchange by ventilation and extracorporeal blood gas exchange and system operating according to the process

1 . A system for supporting a blood gas exchange of a patient by ventilation as well as by extracorporeal blood gas exchange by CO 2 removal, the system comprising:

a medical device comprising a ventilator;

a medical device comprising a CO 2 removal device for the extracorporeal blood gas exchange;

a controller configured to act on the CO 2 removal device; and

a sensor system configured to detect a current measured value concerning an expiratory CO 2 concentration in the breathing gas of the patient, wherein the current measured value is selectable as a start value by an operating action at the system, and wherein:

the controller receiving a difference between a trend parameter and a setpoint for the trend parameter, the trend parameter corresponding to a CO 2 content of blood of the patient;

the trend parameter is a quotient of the current measured value of the expiratory CO 2 concentration in the breathing gas of the patient and the start value of the expiratory CO 2 concentration in the breathing gas of the patient;

the controller acts on the CO 2 removal device.

2 . The system in accordance with claim 1 , wherein the sensor system is further configured to detect an end-expiratory CO 2 concentration in the breathing gas of the patient as the measured value concerning the expiratory CO 2 concentration in the breathing gas of the patient.

3 . The system in accordance with claim 1 ,

wherein the trend parameter is determined with the start value and with the measured value which is currently determined, and

wherein a difference of a set point for the trend parameter and the respective current value of the trend parameter is fed to the controller, which acts on the CO 2 removal device.

4 . The system in accordance with claim 3 , wherein the trend parameter is determined as a standardization of the current measured value in relation to the start value.

5 . The system in accordance with claim 1 , further comprising a display unit, wherein the measured value currently determined is outputted at the display unit and the displayed measured value is selected as the start value by the operating action.

6 . The system in accordance with claim 1 , wherein a spontaneous respiratory rate of the patient is monitored by the sensor system and a signal element is actuated in case a predefined or predefinable threshold value is exceeded.

7 . The system in accordance with claim 1 ,

wherein a weaning mode is activated by means of an operating action on the system, and

wherein a CO 2 removal target is reduced automatically and in a controlled manner in the weaning mode.

8 . The system in accordance with claim 7 ,

wherein an influence of the controller on the CO 2 removal device is deactivated at a beginning of the reduction of the CO 2 removal target,

wherein the trend parameter is monitored in relation to a predefined or predefinable tolerance range during the reduction of the CO 2 removal target, and

wherein the influence of the controller on the CO 2 removal device is reactivated in case of a moving out of the tolerance range, and the reduction of the CO 2 removal target is deactivated.

9 . A process for operating a system for supporting a blood gas exchange of a patient by ventilation as well as by extracorporeal blood gas exchange by a CO 2 removal wherein the system comprises: a medical device comprising a ventilator; a medical device comprising a CO 2 removal device for the extracorporeal blood gas exchange; a controller configured to act on the CO 2 removal device; and a sensor system configured to detect a current measured value concerning an expiratory CO 2 concentration in the breathing gas of the patient, and wherein the current measured value is selectable as a start value by an operating action at the system wherein a difference of a trend parameter formed with the start value and a set point for the trend parameter is fed to the controller, the controller acting on the CO 2 removal device, the process comprising the steps of:

detecting the current measured value concerning the expiratory CO 2 concentration in the breathing gas of the patient by means of the sensor system;

selecting the measured value which is current as the start value by means of the operating action at the system; and

feeding the difference between the trend parameter and the set point for the trend parameter to the controller, the trend parameter being a quotient of the current measured value of the expiratory CO 2 concentration in the breathing gas of the patient and the start value of the expiratory CO 2 concentration in the breathing gas of the patient, the controller acting on the CO 2 removal device, the trend parameter corresponding to a CO 2 content of blood of the patient.

10 . The process in accordance with claim 9 ,

wherein the trend parameter is determined with the start value and the current measured value, and

wherein the difference of the set point for the trend parameter and the trend parameter currently determined is fed to the controller, which acts on the CO 2 removal device.

11 . The process in accordance with claim 10 , wherein the trend parameter is determined as a standardization of the current measured value in relation to the start value.

12 . The process in accordance with claim 9 , wherein

the current measured value is outputted on a display unit and a displayed measured value is selected as the start value by the operating action.

13 . The process in accordance with claim 9 , wherein a spontaneous respiratory rate of the patient is monitored by the sensor system and a signal element is actuated in case a predefined or predefinable threshold value is exceeded.

14 . The process in accordance with claim 9 ,

wherein a weaning mode is activated by means of the operating action on the system, and

wherein a CO 2 removal target is reduced automatically and in a controlled manner in the weaning mode.

15 . The process in accordance with claim 14 ,

wherein an influence of the controller on the CO 2 removal device is deactivated at a beginning of the reduction of the CO 2 removal target,

wherein the trend parameter is monitored in reference to a predefined or predefinable tolerance range during the reduction of the CO 2 removal target and

wherein the influence of the controller on the CO 2 removal device is reactivated and the reduction of the CO 2 removal target is deactivated, on the other hand, in case of a moving out of the tolerance range.

16 . The process according to claim 9 , further comprising

confirming a presence of an acceptable CO 2 concentration in the breathing gas by an operator of the system by the operating action;

regulating operation of the CO 2 removal device to or toward a CO 2 concentration characterized as being acceptable upon such the operating action and wherein removal of carbon dioxide from the blood of the patient is carried out during the regulated operation of the CO 2 removal device.

17 . The process according to claim 9 , wherein a computer program with program code is provided to carry one or more of the steps with the control program run by a processing unit in one or more of the medical devices.

18 . The system in accordance with claim 1 , wherein one or both of the medical devices provide a processor configured for:

detecting the current measured value concerning the expiratory CO 2 concentration in the breathing gas of the patient by means of the sensor system;

selecting the current measured value which is current as the start value by means of the operating action at the system; and

feeding:

the difference of the start value and the current measured value to the controller, which acts on the CO 2 removal device; or

a difference of the trend parameter formed with the start value and the set point for the trend parameter to the controller, which acts on the CO 2 removal device.

19 . The process in accordance with claim 9 , wherein the sensor system is further configured to detect the current measured value concerning the expiratory CO 2 concentration in the breathing gas of the patient comprises an end-expiratory CO 2 concentration in the breathing gas of the patient.

20 . A process for operating a system for supporting a blood gas exchange of a patient by ventilation as well as by extracorporeal blood gas exchange by a CO 2 removal, the process comprising:

providing the system comprising: a medical device comprising a ventilator; a medical device comprising a CO 2 removal device for the extracorporeal blood gas exchange; a controller configured to act on the CO 2 removal device; and a sensor system configured to detect a current measured value concerning an expiratory CO 2 concentration in the breathing gas of the patient, and wherein the current measured value is selectable as a start value by an operating action at the system wherein a difference of a trend parameter formed with the start value and a set point for the trend parameter is fed to the controller, the controller acting on the CO 2 removal device;

detecting a measured value concerning an expiratory CO 2 concentration in the breathing gas of the patient by means of the sensor system;

selecting the measured value which is current as the start value by means of an operating action at the system; and

feeding a difference between a trend parameter and a setpoint for the trend parameter to the controller, the trend parameter being a quotient of a currently determined measured value of the expiratory CO 2 concentration in the breathing gas of the patient and the start value of the expiratory CO 2 concentration in the breathing gas of the patient, the controller acting on the CO 2 removal device, the trend parameter corresponding to a CO 2 content of blood of the patient.