CN113521419A - VVA-ECMO and/or VAV-ECMO connected internal jugular vein drainage reflux cannula - Google Patents

VVA-ECMO and/or VAV-ECMO connected internal jugular vein drainage reflux cannula Download PDF

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Publication number
CN113521419A
CN113521419A CN202110829518.6A CN202110829518A CN113521419A CN 113521419 A CN113521419 A CN 113521419A CN 202110829518 A CN202110829518 A CN 202110829518A CN 113521419 A CN113521419 A CN 113521419A
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ecmo
blood
drainage
drainage tube
tube
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CN202110829518.6A
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邢朝阳
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/36Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
    • A61M1/3621Extra-corporeal blood circuits
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/36Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
    • A61M1/3621Extra-corporeal blood circuits
    • A61M1/3653Interfaces between patient blood circulation and extra-corporal blood circuit
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/36Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
    • A61M1/3621Extra-corporeal blood circuits
    • A61M1/3653Interfaces between patient blood circulation and extra-corporal blood circuit
    • A61M1/3659Cannulae pertaining to extracorporeal circulation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/36Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
    • A61M1/3621Extra-corporeal blood circuits
    • A61M1/3666Cardiac or cardiopulmonary bypass, e.g. heart-lung machines
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/36Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
    • A61M1/3621Extra-corporeal blood circuits
    • A61M1/3666Cardiac or cardiopulmonary bypass, e.g. heart-lung machines
    • A61M1/3667Cardiac or cardiopulmonary bypass, e.g. heart-lung machines with assisted venous return
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M60/00Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/10Location thereof with respect to the patient's body
    • A61M60/104Extracorporeal pumps, i.e. the blood being pumped outside the patient's body
    • A61M60/109Extracorporeal pumps, i.e. the blood being pumped outside the patient's body incorporated within extracorporeal blood circuits or systems
    • A61M60/113Extracorporeal pumps, i.e. the blood being pumped outside the patient's body incorporated within extracorporeal blood circuits or systems in other functional devices, e.g. dialysers or heart-lung machines
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M60/00Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/30Medical purposes thereof other than the enhancement of the cardiac output
    • A61M60/36Medical purposes thereof other than the enhancement of the cardiac output for specific blood treatment; for specific therapy
    • A61M60/38Blood oxygenation

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  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Cardiology (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Hematology (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Pulmonology (AREA)
  • Mechanical Engineering (AREA)
  • Emergency Medicine (AREA)
  • External Artificial Organs (AREA)

Abstract

The utility model provides a connect internal jugular vein drainage backward flow intubate of VVA-ECMO and/or VAV-ECMO, includes the intubate body, and the intubate body is equipped with drainage tube and back flow, and the back flow cover is located on the drainage tube, and the ring formula cavity between drainage tube outer wall and the inside wall of back flow constitutes blood return channel, and the back flow is equipped with blood entry end and a plurality of blood discharge hole, and the drainage tube is equipped with to insert end and tail end, and the end of inserting of drainage tube is equipped with the side opening that is convenient for blood to get into, still includes catheter sheath and the seal wire that matches with the drainage tube. The invention has the advantages that: 1. after the disposable implantation, the free switching of the VVA-ECMO treatment mode and the VAV-ECMO treatment mode or the sharing of the two treatment modes can be realized. 2. Can meet the blood flow velocity and flow rate required by drainage and backflow during treatment. 3. The problem of the conflict of the tube placing positions under the condition that two treatment modes of VVA-ECMO and VAV-ECMO are required at the same time is solved. 4. Effectively solves the problem of high mortality rate caused by two types of special complications of partial patients treated by VA-ECMO.

Description

VVA-ECMO and/or VAV-ECMO connected internal jugular vein drainage reflux cannula
Technical Field
The invention relates to an internal jugular vein cannula for extracorporeal membrane lung oxygenation treatment, in particular to an internal jugular vein cannula for extracorporeal membrane lung oxygenation treatment, which has the functions of drainage and backflow.
Background
Typically, extracorporeal membrane pulmonary oxygenation (ECMO) is used to treat severe cardiac and pulmonary failure. There are generally two types of ECMO used to provide temporary cardiopulmonary support to a patient. One type is the venous-venous ECMO (i.e., VV-ECMO) used to assist only the patient's pulmonary function, and the other type is the venous-arterial ECMO (i.e., VA-ECMO) used to assist the patient's cardiac and pulmonary functions.
For VA-ECMO treatment, when the femoral vein-femoral artery mode is adopted, two special complications may occur in some patients, one is left ventricular dilatation and pulmonary congestion which may occur after VA-ECMO, especially when there is very low left ventricular output or the aortic valve is not closed completely, the ECMO arterial duct ejects blood in a retrograde direction, the flow increases left ventricular afterload, ECMO operates at full flow, and some blood still flows back to the left heart from the bronchial veins and the minimum cardiac veins, which may finally cause left ventricular dilatation and pulmonary congestion. Meanwhile, due to the high-speed operation of the centrifugal pump, the phenomenon of tube shaking sometimes happens due to the fact that the single inferior vena cava blood leading end cannot meet the flow requirement. In the second category, differential hypoxia following VA-ECMO, also known as north-south syndrome, may occur, resulting in hypoxia in the brain and upper body. Both of these complications increase mortality. The complications are due to defects in the operating mode and piping design of the ECMO.
To address the above drawbacks, three-cannula approaches have been proposed in the industry, i.e., a veno-venous-arterial (VVA) cannula and a veno-arterial-venous cannula (VAV) cannula, which have been improved from the original veno-arterial cannula. The venous-arterial (VVA) intubation is added with a drainage tube (forming double drainage) to carry out VVA-ECMO treatment, and can improve left ventricular dilatation, pulmonary congestion and increase venous end blood flow; veno-arterial-venous cannulation (VAV) is a treatment with VAV-ECMO that adds a return tube to increase the supply of oxygenated arterial blood into the pulmonary circulation, improving differential hypoxia. In medical practice, the situation that VVA-ECMO treatment and VAV-ECMO treatment are required simultaneously can also occur, and the problem that the drainage tube and the return tube are arranged in the internal jugular vein simultaneously has the conflict of the tube arrangement positions. The special internal jugular vein drainage reflux intubation for connecting VVA-ECMO and/or VAV-ECMO needs to be designed clinically, the intubation needs the drainage tube and the reflux tube to have enough flow cross section area, and the drainage reflux effect is guaranteed.
Disclosure of Invention
The invention aims to provide an internal jugular vein drainage reflux cannula for connecting VVA-ECMO and/or VAV-ECMO.
The invention adopts the following technical scheme: the blood backflow prevention intubation device comprises an intubation body, wherein the intubation body is provided with a drainage tube and a backflow tube, the backflow tube is sleeved on the drainage tube, a ring sleeve type cavity between the outer wall of the drainage tube and the inner wall of the backflow tube forms a blood backflow channel, the backflow tube is provided with a blood inlet end and a plurality of blood discharge holes, the drainage tube is provided with an insertion end and a tail end, the insertion end of the drainage tube is provided with a side hole convenient for blood to enter, and the blood backflow prevention intubation device further comprises a catheter sheath and a guide wire which are matched with the drainage tube.
The device is placed in an internal jugular vein, has dual functions of drainage and backflow, and is used for connecting a vein-artery extracorporeal membrane pulmonary oxygenation (VVA-ECMO) pipeline or connecting a vein-artery-vein extracorporeal membrane pulmonary oxygenation (VAV-ECMO) pipeline or simultaneously opening two channels to realize the functions of drainage and backflow. During an insertion procedure, the insertion end is advanced into the right atrium. The detailed description is as follows: when the VVA-ECMO connection mode is adopted, namely on the basis of femoral vein-femoral artery VA-ECMO, a drainage pipeline inserted into an internal jugular vein is added through a drainage tube, the tail end of the drainage tube is connected to the femoral vein end in vitro through a pipeline to form a Y shape and is converged together, so that the blood in the right atrium is drained to the femoral vein end pipeline through the drainage tube, and the purposes of increasing the blood flow of the femoral vein end and treating left ventricular dilatation and pulmonary congestion are achieved; when the VAV-ECMO connection mode is adopted, namely on the basis of the femoral vein-femoral artery VA-ECMO, a return pipeline inserted into the internal jugular vein is added through the return pipeline, the blood inlet end of the return pipeline is connected to the femoral artery end through a pipeline to form a Y shape, so that oxygenated blood in the femoral artery end pipeline enters the internal jugular vein through the blood discharge hole of the return pipeline and then enters the superior vena cava, the cardiopulmonary circulation and the upper body arterial blood vessel, and the differential hypoxia is improved. When the VVA-ECMO and VAV-ECMO treatment modes are used together, two channels can be opened simultaneously. The side hole arranged at the insertion end of the drainage tube increases the drainage channel, and can avoid the condition of unsmooth blood drainage when the port at the insertion end is blocked. After the device is placed at one time, the VVA-ECMO and VAV-ECMO treatment modes can be freely switched and used in a combined way. The drainage tube is a hard tube, and needs to meet the strength requirement of being capable of enduring certain negative pressure and positive pressure without deformation, and the drainage tube can endure certain negative pressure, so that the tube wall is not likely to be shriveled inwards when the ECMO centrifugal pump sucks blood, and the sucking effect is affected.
The improved drainage catheter is characterized in that a positioning chuck is arranged at the tail end of the sheath of the catheter sheath and matched with an annular tube head at the tail end of the drainage tube. The positioning clamp can fix the extension length of the tip of the catheter sheath outside the drainage tube, so that the catheter sheath and the front end of the drainage tube cannot generate relative displacement in the embedding process, and the normal function of the catheter sheath can be ensured.
In another improvement, the number of the blood discharge holes is more than 3. More than 3 blood discharge holes are arranged, so that the normal blood flow can be ensured, and the blood stasis in the return pipe can be avoided.
In still another improvement, the number of the side holes is 2 to 4. And the drainage channel is smoother due to the plurality of side holes.
The invention has the following beneficial effects:
1. after the device is placed at one time, the VVA-ECMO and VAV-ECMO treatment modes can be freely switched, and the two treatment modes can be used in combination. When one of the treatment modes needs to be independently used, the other channel is disconnected. When the VVA-ECMO and VAV-ECMO treatment modes are used together, two channels can be opened simultaneously.
2. The device structure of the invention adopts the loop-type design of the return pipe, so that under the condition of unchanging the diameter of the internal jugular vein, the sufficient flow cross section area of the drainage tube and the return pipe can be ensured, and the blood flow velocity and flow rate required by drainage and return in the treatment period can be met.
3. The device has simple structure and convenient placing operation, reduces the operation procedures of respectively placing tubes in the VVA-ECMO and VAV-ECMO treatment modes, and solves the problem of tube placing position conflict when the VVA-ECMO and VAV-ECMO treatment modes are simultaneously used.
4. The operation safety is improved. After the device is placed in one time, the effects of blood drainage and backflow are guaranteed, and the problem of high mortality caused by two special complications of part of patients in a VA-ECMO treatment mode is effectively solved.
Drawings
FIG. 1 is a schematic cross-sectional view of an embodiment of the present invention.
FIG. 2 is a schematic diagram of the three cannula mode of blood circulation of the present invention placed in the internal jugular vein.
Fig. 3 is a schematic view of the insertion structure of the present invention into the internal jugular vein.
Fig. 4 is a schematic view of an assembly structure of an embodiment of the present invention with a catheter sheath.
In the figure: the catheter comprises a catheter body 1, a drainage tube 2, a return tube 3, a blood inlet end 4, a blood discharge hole 5, an insertion end 6, a side hole 7, a tail end 8, a right atrium 9, a catheter sheath 10 and a positioning chuck 11.
Detailed Description
As shown in fig. 1 to 4, an embodiment of the present invention includes a catheter body 1, the catheter body 1 is provided with a drainage tube 2 and a return tube 3, the return tube 3 is sleeved on the drainage tube 2, a loop-shaped cavity between an outer wall of the drainage tube 2 and an inner wall of the return tube 3 forms a blood return channel, the return tube 3 is provided with a blood inlet end 4 and a plurality of blood discharge holes 5, the drainage tube 2 is provided with an insertion end 6 and a tail end 8, the insertion end 6 of the drainage tube 2 is provided with a side hole 7 for allowing blood to enter, and the catheter body further includes a catheter sheath 10 and a guide wire which are matched with the drainage tube 2.
The device is placed in an internal jugular vein, has dual functions of drainage and backflow, and is used for connecting a vein-artery extracorporeal membrane pulmonary oxygenation (VVA-ECMO) pipeline or connecting a vein-artery-vein extracorporeal membrane pulmonary oxygenation (VAV-ECMO) pipeline or simultaneously opening two channels to realize the functions of drainage and backflow. As shown in FIG. 3, during the insertion procedure, the insertion end 6 is required to enter the right atrium 9. The detailed description is as follows: when a VVA-ECMO connection mode is adopted, namely on the basis of femoral vein-femoral artery VA-ECMO, a drainage pipeline inserted into an internal jugular vein is added through the drainage tube 2, the tail end 8 of the drainage tube 2 is connected to the femoral vein end in vitro through a pipeline to form a Y shape, and the Y shape is combined together to realize that the blood in the right atrium 9 is drained to the pipeline at the femoral vein end through the drainage tube 2, so that the aims of increasing the blood flow at the femoral vein end and treating left ventricular dilatation and pulmonary congestion are fulfilled; when the VAV-ECMO connection mode is adopted, namely on the basis of the femoral vein-femoral artery VA-ECMO, a return pipeline inserted into the internal jugular vein is added through the return pipeline 3, the blood inlet end 4 of the return pipeline 3 is connected to the femoral artery end through a pipeline to form a Y shape, so that oxygenated blood in the pipeline at the femoral artery end enters the internal jugular vein through the blood discharge hole 5 of the return pipeline 3 and then enters the superior vena cava, the cardiopulmonary circulation and the upper body arterial blood vessel, and the differential hypoxia is improved. When the VVA-ECMO and VAV-ECMO treatment modes are used together, two channels can be opened simultaneously. The side hole 7 arranged at the insertion end 6 of the drainage tube 2 increases a drainage channel, and can avoid the condition of unsmooth blood drainage when the port at the insertion end 6 is blocked. After the device is placed at one time, the VVA-ECMO and VAV-ECMO treatment modes can be freely switched and used in a combined way. Drainage tube 2 is the rigid tube, need to satisfy the indeformable intensity requirement of certain negative pressure of tolerating and malleation, and drainage tube 2 can tolerate certain negative pressure, and the pipe wall is unlikely to inwards flat income when can ensure the ECMO centrifugal pump suction blood, influences the suction effect.
As shown in fig. 4, in a modification, a positioning chuck 11 is arranged at the tail end of the catheter sheath 10, and the positioning chuck 11 is matched with the annular pipe head of the tail end 8 of the drainage pipe 2. The positioning clamp 11 can fix the extension length of the tip of the catheter sheath 10 outside the drainage tube 2, so that the catheter sheath 10 and the front end of the drainage tube 2 cannot generate relative displacement in the embedding process, and the normal function of the catheter sheath 10 is guaranteed.
In another modification, the number of the blood discharging holes 5 is 3 or more. More than 3 blood discharge holes 5 are arranged, so that the normal blood flow can be ensured, and the congestion in the return pipe 3 is avoided.
In a further improvement, the number of the side holes 7 is 2 to 4. And the drainage channel is smoother due to the plurality of side holes 7.
The invention is not limited to the specific structure of the above embodiment, and other equivalent structures are within the scope of the invention.

Claims (4)

1. An internal jugular vein drainage reflux cannula for connecting VVA-ECMO and/or VAV-ECMO, characterized in that: the blood backflow prevention intubation device comprises an intubation body, wherein the intubation body is provided with a drainage tube and a backflow tube, the backflow tube is sleeved on the drainage tube, a ring sleeve type cavity between the outer wall of the drainage tube and the inner wall of the backflow tube forms a blood backflow channel, the backflow tube is provided with a blood inlet end and a plurality of blood discharge holes, the drainage tube is provided with an insertion end and a tail end, the insertion end of the drainage tube is provided with a side hole convenient for blood to enter, and the blood backflow prevention intubation device further comprises a catheter sheath and a guide wire which are matched with the drainage tube.
2. An internal jugular vein drainage reflux cannula connected VVA-ECMO and/or VAV-ECMO according to claim 1, wherein: the tail end of the sheath of the catheter sheath is provided with a positioning chuck which is matched with the annular tube head at the tail end of the drainage tube.
3. An internal jugular vein drainage reflux cannula for connection of VVA-ECMO and/or VAV-ECMO according to claim 1 or 2, wherein: the number of the blood discharge holes is 3 or more.
4. An internal jugular vein drainage reflux cannula connected VVA-ECMO and/or VAV-ECMO according to claim 3, wherein: the number of the side holes is 2 to 4.
CN202110829518.6A 2021-07-22 2021-07-22 VVA-ECMO and/or VAV-ECMO connected internal jugular vein drainage reflux cannula Pending CN113521419A (en)

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CN202110829518.6A CN113521419A (en) 2021-07-22 2021-07-22 VVA-ECMO and/or VAV-ECMO connected internal jugular vein drainage reflux cannula

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CN202110829518.6A CN113521419A (en) 2021-07-22 2021-07-22 VVA-ECMO and/or VAV-ECMO connected internal jugular vein drainage reflux cannula

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN115068804A (en) * 2022-01-25 2022-09-20 邢朝阳 Bubble removal device for assisting ECMO conduit connection

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2015012240A1 (en) * 2013-07-25 2015-01-29 Kobayashi Yasuhiko Antegrade blood transmission cannula
US20170035987A1 (en) * 2014-04-24 2017-02-09 The Regents Of The University Of California Catheter for Portable Lung Assist Device
CN208448407U (en) * 2017-08-31 2019-02-01 常州市康心医疗器械有限公司 A kind of two-chamber jugular vein intubation
CN109414539A (en) * 2016-07-12 2019-03-01 怡忠科技股份有限公司 Extracorporeal life supports system
CN210056935U (en) * 2018-12-07 2020-02-14 李建朝 Double-cavity tube left ventricle auxiliary device with centrifugal blood pump through femoral artery
CN215537133U (en) * 2021-07-25 2022-01-18 邢朝阳 VVA-ECMO and/or VAV-ECMO connected internal jugular vein drainage reflux cannula

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2015012240A1 (en) * 2013-07-25 2015-01-29 Kobayashi Yasuhiko Antegrade blood transmission cannula
US20170035987A1 (en) * 2014-04-24 2017-02-09 The Regents Of The University Of California Catheter for Portable Lung Assist Device
CN109414539A (en) * 2016-07-12 2019-03-01 怡忠科技股份有限公司 Extracorporeal life supports system
CN208448407U (en) * 2017-08-31 2019-02-01 常州市康心医疗器械有限公司 A kind of two-chamber jugular vein intubation
CN210056935U (en) * 2018-12-07 2020-02-14 李建朝 Double-cavity tube left ventricle auxiliary device with centrifugal blood pump through femoral artery
CN215537133U (en) * 2021-07-25 2022-01-18 邢朝阳 VVA-ECMO and/or VAV-ECMO connected internal jugular vein drainage reflux cannula

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN115068804A (en) * 2022-01-25 2022-09-20 邢朝阳 Bubble removal device for assisting ECMO conduit connection

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