JP2018171340A - Blood purification device, control method thereof and blood removal failure solution method - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a blood purification device for performing blood removal through a puncture needle, capable of efficiently solving blood removal failure due to adhesion of a blood vessel of a patient to a hole of a puncture needle.SOLUTION: A blood purification device 1 comprises: a blood removal line 10; a blood pump 30; a first infusion line 50; an infusion container 51 which is connected to the first infusion line 50; a first opening/closing valve 52 for opening and closing the first infusion line 50; a second infusion line 60; an infusion pump 61 and a chamber 62 arranged on the second infusion line 60; a pressure sensor 40; and a control part 80, in which the infusion container 51 is arranged above a patient P in a vertical direction. When a pressure measured by a pressure sensor 40 in an operation time becomes smaller than a first prescribed value, the control part 80 supplies first, a second infusion to the chamber 62 by the infusion pump 61 until a pressure measured by the pressure sensor 40 becomes a second prescribed value or higher, then, stops the operation of the infusion pump 61 and then opens the first infusion line 50 by the first opening/closing valve 52.SELECTED DRAWING: Figure 1

Description

  The present invention relates to a blood purification apparatus, a control method thereof, and a method for eliminating poor blood removal.

  Conventionally, blood purification treatment has been performed in which blood is taken out from a patient's body, and pathogenic substances, specific white blood cells and the like are removed from the blood and returned to the body. In such blood purification treatment, a blood circuit for circulating blood taken out from the body and returning it to the body, and a blood purifier having a treatment material such as an adsorbent and a separation material for removing / separating a specific substance; Are used.

  The blood circuit of such a blood purification apparatus is connected to a patient's blood vessel via a puncture needle. For example, in the blood circuit, a blood removal line for circulating blood taken from the patient to the blood purifier is connected to the artery A of the patient via a puncture needle 100 as shown in FIG. In recent years, there has been proposed an automatic blood return device that returns blood remaining in the blood removal line to the patient via the puncture needle 100 by reversely rotating a blood pump provided in the blood flow path. (For example, refer to Patent Document 1).

JP 2005-224597 A

  Meanwhile, as shown in FIG. 6, a hole 101 for drawing blood is formed at the distal end of the puncture needle 100, and blood removal is performed through the hole 101 or the distal end of the puncture needle 100 (artery A). When drawing the blood in the blood removal line), as shown by a broken line in FIG. 7, the inner wall W of the artery A may stick to the hole 101, resulting in poor blood removal. In such a case, when the blood is caused to flow backward by a blood pump as described in Patent Document 1, the hole 101 of the puncture needle 100 is clogged by the coagulated mass, and there is a possibility that the blood removal failure may not be eliminated.

  The present invention has been made in view of such circumstances, and in a blood purification apparatus that performs blood removal via a puncture needle, it is effective for poor blood removal caused by a patient's blood vessel sticking to the hole of the puncture needle. The purpose is to eliminate it.

  In order to achieve the above object, a first blood purification apparatus according to the present invention includes a blood removal line for circulating blood taken from a patient to a blood purification device, a blood pump disposed on the blood removal line, and blood removal A first infusion line for supplying the first infusion upstream from the blood pump of the line, an infusion container connected to the first infusion line, a first on-off valve for opening and closing the first infusion line, and blood removal A second infusion line for supplying the second infusion upstream of the blood pump of the line, an infusion pump disposed on the second infusion line, and a downstream of the infusion pump of the second infusion line A chamber, a pressure sensor for measuring the pressure of the blood removal line, and a controller for controlling the infusion pump and the first on-off valve, wherein the infusion container is disposed vertically above the patient. And the control unit is blood pump (and When the pressure measured by the pressure sensor during operation of the liquid pump becomes smaller than the first predetermined value, the second infusion is chambered by the infusion pump until the pressure measured by the pressure sensor becomes equal to or higher than the second predetermined value. Then, the operation of the infusion pump is stopped and the first infusion line is opened by the first on-off valve. At this time, the first predetermined value can be set within a range of −400 mmHg to 20 mmHg, and the second predetermined value can be set within a range of −100 mmHg to 50 mmHg.

  The control method according to the present invention includes a blood removal line for circulating blood taken from a patient to a blood purifier, a blood pump disposed on the blood removal line, and an upstream side of the blood pump of the blood removal line. A first infusion line for supplying the first infusion, an infusion container connected to the first infusion line, a first on-off valve for opening and closing the first infusion line, and upstream of the blood pump in the blood removal line A second infusion line for supplying the second infusion, an infusion pump disposed on the second infusion line, a chamber disposed downstream of the infusion pump of the second infusion line, and the pressure of the blood removal line. A blood purification device in which the infusion container is arranged vertically above the patient, and the pressure measured by the pressure sensor during operation of the blood pump is lower than the first predetermined value. If it becomes smaller, The second infusion is supplied to the chamber by the infusion pump until the pressure measured by the pressure sensor becomes equal to or higher than the second predetermined value, and then the operation of the infusion pump is stopped and the first infusion line is opened by the first on-off valve. In addition, the control unit controls the infusion pump and the first on-off valve.

  Moreover, the blood removal failure elimination method according to the present invention includes a blood removal line for circulating blood taken from a patient to a blood purifier, a blood pump disposed on the blood removal line, and a blood pump of the blood removal line. Than the first infusion line that supplies the first infusion to the upstream side, the infusion container connected to the first infusion line, the first on-off valve that opens and closes the first infusion line, and the blood pump of the blood removal line A second infusion line for supplying the second infusion to the upstream side, an infusion pump disposed on the second infusion line, a chamber disposed on the downstream side of the infusion pump of the second infusion line, and a blood removal line A blood removal device for eliminating blood removal failure in a blood purification apparatus in which an infusion container is arranged vertically above a patient, and the pressure measured by the pressure sensor during operation of the blood pump is Smaller than the first predetermined value First, the second infusion is supplied to the chamber by the infusion pump until the pressure measured by the pressure sensor becomes equal to or higher than the second predetermined value, and then the operation of the infusion pump is stopped and the first on-off valve is used to stop the first infusion. The infusion line is opened.

  When such a configuration and method are employed, when the measured blood pressure of the blood removal line becomes lower than a first predetermined value (eg, −200 mmHg) during operation of the blood pump or infusion pump (eg, provided at the tip of the blood removal line). In the case where the blood vessel of the patient sticks to the hole of the puncture needle, and blood removal failure occurs), first, the second pressure is measured with the infusion pump until the measured pressure becomes a second predetermined value (for example, −50 mmHg) or more. Can be supplied to the chamber, and then the infusion pump can be turned off and the first infusion line can be opened. Thereby, in the state where the pressure of the blood removal line measured through the chamber is returned to the second predetermined value or more, the infusion in the infusion container arranged vertically above the patient is not allowed to flow back into the chamber. The blood can be naturally flowed through the first infusion line and supplied to the blood removal line, and the blood in the blood removal line can be slightly reversed to the patient side. In this way, the blood in the blood removal line is slightly backflowed to the patient side using the difference in height between the infusion container and the patient without backflowing the blood by the blood pump. It is possible to prevent such a situation that the needle hole is clogged, and it is possible to safely eliminate the blood removal failure.

  The blood purification apparatus according to the present invention may include a second opening / closing valve that is disposed upstream of the first infusion line and the second infusion line of the blood removal line and that opens and closes the blood removal line. In such a case, when the pressure measured by the pressure sensor during operation of the blood pump becomes smaller than the first predetermined value, the control unit first closes the blood removal line with the second on-off valve, and then measures with the pressure sensor. The second infusion is supplied to the chamber by the infusion pump until the pressure reaches the second predetermined value or higher, and then the operation of the infusion pump is stopped and the first infusion line is opened by the first on-off valve and the second on-off The blood removal line can be opened with a valve.

  When such a configuration is adopted, when the measured blood pressure of the blood removal line becomes smaller than the first predetermined value during the operation of the blood pump, the blood removal line is first closed, and then the measured pressure is the second pressure. The second infusion can be supplied to the chamber by the infusion pump until the predetermined value or more is reached, and then the operation of the infusion pump can be stopped and the first infusion line and the blood removal line can be opened. Thereby, when the cause of the blood removal failure is removed while returning the pressure of the blood removal line to the second predetermined value or more, the blood of the patient can be prevented from flowing into the chamber.

  In the blood purification apparatus according to the present invention, an air bubble detector can be provided in the first infusion line or the blood removal line located between the patient and the first infusion line. In such a case, the control unit can close the first infusion line with the first on-off valve when the air bubble detector detects air bubbles when the first infusion line is opened with the first on-off valve. In addition, when the control unit detects air bubbles with the bubble detector when the first infusion line is opened with the first on-off valve and the blood removal line is opened with the second on-off valve, blood is removed with the second on-off valve. The line may be closed and / or the first infusion line may be closed with a first on-off valve.

  When such a configuration is adopted, when the first infusion line or the blood removal line is opened in order to eliminate the blood removal failure, the first infusion line (or the blood removal line located between the patient and the first infusion line) is used. When air bubbles are detected by the provided air bubble detector, the first infusion line and blood removal line can be closed. Therefore, it is possible to prevent bubbles from being included in blood or infusion fluid that flows back to the patient side.

  In the blood purification apparatus according to the present invention, the control unit can stop or decelerate the operation of the blood pump when the pressure measured by the pressure sensor during operation of the blood pump becomes smaller than the first predetermined value.

  When such a configuration is adopted, the operation of the blood pump can be stopped or slowed down when the measured blood removal line pressure becomes smaller than the first predetermined value during the operation of the blood pump. Therefore, it is possible to prevent the infusion supplied from the infusion container to the blood removal line by natural flow from flowing to the opposite side of the patient by the blood pump.

  In the blood purification apparatus according to the present invention, the control unit stops or decelerates the operation of the blood pump, and then causes the second infusion to flow into the chamber with the infusion pump until the pressure measured by the pressure sensor becomes equal to or higher than the second predetermined value. Then, the operation of the infusion pump is stopped, the first infusion line is opened by the first on-off valve, and then the first infusion line is closed by the first on-off valve, and the operation of the blood pump and the infusion pump is performed in a predetermined manner. The flow rate can be resumed at a flow rate (for example, a flow rate before the operation of the blood pump is stopped or decelerated).

  When such a configuration is adopted, during the operation of the blood pump, after the operation of the blood pump is stopped or slowed down, the second infusion is supplied by the infusion pump until the measured pressure becomes equal to or higher than the second predetermined value, and then the infusion By stopping the pump operation and opening the first infusion line, the blood removal failure can be solved, and then the first infusion line is closed to automatically operate the blood pump and infusion pump at a predetermined flow rate. Can be resumed.

  In the blood purification apparatus according to the present invention, the control unit can open the infusion line for a predetermined time with the first on-off valve.

  When such a configuration is adopted, when the measured blood removal line pressure becomes lower than the first predetermined value during the operation of the blood pump, the infusion pump first sets the measured pressure until the measured pressure becomes equal to or higher than the second predetermined value. The second infusion can be supplied, and then the operation of the infusion pump can be stopped and the first infusion line can be opened for a predetermined time (for example, 1-2 seconds). That is, the open state of the first infusion line can be controlled based on time.

  In the blood purification apparatus according to the present invention, the control unit can open the infusion line with the first on-off valve until the pressure measured by the pressure sensor becomes equal to or higher than the third predetermined value. As the third predetermined value, a value larger than the first predetermined value (for example, a value in the range of −50 mmHg to 50 mmHg) can be adopted.

  When such a configuration is adopted, when the measured blood removal line pressure becomes lower than the first predetermined value during the operation of the blood pump, the infusion pump first sets the measured pressure until the measured pressure becomes equal to or higher than the second predetermined value. The second infusion can be supplied, and then the operation of the infusion pump can be stopped and the first infusion line can be opened until the measured pressure reaches a third predetermined value (for example, 0 mmHg) or more. That is, the open state of the first infusion line can be controlled based on the pressure.

  A second blood purification apparatus according to the present invention includes a blood removal line for circulating blood taken from a patient to a blood purification device, a blood pump disposed on the blood removal line, and a blood pump upstream of the blood pump of the blood removal line. A first infusion line for supplying the first infusion to the side, an infusion container connected to the first infusion line, a first on-off valve for opening and closing the first infusion line, and upstream of the blood pump in the blood removal line A second infusion line for supplying a second infusion to the side, an infusion pump disposed on the second infusion line, a pressure sensor for measuring the pressure of the blood removal line, an infusion pump, and a first on-off valve The infusion container is arranged vertically above the patient, and the control unit is configured such that the pressure measured by the pressure sensor during operation of the blood pump is smaller than the first predetermined value. First, measure with a pressure sensor. The second infusion is supplied to the second infusion line with the infusion pump until the pressure exceeds the second predetermined value, and then the operation of the infusion pump is stopped and the first infusion line is opened with the first on-off valve. is there.

  When such a configuration is adopted, when the blood removal line pressure becomes lower than the first predetermined value during the operation of the blood pump, first, the second pressure is applied by the infusion pump until the measured pressure becomes equal to or higher than the second predetermined value. Can be supplied to the second infusion line, and then the operation of the infusion pump can be stopped and the first infusion line can be opened. Thereby, in the state where the pressure of the blood removal line measured through the second infusion line is returned to the second predetermined value or more, the infusion in the infusion container arranged vertically above the patient is transferred to the second infusion line. In this case, the blood is allowed to flow naturally through the first infusion line and supplied to the blood removal line, and the blood in the blood removal line can be slightly reversed to the patient side. In this way, the blood in the blood removal line is slightly backflowed to the patient side using the difference in height between the infusion container and the patient without backflowing the blood by the blood pump. It is possible to prevent such a situation that the needle hole is clogged, and it is possible to safely eliminate the blood removal failure.

  ADVANTAGE OF THE INVENTION According to this invention, in the blood purification apparatus which performs blood removal through a puncture needle, it becomes possible to effectively eliminate the blood removal failure caused by the patient's blood vessel sticking to the hole of the puncture needle. .

It is a block diagram for demonstrating the whole structure of the blood purification apparatus which concerns on embodiment of this invention. It is a figure for demonstrating the control method of the blood purification apparatus shown in FIG. 1 (the figure of the state in which the 1st infusion line was obstruct | occluded). It is explanatory drawing which shows the state which the chamber of the blood purification apparatus was narrowed by the negative pressure. It is a figure for demonstrating the control method of the blood purification apparatus shown in FIG. 1 (the figure of the state which supplied the 2nd infusion to the chamber with the infusion pump). It is a figure for demonstrating the control method of the blood purification apparatus shown in FIG. 1 (figure in the state where the 1st infusion line was opened). It is an enlarged view of the puncture needle provided in the front-end | tip of the blood removal line of the blood purification apparatus. It is a figure which shows the state which the blood vessel stuck to the hole of the puncture needle shown in FIG. 6, and the blood loss defect generate | occur | produced.

  Embodiments of the present invention will be described below with reference to the drawings. In addition, the following embodiment is a suitable application example to the last, Comprising: The application range of this invention is not limited to this.

  First, the configuration of the blood purification apparatus 1 according to the embodiment of the present invention will be described with reference to FIG.

  The blood purification apparatus 1 according to this embodiment is used for so-called leukocyte removal therapy (LCAP), and as shown in FIG. 1, a blood removal line 10, a blood purification device 20, a blood pump 30, a pressure sensor 40, A first infusion line 50, an infusion container 51, a first on-off valve 52, a second infusion line 60, an infusion pump 61, a chamber 62, a second on-off valve 70, a control unit 80, a blood return line 90, and the like are provided.

  The blood removal line 10 is a flow path for circulating the blood taken out from the patient P to the blood purifier 20, and the blood return line 90 is a flow for returning the blood purified by the blood purifier 20 to the patient P. Road. The blood removal line 10 and the blood return line 90 constitute a blood circuit for circulating the blood taken out from the body of the patient P and returning it to the body. A puncture needle 100 as shown in FIG. 6 is provided at the distal end of the blood removal line 10, and the blood removal line 10 is connected to the artery of the patient P through the puncture needle 100. Similarly, the blood return line 90 is connected to the vein of the patient P via a puncture needle (not shown).

  The blood purifier 20 purifies the activated white blood cells contained in the blood introduced from the blood inlet 21 by removing it with a filter, and discharges the purified blood from the blood outlet 22. A filter having an adsorbent that removes white blood cells can be employed.

  As shown in FIG. 1, the blood pump 30 is disposed on the blood removal line 10, and operates (forward rotation) under the control of the control unit 80, thereby allowing the patient P to pass through the blood removal line 10. It functions to distribute blood to the blood purifier 20. On the other hand, when the control unit 80 stops the operation of the blood pump 30, the blood flow in the blood removal line 10 is stopped.

  The first infusion line 50 is a flow path for supplying the infusion to the upstream side of the blood pump 30 of the blood removal line 10. The first infusion line 50 in the present embodiment is provided with a bubble detector 53 that detects bubbles included in the infusion flowing through the first infusion line 50. Information about the detection result of the bubble detector 53 is sent to the control unit 80 and used for controlling the first on-off valve 52 and the like.

  The infusion container 51 is a container for storing the infusion, and is connected to the tip of the first infusion line 50. The infusion container 51 in the present embodiment is disposed vertically above the patient P. Thus, when the first infusion line 50 is opened by the first on-off valve 52, the infusion moves from the infusion container 51 to the patient P side by natural flow. In the present embodiment, physiological saline is adopted as the infusion stored in the infusion container 51.

  As shown in FIG. 1, the first on-off valve 52 is disposed on the first infusion line 50 and functions to open and close the first infusion line 50 by operating under the control of the control unit 80. When the first infusion line 50 is opened by the first on-off valve 52, the infusion flows from the infusion container 51 through the first infusion line 50 to the blood removal line 10 and stays in the blood removal line 10 by this infusion. The blood that has been returned is returned to the patient P side. This eliminates poor blood removal.

  The second infusion line 60 is a flow path for supplying the second infusion to the upstream side of the blood pump 30 of the blood removal line 10. As shown in FIG. 1, a second infusion container 63 for storing the second infusion is connected to the tip of the second infusion line 60. In the present embodiment, the second infusion line 60 is connected to a position downstream of the first infusion line 50 of the blood removal line 10. In the present embodiment, an anticoagulant is employed as the second infusion stored in the second infusion container 63.

  As shown in FIG. 1, the infusion pump 61 is disposed on the second infusion line 60, and operates (forward rotation) under the control of the control unit 80, thereby passing the second infusion line 60 through the second infusion line 60. It functions to distribute the second infusion to the blood removal line 10 side. On the other hand, when the control unit 80 stops the operation of the infusion pump 61, the flow of the second infusion in the second infusion line 60 is stopped.

  The chamber 62 is for preventing bubbles flowing through the second infusion line 60 from flowing into the blood removal line 10, and as shown in FIG. 1, the downstream side of the infusion pump 61 of the second infusion line 60. Is arranged. The chamber 62 is provided with a pressure sensor 40 as shown in FIG. The pressure sensor 40 functions to measure the pressure of blood flowing through the blood removal line 10 via the chamber 62. The pressure measured by the pressure sensor 40 is sent to the control unit 80 and used to control the blood pump 30, the first on-off valve 51, the infusion pump 61, and the second on-off valve 70.

  The second on-off valve 70 is disposed upstream of the first infusion line 50 and the second infusion line 60 of the blood removal line 10 and operates under the control of the control unit 80 to open and close the blood removal line 10. To function. When the measured blood pressure of the blood removal line 10 becomes smaller than the first predetermined value during the operation of the blood pump 30, the blood removal line 10 is first closed by the second on-off valve 70, and then the measured pressure The second infusion pump 61 supplies the second infusion to the chamber 62 until the value reaches the second predetermined value or higher. Subsequently, the operation of the infusion pump 61 is stopped and the first on-off valve 51 opens the first infusion line 50. The blood removal line 10 can be opened by the second on-off valve 70. Thereby, when the cause of the blood removal failure is removed while returning the pressure of the blood removal line 10 to the second predetermined value or more, the blood of the patient can be prevented from flowing into the chamber 62.

  The control unit 80 is configured by, for example, a computer including a memory, a CPU (Central Processing Unit), and the like, and controls various devices of the blood purification apparatus 1 by the CPU executing various programs recorded in the memory.

  Specifically, the control unit 80 first stops the operation of the blood pump 30 when the pressure measured by the pressure sensor 40 during the operation of the blood pump 30 becomes smaller than a first predetermined value (for example, −200 mmHg). At the same time, the blood removal line 10 is closed by the second on-off valve 70, and then the second infusion is supplied to the chamber 62 by the infusion pump 61 until the pressure measured by the pressure sensor 40 becomes a second predetermined value (for example, −50 mmHg) or more. Subsequently, the operation of the infusion pump 61 is stopped, the first infusion line 50 is opened for a predetermined time (for example, 1 to 2 seconds) by the first on-off valve 52, and the blood removal line 10 is opened by the second on-off valve 70. Thus, the blood pump 30, the first on-off valve 52, and the second on-off valve 70 are controlled. At this time, when the control unit 80 detects the bubbles with the bubble detector 53 when the first infusion line 50 is opened with the first on-off valve 52 and the blood removal line 10 is opened with the second on-off valve 70, The first infusion line 50 is closed with the first on-off valve 52 (and / or the blood removal line 10 is closed with the second on-off valve 70). Thereafter, the control unit 80 closes the first infusion line 50 with the first on-off valve 52 and restarts the operation of the blood pump 30 at a predetermined flow rate (for example, the flow rate before the operation of the blood pump 30 is stopped). The first predetermined value can be set within a range of −400 mmHg to 20 mmHg, and the second predetermined value can be set within a range of −100 mmHg to 50 mmHg.

  Next, a control method (blood removal failure elimination method) of the blood purification apparatus 1 according to the embodiment of the present invention will be described with reference to FIGS.

  First, as shown in FIG. 2, the control unit 80 closes the first infusion line 50 with the first on-off valve 52 and operates the blood pump 30 (and the infusion pump 61) and the pressure of the blood removal line 10. Is measured by the pressure sensor 40, and when the measured pressure becomes smaller than a first predetermined value (for example, −200 mmHg), it is determined that a blood removal failure has occurred. Such poor blood removal occurs, for example, due to the patient's P blood vessel sticking to the hole 101 of the puncture needle 100 as shown in FIG.

  When such a poor blood removal occurs, the blood pump 30 is operated to create a negative pressure in the blood removal line 10 and the second infusion line 60, thereby providing the second infusion line 60 as shown in FIG. The formed chamber 62 may be constricted. In such a case, when the first infusion line 50 is opened by the first on-off valve 52 in order to supply the infusion from the infusion container 51 to the blood removal line 10 in order to eliminate the poor blood removal, the negative pressure in the chamber 62 causes There may occur a situation in which the infusion supplied from the infusion container 51 to the blood removal line 10 or the blood in the blood removal line 10 flows back into the chamber 62. When such a situation occurs, the second infusion (anticoagulant) supplied from the second infusion line 60 may be diluted and the coagulation function may be reduced.

  Therefore, when detecting a blood removal failure, the control unit 80 in the present embodiment first stops the operation of the blood pump 30 and closes the blood removal line 10 with the second on-off valve 70 as shown in FIG. The blood pump 30 and the infusion pump 61 are controlled so that the infusion pump 61 supplies the second infusion to the chamber 62 until the pressure measured by the pressure sensor 40 becomes equal to or higher than a second predetermined value (for example, −50 mmHg). Next, as shown in FIG. 5, the control unit 80 stops the operation of the infusion pump 61, opens the first infusion line 50 with the first on-off valve 52 for a predetermined time (for example, 1-2 seconds), and opens and closes the second The infusion pump 61, the first on-off valve 52, and the second on-off valve 70 are controlled so that the blood removal line 10 is opened by the valve 70. When the infusion line 50 is opened by the first on-off valve 52 and the blood removal line 10 is opened by the second on-off valve 70, the infusion flows from the infusion container 51 into the blood removal line 10 via the first infusion line 50. By this infusion, blood staying in the blood removal line 10 is returned to the patient P side. This eliminates poor blood removal.

  If the air bubble detector 53 detects air bubbles when the first opening / closing valve 52 opens the first infusion line 50, the control unit 80 immediately closes the first infusion line 50 with the first opening / closing valve 52. (And / or the blood removal line 10 is closed by the second on-off valve 70). Thereby, it is possible to prevent bubbles from being included in blood (or infusion) that flows backward to the patient P side. Thereafter, the controller 80 closes the first infusion line 50 with the first opening / closing valve 52 and restarts the operation of the blood pump 30 at a predetermined flow rate.

  In the blood purification apparatus 1 according to the embodiment described above, the pressure of the blood removal line 10 measured through the chamber 62 disposed in the second infusion line 60 during the operation of the blood pump 30 and the infusion pump 61 is the first. When the blood pressure is smaller than a predetermined value (for example, −200 mmHg) (for example, when the blood vessel of the patient P sticks to the hole 101 of the puncture needle 100 provided at the distal end of the blood removal line 10 and the blood removal failure occurs. First, the infusion pump 61 supplies the second infusion to the chamber 62 until the measured pressure becomes a second predetermined value (for example, −50 mmHg) or more, and then the operation of the infusion pump 61 is stopped and the first infusion is stopped. The infusion line 50 can be opened. Thus, the infusion supplied from the infusion container 51 disposed vertically above the patient P in the state where the pressure of the blood removal line 10 measured through the chamber 62 is returned to the second predetermined value or more is Without being caused to flow back to 62, the blood can flow naturally through the first infusion line 50 and be supplied to the blood removal line 10, and the blood in the blood removal line 10 can be slightly reversed to the patient P side. . As described above, the blood in the blood removal line 10 is slightly reversed to the patient P side by utilizing the difference in height between the infusion container 51 and the patient P without causing the blood to flow backward by the blood pump 30. In addition, it is possible to prevent a situation in which the hole 101 of the puncture needle 100 is clogged by the coagulated mass, and it is possible to safely eliminate poor blood removal.

  In the blood purification apparatus 1 according to the embodiment described above, the pressure of the blood removal line 10 measured through the chamber 62 disposed in the second infusion line 60 is the first predetermined value when the blood pump 30 is in operation. When the value is smaller than the value, the blood removal line 10 is first closed, and then the second infusion is supplied to the chamber 62 by the infusion pump 61 until the measured pressure becomes equal to or higher than the second predetermined value. The operation of the infusion pump 61 can be stopped and the first infusion line 50 and the blood removal line 10 can be opened. Thereby, when the cause of the blood removal failure is removed while returning the pressure of the blood removal line 10 measured through the chamber 62 to the second predetermined value or more, the blood of the patient P flows into the chamber 62. This can be prevented.

  Further, in the blood purification apparatus 1 according to the embodiment described above, when the first infusion line 50 and the blood removal line 10 are opened in order to eliminate the blood removal failure, the bubble detection provided in the first infusion line 50 is detected. When air bubbles are detected by the device 53, the first infusion line 50 and the blood removal line 10 can be closed. Therefore, it is possible to prevent bubbles from being included in blood or infusion fluid that flows back to the patient P side.

  In the blood purification apparatus 1 according to the embodiment described above, the pressure of the blood removal line 10 measured through the chamber 62 disposed in the second infusion line 60 is the first predetermined value when the blood pump 30 is in operation. When it becomes smaller than the value, the operation of the blood pump 30 can be stopped. Therefore, it is possible to prevent the infusion supplied from the infusion container 51 to the blood removal line 10 by natural flow from flowing to the opposite side of the patient P by the blood pump 30.

  In the blood purification apparatus 1 according to the embodiment described above, the infusion pump 61 is operated until the measured pressure becomes equal to or higher than the second predetermined value after the operation of the blood pump 30 is stopped during the operation of the blood pump 30. Then, the second infusion is supplied, and then the operation of the infusion pump 61 is stopped and the first infusion line 50 is opened to eliminate the blood removal failure, and then the first infusion line 50 is closed. The operation of the blood pump 30 and the infusion pump 61 can be automatically restarted at a predetermined flow rate.

  In the blood purification apparatus 1 according to the embodiment described above, the pressure of the blood removal line 10 measured through the chamber 62 disposed in the second infusion line 60 is the first predetermined value when the blood pump 30 is in operation. When the pressure becomes smaller than the value, first, the second infusion is supplied by the infusion pump 61 until the measured pressure becomes the second predetermined value or more, and then the operation of the infusion pump 61 is stopped and the first infusion line 50 is turned on. It can be opened for a predetermined time (for example, 1 to 2 seconds). That is, the open state of the first infusion line 50 can be controlled based on time.

  In addition, in this embodiment, although the example which provided the bubble detector 53 in the 1st infusion line 50 was shown, it is located between the patient P and the 1st infusion line 50 as shown with the broken line in FIG. A bubble detector 11 may be provided in the blood removal line 10.

  Moreover, in this embodiment, although the example which has arrange | positioned the 2nd infusion line 60 in the downstream of the 1st infusion line 50 was shown, even if it arrange | positions the 2nd infusion line 60 in the upstream of the 1st infusion line 50, it was. Good.

  Moreover, the control part 80 in this embodiment opened the 1st infusion line 50, after stopping the driving | operation of the blood pump 30, when the pressure measured with the pressure sensor 40 became smaller than the 1st predetermined value. Although an example is shown, when the flow rate of the blood pump 30 is relatively small, the first infusion line 50 is set after the operation of the blood pump 30 is continued (or the speed is reduced without stopping completely). You may open it.

  Moreover, the control part 80 in this embodiment opens the 1st infusion line 50 with the 1st on-off valve 52 for the predetermined time, when the pressure measured with the pressure sensor 40 becomes smaller than a 1st predetermined value (namely, it is). An example in which the open state of the first infusion line 50 is controlled based on time) is shown, but the control mode of the first on-off valve 52 is not limited to this. For example, when the pressure measured by the pressure sensor 40 becomes smaller than the first predetermined value, the control unit 80 opens and closes the first until the pressure measured by the pressure sensor 40 becomes equal to or higher than a third predetermined value (for example, 0 mmHg). The infusion line 50 can be opened by the valve 52 (that is, the open state of the first infusion line 50 is controlled based on the pressure). Here, as the third predetermined value, a value larger than the first predetermined value (for example, a value in the range of −50 mmHg to 50 mmHg) can be adopted.

  The control unit 80 in the present embodiment first closes the blood removal line 10 with the second on-off valve 70 when the pressure measured by the pressure sensor 40 during operation of the blood pump 30 becomes smaller than the first predetermined value. Although the example (FIG. 4) which showed was shown, the blood removal line 10 does not necessarily need to be obstruct | occluded with the 2nd on-off valve 70 in this case.

  Moreover, in this embodiment, although the example which provided the chamber 62 in the 2nd infusion line 60 was shown, instead of providing the chamber 62 in the 2nd infusion line 60, the pressure sensor 40 which measures the pressure of the blood removal line 10 is shown. Can also be provided in the blood removal line 10. In such a case, when the pressure measured by the pressure sensor 40 during operation of the blood pump 30 becomes smaller than the first predetermined value, the control unit 80 first sets the pressure measured by the pressure sensor 40 to be equal to or higher than the second predetermined value. Until the second infusion pump 61 supplies the second infusion to the second infusion line 60, the operation of the infusion pump 61 is stopped, and the first on-off valve 52 is opened to open the first infusion line 50. An effect of eliminating blood failure can be obtained.

  Moreover, in this embodiment, although the example which connected the 1st infusion line 50 and the 2nd infusion line 60 to the blood removal line 10 in the separate position (merging part) was shown, for example, it is upstream from the 1st infusion line 50. The line branched to the side may be the second infusion line 60.

  Moreover, in this embodiment, although the example which has arrange | positioned the pressure sensor 40 via the chamber 62 was shown, the pressure sensor 40 may be arrange | positioned on the blood removal line 10 or it arrange | positions on the 1st infusion line 50. May be.

  Moreover, in this embodiment, although the example which applied this invention to the blood purification apparatus used for leukocyte removal therapy (LCAP) was shown, the same structure (a puncture needle, a blood removal line, a blood pump, a pressure sensor, The present invention can also be applied to other blood purification apparatuses including a first infusion line, an infusion container, a first on-off valve, a second infusion line, an infusion pump, and the like. For example, simple plasma exchange therapy (PE), double filtration plasma exchange therapy (DFPP), continuous hemofiltration therapy (CHF), continuous hemodialysis therapy (CHD), continuous hemodiafiltration therapy (CHDF), etc. The present invention can also be applied to a blood purification apparatus provided with a blood purifier for filtration and diffusion.

  The present invention is not limited to the above-described embodiments, and those in which those skilled in the art appropriately modify the design are included in the scope of the present invention as long as they have the features of the present invention. . In other words, each element included in the embodiment and its arrangement, material, condition, shape, size, and the like are not limited to those illustrated, and can be appropriately changed. Moreover, each element with which the said embodiment is provided can be combined as much as technically possible, and the combination of these is also included in the scope of the present invention as long as it includes the features of the present invention.

DESCRIPTION OF SYMBOLS 1 ... Blood purification apparatus 10 ... Blood removal line 11 ... Bubble detector 20 ... Blood purifier 30 ... Blood pump 40 ... Pressure sensor 50 ... First infusion line 51 ... Infusion container 52 ... First on-off valve 53 ... Bubble detector 60 ... second infusion line 61 ... infusion pump 62 ... chamber 70 ... second on-off valve 80 ... control unit P ... patient

Claims (16)

A blood removal line for distributing blood taken from a patient to a blood purifier, a blood pump disposed on the blood removal line, and a first infusion fluid upstream of the blood pump in the blood removal line A first infusion line; an infusion container connected to the first infusion line; a first on-off valve for opening and closing the first infusion line; and a second upstream of the blood pump in the blood removal line. A second infusion line for supplying the infusion, an infusion pump disposed on the second infusion line, a chamber disposed on the downstream side of the infusion pump in the second infusion line, and a pressure of the blood removal line A blood purification apparatus comprising: a pressure sensor for measuring the pressure; and a control unit for controlling the infusion pump and the first on-off valve,
The infusion container is arranged vertically above the patient,
When the pressure measured by the pressure sensor during the operation of the blood pump becomes smaller than a first predetermined value, the control unit first performs the infusion until the pressure measured by the pressure sensor becomes equal to or higher than a second predetermined value. A blood purification apparatus that supplies the second infusion to the chamber by a pump, then stops the operation of the infusion pump and opens the first infusion line by the first on-off valve. A second on-off valve disposed on the upstream side of the first infusion line and the second infusion line of the blood removal line to open and close the blood removal line;
When the pressure measured by the pressure sensor during operation of the blood pump becomes smaller than the first predetermined value, the control unit first closes the blood removal line with the second on-off valve, and then the pressure The second infusion is supplied to the chamber by the infusion pump until the pressure measured by the sensor becomes equal to or higher than the second predetermined value, and then the operation of the infusion pump is stopped and the first on-off valve is used to stop the first infusion. The blood purification apparatus according to claim 1, wherein one infusion line is opened and the blood removal line is opened by the second on-off valve. A bubble detector is provided in the first infusion line or in the blood removal line located between the patient and the first infusion line;
The control unit closes the first infusion line with the first on-off valve when the bubble detector detects air bubbles when the first infusion line is opened with the first on-off valve. 3. The blood purification apparatus according to 1 or 2. A bubble detector is provided in the first infusion line or in the blood removal line located between the patient and the first infusion line;
When the air bubble detector detects air bubbles when the first on-off valve opens the first infusion line and the second on-off valve opens the blood removal line, The blood purification apparatus according to claim 2, wherein the blood removal line is closed with an on-off valve and / or the first infusion line is closed with the first on-off valve.   5. The control unit according to claim 1, wherein the control unit stops or decelerates the operation of the blood pump when the pressure measured by the pressure sensor during the operation of the blood pump becomes smaller than the first predetermined value. The blood purification apparatus according to claim 1.   The control unit supplies the second infusion to the chamber with the infusion pump until the pressure measured by the pressure sensor becomes equal to or higher than the second predetermined value after stopping or slowing down the operation of the blood pump. Then, the operation of the infusion pump is stopped, the first infusion line is opened by the first on-off valve, and then the first infusion line is closed by the first on-off valve, and the blood pump and the infusion pump The blood purification apparatus according to claim 5, wherein the operation is restarted at a predetermined flow rate.   The blood purification apparatus according to claim 6, wherein the predetermined flow rate is a flow rate before the operation of the blood pump is stopped or decelerated.   The blood purification apparatus according to any one of claims 1 to 7, wherein the control unit opens the first infusion line for a predetermined time with the first on-off valve.   The blood purification device according to any one of claims 1 to 7, wherein the control unit opens the infusion line with the first on-off valve until a pressure measured by the pressure sensor becomes equal to or higher than a third predetermined value. .   The blood purification apparatus according to claim 9, wherein the third predetermined value is larger than the first predetermined value and is set within a range of -50 mmHg to 50 mmHg.   The blood purification apparatus according to any one of claims 1 to 10, wherein the first predetermined value is set within a range of -400 mmHg to 20 mmHg.   The blood purification apparatus according to any one of claims 1 to 11, wherein the second predetermined value is set within a range of -100 mmHg to 50 mmHg. A blood removal line for distributing blood taken from a patient to a blood purifier, a blood pump disposed on the blood removal line, and a first infusion fluid upstream of the blood pump in the blood removal line A first infusion line; an infusion container connected to the first infusion line; a first on-off valve for opening and closing the first infusion line; and a second upstream of the blood pump in the blood removal line. A second infusion line for supplying the infusion, an infusion pump disposed on the second infusion line, a chamber disposed on the downstream side of the infusion pump in the second infusion line, and a pressure of the blood removal line A blood purification apparatus comprising: a pressure sensor for measuring the pressure; and a control unit for controlling the infusion pump and the first on-off valve,
The infusion container is arranged vertically above the patient,
When the pressure measured by the pressure sensor during operation of the blood pump and the infusion pump becomes smaller than a first predetermined value, the control unit first sets the pressure measured by the pressure sensor to a second predetermined value or more. The blood purification apparatus, wherein the second infusion is supplied to the chamber with the infusion pump until it becomes, then the operation of the infusion pump is stopped and the first infusion line is opened with the first on-off valve. A blood removal line for distributing blood taken from a patient to a blood purifier, a blood pump disposed on the blood removal line, and a first infusion fluid upstream of the blood pump in the blood removal line A first infusion line; an infusion container connected to the first infusion line; a first on-off valve for opening and closing the first infusion line; and a second upstream of the blood pump in the blood removal line. A second infusion line for supplying infusion, an infusion pump disposed on the second infusion line, a pressure sensor for measuring the pressure of the blood removal line, the infusion pump, and the first on-off valve are controlled. A blood purification device comprising a control unit,
The infusion container is arranged vertically above the patient,
When the pressure measured by the pressure sensor during the operation of the blood pump becomes smaller than a first predetermined value, the control unit first performs the infusion until the pressure measured by the pressure sensor becomes equal to or higher than a second predetermined value. A blood purification device that supplies the second infusion to the second infusion line with a pump, then stops the operation of the infusion pump and opens the first infusion line with the first on-off valve. A blood removal line for distributing blood taken from a patient to a blood purifier, a blood pump disposed on the blood removal line, and a first infusion fluid upstream of the blood pump in the blood removal line A first infusion line; an infusion container connected to the first infusion line; a first on-off valve for opening and closing the first infusion line; and a second upstream of the blood pump in the blood removal line. A second infusion line for supplying the infusion, an infusion pump disposed on the second infusion line, a chamber disposed on the downstream side of the infusion pump in the second infusion line, and a pressure of the blood removal line A method for controlling the blood purification apparatus, wherein the infusion container is disposed vertically above the patient,
When the pressure measured by the pressure sensor during the operation of the blood pump becomes smaller than a first predetermined value, the second infusion pump is used for the second time until the pressure measured by the pressure sensor first becomes a second predetermined value or more. The controller controls the infusion pump and the first on-off valve so that the infusion pump is supplied to the chamber, and then the operation of the infusion pump is stopped and the first infusion line is opened by the first on-off valve. A method for controlling the blood purification apparatus. A blood removal line for distributing blood taken from the patient to a blood purifier, a blood pump disposed on the blood removal line, and a first infusion for supplying a first infusion upstream from the blood pump of the blood removal line. One infusion line, an infusion container connected to the first infusion line, a first on-off valve for opening and closing the first infusion line, and a second infusion on the upstream side of the blood pump in the blood removal line A second infusion line, a transfusion pump disposed on the second infusion line, a chamber disposed downstream of the infusion pump in the second infusion line, and a pressure of the blood removal line. A method for eliminating poor blood removal in a blood purification apparatus, wherein the infusion container is arranged vertically above a patient,
When the pressure measured by the pressure sensor during the operation of the blood pump becomes smaller than a first predetermined value, the second infusion pump is used for the second time until the pressure measured by the pressure sensor first becomes a second predetermined value or more. A method for eliminating poor blood removal, wherein infusion is supplied to the chamber, and then the operation of the infusion pump is stopped and the first infusion line is opened by the first on-off valve.

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