JP3184831B2 - A device for simultaneous simultaneous administration of multiple infusions or drug solutions - Google Patents

Description

Description: TECHNICAL FIELD The present invention relates to an apparatus for continuously administering a plurality of infusions or medical solutions.

BACKGROUND OF THE INVENTION Conventional devices of this type are conduits for introducing at least one pump from a container containing an infusion or medicinal solution through a connecting piece into a normal patient conduit, with a valve flow for supplying each conduit. Consists of a control device connected to the flow element, the valve, the pump and the signal to the flow element.

There has recently been a strong interest in the ever-increasing use of manually administered parenteral infusion pumps for accurate and continuous administration of infusions or medicinal solutions.

More recently, there has been increasing interest in controlling the supply of highly active drugs in response to physiological parameters.

Generally, three to four different drug solutions or infusions are administered using a plurality of independent pumps or control methods to gain access to the patient's blood circulation via a conventional central venous catheter.

Generally, an associated disposable conduit is used in a pump for this purpose. It is connected to the collecting conduit to the catheter via a three-way cock downstream of the pump.

In addition, the so-called gravity injection equipment and central blood pressure measurement means,
A three-way cock is also connected to the patient conduit.

 Such an arrangement has the following disadvantages: 1. Individual structures are generally complex and can be mixed.

2. Individual plugs, three-way cocks, etc. in the injection conduit contain risks of contamination.

3. The combination of pump and gravity infusion system to deliver the infusion to the patient, if not fully supplied,
The pressure monitoring system of the pump cannot respond to pressures of up to 0.2 bar due to gravity, so that infusion stops are not detected and remain invisible until indirectly detected by the patient monitor.

4.If the infusion conduit is blocked downstream of the pump, for example, if the three-way cock is accidentally closed, the pumps will either respond to the pressure monitoring system of one pump or deliver due to excessive pressure in the conduit. Continue driving until you stop.

Due to the deformation of the infusion conduit, the solution is partially stored, but may be suddenly released to the patient after the three-way cock has been opened or obstructed.

False closure of the three-way cock is relatively frequent. This is because the tap connected to the pump must be temporarily closed to take a sample or measure central blood pressure.

There are certain operating criteria and rules to avoid the above risks, but this requires considerable user attention and cost.

For example, the combined use of pump infusion and gravity infusion is considered immature. This means that an infusion pump must be used, even when precise conditions are not required for the delivery of the medicinal solution or infusion, which is costly.

To avoid some of the disadvantages described above, a so-called multi-infusion system was developed.

DE-PS 33, 329, 977 discloses a facility for dosing and purchasing solutions from several infusion containers. A plurality of gravity injection equipment with a drip counter is connected through the outlet tubing, and a clamp valve is combined with the collecting conduit and introduced to the patient. Downstream of the patient conduit is a flow sensor, followed by a delivery pump. All valves, flow sensors and pumps are connected to the control system.

The infusion rate of each liquid selected by the doctor is transmitted to the control system according to the number of infusions. Each valve is open until the number of infusions has reached a predetermined passage. The valve is then closed and the valve for the next pass is opened. In each case, a specific number of drops is measured and supplied to the collecting conduit until a switchover takes place.

This device has many disadvantages. The injections are continuous, but the individual solutions are not delivered continuously. Moreover, it is not possible to deliver highly medicinal solutions with low delivery, at the same time as, for example, high delivery of parenteral nutrient solutions.

Another disadvantage is that operating one pump at a constant delivery rate causes pump failure to result in uncontrolled injection.

The object of the present invention is to avoid the above-mentioned disadvantages and to deliver a medicinal solution having a high medicinal effect at an accurate and low injection rate, and at the same time to achieve a high injection rate with average accuracy and a high injection rate with moderate accuracy. To provide a device for administration introduction which can be sent by This is not only simpler than conventional instruments, but also allows more reliable use and reduces costs.

This problem is solved by the device according to the aspect characterized in claim 1.

In the multi-injection apparatus according to the present invention, a plurality of pumps and gravity means are combined with each other.

Here, a highly accurate syringe infusion pump with a low infusion rate is combined with a direct perineal introduction pump with average accuracy at a high infusion rate.

For high injection rates with moderate accuracy, gravity injection means are applied. Both the pump and the gravity infusion means are connected downstream to the transmission conduit and are connected to a normal patient conduit.

Each delivery conduit incorporates a clamp valve connected to a central processing unit (CPU) that includes a control unit.

The central processing or arithmetic unit is simultaneously connected to all pumps such that a predetermined infusion rate input to the central processing unit is transmitted to the pumps. The central processing unit
Further, the apparatus is provided with a bar code reader capable of obtaining data of the injection container itself indicated by the bar code.
The central processing unit also has information about the composition of the combined infusion and the rate at which it is administered.

Therefore, the central processing unit can calculate the total liquid volume to be administered to the patient at any time, and can calculate the energy amount and the specific substance amount (sodium, potassium, other electrolytes, amino acids, fat, glucose, etc.).

Moreover, such information can be copied to a screen or printed. Instead of a barcode reader,
Other reading means can also be used and automatic information acquisition is possible. If such measures are not taken, manuals are possible. A valve is also attached to the patient conduit.

It is important for the device according to the invention to have a flow element downstream of the pump, whereby the monitoring of the liquid activates a control unit which stops the device by closing the valve and stopping the pump.

Desirably, the flow element is mounted on the patient conduit.

The flow element of the normal patient conduit downstream of the pump or of a unified downstream of all infusion conduits helps to find any obstruction of the infusion, such as a clogged catheter.

Occlusion of the catheter has a significant effect on the patient, whether at the end of the supply conduit or for other reasons.

First, the patient is not supplied with the drug present in the infusion. Those with half-lives of several minutes (such as nitroprusside for blood pressure regulation), even after a short time, can result in a dangerous rise in blood pressure.

However, the pumping effect may also cause a pressure increase in the conduit before the obstruction.

Due to the elasticity of the conduits and tubes described above, some infusion is stored.

Normally, the pressure detector is in the infusion pump, so that if the infusion eventually stops, this pressure increase can be detected, but when the obstruction is removed, the stored volume suddenly drops in the patient. It will be over-injected.

Before the pressure rises, the flow element downstream of the pump
Blockage of a flow can be detected. Although the tube downstream of the flow element has an elastic portion, the volume stored is much less than the entire system.

In addition, upon blockage and pressure build-up, a significant amount of the pumped flow is stored in the tube.

That is, the pressure in the tube section upstream of the flow element and downstream through the flow element decreases.

Even in this case, the flow is not zero, but it is reduced by more than 50%. This change can be easily detected.

As a result of this detection, not only the valve but also the pump is stopped.

Except for testing and control purposes, the pump works against the valve in any case. Otherwise, the storage volume accumulates before the valve.

Preferably, the flow element constitutes an infusion detector, and the central blood pressure measuring device is connected to the patient conduit.

According to a further embodiment in the patient conduit, an additional air detector can be arranged and at the same time connected to a central processing unit. A further advantage is that the tube clamp valve is mechanically actuated and monitored electronically, or is electronically actuated by a central processing unit and is extensively monitored.

Preferably, the clamp valve and the sensor can be connected by a so-called sensor / valve, block. If at least one gravity injection means is connected, the flow element can be adjusted by the gravity injection means in the corresponding connection conduit instead of the patient conduit. Since the gravity injection means usually has a drip adjustment function with a manual or automatically operated clamp, the function of the flow element is also undertaken.

The signal from the associated infusion sensor is used to detect occlusion of the patient conduit.

This monitoring is made possible by the following; usually, a pump and a parallel gravity infusion means deliver the infusate to the patient. If the patient conduit is obstructed by the occlusion of the catheter, for example by increasing the pumping action of the pressure in the system, the infusion rate in the gravity manipulating system will decrease and eventually reach zero. The pump feeds back into the gravity injection system. This is a dangerous condition in itself, since no obstruction of the infusion can be found, but in the arrangement according to the invention, this condition is found in the infusion sensor and as a result the device is shut down.

The device according to the invention enables a risk-free coupling of the pump to the gravity infusion means, since obstruction of the flow to the patient can be found in the flow element.

The valve is electrically controlled and monitored by a central processing unit to prevent the valve from being accidentally left closed despite the pump being started. If a central blood pressure measuring means is connected to the patient conduit, this automatic measurement can also be performed. Central blood pressure can also be detected with a manual or automatic closed water column. Further advantageously, the automatic detection device of the water column can be embodied as an ultrasonic level sensor, which is fed into a valve whose ultrasonic reflection point rises by a corresponding distance.

The air detector may be of a known ultrasonic type. Advantageously, it is connected to a valve in the patient conduit, which closes when the air sensor is activated.

To drain from the conduit, the drain is connected to the patient conduit. First, all valves in the delivery conduit are closed through the central processing unit and the control unit.

If a combination of a hydrophobic filter and a check valve is attached to the patient conduit, the discharge valve in the discharge means will also remain closed. Otherwise, this valve is opened by the control unit. The valve in the first delivery conduit is then opened and the branch pump is activated to deliver at a high rate until the air sensor reports no air. The valve and the discharge valve in the delivery conduit are then closed and the pump is stopped.

The valve in the patient conduit and the valve in the second delivery conduit are then opened and the branch pump is activated. The pump first pumps air, thereby eliminating and discarding any solution remaining in the patient conduit.

In this way, the flushing of the tubes takes place simultaneously. As soon as the air sensor responds, the valve in the patient conduit is closed and the drain valve is opened. Pump delivery continues until the air sensor reports no air. The pump is stopped and the valve in the delivery conduit is closed again. In this way, it is also discharged from other delivery conduits. After these steps are completed, the patient conduit is attached to the patient and infusion begins.

In a further embodiment, if the central blood pressure measuring means is connected to the patient conduit, said means is put into operation, the valves in the supply line to the patient conduit and the valves in the delivery line are opened and the other valves are opened. Stays closed. The pump connected to the delivery conduit runs and continues to pump fluid until the central blood pressure measurement means leaks or is responded. The gravity injection means is operated in a similar manner. For this purpose, the valve in the delivery conduit of the gravity injection means and the discharge valve are opened. Under the effect of gravity injection, liquid enters the delivery conduit and air is expelled. The valve (the valve in the delivery conduit to the injection means and vent valve) is closed again until the air sensor reports no air. If a gravity injection device with a drop sensor is connected to the delivery conduit and the drop sensor is connected in terms of electrical signals to the central processing unit and the control unit, the latter will obtain a predetermined drop rate on average. Open and close the valve in a generally known manner, as described above. This indicates that the system is operated as a dripping regulator.

 Next, exemplary embodiments will be described in detail with reference to the drawings.

The figure shows a multi-infusion means, which consists of two continuous peristaltic infusion pumps 1 and 2, two syringe infusion pumps 3 and 4, one gravity infusion means 16 and a central blood pressure measuring means 15.

Linear aseptic infusion pumps 1 and 2 are connected to infusion fluid containers 25 and 26, respectively. Each infusion pump is connected to a delivery conduit designated 18,19,20,21,36 as well as gravity infusion means. Each delivery conduit has a clamp valve 5, 6, 7, 8, 11 connected to the central processing unit and control unit 17 for signals.

The central processing unit and the control unit are likewise an injection pump
Connected with 1,2,3,4. The delivery rate of the infusion pump is controlled by a central processing unit and a control unit according to a predetermined program. The delivery conduits 18, 19, 20, 21, 36 and the supply line 35 to the central blood pressure measuring means 15 are connected to the patient conduit 23 through the joint piece 27. The patient conduit or tube 23 has an air sensor 13, a flow element 14, an additional valve 12
Is attached. These are likewise connected to the control unit 17 of the central processing unit.

Further, the discharging means 22 is provided with a control unit of the central processing unit.
It is connected to the connecting piece 27 in the form of a connecting tube piece with the valve 9 also connected to 17. Discharge means 22
Instead of its valve 9, it is closed in an aseptic manner with respect to the environment, possibly by means of a hydrophobic filter 28 having a check valve (not shown).

The multi-injection means is composed of various injection methods as described above, and can administer various amounts of an infusion solution and a drug solution at different concentrations.

Air sensor 13 and flow element 14 in the patient's conduit
The need for pressure and air sensors, typically located in the delivery conduit, is eliminated.

The arrangement according to the invention guarantees a high degree of safety for the patient. Because interruption of flow to the patient is a flow element
14 can be detected. Through the central process and the control unit, the corresponding valve in the delivery conduit, the safety valve 12, is immediately closed. Further, the multi-injection device is a CVP measuring means 15
May be connected to the patient conduit 23.

[Brief description of the drawings]

The figure is an explanatory view of a device for continuously and simultaneously administering an infusion or a drug solution according to the present invention. 1,2 ... infusion pump, 3,4 ... infusion pump 5,6,7,8,11 ... clamp valve 13 ... air sensor, 14 ... flow element 15 ... central blood pressure measurement means 17 ... control Unit 18,19,20,21,36 …… Distribution conduit 27 …… Connection piece 35 …… Supply line

Claims (11)

(57) [Claims] 1. A delivery conduit which communicates with at least one pump, a container containing an infusion or a medicinal solution and which is connected to a general patient conduit via a junction piece, a valve attached to each of the delivery conduits, a valve in the patient conduit. An apparatus for simultaneously and continuously administering a plurality of infusions or medical solutions containing a flow element for detecting a flow and a signal, including a valve, a pump and a control unit connected to the flow element, wherein the flow element (14) is provided with a pump (1). The control unit (17) is arranged downstream of the pumps (1 to 4), detecting the stop of the flow by the flow element (14) and closing the valves (5 to 8, 11). Wherein the device is deactivated by switching off the device. 2. The device according to claim 1, wherein the flow element is an infusion monitor. 3. Apparatus according to claim 1, wherein the flow element (14) is mounted on a patient conduit (23). 4. A joining means (27) comprising: a discharging means (22);
Apparatus according to any of the preceding claims, wherein the apparatus is connected to a device. 5. The device according to claim 4, wherein the discharge means (22) is formed as a tube member with which a valve (9) engages. 6. The apparatus according to claim 4, wherein said discharge means (22) is closed by a hydrophobic sterile filter (28). 7. An air sensor (13) located upstream of a flow element (14) mounted on a patient conduit (23).
Responds to the signal of the air sensor (13) in the exhaust system that discharges air in all the conduits, and according to a predetermined program, the valves (5, 8, 11, 12 and 9) and the pumps (1 to 5). Apparatus according to any of claims 3 to 6, which is connected to a control unit (17) for controlling (4). 8. Downstream of a flow element (14) attached to a patient conduit (23), detecting flow cessation by the flow element (14) and closing the patient conduit with the aid of a control unit (17). Apparatus according to any of the preceding claims, wherein a shut-off valve (12) is further arranged. 9. Apparatus according to claim 1, wherein the gravity injection means (16) is connected to the connection piece (27) by a connection conduit (36) into which a valve (11) is inserted. 10. Apparatus according to claim 9, wherein the flow element (14) is arranged to connect to the connecting conduit (36) communicating with the gravity injection means (16) but not to the patient's conduit. . The central blood pressure measuring means (15) is provided with a valve (1).
Apparatus according to any of the preceding claims, which is connected to the joining piece (27) by a connecting conduit (35) that can be closed by 0).