JPH02161953A - Artificial lung-containing artificial heart - Google Patents

Abstract

PURPOSE:To maintain a compact and good blood circulation state and to exhibit excellent gas exchange efficiency by building a gas exchange function part into a pump function part having a pulsation forming mechanism so as to exist therein. CONSTITUTION:Oxygen is passed in the internal passages of a hollow yarn bundle 1 constituting the gas exchange function part and blood is filled in a housing 9. Air is introduced into and discharged from an air chamber 7 through an air introducing and discharging port 11. Then a diaphragm 6 in the air chamber repeats advancing and retreating in a vertical direction and the pressure in the housing changes pulsatively and the blood flows pulsatively from a blood introducing port 2 to a blood discharge port 3 correspondingly. The gas exchange of O2 and CO2 is executed via the film wall of the hollow yarn bundle during this time and the revived blood is introduced into the living body. Since the gas exchange function part is built into the pump function part so as to exist therein in such a manner, the blood flows to the outside of a gas exchange film and the excellent gas exchange efficiency is obtd. The compact device is thus obtd. and the blood is circulated in the form of pulsation flow so that the blood can be circulated to the peripheral organs.

Description

[Detailed Description of the Invention] [Industrial Application Field] The present invention relates to an artificial organ that is placed outside the body to resuscitate and circulate a patient's blood, and more specifically, the present invention relates to an artificial organ that is installed outside the body to resuscitate and circulate a patient's blood. This invention relates to an artificial heart with a built-in artificial lung that carries the burden of the artificial lung.

[Prior Art] In recent years, ECMO (Extra-Me
Artificial heart-lung machines such as mbrane Oxygenation are used. In addition to the above-mentioned prototype oxygenator, there are bubble-type oxygenators.
There has also been proposed a membrane type artificial heart-lung device, as in Japanese Patent No. 4346, in which a pumping function section serving as an artificial heart is built into a prototype artificial lung.

[Problems to be Solved by the Invention] As shown in FIG. 2, for example, an artificial heart-lung machine represented by ECMO has a pump PI, in contrast to a prototype oxygenator A that performs gas exchange between 02 and CO2.

It is constructed by combining an artificial heart part consisting of a long blood conduit 1 via P2, and the blood extracted from the living body by pump PI is supplied to the prototype artificial lung A.
Gas exchange between 2 and 002 is performed, and the resuscitated blood is introduced into the living body again by pump P2. However, the above-mentioned practical heart-lung machine has the problem that it is large-scale and complicated, and that it is difficult to control, and there are many points that need to be improved. In addition, many of the oxygenator membranes used in the above devices employ microporous membranes that allow gas exchange to occur through minute pores; There is a problem in that gas is deposited in the pores and the gas exchange ability is reduced. Furthermore, centrifugal pumps and roller pumps are used as pumps to maintain blood circulation, but these pumps generate a steady flow, which is different from the biological heart, which generates a pulsating flow. come. That is, a steady flow is not preferable for maintaining circulation to peripheral organs, and it is desirable to employ a pulsating flow pump to maintain a good circulation state. Also, the roller pump has the effect of squeezing the blood supply line.
There are problems such as damage to the inner surface of the tube and destruction of blood cell components, resulting in hemolysis. On the other hand, Dashin bombs have less problems with hemolysis, but they do have the problem of heat generation due to rotational motion, which requires countermeasures such as incorporating a heat exchanger for cooling. As mentioned above, the ECMO type artificial heart-lung machine has many problems that need to be solved.

On the other hand, the prototype heart-lung machine disclosed in Japanese Patent Publication No. 57-4346, as shown in FIG. It is, so to speak, an artificial lung with a built-in artificial heart, and is advantageous for blood circulation in that it uses pulsating flow, but has the problem of low gas exchange efficiency with respect to blood. In other words, it provides a pump function by directly pressurizing and depressurizing the integral membrane using pulsating pressurization of oxygen, and when trying to make it compact, it is difficult to provide sufficient gas-liquid contact area. If the blood flow vibrator section and pump section are constructed of a bundle of hollow fiber-like tubules for the purpose of increasing the area, pressurization of oxygen to about 120 a + mHg, which is close to the biological blood pressure, will cause the volume of the pipe section necessary for pumping to decrease. The problem is that it is difficult to

As described above, the artificial heart-lung machines that have been proposed so far are still unsatisfactory, and there is a pressing need for improvement.

The present invention has been made in view of these circumstances, and an object of the present invention is to provide an artificial heart-lung machine that is compact, capable of maintaining a good blood circulation state, and exhibiting excellent gas exchange efficiency. The purpose is to

[Means for Solving the Problems] The artificial heart-lung machine of the present invention that can achieve the above object includes a gas exchange function section that performs gas exchange with blood, and a gas exchange function section that performs gas exchange with blood drawn from a living body. After attaching
In a composite artificial organ having a pump function section for reintroduction into a living body, the gist is that a gas exchange function section is built into the pump function section provided with a pulsation forming mechanism.

[Effect] The method with the best gas exchange efficiency in the oxygenator part is the bubble-type oxygenator, which brings gas and liquid into direct contact with each other. Currently, membrane oxygenators are used to exchange CO2 in the blood with 02 in the outside air. In increasing the gas exchange efficiency when gas exchange is performed using an intervening membrane, it is considered that it is more effective to stir and flow the liquid phase than to stir and flow the gas phase. In order to make the device more compact and to make the device more compact, an artificial lung part through which oxygen, etc. flows through a gas exchange membrane is built into the pump function part through which blood flows.
The pump function section is equipped with a pulsation forming mechanism that gives pulsations to the blood flow, thereby maintaining good blood circulation and preventing destruction of blood cell components.

Examples of pump units with a pulsation forming mechanism include a tubular type that contracts a tube through which blood flows, a balloon type that repeatedly deflates and expands a balloon in the blood, and a diaphragm that has a gas exchange membrane that moves up and down due to fluid pressure. type, a double bag type in which the inner bag contracts and expands, and a butcher plate type in which a disk-like flat plate is attached to the gas exchange membrane and moves up and down, but of course it is not limited to these. In addition, it is preferable to install a check valve at or near the blood inlet/outlet of the pump function part, and the check valve is preferably a ball valve, a leaflet valve, or a disk valve.

The gas exchange function section, that is, the artificial lung section applied to the present invention is configured inside the pump function section as described above,
For example, there are flat membrane types and hollow fiber membrane types, but the hollow fiber membrane type is preferable from the viewpoint of increasing gas exchange efficiency. In the present invention, all or part of the part that comes into contact with blood is made of antithrombotic material. The entire artificial organ may be formed of an antithrombotic material, but for example, the main structure is first formed of a material with sufficient resistance to repeated stress, sufficient elasticity, moldability, etc. Parts of the body that come into contact with blood may be surface-treated or coated with anti-thrombotic materials; however, if anti-thrombotic materials are not used, a large amount of heparin must be injected into the blood, resulting in A problem arises in which the patient becomes prone to bleeding. Antithrombotic materials include polyurethanes, preferably polyether-type segmented polyurethanes, polydimethylsiloxanes,
Polydimethylsiloxane-polyurethane block or graft copolymers, high molecular weight polyester plasticizer-containing polyvinyl chloride, polystyrene-poly(2-hydroxyethyl)acrylate copolymers, and even heparin are ionically bonded and slowly released from the surface. Examples include, but are not limited to, known materials such as materials that exhibit antithrombotic properties by being exposed to the antithrombotic effect.

[Embodiment] FIG. 1 is a cross-sectional explanatory diagram showing an embodiment of the present invention, in which the gas exchange function section is composed of a hollow fiber bundle 1 made of an antithrombotic material and is built into a housing 9. are connected to a header section 8a having an oxygen inlet 4 and a header section 8b having a gas outlet 5, respectively. Further, the housing 9 is formed with a blood inlet 2 and a blood outlet 3 so as to be substantially opposed to each other, and the housing 9 is located at the lower center of the drawing.
A part of the air chamber 7 is made to protrude and is partitioned by a diaphragm 6 made of polyurethane to form an air chamber 7. And blood inlet 2
A backflow prevention valve 10, 10 is provided at the blood outlet 3 and the blood outlet 3, respectively.

In the artificial heart with a built-in artificial lung of the embodiment configured as described above, oxygen is caused to flow through the internal passage of the hollow fiber bundle 1 constituting the gas exchange function section, and the housing 9 is filled with blood,
When air is introduced into and discharged from the air chamber 7 through the air introduction/discharge port 11, the diaphragm 6 within the air chamber 7 repeatedly advances and retreats in the vertical direction in the drawing, and the pressure within the housing 9 changes pulsatingly. Accordingly, blood flows in a pulsating manner from the blood inlet 2 to the blood outlet 3. During this time, gas exchange between O2 and Co2 occurs through the membrane wall of the hollow fiber bundle, and the resuscitated blood is introduced into the living body through the blood outlet 3.

FIGS. 4(^) and 4(B) are explanatory diagrams showing other embodiments, FIG. 4(A) is a cross-sectional explanatory diagram as seen from the side, and FIG.
) is a sectional view taken along line BB in FIG. 4(A). Basically, the structure is similar to that of the embodiment shown in FIG. A pulsation forming mechanism consisting of an air chamber 7 and an air chamber 7 is provided.

FIGS. 5(A) and 5(B) are explanatory diagrams showing still other embodiments, FIG. 5(A) is a cross-sectional explanatory diagram seen from the side, and FIG. 5(B) is an explanatory diagram of FIG. 5(A). It is a BB line cross-sectional explanatory view. The basic configuration is the same as the example shown in FIG. 1 and the example shown in FIG. A blood inlet 4 is formed in the upper part, and a blood outlet 5 is formed in the lower part so as to be diagonally opposed to each other.

In the embodiment shown in FIG. 1.4.5, oxygen and air for driving the diaphragm are used in separate systems, but in the embodiment shown in FIG. 6, air is used as the oxygen supply source. Inside the housing 9, there are diaphragms 6 at both ends of the plates 1 and 2.
It is divided into an air circulation section A and a blood circulation section K by a partition wall to which a partition wall is attached. A plate drive shaft 13 is fixed to the plate 12, and by moving the plate drive shaft 13 up and down by a drive unit 14 which is a power source, the plate 12 and the diaphragm 6 are moved forward and backward to function as a blood pump. ing. In addition, a gas exchange section consisting of a hollow fiber bundle 1 is housed in the blood circulation section defined by the plate 12 and the diaphragm 6 in a sufficiently sealed state with the blood circulation section A, and both ends of the hollow fiber bundle 1 are A ladder H, , H, is attached to each of the holes to introduce air into the hollow fiber bundle 1 from the header H1, and also to introduce air from the header H3 into the air outlet 3.
It is configured so that it can be extracted to On the one hand, the liquid is introduced into the blood circulation section from the blood inlet 2 as the plate 12 and the diaphragm 6 advance and retreat, and is further circulated to the living body from the blood outlet 3, thereby preventing backflow of blood. A backflow prevention valve 10.10 prevents blood inlet 2 and blood outlet 3.
Interventions are provided for each. As described above, by causing air and blood to flow, gas exchange is performed in the hollow fiber bundle 1, and the resuscitated blood is returned to the living body. In the above description, the plate 12 and the diaphragm 6 are moved forward and backward by the plate drive shaft 13, but they can also be moved forward and backward by applying pulsation to the air introduced into the air circulation chamber A.

[Effects of the Invention] The present invention is configured as described above, and since the gas exchange function section is built into the pump function section, blood flows outside the gas exchange membrane and excellent gas exchange efficiency can be obtained. can.

Furthermore, the apparatus can be made compact, and since the blood is circulated as a pulsating flow, excellent performance can be obtained in circulating blood to the peripheral organs.

[Brief explanation of the drawing]

1, 4 to 6 are cross-sectional explanatory views showing embodiments of the present invention, and FIGS. 2.3 are cross-sectional explanatory views showing a conventional example.

Claims (1)

[Scope of Claims] A composite artificial organ having a gas exchange function unit that performs gas exchange with blood, and a pump function unit that subjects blood extracted from a living body to gas exchange and then reintroduces it into the living body, comprising: An artificial heart with a built-in artificial lung, characterized in that a gas exchange function part is built into a pump function part having a mechanism.