CA1226493A - Apparatus for receiving and reinfusing blood - Google Patents
Apparatus for receiving and reinfusing bloodInfo
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- CA1226493A CA1226493A CA000485762A CA485762A CA1226493A CA 1226493 A CA1226493 A CA 1226493A CA 000485762 A CA000485762 A CA 000485762A CA 485762 A CA485762 A CA 485762A CA 1226493 A CA1226493 A CA 1226493A
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- container
- blood
- patient
- pressure
- connection
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Abstract
TITLE OF THE INVENTION
APPARATUS FOR RECEIVING AND REINFUSING BLOOD
ABSTRACT OF THE DISCLOSURE
In apparatus for receiving and reinfusing a patient's own blood, a concertina-like container with a high degree of resiliency is adapted to expand into an extended condition, the container drawing blood from the patient by being compressed before being connected to the patient and then sucking the blood into the container by expansion under the effect of the container resiliency.
APPARATUS FOR RECEIVING AND REINFUSING BLOOD
ABSTRACT OF THE DISCLOSURE
In apparatus for receiving and reinfusing a patient's own blood, a concertina-like container with a high degree of resiliency is adapted to expand into an extended condition, the container drawing blood from the patient by being compressed before being connected to the patient and then sucking the blood into the container by expansion under the effect of the container resiliency.
Description
I
BACKC~OUND OF THE INVENTION
In certain surgical operations, for example and in particular in heart surgery, and also in the case of severe injuries or wounding, a patient Roy very often suffer from substantial blood losses which must be ccmp~nsated by irr~nediate blood transfusion if the life of the patient is not to be put at risk. Particularly in the case of surgical operations, the loss of blood is such that the blood which has been lost frorrl the body is often still available, namely being in the form of accumulations of blood in cavities in the body of the patient, to which the surgeon has relatively ready access. It is therefore already known for the blood to be collected from such accumulations in the body, and no-infused into the same patient. Such a procedure which involves collecting the blood from and reinfusing the collected blood into the same patient is referred to as intra--ope{ative auto transfusion.
Particularly in the case of heart surgery, for the purposes of performing auto transfusion, it is known for the patient to be connecter to a heart lung machine for sucking the blood from the patient by means of pumps installed in the machine and resupplying the blood to the patient. However, such machines are extremely expensive and are therefore not available in every operating theater, while in addition, in spite of the blood being carefully treated in machines of that type, the blood, being a fluid that is very sensitive and easily damaged, may nonetheless suffer a certain amount of damage in its comparatively long path of flow through the machine from the patient and back to the patient again.
In an effort to remedy that problem, an apparatus has been put forward, for receiving and reinfusing a patient's Cowan blood, wherein the blood is sucked in by way of a suction head, a suction line connected thereto and a suction connection, into a rigid container. The container cc~nun~cates by way of at least one further connection with a vacuum source which is Z~6 I
operative to produce, within the container, the reduced pressure required for sucking the blood from the patient. The container may have for example a capacity of about 2000 cm2, and when the container is completely or substantially filled, the suction line is clamped off, the line connecting to the vacuum source is disconnected from the above-mentioned further vacuum connection and a conventional infusion figment, possibly with a blood filter disposed on the upstream side thereof, is then fitted to the further connection from which the suction line was removed, so that the blood in the container can be infused back into the patient in the usual manner.
Although that arrangement has the advantage that the blood can be taken from the patient over a short flow path, thereby substantially avoiding damage to the blood, nonetheless it suffers from some disadvantages which mean that it is not entirely satisfactory. A major disadvantage is that that apparatus can only be used to reinfuse the blood from the container, into a blood vessel in the patient, in the manner of a conventional blood transfusion. As however an auto transfusion operation of the kind concerned herein is effected whenever a patient has suffered serious blood losses, it is also a point of major importance that the blood is reinfused back into the patient in the shortest possible time, as otherwise the patient may suffer from a considerable deficiency of body blood, such as to endanger the patient's life, over a considerable period of time. Such rapid reinfusion of blood can generally only be achieved by pressure infusion of the blood taken from the patient, but the above-described known apparatus is not designed to perform such pressure infusion and in addition, in consequence, such a pressure infusion cannot be effected without the danger of inducing an air embolism in the patient. Another disadvantage of the known '~26~93 apparatus is that, after an accumulation of blood in the patient's body has been drawn into the container, it is necessary to prevent air Fran being drawn into the container after the blood, which is effected by the suction line being closed off by means of a clamp; however, the suction force produced by the vacuum source still continues to apply a suction effect within the rigid container, and that may also give rise to the not inconsiderable danger of damaging the blood, as for example the reduced pressure or suction force may cause excessive expansion of the red blood corpuscles, and may even cause them to burst.
In another apparatus for interpretive auto transfusion, which is similar to the apparatus just discussed above, the patient's blood is initially sucked into a rigid container and then reinfused into the patient from that container by means of a blood pinup (see US patent specifications No 4 047 526 and 4 033 345). In one embodiment of that known apparatus, the blood pump which is connected to the container is formed by an axially compressible concertina or harmonica-like arrangement which is releasable connected to the container and which can be operated to produce a vacuum which can overcome the vacuum in the rigid container. The harmonica-like arrangement is disconnected from the rigid container, after it is filled with blood, and handed over to the anesthetist for the purposes of the reinfusion operation. In another form of the known apparatus, the blood pump is formed by a further container and is non-releasably connected to the rigid container in which the blood is received Fran the patient's body.
The blood pump has a third inner, yield ably deformable container, and a respective check valve at its inlet and its outlet. The deformable container is can pressed and re-expanded by alternately applying an increased pressure and a reduced pressure to a connection on the deformable container, so that in that way, and with the two check valves being suitably operative, the . .
Z'~6~33 blood is sucked out of the first rigid container and then passed on to the patient through the outlet valve.
Although that apparatus permits the blood to be rapidly reinfused into the patient, it suffers frock the disadvantage that the blood acmes into contact with a comparatively large surface area which is foreign to the blood, namely the surfaces in the rigid container and in the blood pump, while in addition there is the danger for the blood to be detrimentally effected and possibly damaged by the vacuum produced in the blood pump, being a stronger vacuum than that in the rigid container.
SUMMARY OF To INVENTION
An object of the present invention is to provide an auto-transfusion apparatus which does not suffer from the disadvantages of the above-discussed prior art.
Another object of the present invention is to provide an auto transfusion apparatus which can take blood Fran a patient over a short flow distance and without damage, and also quickly reinfuse the blood over a short flow distance, again without damage.
Still another object of the present invention is to provide an auto transfusion apparatus which is simple and reliable in operation.
Yet another object of the present invention is to provide an auto transfusion apparatus which constitutes a fully independent and self-contained unit not requiring other vessels or containers for performing the reinfusion operation.
A further object of the present invention is to provide an auto transfusion apparatus which is operable to produce pressure infusion of the blood in order to restore the blood to the patient rapidly and I I I
without the risk of air embolism.
To achieve these and other objects, in a first aspect, the present invention provides an apparatus for receiving and reinfusing a patient's own blood, comprising a readily deformable container having a first connection for drawing blood from the patient by way of a suction line, and a further connection adapted to be connected to a reduced pressure or suction source, thereby to produce within the container the reduced pressure or suction force required to draw the blood from the patient. Disposed around the deformable container is a further rigid container which thus encloses the deformable inner container. The outside of the inner container and the inside of the outer container between them thus define a space to which there is connected a closable pressurizing corunection, for the solute eddy of a pressure medium into the space between the inner and outer containers In the construction in accordance with the principles of the invention, as just set out above, blood is sucked in by way of the suction connection, by virtue of the reduced pressure or suction force obtaining in the outer or rigid container and within the readily deformable container. The reduced pressure in the container cannot result in collapse of the inner easily deformable container as, during the suction operation, the further space defined between the outside of the easily deformable, inner container and the inside wall of the rigid container is closed relative to the exterior, for example by a plug member or the like which is fitted to the pressure connection, or by the pressure connection being connected, during the suction operation, to a source producing a lower reduced pressure. When the container is suitably filled with blood, the suction line is clamped off or the suction connection itself is closed in a suitable manner, for Sample by means of a valve. A pressure source, for example a manually operable hand inflator of rubber ball type, is new connected to the pressure connection so that a pressure medium, in a controllable am unto and under a controllable pressure, can then be introduced into the further space outside the outer or readily defol~ble container. As the rigid inner container does not experience any definition under the pressure of the pressure medium introduced by the pressure source, the blood contained in the inner container is subjected to a pressure corresponding to the pressure of the pressure medium introduced, whereby, after the arrangement is connected to the patient by way of a pressure infusion fitlnent and possibly a blood filter connected to the upstream side thereof, the blood can be runoffs into the patient, in a short time.
It will be appreciated that the blood contained in the inner container is subjected to the pressure force from the exterior over a large area, more particularly, over the area of the outside of the readily deformable inner container, so that there is no serious danger of squeezing the red blood carousels or otherwise damaging the constituents of the blood, which may frequently suffer damage of that kind when passing through pumps and by coming into contact with materials which are not entirely compatible with blood. It will also be appreciated that the inner container which accommodates the blood and which is preferably in the form of a bag or pouch, similarly to the conventional bags or pouches for blood transfusions, is made from a material which is compatible with blood, for example polyethylene, silicorerubber, PURR PVC, and the like.
The bag or pouch which preferably constitutes the inner container is desirably of such a configuration that, in the undeformed condition, it substantially follows or matches the contour of the inside wall surface of the outer rigid container and is sealingly corrected to the inside wall of the rigid outer container, preferably in the vicinity of the suction connection and the further connection thereon. The join may be made by adhesive or by suitably welding the suitably selected plastic materials forming the outer and inner containers. In another advantageous feature of this form of the apparatus according to the principles of the present invention, which is of advantage from the manufacturing process point of view, the inner container is made for example from a suitable plastic film or foil, and connection nozzles or connecting means comprising a hard material are welded into the bag at the two ends thereof, the outside surface of the connecting nozzles or members forming respective sealing surfaces which are co-operable with corresponding sealing surfaces at apertures in the outer container, through which the connecting members therefore sealingly extend. slat arrangement may be produced for example by sealing rinc3s or the like being fitted into one of the respective pair of sealing surfaces in question. It is also possible however to use adhesive means or plastic welding at that location.
Instead of the idler container being in the form of a bag or pouch, it may alternatively be in the form of an axially compressible folding bellows or concertina-like container, with at least one of the two connections being formed thereon, by means of a connecting nozzle or like connecting member. If the connections are at the two ends of the axially compressible container, although it should be appreciated that that is not necessarily the case, one such connection must then be guided slid ably and sealingly in a suitable aperture in the outer rigid container so that the blood contained in the inner container can be discharged therefrom by pressure medium introduced into the space defined between the inner container and the outer container, for reinfusion purposes Jo ZZ~ 3 In another aspect, the above-indicated objects of the present invention are achieved by an auto transfusion apparatus comprising a container having a suction connection for drawing blood from the patient and a further connection connectable to a suction source, for producing a reduced pressure in the container to draw blood whereinto.
}however, whereas in the above-discussed first aspect of the invention, the container is render rigid by virtue of suitable selection of the material and the wall thickness of the outer container, this second aspect of the presort invention provides that the container for receiving the blood is an axially canpressible concertina-like enclosure which is rendered axially rigid or non-deforrnable by a rigid mounting means or holder structure which is adapted to be secured to mutually oppositely disposed ends of the concertina-like container, to prevent collapse thereof under a reduced pressure in its interior. The concertina-like container canprises a material which is of suitable bending strengthened the wall thickness thereof is so selected that, although the concertina-like container is axially compressible in the above-indicated manner, by virtue of for example a film hinge-type configuration at the bend edges where the individual fold portions of the concertina-like container are joined together, nonetheless the concertina-like container does not experience any deformation or deformation to any substantial extent, in the radial direction, because of the stiffness and rigidity achieved by virtue of the concertina-like construction.
By virtue of a rigid holding or bracing means, for example a frame arrangement or a support structure, in which the concertina-like container may be fitted, when in the expanded condition, in such a way that the support structure secures positive connecting elements at the ends of the container, it is possible to provide that, when the reduced 2Z~ ~93 pressure is applied to the container, it still remains in its expanded condition, so that blood can then be sucked into the interior of the container by way of the appropriate suction connection thereon. When the container is then completely or substantially filled, the arrangement S is closed off in a similar manner to that described above, to stop the further intake of blood. In this form of the apparatus according to the principles of the present invention however, the blood is reinfused into the patient not by connecting the apparatus to a pressure medium source, but by compressing the blood-containing enclosure in the axial direction. The compression operation to cause reinfusion of the blood may be carried out in various different ways, for example, Noel, as by an anesthetist, by putting it into a pressure arrangement, for example an inflatable pressure sleeve, or the like. manual compression in particular has the advantage that it is then possible for the anesthetist to more sensitively control the pressure, than can be achieved for example by using a feed of pressure air.
Having regard to the above-mentioned disadvantage of the known apparatus, whereby there is the danger of damage to the blood due to the reduced pressure within a rigid container continuing to act on the blood therein, although the suction line has been closed off as by means of a clamp, a development of the apparatus of the present invention, in the first-mentioned aspect and in the further aspect referred to above, provides that a pressure limiting means is disposed in the suction line connecting to the suction source, in order to limit the reduced pressure which can be produced in the blood-containing container. A simple form of such a pressure limiting means may comprise a portion of hose comprising silicorerubber, which is adapted to collapse at a given reduction in pressure therein. If the suction force reaches a pressure which is critical to the blood, the collapsible hose portion is compressed by the pressure difference between its interior and its exterior, thereby preventing further evacuation of the blood-containing container.
In a further aspect of the invention which is also based on the principle of the teaching of this invention of pressure reinfusion of the blood drawn from the patient, in a careful manner, the apparatus comprises a container for receiving blood drawn from the patient, in the form of an axially compressible concertina-like container which can be returned from a compressed condition to an extended condition by resilient means such as the inherent resiliency of the material constituting the container and/or by an external force which engages for example the ends of the container. Operatively associated with a suction connection for drawing blood from the patient is a check valve which is operable to open in such a direction as to punt a flow of blood into the container, while operatively associated with a further com~ection for reinfusion of blood from the container is a check valve which opens to permit a flow of blood out of the container.
In this further aspect of the invention, the suction effect is generated by expansion of the axially compressible container, from an initially compressed condition, such expansion being caused by inherent elasticity of the material constituting the container and/or a spring force. In order to ensure that the blood is not subjected to treatment likely to cause damage thereto, the degree of suction applied can be controlled by the extent to which the container is initially compressed.
In this construction also, the material and the wall thickness of the compressible container is so selected that the reduced pressure which occurs upon expansion of the container, in the interior of the container, "
1 22~93 does not result in the side walls of the container being deformed inwardly, as by the corrugated con figuration of the container being inverted in an inward direction; that non-deformable effect can be readily achieved, by virtue of the higher degree of inherent stiffness of the corrugated--5 like configuration of the container. The check valves provided in the various collections of the container ensure that the blood which is sucked into the container cannot reverse its flow through the respective connection , and that the reduced pressure in the container, which is required for drawing the blood whereinto, is not destroyed by in flowing air from the connection which is subsequently to be used for the reinfusion operation.
In the apparatus in accordance with this aspect of the present invention also, reinfusion can be effected by manually or mechanically compressing the container, in the same way as referred to herein before.
The above-mentioned valve assembly in the container also enables a surgeon if necessary to recompress the container by hand, when in an only partially filled condition, so that air also contained in the container is discharged through the check valve which is operative to open in an outward flow direction so that, by releasing the container again, further blood can be drawn into the container, to fill the part of the interior space therein from which the air was discharged by the fresh compression effect. In order in that situation to ensure that, when the container is compressed in order to discharge the air therein, blood is not also discharged from the container with the air, a preferred feature of this aspect of the invention provides that disposed upstream of the second check valve operatively associated with the further connection is a check valve operative to prevent a flow of liquid out of the container, the check valve being operative to check a flow there through only when that flow is constituted by a liquid. Such a liquid check valve may be for
BACKC~OUND OF THE INVENTION
In certain surgical operations, for example and in particular in heart surgery, and also in the case of severe injuries or wounding, a patient Roy very often suffer from substantial blood losses which must be ccmp~nsated by irr~nediate blood transfusion if the life of the patient is not to be put at risk. Particularly in the case of surgical operations, the loss of blood is such that the blood which has been lost frorrl the body is often still available, namely being in the form of accumulations of blood in cavities in the body of the patient, to which the surgeon has relatively ready access. It is therefore already known for the blood to be collected from such accumulations in the body, and no-infused into the same patient. Such a procedure which involves collecting the blood from and reinfusing the collected blood into the same patient is referred to as intra--ope{ative auto transfusion.
Particularly in the case of heart surgery, for the purposes of performing auto transfusion, it is known for the patient to be connecter to a heart lung machine for sucking the blood from the patient by means of pumps installed in the machine and resupplying the blood to the patient. However, such machines are extremely expensive and are therefore not available in every operating theater, while in addition, in spite of the blood being carefully treated in machines of that type, the blood, being a fluid that is very sensitive and easily damaged, may nonetheless suffer a certain amount of damage in its comparatively long path of flow through the machine from the patient and back to the patient again.
In an effort to remedy that problem, an apparatus has been put forward, for receiving and reinfusing a patient's Cowan blood, wherein the blood is sucked in by way of a suction head, a suction line connected thereto and a suction connection, into a rigid container. The container cc~nun~cates by way of at least one further connection with a vacuum source which is Z~6 I
operative to produce, within the container, the reduced pressure required for sucking the blood from the patient. The container may have for example a capacity of about 2000 cm2, and when the container is completely or substantially filled, the suction line is clamped off, the line connecting to the vacuum source is disconnected from the above-mentioned further vacuum connection and a conventional infusion figment, possibly with a blood filter disposed on the upstream side thereof, is then fitted to the further connection from which the suction line was removed, so that the blood in the container can be infused back into the patient in the usual manner.
Although that arrangement has the advantage that the blood can be taken from the patient over a short flow path, thereby substantially avoiding damage to the blood, nonetheless it suffers from some disadvantages which mean that it is not entirely satisfactory. A major disadvantage is that that apparatus can only be used to reinfuse the blood from the container, into a blood vessel in the patient, in the manner of a conventional blood transfusion. As however an auto transfusion operation of the kind concerned herein is effected whenever a patient has suffered serious blood losses, it is also a point of major importance that the blood is reinfused back into the patient in the shortest possible time, as otherwise the patient may suffer from a considerable deficiency of body blood, such as to endanger the patient's life, over a considerable period of time. Such rapid reinfusion of blood can generally only be achieved by pressure infusion of the blood taken from the patient, but the above-described known apparatus is not designed to perform such pressure infusion and in addition, in consequence, such a pressure infusion cannot be effected without the danger of inducing an air embolism in the patient. Another disadvantage of the known '~26~93 apparatus is that, after an accumulation of blood in the patient's body has been drawn into the container, it is necessary to prevent air Fran being drawn into the container after the blood, which is effected by the suction line being closed off by means of a clamp; however, the suction force produced by the vacuum source still continues to apply a suction effect within the rigid container, and that may also give rise to the not inconsiderable danger of damaging the blood, as for example the reduced pressure or suction force may cause excessive expansion of the red blood corpuscles, and may even cause them to burst.
In another apparatus for interpretive auto transfusion, which is similar to the apparatus just discussed above, the patient's blood is initially sucked into a rigid container and then reinfused into the patient from that container by means of a blood pinup (see US patent specifications No 4 047 526 and 4 033 345). In one embodiment of that known apparatus, the blood pump which is connected to the container is formed by an axially compressible concertina or harmonica-like arrangement which is releasable connected to the container and which can be operated to produce a vacuum which can overcome the vacuum in the rigid container. The harmonica-like arrangement is disconnected from the rigid container, after it is filled with blood, and handed over to the anesthetist for the purposes of the reinfusion operation. In another form of the known apparatus, the blood pump is formed by a further container and is non-releasably connected to the rigid container in which the blood is received Fran the patient's body.
The blood pump has a third inner, yield ably deformable container, and a respective check valve at its inlet and its outlet. The deformable container is can pressed and re-expanded by alternately applying an increased pressure and a reduced pressure to a connection on the deformable container, so that in that way, and with the two check valves being suitably operative, the . .
Z'~6~33 blood is sucked out of the first rigid container and then passed on to the patient through the outlet valve.
Although that apparatus permits the blood to be rapidly reinfused into the patient, it suffers frock the disadvantage that the blood acmes into contact with a comparatively large surface area which is foreign to the blood, namely the surfaces in the rigid container and in the blood pump, while in addition there is the danger for the blood to be detrimentally effected and possibly damaged by the vacuum produced in the blood pump, being a stronger vacuum than that in the rigid container.
SUMMARY OF To INVENTION
An object of the present invention is to provide an auto-transfusion apparatus which does not suffer from the disadvantages of the above-discussed prior art.
Another object of the present invention is to provide an auto transfusion apparatus which can take blood Fran a patient over a short flow distance and without damage, and also quickly reinfuse the blood over a short flow distance, again without damage.
Still another object of the present invention is to provide an auto transfusion apparatus which is simple and reliable in operation.
Yet another object of the present invention is to provide an auto transfusion apparatus which constitutes a fully independent and self-contained unit not requiring other vessels or containers for performing the reinfusion operation.
A further object of the present invention is to provide an auto transfusion apparatus which is operable to produce pressure infusion of the blood in order to restore the blood to the patient rapidly and I I I
without the risk of air embolism.
To achieve these and other objects, in a first aspect, the present invention provides an apparatus for receiving and reinfusing a patient's own blood, comprising a readily deformable container having a first connection for drawing blood from the patient by way of a suction line, and a further connection adapted to be connected to a reduced pressure or suction source, thereby to produce within the container the reduced pressure or suction force required to draw the blood from the patient. Disposed around the deformable container is a further rigid container which thus encloses the deformable inner container. The outside of the inner container and the inside of the outer container between them thus define a space to which there is connected a closable pressurizing corunection, for the solute eddy of a pressure medium into the space between the inner and outer containers In the construction in accordance with the principles of the invention, as just set out above, blood is sucked in by way of the suction connection, by virtue of the reduced pressure or suction force obtaining in the outer or rigid container and within the readily deformable container. The reduced pressure in the container cannot result in collapse of the inner easily deformable container as, during the suction operation, the further space defined between the outside of the easily deformable, inner container and the inside wall of the rigid container is closed relative to the exterior, for example by a plug member or the like which is fitted to the pressure connection, or by the pressure connection being connected, during the suction operation, to a source producing a lower reduced pressure. When the container is suitably filled with blood, the suction line is clamped off or the suction connection itself is closed in a suitable manner, for Sample by means of a valve. A pressure source, for example a manually operable hand inflator of rubber ball type, is new connected to the pressure connection so that a pressure medium, in a controllable am unto and under a controllable pressure, can then be introduced into the further space outside the outer or readily defol~ble container. As the rigid inner container does not experience any definition under the pressure of the pressure medium introduced by the pressure source, the blood contained in the inner container is subjected to a pressure corresponding to the pressure of the pressure medium introduced, whereby, after the arrangement is connected to the patient by way of a pressure infusion fitlnent and possibly a blood filter connected to the upstream side thereof, the blood can be runoffs into the patient, in a short time.
It will be appreciated that the blood contained in the inner container is subjected to the pressure force from the exterior over a large area, more particularly, over the area of the outside of the readily deformable inner container, so that there is no serious danger of squeezing the red blood carousels or otherwise damaging the constituents of the blood, which may frequently suffer damage of that kind when passing through pumps and by coming into contact with materials which are not entirely compatible with blood. It will also be appreciated that the inner container which accommodates the blood and which is preferably in the form of a bag or pouch, similarly to the conventional bags or pouches for blood transfusions, is made from a material which is compatible with blood, for example polyethylene, silicorerubber, PURR PVC, and the like.
The bag or pouch which preferably constitutes the inner container is desirably of such a configuration that, in the undeformed condition, it substantially follows or matches the contour of the inside wall surface of the outer rigid container and is sealingly corrected to the inside wall of the rigid outer container, preferably in the vicinity of the suction connection and the further connection thereon. The join may be made by adhesive or by suitably welding the suitably selected plastic materials forming the outer and inner containers. In another advantageous feature of this form of the apparatus according to the principles of the present invention, which is of advantage from the manufacturing process point of view, the inner container is made for example from a suitable plastic film or foil, and connection nozzles or connecting means comprising a hard material are welded into the bag at the two ends thereof, the outside surface of the connecting nozzles or members forming respective sealing surfaces which are co-operable with corresponding sealing surfaces at apertures in the outer container, through which the connecting members therefore sealingly extend. slat arrangement may be produced for example by sealing rinc3s or the like being fitted into one of the respective pair of sealing surfaces in question. It is also possible however to use adhesive means or plastic welding at that location.
Instead of the idler container being in the form of a bag or pouch, it may alternatively be in the form of an axially compressible folding bellows or concertina-like container, with at least one of the two connections being formed thereon, by means of a connecting nozzle or like connecting member. If the connections are at the two ends of the axially compressible container, although it should be appreciated that that is not necessarily the case, one such connection must then be guided slid ably and sealingly in a suitable aperture in the outer rigid container so that the blood contained in the inner container can be discharged therefrom by pressure medium introduced into the space defined between the inner container and the outer container, for reinfusion purposes Jo ZZ~ 3 In another aspect, the above-indicated objects of the present invention are achieved by an auto transfusion apparatus comprising a container having a suction connection for drawing blood from the patient and a further connection connectable to a suction source, for producing a reduced pressure in the container to draw blood whereinto.
}however, whereas in the above-discussed first aspect of the invention, the container is render rigid by virtue of suitable selection of the material and the wall thickness of the outer container, this second aspect of the presort invention provides that the container for receiving the blood is an axially canpressible concertina-like enclosure which is rendered axially rigid or non-deforrnable by a rigid mounting means or holder structure which is adapted to be secured to mutually oppositely disposed ends of the concertina-like container, to prevent collapse thereof under a reduced pressure in its interior. The concertina-like container canprises a material which is of suitable bending strengthened the wall thickness thereof is so selected that, although the concertina-like container is axially compressible in the above-indicated manner, by virtue of for example a film hinge-type configuration at the bend edges where the individual fold portions of the concertina-like container are joined together, nonetheless the concertina-like container does not experience any deformation or deformation to any substantial extent, in the radial direction, because of the stiffness and rigidity achieved by virtue of the concertina-like construction.
By virtue of a rigid holding or bracing means, for example a frame arrangement or a support structure, in which the concertina-like container may be fitted, when in the expanded condition, in such a way that the support structure secures positive connecting elements at the ends of the container, it is possible to provide that, when the reduced 2Z~ ~93 pressure is applied to the container, it still remains in its expanded condition, so that blood can then be sucked into the interior of the container by way of the appropriate suction connection thereon. When the container is then completely or substantially filled, the arrangement S is closed off in a similar manner to that described above, to stop the further intake of blood. In this form of the apparatus according to the principles of the present invention however, the blood is reinfused into the patient not by connecting the apparatus to a pressure medium source, but by compressing the blood-containing enclosure in the axial direction. The compression operation to cause reinfusion of the blood may be carried out in various different ways, for example, Noel, as by an anesthetist, by putting it into a pressure arrangement, for example an inflatable pressure sleeve, or the like. manual compression in particular has the advantage that it is then possible for the anesthetist to more sensitively control the pressure, than can be achieved for example by using a feed of pressure air.
Having regard to the above-mentioned disadvantage of the known apparatus, whereby there is the danger of damage to the blood due to the reduced pressure within a rigid container continuing to act on the blood therein, although the suction line has been closed off as by means of a clamp, a development of the apparatus of the present invention, in the first-mentioned aspect and in the further aspect referred to above, provides that a pressure limiting means is disposed in the suction line connecting to the suction source, in order to limit the reduced pressure which can be produced in the blood-containing container. A simple form of such a pressure limiting means may comprise a portion of hose comprising silicorerubber, which is adapted to collapse at a given reduction in pressure therein. If the suction force reaches a pressure which is critical to the blood, the collapsible hose portion is compressed by the pressure difference between its interior and its exterior, thereby preventing further evacuation of the blood-containing container.
In a further aspect of the invention which is also based on the principle of the teaching of this invention of pressure reinfusion of the blood drawn from the patient, in a careful manner, the apparatus comprises a container for receiving blood drawn from the patient, in the form of an axially compressible concertina-like container which can be returned from a compressed condition to an extended condition by resilient means such as the inherent resiliency of the material constituting the container and/or by an external force which engages for example the ends of the container. Operatively associated with a suction connection for drawing blood from the patient is a check valve which is operable to open in such a direction as to punt a flow of blood into the container, while operatively associated with a further com~ection for reinfusion of blood from the container is a check valve which opens to permit a flow of blood out of the container.
In this further aspect of the invention, the suction effect is generated by expansion of the axially compressible container, from an initially compressed condition, such expansion being caused by inherent elasticity of the material constituting the container and/or a spring force. In order to ensure that the blood is not subjected to treatment likely to cause damage thereto, the degree of suction applied can be controlled by the extent to which the container is initially compressed.
In this construction also, the material and the wall thickness of the compressible container is so selected that the reduced pressure which occurs upon expansion of the container, in the interior of the container, "
1 22~93 does not result in the side walls of the container being deformed inwardly, as by the corrugated con figuration of the container being inverted in an inward direction; that non-deformable effect can be readily achieved, by virtue of the higher degree of inherent stiffness of the corrugated--5 like configuration of the container. The check valves provided in the various collections of the container ensure that the blood which is sucked into the container cannot reverse its flow through the respective connection , and that the reduced pressure in the container, which is required for drawing the blood whereinto, is not destroyed by in flowing air from the connection which is subsequently to be used for the reinfusion operation.
In the apparatus in accordance with this aspect of the present invention also, reinfusion can be effected by manually or mechanically compressing the container, in the same way as referred to herein before.
The above-mentioned valve assembly in the container also enables a surgeon if necessary to recompress the container by hand, when in an only partially filled condition, so that air also contained in the container is discharged through the check valve which is operative to open in an outward flow direction so that, by releasing the container again, further blood can be drawn into the container, to fill the part of the interior space therein from which the air was discharged by the fresh compression effect. In order in that situation to ensure that, when the container is compressed in order to discharge the air therein, blood is not also discharged from the container with the air, a preferred feature of this aspect of the invention provides that disposed upstream of the second check valve operatively associated with the further connection is a check valve operative to prevent a flow of liquid out of the container, the check valve being operative to check a flow there through only when that flow is constituted by a liquid. Such a liquid check valve may be for
2;~6 ~93 ex~nple a pivotal fin or foil cushion which is arranged, upstream of said connection, within the compressible container, or alternatively a ball member which is heavier than air but lighter than liquid.
Zen therefore the blood reaches the opening of the further connection, due to compression of the compressible container, the above-mentioned fin or foil cushion or ball member, which up ill then could not produce its flow-blocking action while the air was being discharged from the container by compression thereof, floats up on the blood as it moves towards the further connection, and causes that connection to be closed off.
It would also be possible to use a hydrophobic filter means as the liquid check valve It will be appreciated that in all the basic aspects and embodiments of the apparatus in accordance with the principles of this invention, as set out above, the respective containers comprise materials which are acceptable and compatible from the physiological point of view, for example, polyethylene, polyurethane or polyamide, and are preferably also transparent or translucent to make it possible to monitor the level of blood in the container.
Further objects, features and advantages of the present invention will be apparent from the following description of preferred embodiments, given with reference to the accanpanying drawings, and from the appended claims.
BRIEF DESCRIPTION OF THE DRAWINGS
Figure 1 shows a view, partly in longitudinal section, of the container assembly of a first embodiment of the apparatus in accordance with the invention, wherein some components of the apparatus, being components which will be apparent to the man skilled in the art, are not illustrated in fully detailed form, for the sake of simplicity and clarity of the drawing, Z2tj493 Figure 2 shows a diagrammatic view in longitudinal section through the container arrangement in accordance with a second emkcdiment of the apparatus according to the invention, and Figure 3 shows a view in longitudinal section, similarly to Figures 1 and 2, of the container arrangement of a third embodiment of the apparatus according to this invention.
Description OF PROOFREAD EM~DDI~NTS
Reference will now be made to the accompany yin drawings showing various components and features of the apparatus according to the present invention, as will now be described.
The embodiment of the apparatus of which the major part is shun in Figure 1, for receiving and reinfusing blood, comprises a container arrangement which is generally denoted by reference numeral 1.
Connected to the container arrangement 1 is a suction line or conduit 2 which can be closed off by any suitable means, such as a clamp, and which in turn can be connected to a suction head for sucking blood into the apparatus. The container arrangement 1 is also connected to a releasable vacuum or reduced pressure or suction line or conduit 3, for connection to a reduced pressure or suction source, for example a vacuum pump, as diagrammatically indicated at 4. It should be noted at this point that the apparatus can also be connected to a per so known infusion figment or instrument, possibly with a blood filter disposed upstream thereof, which can be connected to the container arrangement 1 in place of the line 2 or the line 3, and which serves for reinfusion of blood contained in the container arrangement 1, as will be described I 2~6~93 hereinafter.
ho will be readily apparent from Figure 1, the container arrangement 1 comprises an outer container 11 which is of a rigid form by virtue for example of the material used and the wall thickness employed, and an inner, readily deformable container 12 which is disposed within the outer container 11 and which may be for example in the form of a bag or pouch of any suitable material. The outer rigid container 11, which may ye of any desired configuration but which is desirably substantially cylindrical, and which is substantially closed at its respective ends, as clearly shown in Figure 1, is provided with apertures 13 and 14 at its two opposite ends. As shown in Figure 1, each of the apertures 13 and 14 is surrounded by a collar portion which extends generally outwardly in the axial or longitudinal direction of the container 11, to form a kind of neck configuration. The purpose of the neck configurations at apertures 13 and 14 will become apparent below.
At its opposite ends, the bag or pouch 12 also has openings into which are fitted connecting members or nozzles as indicated at lo, being secured to the bag or pouch 12 for example by a welding operation.
The connecting members 15 comprise a comparatively rigid plastic material to which the suction line 2 and the reduced pressure line 3 can be connected by means of suitable hose coupling arrangements diagrammatically illustrated in Figure 1. When the bag 12 is in the substantially undeformed condition shown in solid lines in Figure 1, the bag 12 is of a shape which substantially corresponds to the inside contour of the outer container 11 so that, in that condition, a closed space 16 defined between the outside of the inner bag 12 and the inside wall surface of the outer container 11 is of comparatively small volume. The space 16 is closed relative to the exterior of the container arrangement 1 by virtue of the 'J-22tjL~93 outside surface of the connecting members 15 being sealed to the inside surfaces of the neck portions around the apertures 13 and 14 in the outer container 11. That sealing effect is produced for example by welding, by adhesive means, or by seals which are fitted into the S respective sealing surfaces, and the like. In that way, the space 16 between the inner container 12 and the outer container 11 is accessible only by way of a pressure connection indicated in diagrammatic form at 17, which is provided on the wall of the outer container 11. The pressure connection 17 can be closed off, when not in use, by a removable cover as indicated at 18, while, in use of the arrangement, a pressure line 19 which is connected to a pressure medianly source snot illustrated in the drawing) can be connected to the pressure connection 17 after the cover 18 has been removed.
The outer container if has a scale 20 to permit the level of filling of blood in the container arrangement 1 to be read off.
The wall thickness and the material of the outer container 11 are such that the outer container 11 is capable of withstanding the pressure forces occurring, both from the outside and from the inside, without substantial deformation. On the other hand, the bag or pouch 12 comprises a thin and easily foldable or deformable plastic film or foil material, for example polyethylene.
The line 3 incorporates a hose portion 21 comprising an easily deformable material such as silicone rubber to act as a reduce pressure limiting means, in order to ensure therefore that the reduced pressure generated within the inner container 12 by the source 4 cannot fall below a given pressure at which damage to the blood in the container 12 might occur.
Z2t~ 3 The made of operation of the construction illustrated by way - of example in Fuller 1 is as follows:
When, for example in the course of a surgical operation, blood accumulates in a cavity in the body of the patient being operated on, blood may be sucked therefrom by means of the present apparatus by connecting the line 3 to the reduced pressure source 4 while the suction line 2, with the suction head thereon, is introduced by the surgeon or an assistant into the accumulation of blood which is to be sucked away from the patient. us a result of the reduced pressure generated within the bag 12 by the source I, blood is then sucked into the bag 12. As, at that time, the space 16 is sealed relative to the exterior by the cover 18 fittc~ on the pressure connection 17, or is alternatively also connected to the reduced pressure source 4 by way of a suitable line (not shown), the reduced pressure obtaining in the interior of the bag 12 cannot cause the bag 12 to fold or collapse inwardly. On the contrary, the bag 12 remains substantially in the condition shown in Figure 1, as movement of the bag 12 inwardly away from the wall of the outer container 11, under the effect of the reduced pressure produced within the container 12, is opposed by the reduction in pressure in the space 16, which would occur when the wall of the bag 12 moves inwardly, so that the bag 12 is thus held in a condition of equilibrium, balanced between the pressure within the bag 12 and the pressure in the space 16. When the bag 12 and thus the container 11 is substantially filled, or when the accumulated blood in the patient has been sucked away into the apparatus, the suction line 2 is closed off by a suitable means such as a damp (not shown), the reduced pressure line 3 is disconnected, and a pressure infusion fitrnent or instrument (not shown), possibly with a blood filter disposed upstream thereof in the usual way, is connected to the connecting ~.22~;~93 means 15 from which the line 3 has been disconnected. The needle of the pressure infusion instn~ment has already been inserted into one of the patient's blood vessels, and secured in place. The cover 18 is now removed from the pressure connection 17, or, where the pressure connection S 17 has also been connected to the reduced pressure source 4, that connecting line is also disconnected from the pressure connection 17, and in its place, the pressure line 19 is connected to the connection 17. By a controlled feed of pressure median, for example caressed gas, into the space 16, pressure can now be applied to the outside of the bag 12, within the container 11. That pressure accordingly acts on the blood contained in the bag 12 and feeds that blood to the patient by way of the connection arrangement 13, 15 and the pressure infusion instrwnent, the length of the period of time required for such pressure infusion depending on the amount of blood to be reinfused and also on the level of pressure applied in the space it. Figure 1 shows in broken lines the deformed condition of the bag 12 which will thus collapse inwardly as the blood is discharged from the bag 12 back into the patient, forming a folded configuration as that happens.
After the bag 12 has been emptied of all the blood contained therein, and is therefore in an at least substantially completely compressed condition, the bag 12 can be re-expanded to its original undeformed condition, by again connecting the connection 17 to a reduced pressure source, to draw the bag 12 outwardly into contact with the inside wall surface of the outer container 11.
Instead of using compressed gas as the pressure medium for producing the discharge of blood from the container arrangement 1, it is also possible to cause discharge of the blood contained in the bag 12, by means of an infusion solution which is supplied by means of a pump.
~!.Z2~93 Reference will now be made to Figure 2 showing a second form of the apparatus according to the principles of this invention, in which, instead of comprising the container arrangement 1 with the containers 11, ha and 12, aye, the illustrated apparatus comprises a container in the form of a concertina-like enclosure, as indicated generality 30.
The wall thickness and the material in the region of the folds 31 defined by the concertina-like container 30 are such that the folds are not compressed substantially in a radial direction, even when a reduced pressure obtains within the container 30. On the other hand, in the 10 region of edges 32 at which the portions of the folds are joined together, the wall thickness of the container 30 is comparatively thin, to constitute a form of film hinge arrangement, so that the concertina-like container can be relatively easily compressed in an axial direction, as indicated by arrow 33.
I
At its opr~sitely disposed ends, the container 30 has connections 15 which can be connected to a suction line, and to a reduced pressure line and a pressure infusion instrument respectively, in the same maimer as described above with reference to Figures 1 and lay The connections 15 have a rib at their free end, for suitably connecting the respective lines thereto, as shown in Figure 1 for example, and also a further outwardly protecting annular rib aye, the purpose of which will now be explained.
As can be clearly seen in figure 2, the container 30 is engaged by a frame structure or holder means diagrarr~natically indicated at 36, which is of a generally U-shaped configuration providing respective arms 39 and 35, each of which has a generally forked end portion. In the expanded condition of the container 30, thus as shown in Figure 2, the forked end of each of the arms 34 and 35 engages partially around a respective connection 15, under the annular rib lea thereon, so as to hold the connections 15 at a spacing defined by the spacing between the forked ends of the awns 39 and 35 of the holder structure 36, thus also holding the container 30 in the expanded condition shown. It will be appreciated that the holder structure 36 and the co-operation thereof with the container 30 are such that the container 30 is held in the expanded condition, even when a reduced pressure is applied to the interior of the container 30, in a similar mauler to the reduced pressure produced within the bag or pouch 12, aye shown in Figures 1 and lo respectively. It is possible for the two end walls 37 and 38 of the container 30 to be of a stronger or more rigid construction, or to be provided with a stiffening insert, in order to prevent the container 30 taking up an inwardly curved configuration at those points.
In the condition shown in Figure 2, the container 30 fonts the equivalent to the rigid outer container 11 in the construction shown for employ in Figure 1. It will be appreciated however that, as the container 30, as soon as it is removed from its position of form-locking engagement with the arms 34 and 35 of the holder structure 36, represents a readily deformable container corresponding to the bag or pouch 12 in the construction shown in Fuller 1, it also performs the function of that bag or pouch.
More specifically, the made of operation of the construction shown in Figure 2 is as follows:
First of all, a reduced pressure is produced in the interior of the concertina-like container 30, by connecting a reduced pressure source to one of the connections lo. Blood is sucked from an accumulation thereof in the body of the tent, into the interior of the container 30, by tune reduced pressure there within, by way of the suction line connected to the connection 15. When the accumulated blood has been sucked away or when the container 30 has been entirely or substantially filled with blood, the suction line is closed off as by means of a clamp, and the reduced pressure line is disconnected and replaced by a pressure infusion arrangement, in the same way as described above with reference to Figure 1. The container 30 can now be removed from the structure 36. The blood contained in the container 30 is then reinfused into the patient by axially cc~npressing the container 30 in the direction indicated by the arrow 33. As already mentioned above, the container 30 may be axially compressed either manually or by introducing the container 30 into an inflatable pressure sleeve, or by means of another arrangement for applying pressure to the container 30.
Reference is now made to Figure 3 showing another construction in accordance with the present invention, in which the container for receiving the blood to be reinfused is in the form of a concertina-like container 40 which in principle is the same as the container 30 shown in Figure 2 but which has a higher degree of inherent elasticity than the container 30, by virtue of being of a suitable wall thickness, in the region of the edges I at which the fold portions defining the concertina-like configuration are interconnected. The inherent resiliency of the container 40 provides that, after the container 40 has been axially ccsnpressed, it will autolnatically return to its expanded condition. Such inherent resiliency can be assisted and promoted by a suitable spring means such as a spreading spring 43 which is connected to the end surface portions of the container 40 and which seeks to expand the container q0 in an axial direction. It would be possible to use such a spring means, instead of relying on the inherent resiliency of the container 40, as well as utilizing both inherent resiliency and spring means.
Like the above-described embodiments, the container 40 also has connections 15. One of the connections 15 can also be coupled to a suction line 2, in the manner already described above, so that blood can be sucked into the interior of the container 40. However, in contrast to the previously described err~odirnents, the other connection 15, being the upper connection in Figure 3, is not connected to a reduced pressure source, but instead is used exclusively in the operatiorof reinfusing the blood, for connecting a pressure infusion instrument of which Figure
Zen therefore the blood reaches the opening of the further connection, due to compression of the compressible container, the above-mentioned fin or foil cushion or ball member, which up ill then could not produce its flow-blocking action while the air was being discharged from the container by compression thereof, floats up on the blood as it moves towards the further connection, and causes that connection to be closed off.
It would also be possible to use a hydrophobic filter means as the liquid check valve It will be appreciated that in all the basic aspects and embodiments of the apparatus in accordance with the principles of this invention, as set out above, the respective containers comprise materials which are acceptable and compatible from the physiological point of view, for example, polyethylene, polyurethane or polyamide, and are preferably also transparent or translucent to make it possible to monitor the level of blood in the container.
Further objects, features and advantages of the present invention will be apparent from the following description of preferred embodiments, given with reference to the accanpanying drawings, and from the appended claims.
BRIEF DESCRIPTION OF THE DRAWINGS
Figure 1 shows a view, partly in longitudinal section, of the container assembly of a first embodiment of the apparatus in accordance with the invention, wherein some components of the apparatus, being components which will be apparent to the man skilled in the art, are not illustrated in fully detailed form, for the sake of simplicity and clarity of the drawing, Z2tj493 Figure 2 shows a diagrammatic view in longitudinal section through the container arrangement in accordance with a second emkcdiment of the apparatus according to the invention, and Figure 3 shows a view in longitudinal section, similarly to Figures 1 and 2, of the container arrangement of a third embodiment of the apparatus according to this invention.
Description OF PROOFREAD EM~DDI~NTS
Reference will now be made to the accompany yin drawings showing various components and features of the apparatus according to the present invention, as will now be described.
The embodiment of the apparatus of which the major part is shun in Figure 1, for receiving and reinfusing blood, comprises a container arrangement which is generally denoted by reference numeral 1.
Connected to the container arrangement 1 is a suction line or conduit 2 which can be closed off by any suitable means, such as a clamp, and which in turn can be connected to a suction head for sucking blood into the apparatus. The container arrangement 1 is also connected to a releasable vacuum or reduced pressure or suction line or conduit 3, for connection to a reduced pressure or suction source, for example a vacuum pump, as diagrammatically indicated at 4. It should be noted at this point that the apparatus can also be connected to a per so known infusion figment or instrument, possibly with a blood filter disposed upstream thereof, which can be connected to the container arrangement 1 in place of the line 2 or the line 3, and which serves for reinfusion of blood contained in the container arrangement 1, as will be described I 2~6~93 hereinafter.
ho will be readily apparent from Figure 1, the container arrangement 1 comprises an outer container 11 which is of a rigid form by virtue for example of the material used and the wall thickness employed, and an inner, readily deformable container 12 which is disposed within the outer container 11 and which may be for example in the form of a bag or pouch of any suitable material. The outer rigid container 11, which may ye of any desired configuration but which is desirably substantially cylindrical, and which is substantially closed at its respective ends, as clearly shown in Figure 1, is provided with apertures 13 and 14 at its two opposite ends. As shown in Figure 1, each of the apertures 13 and 14 is surrounded by a collar portion which extends generally outwardly in the axial or longitudinal direction of the container 11, to form a kind of neck configuration. The purpose of the neck configurations at apertures 13 and 14 will become apparent below.
At its opposite ends, the bag or pouch 12 also has openings into which are fitted connecting members or nozzles as indicated at lo, being secured to the bag or pouch 12 for example by a welding operation.
The connecting members 15 comprise a comparatively rigid plastic material to which the suction line 2 and the reduced pressure line 3 can be connected by means of suitable hose coupling arrangements diagrammatically illustrated in Figure 1. When the bag 12 is in the substantially undeformed condition shown in solid lines in Figure 1, the bag 12 is of a shape which substantially corresponds to the inside contour of the outer container 11 so that, in that condition, a closed space 16 defined between the outside of the inner bag 12 and the inside wall surface of the outer container 11 is of comparatively small volume. The space 16 is closed relative to the exterior of the container arrangement 1 by virtue of the 'J-22tjL~93 outside surface of the connecting members 15 being sealed to the inside surfaces of the neck portions around the apertures 13 and 14 in the outer container 11. That sealing effect is produced for example by welding, by adhesive means, or by seals which are fitted into the S respective sealing surfaces, and the like. In that way, the space 16 between the inner container 12 and the outer container 11 is accessible only by way of a pressure connection indicated in diagrammatic form at 17, which is provided on the wall of the outer container 11. The pressure connection 17 can be closed off, when not in use, by a removable cover as indicated at 18, while, in use of the arrangement, a pressure line 19 which is connected to a pressure medianly source snot illustrated in the drawing) can be connected to the pressure connection 17 after the cover 18 has been removed.
The outer container if has a scale 20 to permit the level of filling of blood in the container arrangement 1 to be read off.
The wall thickness and the material of the outer container 11 are such that the outer container 11 is capable of withstanding the pressure forces occurring, both from the outside and from the inside, without substantial deformation. On the other hand, the bag or pouch 12 comprises a thin and easily foldable or deformable plastic film or foil material, for example polyethylene.
The line 3 incorporates a hose portion 21 comprising an easily deformable material such as silicone rubber to act as a reduce pressure limiting means, in order to ensure therefore that the reduced pressure generated within the inner container 12 by the source 4 cannot fall below a given pressure at which damage to the blood in the container 12 might occur.
Z2t~ 3 The made of operation of the construction illustrated by way - of example in Fuller 1 is as follows:
When, for example in the course of a surgical operation, blood accumulates in a cavity in the body of the patient being operated on, blood may be sucked therefrom by means of the present apparatus by connecting the line 3 to the reduced pressure source 4 while the suction line 2, with the suction head thereon, is introduced by the surgeon or an assistant into the accumulation of blood which is to be sucked away from the patient. us a result of the reduced pressure generated within the bag 12 by the source I, blood is then sucked into the bag 12. As, at that time, the space 16 is sealed relative to the exterior by the cover 18 fittc~ on the pressure connection 17, or is alternatively also connected to the reduced pressure source 4 by way of a suitable line (not shown), the reduced pressure obtaining in the interior of the bag 12 cannot cause the bag 12 to fold or collapse inwardly. On the contrary, the bag 12 remains substantially in the condition shown in Figure 1, as movement of the bag 12 inwardly away from the wall of the outer container 11, under the effect of the reduced pressure produced within the container 12, is opposed by the reduction in pressure in the space 16, which would occur when the wall of the bag 12 moves inwardly, so that the bag 12 is thus held in a condition of equilibrium, balanced between the pressure within the bag 12 and the pressure in the space 16. When the bag 12 and thus the container 11 is substantially filled, or when the accumulated blood in the patient has been sucked away into the apparatus, the suction line 2 is closed off by a suitable means such as a damp (not shown), the reduced pressure line 3 is disconnected, and a pressure infusion fitrnent or instrument (not shown), possibly with a blood filter disposed upstream thereof in the usual way, is connected to the connecting ~.22~;~93 means 15 from which the line 3 has been disconnected. The needle of the pressure infusion instn~ment has already been inserted into one of the patient's blood vessels, and secured in place. The cover 18 is now removed from the pressure connection 17, or, where the pressure connection S 17 has also been connected to the reduced pressure source 4, that connecting line is also disconnected from the pressure connection 17, and in its place, the pressure line 19 is connected to the connection 17. By a controlled feed of pressure median, for example caressed gas, into the space 16, pressure can now be applied to the outside of the bag 12, within the container 11. That pressure accordingly acts on the blood contained in the bag 12 and feeds that blood to the patient by way of the connection arrangement 13, 15 and the pressure infusion instrwnent, the length of the period of time required for such pressure infusion depending on the amount of blood to be reinfused and also on the level of pressure applied in the space it. Figure 1 shows in broken lines the deformed condition of the bag 12 which will thus collapse inwardly as the blood is discharged from the bag 12 back into the patient, forming a folded configuration as that happens.
After the bag 12 has been emptied of all the blood contained therein, and is therefore in an at least substantially completely compressed condition, the bag 12 can be re-expanded to its original undeformed condition, by again connecting the connection 17 to a reduced pressure source, to draw the bag 12 outwardly into contact with the inside wall surface of the outer container 11.
Instead of using compressed gas as the pressure medium for producing the discharge of blood from the container arrangement 1, it is also possible to cause discharge of the blood contained in the bag 12, by means of an infusion solution which is supplied by means of a pump.
~!.Z2~93 Reference will now be made to Figure 2 showing a second form of the apparatus according to the principles of this invention, in which, instead of comprising the container arrangement 1 with the containers 11, ha and 12, aye, the illustrated apparatus comprises a container in the form of a concertina-like enclosure, as indicated generality 30.
The wall thickness and the material in the region of the folds 31 defined by the concertina-like container 30 are such that the folds are not compressed substantially in a radial direction, even when a reduced pressure obtains within the container 30. On the other hand, in the 10 region of edges 32 at which the portions of the folds are joined together, the wall thickness of the container 30 is comparatively thin, to constitute a form of film hinge arrangement, so that the concertina-like container can be relatively easily compressed in an axial direction, as indicated by arrow 33.
I
At its opr~sitely disposed ends, the container 30 has connections 15 which can be connected to a suction line, and to a reduced pressure line and a pressure infusion instrument respectively, in the same maimer as described above with reference to Figures 1 and lay The connections 15 have a rib at their free end, for suitably connecting the respective lines thereto, as shown in Figure 1 for example, and also a further outwardly protecting annular rib aye, the purpose of which will now be explained.
As can be clearly seen in figure 2, the container 30 is engaged by a frame structure or holder means diagrarr~natically indicated at 36, which is of a generally U-shaped configuration providing respective arms 39 and 35, each of which has a generally forked end portion. In the expanded condition of the container 30, thus as shown in Figure 2, the forked end of each of the arms 34 and 35 engages partially around a respective connection 15, under the annular rib lea thereon, so as to hold the connections 15 at a spacing defined by the spacing between the forked ends of the awns 39 and 35 of the holder structure 36, thus also holding the container 30 in the expanded condition shown. It will be appreciated that the holder structure 36 and the co-operation thereof with the container 30 are such that the container 30 is held in the expanded condition, even when a reduced pressure is applied to the interior of the container 30, in a similar mauler to the reduced pressure produced within the bag or pouch 12, aye shown in Figures 1 and lo respectively. It is possible for the two end walls 37 and 38 of the container 30 to be of a stronger or more rigid construction, or to be provided with a stiffening insert, in order to prevent the container 30 taking up an inwardly curved configuration at those points.
In the condition shown in Figure 2, the container 30 fonts the equivalent to the rigid outer container 11 in the construction shown for employ in Figure 1. It will be appreciated however that, as the container 30, as soon as it is removed from its position of form-locking engagement with the arms 34 and 35 of the holder structure 36, represents a readily deformable container corresponding to the bag or pouch 12 in the construction shown in Fuller 1, it also performs the function of that bag or pouch.
More specifically, the made of operation of the construction shown in Figure 2 is as follows:
First of all, a reduced pressure is produced in the interior of the concertina-like container 30, by connecting a reduced pressure source to one of the connections lo. Blood is sucked from an accumulation thereof in the body of the tent, into the interior of the container 30, by tune reduced pressure there within, by way of the suction line connected to the connection 15. When the accumulated blood has been sucked away or when the container 30 has been entirely or substantially filled with blood, the suction line is closed off as by means of a clamp, and the reduced pressure line is disconnected and replaced by a pressure infusion arrangement, in the same way as described above with reference to Figure 1. The container 30 can now be removed from the structure 36. The blood contained in the container 30 is then reinfused into the patient by axially cc~npressing the container 30 in the direction indicated by the arrow 33. As already mentioned above, the container 30 may be axially compressed either manually or by introducing the container 30 into an inflatable pressure sleeve, or by means of another arrangement for applying pressure to the container 30.
Reference is now made to Figure 3 showing another construction in accordance with the present invention, in which the container for receiving the blood to be reinfused is in the form of a concertina-like container 40 which in principle is the same as the container 30 shown in Figure 2 but which has a higher degree of inherent elasticity than the container 30, by virtue of being of a suitable wall thickness, in the region of the edges I at which the fold portions defining the concertina-like configuration are interconnected. The inherent resiliency of the container 40 provides that, after the container 40 has been axially ccsnpressed, it will autolnatically return to its expanded condition. Such inherent resiliency can be assisted and promoted by a suitable spring means such as a spreading spring 43 which is connected to the end surface portions of the container 40 and which seeks to expand the container q0 in an axial direction. It would be possible to use such a spring means, instead of relying on the inherent resiliency of the container 40, as well as utilizing both inherent resiliency and spring means.
Like the above-described embodiments, the container 40 also has connections 15. One of the connections 15 can also be coupled to a suction line 2, in the manner already described above, so that blood can be sucked into the interior of the container 40. However, in contrast to the previously described err~odirnents, the other connection 15, being the upper connection in Figure 3, is not connected to a reduced pressure source, but instead is used exclusively in the operatiorof reinfusing the blood, for connecting a pressure infusion instrument of which Figure
3 diagrammatically indicates the connecting pipe and the associated dame portion of a blood filter 44.
Disposed in the connection 15 to which the suction line 2 is to be connected is a non-return or check valve 45 which is operative to open in a direction such as to permit blood to flow into the container 40, while however being in a closed condition in the opposite direction, so that blood cannot be discharged from the container 40 through the lower connection 15 shown in Figure 3. The opposite connection 15 which is subsequently connected to the pressure infusion instrument as shown in Figure 3 also has a non-return or check valve 46 which is operative to open in a flow direction out of the interior of the container 90, Chile however producing its check function in the opposite direction of flow, namely, inwardly of the container 40. In addition, disposed in the vicinity of the opening 47 with which the check valve 46 is operatively associated and which leads to the connection 15 is a light air-filled film or foil cushion 48 which is so disposed that it hangs downwardly in the manner shown in Figure 3, under the effect of its own weight. The cushion member 48 cannot be moved into a position in front of the opening 47, by virtue of a flow of air outwardly of the container through the check valve 46.
The mode of operation of the construction shown in Figure 3 is as follows:
Firstly, the container 40 is axially compressed to its minimum volume by a manual pressure force, for which purpose it is necessary to overcome both the inherent resiliency of the concertina-like or corrugated Lyle of the container 30, and also the spring force of the spring 43, where such is provided. The suction line 2 is clamped off when the container 40 is in the compressed condition so that no air can pass into the container 40 and therefore the container 40 is retained automatically in the compressed condition. If now the suction head (not shown) connected to the suction line 2 is introduced into an accumulation of blood for example in the body of a patient, and the clamp closing off the suction line 2 is slowly released, the inherent elasticity of the container 40 and also the spring force applied by the spring 43 will cause the container 40 to expand in its axial direction. That causes an increase in the internal volume of the container 40, relative to its initial ~.2Z64~93 compressed condition, and blood will therefore be sucked into the container 40 through the suction line 2 and the check valve 45 which is thus in an open position. The other check valve 46, being closed, will prevent the entry of air into the container 40 during that phase of operation, so that the effect of reduced pressure in the container 40 is not nullified by an intake of air through the upper connection shown in Figure 3. If, due to lack of attention or due to a certain amount of leakage, a certain quantity of air also passes into the container 40 so that the container is not completely filled with blood, although it has already expanded to the maximum extent, the surgeon or assistant may manually compress the container 40 again in order to remove that air frock the container 90 by way of the connection lo in which the check valve 46 is disposed. when that occurs, the cushion member 48 ensures that blood cannot additionally pass through the check valve 46, which would be undesirable.
That is because the member 48 floats up on the surface of the blood in the container 40 and is thereby moved into a position in front of the opening 47 so as to close off the opening 47 and prevent blood from escaping from the connection 15 with the air which is being discharged there through.
When the container 40 is filled with blood in the manner just described above, it can be used for the reinfusion operation in the same manner as described above with reference to the embodiment shown in Figure 2. In other words, the container 40 is manually or mechanically compressed to cause blood to be reinfused into the patient by way of the pressure infusion figment 44 which is then connected to the connection 15. An important consideration in that connection is that the cushion member 48 is displaced from its position in front of the opening 47, by the connecting tube of the blood filter or by the corresponding tube of the 3.~t:~93 pressure infusion fitrnent, so that the rneml>er 48 no longer closes off the opening 47 and blood can be discharged through the connection 15.
In a modified form of the embodiments illustrated, the connections 5 15 may be arrayed on the same end of the container, in which cafe it is necessary to avoid short-circuits in regard to the flow of blood, by suitably extending the connecting structures into the interior of the container. It is also readily possible for the various valve functions, for example in respect of the check valves 45 and 46, to be performed at a 10 different position, for example in the lines or conduits connected thereto, or short line or conduit portions which then themselves form the connections lo. It will be appreciated that the invention is also in no way restricted to the kind of connecting configurations illustrated in the specific embodiments shown herein. It should also be appreciated 15 that, in the embodiment shown in Figure 3, the inherent or natural resiliency of the container 40 can also be provided by springs or metal members which are embedded directly in or associated with the plastic material constituting the container 40.
It will be seen that all the embodiments described herein before 20 enjoy great ease of manufacture. There are many different forms of concertina-like or collapsible containers available on the market, and such containers can be readily adapted to the requirements of the present invention, by only slight modifications (for example, in regard to the connections). In the case of the construction Sheehan in Figure 1, the 25 outer, rigid container 11 may be formed Fran two container halves which are joined together in an axial plane, with the bag 12 and its connecting members being inserted therein before the container halves are joined together.
to 3 1 As indicated above, the real purpose of the apparatus described herein is auto transfusion, that is to say, receiving and no- -infusing a patient's own blood which is sucked for example from cavities in the patient's body or the like. Because a reduced pressure is constantly maintained within the container, by virtue of the reduced pressure source, for example as shown at 4 in Figure 1, the apparatus is capable of sucking in blood, even after a blood-air mixture has been sucked in or when only air is sucked in by virtue of the suction head for drawing in the blood from the patient owing inadequately immersed in the blood to be sucked in. However, it should be appreciated that, by virtue of its design and construction, the apparatus can be used not only for auto transfusion, but can also be employed for drainage operations, for example for draining a wound, and can also be used in particular for blood donors.
With the embodiment according to Fig. 3 it may be thought about to combine the concertina-like container 40 integrally with a further container (not shown), so that the lower part of such combined container has a mere container function, while the upper part thereof has the combined function as container and as a pump. For this embodiment it is further advantageous to extend the lower connection 15 into the interior of the container, e.g. by means of a short tube, so that a sucked in mixture of blood and air is not directly drawn through the reservoir of blood already contained.
In order to avoid clamping of the suction line after accumulated blood has been sucked away, it is also possible to provide a check valve in that line.
Various other modifications and alternations may of course be made in the above-described embodiments and the modified forms thereof, without thereby departing from the spirit and scope of the present invention.
Disposed in the connection 15 to which the suction line 2 is to be connected is a non-return or check valve 45 which is operative to open in a direction such as to permit blood to flow into the container 40, while however being in a closed condition in the opposite direction, so that blood cannot be discharged from the container 40 through the lower connection 15 shown in Figure 3. The opposite connection 15 which is subsequently connected to the pressure infusion instrument as shown in Figure 3 also has a non-return or check valve 46 which is operative to open in a flow direction out of the interior of the container 90, Chile however producing its check function in the opposite direction of flow, namely, inwardly of the container 40. In addition, disposed in the vicinity of the opening 47 with which the check valve 46 is operatively associated and which leads to the connection 15 is a light air-filled film or foil cushion 48 which is so disposed that it hangs downwardly in the manner shown in Figure 3, under the effect of its own weight. The cushion member 48 cannot be moved into a position in front of the opening 47, by virtue of a flow of air outwardly of the container through the check valve 46.
The mode of operation of the construction shown in Figure 3 is as follows:
Firstly, the container 40 is axially compressed to its minimum volume by a manual pressure force, for which purpose it is necessary to overcome both the inherent resiliency of the concertina-like or corrugated Lyle of the container 30, and also the spring force of the spring 43, where such is provided. The suction line 2 is clamped off when the container 40 is in the compressed condition so that no air can pass into the container 40 and therefore the container 40 is retained automatically in the compressed condition. If now the suction head (not shown) connected to the suction line 2 is introduced into an accumulation of blood for example in the body of a patient, and the clamp closing off the suction line 2 is slowly released, the inherent elasticity of the container 40 and also the spring force applied by the spring 43 will cause the container 40 to expand in its axial direction. That causes an increase in the internal volume of the container 40, relative to its initial ~.2Z64~93 compressed condition, and blood will therefore be sucked into the container 40 through the suction line 2 and the check valve 45 which is thus in an open position. The other check valve 46, being closed, will prevent the entry of air into the container 40 during that phase of operation, so that the effect of reduced pressure in the container 40 is not nullified by an intake of air through the upper connection shown in Figure 3. If, due to lack of attention or due to a certain amount of leakage, a certain quantity of air also passes into the container 40 so that the container is not completely filled with blood, although it has already expanded to the maximum extent, the surgeon or assistant may manually compress the container 40 again in order to remove that air frock the container 90 by way of the connection lo in which the check valve 46 is disposed. when that occurs, the cushion member 48 ensures that blood cannot additionally pass through the check valve 46, which would be undesirable.
That is because the member 48 floats up on the surface of the blood in the container 40 and is thereby moved into a position in front of the opening 47 so as to close off the opening 47 and prevent blood from escaping from the connection 15 with the air which is being discharged there through.
When the container 40 is filled with blood in the manner just described above, it can be used for the reinfusion operation in the same manner as described above with reference to the embodiment shown in Figure 2. In other words, the container 40 is manually or mechanically compressed to cause blood to be reinfused into the patient by way of the pressure infusion figment 44 which is then connected to the connection 15. An important consideration in that connection is that the cushion member 48 is displaced from its position in front of the opening 47, by the connecting tube of the blood filter or by the corresponding tube of the 3.~t:~93 pressure infusion fitrnent, so that the rneml>er 48 no longer closes off the opening 47 and blood can be discharged through the connection 15.
In a modified form of the embodiments illustrated, the connections 5 15 may be arrayed on the same end of the container, in which cafe it is necessary to avoid short-circuits in regard to the flow of blood, by suitably extending the connecting structures into the interior of the container. It is also readily possible for the various valve functions, for example in respect of the check valves 45 and 46, to be performed at a 10 different position, for example in the lines or conduits connected thereto, or short line or conduit portions which then themselves form the connections lo. It will be appreciated that the invention is also in no way restricted to the kind of connecting configurations illustrated in the specific embodiments shown herein. It should also be appreciated 15 that, in the embodiment shown in Figure 3, the inherent or natural resiliency of the container 40 can also be provided by springs or metal members which are embedded directly in or associated with the plastic material constituting the container 40.
It will be seen that all the embodiments described herein before 20 enjoy great ease of manufacture. There are many different forms of concertina-like or collapsible containers available on the market, and such containers can be readily adapted to the requirements of the present invention, by only slight modifications (for example, in regard to the connections). In the case of the construction Sheehan in Figure 1, the 25 outer, rigid container 11 may be formed Fran two container halves which are joined together in an axial plane, with the bag 12 and its connecting members being inserted therein before the container halves are joined together.
to 3 1 As indicated above, the real purpose of the apparatus described herein is auto transfusion, that is to say, receiving and no- -infusing a patient's own blood which is sucked for example from cavities in the patient's body or the like. Because a reduced pressure is constantly maintained within the container, by virtue of the reduced pressure source, for example as shown at 4 in Figure 1, the apparatus is capable of sucking in blood, even after a blood-air mixture has been sucked in or when only air is sucked in by virtue of the suction head for drawing in the blood from the patient owing inadequately immersed in the blood to be sucked in. However, it should be appreciated that, by virtue of its design and construction, the apparatus can be used not only for auto transfusion, but can also be employed for drainage operations, for example for draining a wound, and can also be used in particular for blood donors.
With the embodiment according to Fig. 3 it may be thought about to combine the concertina-like container 40 integrally with a further container (not shown), so that the lower part of such combined container has a mere container function, while the upper part thereof has the combined function as container and as a pump. For this embodiment it is further advantageous to extend the lower connection 15 into the interior of the container, e.g. by means of a short tube, so that a sucked in mixture of blood and air is not directly drawn through the reservoir of blood already contained.
In order to avoid clamping of the suction line after accumulated blood has been sucked away, it is also possible to provide a check valve in that line.
Various other modifications and alternations may of course be made in the above-described embodiments and the modified forms thereof, without thereby departing from the spirit and scope of the present invention.
Claims (3)
1. In an apparatus for receiving and reinfusing a patient's own blood, comprising: a container; a first connection on said container, adapted to be connected to a suction line for sucking blood from the patient into the container;
and at least one second connection on the container, for reinfusion of the blood in the container, the improvement which provides that the container is axially compressible but relatively rigid in a radial direction and is adapted to be displaced from a compressed condition into an expanded condition by resiliency means, and that a first check valve is operatively associated with said first connection, operable to open in a direction of flow into the container, and a second check valve is operatively associated with said at least one second connection, operable to open in a direction of flow out of said container.
and at least one second connection on the container, for reinfusion of the blood in the container, the improvement which provides that the container is axially compressible but relatively rigid in a radial direction and is adapted to be displaced from a compressed condition into an expanded condition by resiliency means, and that a first check valve is operatively associated with said first connection, operable to open in a direction of flow into the container, and a second check valve is operatively associated with said at least one second connection, operable to open in a direction of flow out of said container.
2. Apparatus as set forth in claim 1 wherein said resiliency means comprises natural resiliency of the material constituting said container.
3. Apparatus as set forth in claim 1 wherein said container has first and second ends and said resiliency means comprises spring means engaging the respective ends of the container.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CA000485762A CA1226493A (en) | 1982-05-17 | 1985-06-27 | Apparatus for receiving and reinfusing blood |
Applications Claiming Priority (4)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| DE3218561A DE3218561C2 (en) | 1982-05-17 | 1982-05-17 | Device for taking up and reinfusing blood |
| DEP3218561.8 | 1982-05-17 | ||
| CA000428246A CA1195197A (en) | 1982-05-17 | 1983-05-16 | Apparatus for receiving and reinfusing blood |
| CA000485762A CA1226493A (en) | 1982-05-17 | 1985-06-27 | Apparatus for receiving and reinfusing blood |
Related Parent Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA000428246A Division CA1195197A (en) | 1982-05-17 | 1983-05-16 | Apparatus for receiving and reinfusing blood |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA1226493A true CA1226493A (en) | 1987-09-08 |
Family
ID=25670033
Family Applications (2)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA000485762A Expired CA1226493A (en) | 1982-05-17 | 1985-06-27 | Apparatus for receiving and reinfusing blood |
| CA000485761A Expired CA1226492A (en) | 1982-05-17 | 1985-06-27 | Apparatus for receiving and reinfusing blood |
Family Applications After (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA000485761A Expired CA1226492A (en) | 1982-05-17 | 1985-06-27 | Apparatus for receiving and reinfusing blood |
Country Status (1)
| Country | Link |
|---|---|
| CA (2) | CA1226493A (en) |
-
1985
- 1985-06-27 CA CA000485762A patent/CA1226493A/en not_active Expired
- 1985-06-27 CA CA000485761A patent/CA1226492A/en not_active Expired
Also Published As
| Publication number | Publication date |
|---|---|
| CA1226492A (en) | 1987-09-08 |
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| Date | Code | Title | Description |
|---|---|---|---|
| MKEX | Expiry |