CN106413640B - 用于患者温度控制的具有用于多重换热形式的多个冷却剂腔的换热系统 - Google Patents

用于患者温度控制的具有用于多重换热形式的多个冷却剂腔的换热系统 Download PDF

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CN106413640B
CN106413640B CN201480075073.5A CN201480075073A CN106413640B CN 106413640 B CN106413640 B CN 106413640B CN 201480075073 A CN201480075073 A CN 201480075073A CN 106413640 B CN106413640 B CN 106413640B
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J·T·达布罗维亚克
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    • F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
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    • A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
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    • A—HUMAN NECESSITIES
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    • A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
    • A61F7/12—Devices for heating or cooling internal body cavities
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    • F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
    • F28—HEAT EXCHANGE IN GENERAL
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Abstract

制冷剂流动通过的冷板(30，32)限定了在其之间的狭槽(34)，其能够接收闸盒(50)，具有相对较低流速的从血管内换热导管(12)流出的无菌工作流体通过该闸盒。来自导管(12)的工作流体通过闸盒(50)的壁通过与冷板(30，32)的换热而被加热或冷却从而维持工作流体的无菌。另一方面，高流速工作流体腔围绕冷板(30，32)并且来自外部换热垫(14)的非无菌的工作流体流动通过高流速工作流体腔以通过与冷板(30，32)的直接接触换热。

Description

用于患者温度控制的具有用于多重换热形式的多个冷却剂腔 的换热系统
技术领域
本申请一般涉及用于患者温度控制的换热系统，其具有用于多重换热形式的多个冷却剂腔。
背景技术
已经引入了患者温度控制系统来防止神经重症监护病房中的患者由于发生蛛网膜下腔出血或者其它神经疾病(诸如，中风)而发烧。此外，已经将这种系统用于引发轻度或者中度的低温来改善发生这种疾病(诸如，中风、心脏骤停、心肌梗塞、创伤性脑损伤和高颅内压)的患者的预后。在美国专利6,419,643、6,416,533、6,409,747、6,405,080、6,393,320、6,368,304、6,338,727、6,299,599、6,290,717、6,287,326、6,165,207、6,149,670、6,146,411、6,126,684、6,306,161、6,264,679、6,231,594、6,149,676、6,149,673、6,110,168、5,989,238、5,879,329、5,837,003、6,383,210、6,379,378、6,364,899、6,325,818、6,312,452、6,261,312、6,254,626、6,251,130、6,251,129、6,245,095、6,238,428、6,235,048、6,231,595，6,224,624、6,149,677、6,096,068、6,042,559中公开了血管内换热导管的示例，所有这些专利以引用的方式并入本文。
可以使用外部的患者温度控制系统。在美国专利6,827,728、6,818,012、6,802,855、6,799,063、6,764,391、6,692,518、6,669,715、6,660,027、6,648,905、6,645,232，6,620,187、6,461,379、6,375,674、6,197,045和6,188,930(统称为“外部垫专利”)中公开了这种系统，所有这些专利以引用的方式并入本文。
在本发明受让人的美国专利7,070,612号中(其也通过引用并入本文)，描述和专利保护了一种换热台，其能够接收血管内换热导管以及外部换热垫的工作流体环路的螺旋管。通常，在所有的血管内和患者外部温度控制方案中，流过导管或垫的工作流体的温度通过换热台基于由患者实际体温提供的反馈的来调节，该实际体温特别是可由直肠、食管等各种测量的核心体温、鼓膜耳温、血液温度(如腔静脉中的血液温度)等。通过将工作流体热联接到台中的加热和/或冷却元件来调节工作流体温度。
发明内容
如本文所理解的，与血管内导管不同，外部垫的工作流体可以不要求是无菌的。此外，如本文中所理解的，外部垫的工作流体的流速可以显著大于通过血管内导管的无菌工作流体的流速。考虑到这些认识，在一些应用中，可能希望使用具有导管和垫的相同的换热器，但是根据其不同的特性定制在换热器内的两个不同的工作流体通道，从而适应其各自的换热形式(内部的使用导管的与血液的血管内换热以及外部的使用垫的通过皮肤的换热)。
如本文中所使用的，除非另有由权利要求的语言特别限定，“垫”是指配置为靠在患者皮肤放置的任何设备，工作流体(在此也称为“冷却剂”，不论其是从患者移除或增加热量)可以流动通过垫与人类患者换热。
一种换热器，包括：至少第一和第二换热板组件，在其之间限定了第一形式工作流体腔。第一形式工作流体腔配置为用于接收保持器，通过所述保持器无菌工作流体可以流到第一形式患者换热件和从第一形式患者换热件流出，从而无菌工作流体不接触板组件就可以使得无菌工作流体可以与板组件通过保持器换热。限定在换热器中的至少第二形式工作流体腔，通过所述第二形式工作流体腔第二工作流体可以流到第二形式患者换热件和从第二形式患者换热件流出，从而使得来自第二形式患者换热件的第二工作流体可以通过直接接触板组件中的至少一个与板组件的至少一个换热。
第一形式患者换热件可以由血管内换热导管建立，并且换热器可以包括第一形式患者换热件。另一方面，第二形式患者换热件由外部应用的交换垫建立，并且系统可以包括垫。来自第二形式患者换热件的第二工作流体不需要是无菌的。
在一些示例中，第二形式工作流体腔包括第一板组件中的第一子腔和第二板组件中的第二子腔。每个板组件可包括至少一个相应的制冷剂通道，制冷剂可以流动通过其中以加热或冷却相应的板组件。在示例性实施方式中，制冷剂必须顺序流动通过制冷剂通道从而使得所有制冷剂必须在流动通过第二板组件的制冷剂通道之前首先流动通过第一板组件的制冷剂通道。在其他示例中，制冷剂平行流动通过制冷剂腔。相反地，在示例性实施例中，第二工作流体必须平行流动通过第一和第二子腔。或者，第二工作流体可以顺序流动通过第一和第二子腔。
在另一个方面，一种系统具有至少第一和第二板组件，通过第一和第二板组件制冷剂可以流动通过相应的第一和第二制冷剂腔。板组件限定了其之间的狭槽，其可以接收来自血管内换热器导管的第一工作流体，从而使得来自导管的第一工作流体可以被流动通过制冷剂腔的制冷剂加热或冷却。板组件还包还包括相应的第一和第二制冷剂腔横向外侧的相应的第一和第二工作流体腔，并且被配置为用于接收来自外部换热垫的第二工作流体从而促进第二工作流体和制冷剂之间的换热。
在另一个方面，系统包括第一板和在第一板的第一侧上的第一工作流体腔。第一制冷剂腔是在第一板的与第一侧相对的第二侧上，从而通过第一板促进在第一制冷剂腔和第一工作流体腔之间的换热。第二工作流体腔与第一制冷剂腔由壁隔开，由此在第二工作流体腔和第一制冷剂腔之间的换热可以生效。
关于本发明的结构和操作的细节，均可以参照附图得以最好的理解，在附图中，类似的附图标记表示类似的部件。
附图说明
在附图中：图1是根据本发明的非限制性系统的示意图；
图2是换热系统的示例工作流体闸盒保持器部分的透视图；
图3是在图2中示出的闸盒保持器的一半的透视图，其中，将不透明的金属内表面以透明的方式示出为以揭示蜿蜒的制冷剂通路；
图4是配置为与图2和图3中示出的闸盒保持座接合的示例工作流体闸盒的透视图；
图5是沿图2中线5-5所见的截面图；以及
图6是沿图2中线5-5可见的替代实施方式的截面图。
具体实施方式
首先参照图1，根据本原理，系统10可以包括血管内换热导管12，该血管内换热导管12被控制系统14控制以控制患者温度，例如，以防止患者16变得发热或者以引发患者16的治疗性的低温。在导管中，工作流体(也称为“冷却剂”)，诸如但不限于生理盐水，(通常在控制系统中的泵“P”的作用下)在封闭环路中从控制系统14循环，通过流体供应线L1，通过导管12，并且通过流体回流线L2回到系统14，从而使得无冷却剂进入身体。虽然下面公开了某些优选的导管，但是要理解，根据本原理可以使用其它导管，包括但不限于上面公开的或者在以下美国专利中公开的导管中的任何一种导管，以下所有专利以引用的方式并入本文：美国专利5,486,208、5,837,003、6,110,168、6,149,673、6,149,676、6,231,594、6,264,679、6,306,161、6,235,048、6,238,428、6.245,095、6,251,129、6,251,130、6,254,626、6,261,312、6,312,452、6,325,818、6,409,747、6,368,304、6,338,727、6,299,599、6,287,326、6,126,684。导管12可以防止在静脉系统中，例如，在上腔静脉或者下腔静脉中。
替代导管12或者在导管12之外，系统10可以包括一个或者多个垫18，该一个或者多个垫18位于靠在患者16的皮肤外部(为了清楚起见，仅示出了一个垫18)。垫18可以是，但不限于，在外部垫专利中公开的垫中的任何一种。根据在外部垫专利中阐述的原理，垫18的温度可以由控制系统14控制以与患者16换热，包括：响应于患者出现的例如心脏骤停、心肌梗塞、中风、高颅内压、创伤性脑损伤或者可以通过降低体温减轻其影响的其它疾病，引发患者治疗性的轻度或者中度的低温。垫18可以通过流体供应线L3从系统14接收工作流体，并且通过流体回流线L4使工作流体回流到系统14。注意，在一些实施例中，系统14、20建立在单个组件中。
控制系统14可以包括一个或多个微处理器20，其接收目标和患者温度作为输入，并且，在其他事项外，控制泵“P”和具有旁通阀24的制冷剂压缩机22，旁通阀24可被打开以允许制冷剂绕过压缩机。制冷剂通过控制系统14内的换热器循环并且在下面进一步描述。
实际上并现在参照图2，示出了控制系统14中的换热器的示例的部分，其包括至少两个冷板30、32，该至少两个冷板30、32在其间限定出闸盒狭槽34，在一个实施例中，狭槽34的宽度“W”小于40密耳(0.040″)，并且可以在29密耳与31密耳之间(0.029″-0.031″)。在具体示例中，宽度“W”可以是30密耳。如下面进一步的描述，狭槽34可以建立冷却剂腔以接收换热件，例如但不限于闸盒，通过该闸盒工作流体从血管内换热导管流出。因为换热通过换热件的壁起效，来自导管的工作流体不接触换热件壁外侧的控制系统14的换热器中的任何表面或流体。以这种方式，通过血管内导管循环的工作流体(在非限制性示例中典型的是生理盐水)可以保持无菌。因此，注意力将首先集中于由狭槽34确定的冷却剂腔。
冷板30、32可以由金属制成，并且，如图所示，可以是直线的，并且事实上，可以是接近正方形的。冷板30、32可以沿着左右侧壁36彼此抵接，竖直狭长的闸盒框架容座R1和R2位于相应侧壁36的紧邻内侧，并且狭槽34在壁36之间延伸并且终止于容座R1、R2，如图所示。框架容座R1、R2比狭槽36更宽。
在所示的示例中，制冷剂入口管和出口管38、40延伸通过至少一个冷板32以将制冷剂从压缩机传送到冷板中的制冷剂通路中。这建立了在由狭槽34建立的第一冷却剂腔之外的(并与第一冷却剂腔热接触的)第二冷却剂腔。每个冷板可以具有自己的制冷剂入口管和出口管，或者，在所示的实施例中，可以仅有一个冷板形成有制冷剂入口管和出口管，而另一个冷板热联接至制冷剂在其中流动的冷板和/或通过通路从另一个冷板接收制冷剂，该通路形成为通过侧壁36中的一个或者两个。
在一个示例中，垫工作流体的入口和出口Pin和Pout也可以形成于所示的冷板中的至少一个上。如下面更详细讨论的，来自垫18的工作流体经由线L3和L4可以被引入垫工作流体入口和出口Pin和Pout以与流动通过冷板的制冷剂进行换热。此外，为提供加热的工作流体，一个或多个电加热器41可以被安装在一个或两个冷板上以加热冷板。代替加热冷板地，旁通阀24(图1)可被打开以允许来自压缩机的热的气态制冷剂绕过压缩机作为气态制冷剂循环通过该系统，。
图3示出了从透明的内表面看到的示例的冷板32的细节，要理解，该内表面通常是金属的，并且在图3中示出的蜿蜒制冷剂通路42通常是人眼不可见的。在任何情况下，将制冷剂入口38流体连接至制冷剂出口40的示例的制冷剂通路可以是如图所示的蜿蜒形状，或者可以是一些其它形状或者图案，诸如，人字形图案、波浪图案等。
图4示出了根据本原理的示例的工作流体闸盒50。闸盒50配置为贴合地适配到限定在冷板30、32之间的狭槽34和闸盒框架容座R1、R2中。在操作中，来自可与患者接合的换热元件(诸如，导管12)的工作流体(诸如，生理盐水)流经闸盒50，工作流体与冷板中的制冷剂换热。在示例实施例中，闸盒50是低成本单次使用型一次性制品，其可以包含例如循环经过导管12的无菌生理盐水。闸盒可以由医护人员放置在冷板30、32之间的狭槽34中，并且，当工作流体流经膜部分时，膜部分膨胀，实现与冷板30、32的热接触，该膜部分限定出供示例生理盐水流经的空间或者工作流体腔。
在所示的示例中，闸盒50包括框架52，该框架52限定出外周和优选的直线的开口，如所示的，该开口在至少三个面上被框架的外周界定。在所示的非限制性示例中，框架包括狭长的平行六面体形状的顶档53和狭长的平行六面体形状的左右侧档54，该左右侧档54彼此平行并且垂直于顶档32。示例框架52可以具有金属条或者底档51，该金属条或者底档51与顶档相对并且连接至左右侧档以对膜进行支撑并且便于将膜以双轴张紧地放置。在任何情况下，示例框架52是直线的并且配置为紧密容纳在两个冷板30、32之间，侧档54与冷板30、32之间的框架容座R1、R2滑动地接合，并且下述的膜组件通过狭槽36与冷板中的制冷剂通道紧密并列。
在图4中，框架(在所示的示例中，是其顶档53)形成有已经设置有入口管58的流体入口56和已经设置有出口管62的流体出口60。该入口和出口建立通过框架进入开口中的相应的流体通路。入口管和出口管58、62可以与流体回流和供应线L1、L2接合，该流体回流和供应线L1、L2与导管12相关联。管58、62可以刚好终止于顶档53(图4)下方，或者它们可以向下延伸任何所需的长度至组件的底部，即，管58、62可以延伸左右侧档54的几乎整个长度，刚好结束于下述膜组件的底缝上方。
事实上，高分子膜组件64连接至框架52，从而阻塞在四个面上被框架界定的开口，如图所示。膜组件包括第一膜66，该第一膜66与第二膜68平行并且与第二膜68接近地分隔开，在其间留有空间，这建立了工作流体腔。流体入口56和流体出口60与膜66、68之间的空间中连通。膜66、68中的至少一个膜(优选地，两个)张紧地设置在开口中。当用工作流体装填膜之间的空间时，该空间可膨胀。
在一个示例中，每个膜的厚度不大于2密耳(0.002″)，并且更优选地，其厚度在1密耳与2密耳之间(0.001″-0.002″)，包括本数。示例优选的膜66、68与开口一起延伸，并且与开口类似地几乎为正方形，示例膜的顶部边缘和底部边缘的长度约等于膜的左右边缘的长度(在±10％内，并且更优选地，在±5％内)。在其它实施例中，可以使用达1∶1.5的纵横比来替代正方形(1∶1)纵横比。在膜之间的工作流体腔也是直线的，并且在优选实施例中，在膜之间不存在障碍，这意味着工作流体腔是完全直线的，几乎为正方形腔。
由于膜66、68的薄度、冷板30、32彼此接近的程度、以及当闸盒与冷板接合时冷板30、32之间的膜组件，在图中示出的系统为在冷板中循环的制冷剂与在膜66、68之间循环的工作流体之间的热传递提供了低阻抗。在膜之间的工作流体腔由于工作流体流生成的背压而膨胀，从而消除或者减低了对冷板中的移动机构的需要。而且，在这两个冷板之间的窄的狭槽34通过减小在冷板与工作流体之间的传导路径长度而提供了更好的热传递。框架使得易于处理，诸如，将闸盒插入冷板/从冷板移除闸盒。
相对于在膜66、68之间的具有宽-长纵横比接近1∶1(即，正方形或者接近正方形)的示例工作流体腔，与不那么正方形的配置相比，减小了引发工作流体流过换热器所需的背压的量。这减小了工作流体泵必须进行的工作量，这是期望的，原因有两个。第一个原因是，由于泵可能是一次性的，所以更低的性能要求转化成更低成本的一次性的且更安静的系统。例如，蠕动滚轮泵提供安静的操作和低成本一次性元件，但是当仅需要适中的压力时最高效地运行。第二个原因是，降低工作流体泵的工作减小了通过泵本身传递到工作流体中的热量。此外，低的宽/长纵横比产生更低的工作流体速度，这减小了混合量，但是在本示例的系统中，该期望(从换热的角度来看)的效果可忽略不计，这是由于雷诺数通常＜1000，这意味着层流态。而且，低的宽/长纵横比大大减少了流体流路中的弯折(“转角”)数量。这些弯折是供流体混合的区域，其促进了热传递。如果没有这些弯折，流体边界层出现。然而，通过在冷板之间维持窄的狭槽，在此抵消了这种效果。这样，主要的传热机制是传导，但是传导路径的长度(因此，边界层)小，导致传热速率相对高。
在优选示例中，在被组装到框架期间，膜66、68被拉伸至张紧状态，优选是双轴地张紧(即，张紧在顶档与底档53、51之间，并且还张紧在左右侧档54之间)。可以在产品的保质期内维持该张紧。预张紧使材料的褶皱最少化，这是有利的，因为褶皱会阻碍工作流体流动并且产生空气间隙，这降低了工作流体与冷板之间的热传递。褶皱还可以使将膜组件插入到窄狭槽34中复杂化。
为了建立膜的预张紧，可以将框架制成两半，并且，柱(诸如，螺纹紧固件)可以横向地延伸至框架的一半，膜66、68拉伸在柱以及在膜中制成的用以容纳柱的孔上。然后，将框架的另一半定位，以将膜组件的直线边界部夹设在框架的两半之间，并且封罩(诸如相应的螺母)与柱接合以将框架的两半保持在一起，并且膜组件张紧地保持在框架的两半之间。图4示出，工作流体腔由膜组件的底缝74A在底部封闭，该底缝是边界部74的部分。除了施加张紧以避免在使用期间出现褶皱之外，也可以使用附加的柱来避免在焊接过程期间出现褶皱，从而改善焊接点的质量。
在边界部74中，可以使用至少一层(优选地，多层)高分子薄膜以对膜66、68进行增强以建立焊缝，柱孔被形成通过该焊缝(在膜组件的侧面处)，这允许更容易的制备。通过仅仅将增强层置于边界部74上，膜组件的中心“窗”仅仅包括在工作流体与冷板30、32中的一个之间的薄的单层膜，以使对热传递的阻碍最小化。可以使用模切增强层，该模切增强层利用一片材料对整个周边进行增强。
在一些示例中，高分子膜66、68是高度可拉伸的，至少大于25％的伸长率。这使膜能够从图4和图5中示出的空的扁平状态变成膨胀的形状(在冷板之间的狭槽34内)，而不发生褶皱。其还使膜能够容易地符合在冷板的面上的特征。
另外，膜可以由也可以制成管的材料制成。然后，可以将管(诸如在图4中示出的入口管和出口管58、62)热焊接(例如，通过使用RF密封)至膜，这比粘合剂粘结更可靠且更快。膜66、68不需要提供其自身的侧向支撑，这是因为冷板32、34和框架为膨胀的膜组件提供了支撑，使得其能够承受由于工作流体流经膜之间所生成的压力。结构特征，诸如，凸块、凹陷、凸肋等，可以位于冷板上以优化热传递。这在经济上可以是有利的，因为冷板是可重复使用的部件。在冷板中可切割出歧管，以使生理盐水流的分布均等。
已经描述了示例性的非限制性的在控制系统14中的换热器和血管内温度控制导管12内的无菌工作流体之间的结构的换热组合，现在注意力转向图5，其示出了冷板中附加的冷却剂腔的示例性实施例，通过所述附加的冷却剂腔实现与来自外部的换热垫18的工作流体(包括非无菌的工作流体)的换热。注意显示于图5的板结构优选是金属或其它高热导率的材料。
如图所示，冷板30、32可以是限定多个流体腔的多个板组件，尽管在下面的讨论中它们统称为“板”30和32。在所示的非限制性示例中，制冷剂入口和出口管38、40延伸通过冷板32的外壁80和隔板壁82以将来自压缩机22的制冷剂联通进入冷板中的制冷剂通路42，其建立了由隔板壁82和内壁84界定的制冷剂腔。在内壁84的另一侧是导管工作流体闸盒狭槽34，如前所述，每个冷板可具有其自己的制冷剂入口和出口管，或只有一个冷板可以形成有制冷剂入口和出口管且另一个冷板或者热联接到制冷剂在其中流动的冷板和/或通过形成在冷板之间的通路从另一冷板接收制冷剂。在所示的示例中，冷板30、32的热联接是通过侧壁36(图2)、共同的底壁86(图5)以及通过其中形成有狭槽34的顶壁88的不中断部分。
在一些示例中，冷板30、32是彼此的镜像结构。在图5的示例中，在左手侧冷板(32)中的制冷剂腔通过制冷剂供应和回流通道90、92与右手侧冷板30中的制冷剂腔94流体联通。因此，冷板的制冷剂腔跨过闸盒狭槽34并且由此被相应的内壁84分隔，制冷剂顺序流动通过左侧和右侧制冷剂腔，首先从致冷剂入口管38进入左制冷剂腔，然后通过制冷剂供应通道90、左手侧制冷剂腔94，通过制冷剂回流通路92返回，并且从制冷剂出口管40流出。当如在示例显示的提供两个致冷剂腔时，这增加了致冷剂流体通过制冷剂腔的流速。
与此相反，垫工作流体通道的流体流可以在左侧和右侧垫流体腔平行地管道流过，其如所示的跨在制冷剂腔上并且由此被相应的隔离壁82所分隔。在所示的非限制性示例中，来自外部垫的流体流动通过垫工作流体入口Pin进入形成于底部壁86的入口室100。流体平行流动通过入口端口102、104进入左侧和右侧垫工作流体腔106、108。流体通过形成于顶板88中的上部室110流出垫工作流体腔并且离开工作流体出口Pout回到外部垫。这个示例的平行流体的流动减小了垫工作流体系统中的背压。
注意的是，上述流体顺序流动通过制冷剂腔以及平行流经垫工作流体腔仅仅是示例性的，而非限制性的。因此，通过垫工作流体腔的流体的流动可以是顺序的和/或通过制冷剂腔的流体流动可以是平行的。还要注意的是，示出和描述的特定的示例性管道布置仅仅是通过多腔冷板30、32的管道流动的一个示例。
实际上，图6示出与图5中所示的系统类似的系统，除了通过制冷剂腔的流体流动是平行的。两个制冷剂腔都可以与制冷剂入口室200联通，通过该制冷剂入口室，制冷剂平行流入到每个制冷剂腔94。此外，两个制冷剂腔都可以与制冷剂出口室202流通，通过该制冷剂出口室，制冷剂平行地流出每个制冷剂腔94回到压缩机。
现在可以理解的是，在血管内换热形式中，来自导管12的工作流体流经设置在狭槽34的闸盒50与制冷剂腔42、94中的制冷剂通过相应的内壁84换热。导管工作流体不与冷板换热器的任何部分接触，这是因为其流动通过过闸盒50。以这种方式，导管工作流体保持其无菌性并且被包封在封闭的流体回路中用以承受，例如七十磅每平方英寸(70psi)的，循环流体压力。
另一方面，由于垫工作流体通过外部垫与患者分离，其可以不要求无菌，在这种情况下，垫工作流体在冷板30、32中直接接触隔板82从而在制冷剂腔42、94中与制冷剂换热。
虽然本文示出了并且详细描述了具体的“用于患者温度控制的具有用于多重换热形式的多个冷却剂腔的换热系统”，但是除了随附权利要求书之外，本发明的范围不受其它内容的限制。

Claims (20)

1.一种换热器，包括：
至少第一换热板组件和第二换热板组件，第一工作流体腔限定在所述第一换热板组件和所述第二换热板组件之间，所述第一工作流体腔配置为用于接收保持器，无菌工作流体通过所述保持器能够流入第一患者换热件并从第一患者换热件流出，从而无菌工作流体能够通过所述保持器与板组件换热而无菌工作流体不接触板组件；以及
至少第二工作流体腔，第二工作流体能够通过所述第二工作流体腔流入第二患者换热件并从第二患者换热件流出，从而使得来自所述第二患者换热件的第二工作流体能够通过直接接触所述板组件中的至少一个来与所述板组件中的至少一个换热。
2.如权利要求1所述的换热器，其中，所述第一患者换热件由血管内换热导管建立。
3.如权利要求1所述的换热器，包括所述第一患者换热件。
4.如权利要求1所述的换热器，其中，所述第二患者换热件由外部应用的交换垫建立。
5.如权利要求1所述的换热器，包括所述第二患者换热件。
6.如权利要求5所述的换热器，其中，来自所述第二患者换热件的所述第二工作流体不是无菌的。
7.如权利要求1所述的换热器，其中，所述第二工作流体腔包括所述第一换热板组件中的第一子腔和所述第二换热板组件中的第二子腔。
8.如权利要求1所述的换热器，其中，每个板组件包括至少一个相应的制冷剂通道，制冷剂能够流动通过所述制冷剂通道以加热或冷却相应的板组件。
9.如权利要求8所述的换热器，其中，制冷剂必须顺序流动通过制冷剂通道从而使得所有制冷剂必须在流动通过所述第二换热板组件的制冷剂通道之前首先流动通过所述第一换热板组件的制冷剂通道。
10.如权利要求8所述的换热器，其中，制冷剂能够平行流动通过制冷剂通道。
11.如权利要求7所述的换热器，其中，所述第二工作流体必须平行流动通过所述第一子腔和所述第二子腔。
12.一种换热系统，包括：
至少第一板组件和第二板组件，通过所述第一板组件和所述第二板组件制冷剂能够流动通过相应的第一制冷剂腔和第二制冷剂腔，狭槽限定在所述第一板组件和所述第二板组件之间，其能够接收来自第一患者换热件的第一工作流体，从而使得来自所述第一患者换热件的所述第一工作流体能够被流动通过第一制冷剂腔和第二制冷剂腔的制冷剂加热或冷却；以及
所述第一板组件和所述第二板组件还包括相应的第一制冷剂腔和第二制冷剂腔横向外侧的相应的第一工作流体腔和第二工作流体腔，并且其被配置为用于接收来自第二患者换热件的第二工作流体从而促进所述第二工作流体和所述制冷剂之间的换热。
13.如权利要求12所述的系统，其中，所述狭槽配置为用于接收保持器，第一工作流体能够流动通过所述保持器，从而使得所述第一工作流体不接触所述第一板组件和所述第二板组件就能够在所述第一板组件和所述第二板组件与所述第一工作流体之间换热。
14.如权利要求12所述的系统，其中，所述第一患者换热件包括导管。
15.如权利要求12所述的系统，其中，所述第二患者换热件包括外部换热垫。
16.如权利要求12所述的系统，其中，制冷剂能够顺序流动通过所述第一制冷剂腔和所述第二制冷剂腔，从而使得所有制冷剂能够在流动通过所述第二板组件的所述第二制冷剂腔之前首先流动通过所述第一板组件的所述第一制冷剂腔。
17.如权利要求12所述的系统，其中，制冷剂能够平行流动通过所述第一制冷剂腔和所述第二制冷剂腔。
18.如权利要求12所述的系统，其中，所述第二工作流体能够平行流动通过所述第一工作流体腔和所述第二工作流体腔。
19.一种换热系统，包括：
至少第一板；
在第一板的第一侧上的至少第一工作流体腔；
在第一板的与第一侧相对的第二侧上的至少第一制冷剂腔，从而使得通过第一板促进在第一制冷剂腔和第一工作流体腔之间的换热；
至少第二工作流体腔，所述第二工作流体腔与第一制冷剂腔被壁隔开，由此在第二工作流体腔和第一制冷剂腔之间的换热能够生效；
至少第二板，所述第一工作流体腔位于所述第一板和所述第二板之间；以及
在第二板的与第一工作流体腔相对的一侧上的至少第二制冷剂腔，从而使得通过第二板促进在第二制冷剂腔和第一工作流体腔之间的换热。
20.如权利要求19所述的系统，包括：
至少第三工作流体腔，所述第三工作流体腔与所述第二制冷剂腔被屏障隔开，由此在第三工作流体腔和第二制冷剂腔之间的换热能够生效。
CN201480075073.5A 2014-02-07 2014-10-03 用于患者温度控制的具有用于多重换热形式的多个冷却剂腔的换热系统 Active CN106413640B (zh)

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EP3091950A4 (en) 2017-09-27
EP3091950A1 (en) 2016-11-16
AU2014381670B2 (en) 2017-09-07
EP3091950B1 (en) 2019-06-26
JP2023027038A (ja) 2023-03-01
CN111388183A (zh) 2020-07-10
JP6524106B2 (ja) 2019-06-05
CN106413640A (zh) 2017-02-15
JP7257030B2 (ja) 2023-04-13
US9474644B2 (en) 2016-10-25
EP3545919A1 (en) 2019-10-02
AU2017272210A1 (en) 2018-01-04
US20210113364A1 (en) 2021-04-22
WO2015119670A1 (en) 2015-08-13
JP2017505194A (ja) 2017-02-16
CA2998233A1 (en) 2015-08-13
CN111388183B (zh) 2022-08-16

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