CN113521418A - Double-filtration adsorption plasma replacement system - Google Patents

Abstract

The invention provides a double-filtration adsorption plasma exchange system, which comprises a set of blood purification passage, a primary plasma separator, a secondary plasma separator and a perfusion device, wherein the blood purification passage is communicated with the primary plasma separator, the secondary plasma separator and the perfusion device; the primary plasma separator is used for separating plasma, the secondary plasma separator is used for filtering macromolecules such as triglyceride in the plasma, and the perfusion device is used for separating, filtering and adsorbing molecules such as cell factors in the plasma. The invention provides a double-filtration adsorption plasma exchange system which simultaneously completes plasma exchange, hemodialysis perfusion, continuous plasma filtration and adsorption and the like at one time in the aspect of blood purification technology, and has great social value and scientific prospect. The invention only needs 1 set of blood purification channel, 1 primary plasma separator, 1 secondary plasma separator and 1 perfusion apparatus, and has the advantages of low cost, simple operation, low time consumption, manpower and financial resources and the like.

Description

Double-filtration adsorption plasma replacement system

Technical Field

The invention relates to the technical field of blood purification, in particular to a double-filtration adsorption plasma replacement system.

Background

Severest Acute Pancreatitis (SAP) is inflammatory injury such as edema, hemorrhage and necrosis caused by self digestion of pancreatic tissues due to various reasons, is accompanied with severe complications such as systemic inflammatory response syndrome and multi-organ functional failure, and is a common critical disease of a digestive system, wherein Hypertriglyceridemia (HTG) becomes a risk factor of the SAP and accounts for about 10% of all SAP cases, and hypertriglyceridemia severe acute pancreatitis (HL-SAP) is developed in a mild and severe way every year, once developed, the fatality rate is as high as about 30-40%, and the annual recurrence rate is as high as more than 50%. The pathogenesis of high-lipid severe acute pancreatitis (HL-SAP) mainly comprises two major aspects of hypertriglyceridemia and cytokine storm (CSS), the two aspects can induce multi-organ functional failure to cause the continuous progress of the disease condition and even death, and the current clinical treatment mainly adopts multidisciplinary comprehensive treatment and selective blood purification support. The blood purification technology mainly adopts combined or independent hemodialysis, continuous plasma filtration and adsorption, plasma replacement and the like. Many foreign reports are about the treatment mode of plasma exchange combined with hemodialysis, and many domestic methods are about hemodialysis perfusion or Continuous Plasma Filtration Adsorption (CPFA). CPFA is a novel blood purification technology developed in recent years, written in Chinese guidance for acute pancreatitis in 2019, can remove cytokines, but aiming at HL-SAP treatment, the disease development can be inhibited by combining double plasma replacement surgery (DFPP) or single plasma replacement (PE) in times and every other day. Neither plasma replacement, hemodialysis, perfusion, nor continuous plasma filtration and adsorption can simultaneously solve two major core problems of hypertriglyceridemia and cytokine storm, so that HL-SAP patients in critical stage have extremely high risk of disease progression and deterioration.

It is therefore necessary in the blood purification art to find a device or system that can complete plasmapheresis, hemodialysis, perfusion, and continuous plasma filtration and adsorption at the same time.

In view of the immature thinking of scholars at home and abroad on clinical treatment experience of high-fat severe acute pancreatitis, by researching artificial liver technology and blood purification technology for a long time, on the premise of following the latest recommendation of guidance of AP2019 in China that SAP is treated by CPFA, the study creatively combines two technical cores of CPFA and DFPP, firstly proposes a double filtration adsorption plasma replacement system (DFAPP) and applies clinical bed in China, solves two major core pathogenesis of HL-SAP hypertriglyceridemia and cytokine storm at one time, and observes 20 cases of patients with obvious clinical curative effect at present, and the technology is unique in China and is in the advanced technical field and the research front end at home and abroad. Clinical research on the treatment of HL-SAP by DFAPP has great social value and scientific prospect, and the technical application obtains the fund funding of a special subject of science and technology hall in Shaanxi province in 2021.

Disclosure of Invention

Technical problem to be solved

The invention provides a double-filtration adsorption plasma exchange system which is used for simultaneously solving the technical problems of plasma exchange, hemodialysis, perfusion and continuous plasma filtration and adsorption at one time.

(II) technical scheme

The invention provides a double-filtration adsorption plasma exchange system, which comprises a set of blood purification passage, a primary plasma separator, a secondary plasma separator and a perfusion device, wherein the blood purification passage is communicated with the primary plasma separator, the secondary plasma separator and the perfusion device; the primary plasma separator is used for separating plasma, the secondary plasma separator is used for filtering macromolecules such as triglyceride in the plasma, and the perfusion apparatus is used for separating molecules such as cytokines in the filtered adsorbed plasma.

Further, the primary plasma separator adopts an OP-08 membrane to separate plasma, and the aperture of the OP-08 membrane is 0.3 μm.

Further, the secondary plasma separator adopts an EC-50 membrane to filter out macromolecules such as triglyceride and the like in the plasma, and the aperture of the EC-50 membrane is 0.035 mu m.

Further, the perfusion device adopts an ion exchange resin adsorbent to adsorb middle molecules for plasma separation, filtration and adsorption, and the ion exchange resin adopts BS 330.

Further, an anticoagulant injection micro pump, an arterial pump and a dialysis pump are arranged on the blood purification passage, the anticoagulant injection micro pump is communicated with the arterial pump, the arterial pump is communicated with the primary plasma separator, and the arterial pump is used for conveying blood to be separated to the primary plasma separator; one end of the dialysis pump is communicated with the primary plasma separator, the other end of the dialysis pump is communicated with the secondary plasma separator, and the dialysis pump is used for conveying the blood plasma in the primary plasma separator into the secondary plasma separator.

The plasma separator further comprises a filtrate pump and a waste liquid bag, one end of the filtrate pump is communicated with the outlet end of the inner membrane of the secondary plasma separator, the other end of the filtrate pump is communicated with the waste liquid bag, and the filtrate pump is used for conveying the waste liquid separated by the secondary plasma separator into the waste liquid bag.

The venous purification device further comprises a replacement liquid bag and a replacement pump, wherein one end of the replacement pump is communicated with the venous input end of the blood purification channel, the other end of the replacement pump is communicated with the replacement liquid bag, and the replacement pump is used for conveying replacement liquid in the replacement liquid bag to the blood purification venous kettle to supplement the loss amount of filtrate.

Furthermore, the inlet end of the perfusion apparatus is communicated with the external membrane pipeline of the secondary plasma aliquoting apparatus, and the outlet end of the perfusion apparatus is communicated with the venous pot port.

Further, the primary plasma separator is in communication with an output of the blood purification circuit.

The invention discloses a using method of a double-filtration adsorption plasmapheresis system, which comprises the following steps:

the method comprises the following steps: starting the power pump, and conveying the blood to be filtered into the primary plasma separator through the power pump;

step two: separating the blood to be filtered by the primary plasma separator, wherein the primary plasma separator adopts an OP-08 membrane to separate out plasma;

step three: turning on the dialysis pump, and conveying the plasma separated by the primary plasma separator into the secondary plasma separator through the dialysis pump;

step four: separating plasma by the secondary plasma separator using an EC-50 membrane to filter out triglycerides in the plasma;

step five: turning on the filtrate pump for transferring the waste fluid separated by the secondary plasma separator into the waste fluid bag.

Step six: conveying the plasma separated, replaced and purified by the secondary plasma separator into the perfusion device;

step seven: the perfusion device adopts ion exchange resin adsorbent to adsorb cell factors, and performs plasma separation, filtration and adsorption to obtain plasma after separation, filtration, adsorption and purification.

Step eight: the replacement pump is started, the speed is adjusted to be the same as that of the filtrate pump, and the in-out balance is kept; and meanwhile, an anticoagulant injection micro pump is started, and the separated, filtered, adsorbed and purified blood plasma is returned to the venous pot and returns to the human body through the venous end.

Advantageous effects

Aiming at high-lipid severe acute pancreatitis, the current domestic and foreign guidelines and expert consensus all adopt hemodialysis or continuous plasma filtration and adsorption combined plasma replacement technology, and the technical defects comprise that: (1) in the prior art, the treatment time needs more than 24-28 hours once, and the treatment is performed in two or three different treatment modes according to the pathogenesis of hypertriglyceridemia, cytokine storm and the like in turn, so that the risk of continuous deterioration and even death of the disease is invisibly increased for patients in critical conditions; but the technology only needs a one-time operation mode to treat 4-6 hours, does not need separate and alternate-day operations, simultaneously solves the pathogenesis of hypertriglyceridemia and cytokine storm which cause pancreatitis, greatly saves the treatment time, greatly reduces the risk of serious illness deterioration and even death, and improves the clinical rescue rate.

(2) The prior art needs 3 sets of blood purification passages, 2 primary plasma separators, 1 secondary plasma separator, 1 perfusion device and 2-3 blood filters in the treatment process, and has high cost, low treatment reaction speed, complex operation and large consumption of manpower, material resources and financial resources. The technology only needs 1 set of blood purification passage, 1 primary plasma separator, 1 secondary plasma separator and 1 perfusion apparatus, and has the advantages of low cost, simple operation, low time consumption, manpower and financial resources and the like.

Additional features and advantages of the invention will be set forth in the description which follows, and in part will be obvious from the description, or may be learned by practice of the invention. The objectives and other advantages of the invention will be realized and attained by the structure particularly pointed out in the written description and claims hereof as well as the appended drawings.

The technical solution of the present invention is further described in detail by the accompanying drawings and examples.

Drawings

The accompanying drawings, which are included to provide a further understanding of the invention and are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and together with the description serve to explain the principles of the invention and not to limit the invention.

FIG. 1 is a flow chart of a dual filtration adsorption plasmapheresis system in an embodiment of the present invention.

1. Anticoagulant injection micro pump, 2 power pump, 3 primary plasma separator, 4 dialysis pump, 5 secondary plasma separator, 6 filtrate pump, 7 displacement liquid box, 8 waste liquid bag, 9 perfusion device and 10 displacement pump.

Detailed Description

The preferred embodiments of the present invention will be described in conjunction with the accompanying drawings, and it will be understood that they are described herein for the purpose of illustration and explanation and not limitation.

The embodiment of the invention provides a double-filtration adsorption plasma exchange system, which comprises a set of blood purification passage, a primary plasma separator 3, a secondary plasma separator 5 and a perfusion device 9, wherein the blood purification passage is communicated with the primary plasma separator 3, the secondary plasma separator 5 and the perfusion device 9; the primary plasma separator 3 is used for separating out plasma, the secondary plasma separator 5 is used for filtering out triglyceride in the plasma, and the perfusion apparatus 9 is used for separating, filtering and adsorbing cytokine in the plasma.

Wherein the primary plasma separator 3 adopts OP-08 membrane to separate plasma, and the aperture of the OP-08 membrane is 0.3 μm.

Wherein the secondary plasma separator 5 adopts an EC-50 membrane to filter triglyceride in plasma, and the aperture of the EC-50 membrane is 0.035 μm.

Wherein, the perfusion device 9 adopts ion exchange resin adsorbent to adsorb mesomolecules, and performs plasma separation, filtration and adsorption, and the ion exchange resin adopts BS 330.

Wherein the blood purification passage is provided with an anticoagulant injection micropump 1, an arterial pump, a dialysis pump 4, the anticoagulant injection micropump 1 is communicated with the arterial pump, the arterial pump is communicated with the primary plasma separator 3, the arterial pump is used for conveying the blood to be separated to the primary plasma separator 3; the dialysis pump 4 is connected to the primary plasma separator 3 at one end, and the dialysis pump 4 is connected to the secondary plasma separator 5 at the other end, and the dialysis pump 4 is used for conveying the plasma in the primary plasma separator 3 to the secondary plasma separator 5.

The plasma separator comprises a secondary plasma separator 5, and is characterized by further comprising a filtrate pump 6 and a waste liquid bag 8, wherein one end of the filtrate pump 6 is communicated with the outlet end of the inner membrane of the secondary plasma separator 5, the other end of the filtrate pump 6 is communicated with the waste liquid bag 8, and the filtrate pump 6 is used for conveying the waste liquid separated by the secondary plasma separator 5 into the waste liquid bag 8.

The disposable venous transfusion system further comprises a replacement liquid bag and a replacement pump 10, wherein one end of the replacement pump 10 is communicated with the venous input end of the blood purification channel, the other end of the replacement pump 10 is communicated with the replacement liquid bag, and the replacement pump 10 conveys replacement liquid in the replacement liquid bag to the blood purification venous pot for supplementing the lost amount of filtrate.

Wherein, the inlet end of the perfusion apparatus 9 is communicated with the external membrane pipeline of the secondary plasma aliquoting apparatus, and the outlet end is communicated with the port of the venous pot.

Wherein the primary plasma separator 3 communicates with the output of the blood purification circuit.

The invention discloses a using method of a double-filtration adsorption plasmapheresis system, which comprises the following steps:

the method comprises the following steps: starting the power pump 2 and conveying the blood to be filtered into the primary plasma separator 3 through the power pump 2;

step two: separating the blood to be filtered by the primary plasma separator 3, wherein the primary plasma separator 3 adopts OP-08 membrane to separate out plasma;

step three: turning on the dialysis pump 4, and transferring the plasma separated in the primary plasma separator 3 to the secondary plasma separator 5 through the dialysis pump 4;

step four: separating plasma by the secondary plasma separator 5, the secondary plasma separator 5 filtering triglycerides from the plasma using an EC-50 membrane;

step five: the filtrate pump 6 is turned on, and the filtrate pump 6 is used to transfer the waste liquid separated by the secondary plasma separator 5 into the waste liquid bag 8.

Step six: conveying the plasma separated, replaced and purified by the secondary plasma separator 5 to the perfusion device 9;

step seven: the perfusion device 9 adopts ion exchange resin adsorbent to adsorb cell factors, and performs plasma separation, filtration and adsorption to obtain plasma after separation, filtration, adsorption and purification.

Step eight: the replacement pump 10 is started, the speed is adjusted to the same speed as that of the filtrate pump 6, and the in-out balance is kept; and meanwhile, the anticoagulant injection micro pump 1 is started, and the separated, filtered, adsorbed and purified blood plasma is returned to the venous pot and returns to the human body through the venous end.

A double filtration adsorption plasmapheresis (DFAPP) adopts a Japanese JUN-55X blood purifying machine to operate a therapeutic machine, and an indwelling femoral vein single-needle double-lumen catheter (Abel 11.5cm multiplied by 13.5cm) is treated for the first time.

The DFAPP system: separating out plasma by using a primary plasma separator (OP-08, with the membrane aperture of 0.3 mu m), filtering large molecules by serially connecting a secondary plasma separator (EC-50, with the membrane aperture of 0.035 mu m), adsorbing middle molecules by using a parallel perfusion device-ion exchange resin (BS330) adsorbent, and carrying out plasma separation, filtration and adsorption treatment, so that molecules such as triglyceride, fatty acid, endotoxin, inflammation media, cytokines, phenol, sulfur, alcohol and the like in a body can be rapidly and efficiently removed. The treatment time is 4-6h, and the amount of the replacement absorbed plasma is about 5L. For preventing and treating allergy, dexamethasone (H20130301, 5mg, Belgium Peucedanum Co.) 5mg + 5% calcium gluconate 20ml is injected intravenously before treatment; the anticoagulant is low molecular heparin sodium needle (H31022051, 4000U, Shanghai first Biochemical medicine Co., Ltd.), and the dosage is determined according to the blood coagulation function of the patient. The indexes of electrocardio, blood pressure, oxygen saturation and the like are monitored in the whole process, and the disease condition change of the patient is closely observed.

Aiming at high-lipid severe acute pancreatitis, the current domestic and foreign guidelines and expert consensus all adopt hemodialysis or continuous plasma filtration and adsorption combined plasma replacement technology, and the technical defects comprise that: (1) in the prior art, the treatment time needs more than 24-28 hours once, and the treatment is performed in two or three different treatment modes according to the pathogenesis of hypertriglyceridemia, cytokine storm and the like in turn, so that the risk of continuous deterioration and even death of the disease is invisibly increased for patients in critical conditions; but the technology only needs a one-time operation mode to treat 4-6 hours, does not need separate and alternate-day operations, simultaneously solves the pathogenesis of hypertriglyceridemia and cytokine storm which cause pancreatitis, greatly saves the treatment time, greatly reduces the risk of serious illness deterioration and even death, and improves the clinical rescue rate. (2) The prior art needs 3 sets of blood purification passages, 2 primary plasma separators, 1 secondary plasma separator, 1 perfusion device and 2-3 blood filters in the treatment process, and has high cost, low treatment reaction speed, complex operation and large consumption of manpower, material resources and financial resources. The technology only needs 1 set of blood purification passage, 1 primary plasma separator, 1 secondary plasma separator and 1 perfusion device, and has the advantages of low cost, simple and convenient operation, low time consumption, manpower and financial resources and the like.

Technical operation

(one) preparation for boot

Opening a switch at the back of the JUN-55X machine, pressing a [ prepare ] key, touching a [ run ] key on a screen, selecting to remove accumulated quantity and use after time, and touching a [ execute ].

A touch screen [ set operation conditions ] module, a touch treatment mode [ self-defined mode ], and a determination that the measurement container is not used in any of the replacement fluid circuit, the dialysate circuit, and the filtrate circuit.

Touching the module [ setting alarm condition ], touching the module [ setting alarm pressure ] again, and setting a pressure alarm value according to clinical use habits:

4. DFAPP pipeline installation sequence

The first step is to install the arterial line (red mark) according to the installation instruction diagram of the arterial line on the machine.

Arterial ampulla → arterial pump tube → closing arterial pump cover → insufficient blood flow monitoring liquid pillow

Secondly, installing the venous pipeline (blue mark) according to the installation instruction diagram of the venous pipeline on the machine

Venous pot → air detection

The third step is to install a first-level membrane plasma separator membrane external pipeline (coffee and green marks),

filtrate pot → blood leakage monitor → dialysate pump tube → dialysate pump cover closed (note green label line on left side)

Fourth step installation filtration liquid pipeline yellow mark)

Filtered fluid metering cavity → filtered fluid flow-resistance control valve → filtered fluid pump pipe → closed filtered fluid pump cover

The fifth step: mounting replacement liquid pipeline (blue)

The replacement liquid with needle is supplemented with liquid pipeline → flow plug control valve → replacement liquid metering cavity → replacement liquid pump pipe → replacement liquid pump cover is closed → blue mark end of replacement liquid pump pipe is connected with blue mark end of Y-shaped pipeline above the venous kettle.

And a sixth step: external membrane pipeline for mounting plasma component separator

The white marked end of the plasma component separator outer membrane pipeline is connected with the white marked end pipeline of the Y-shaped pipeline on the venous pot. After the connection, the section of pipeline is clamped and closed by pliers. After the priming of all the pipelines and the filter is finished, a bidirectional connecting pipe is needed to be connected with the primed perfusion device between the outer mold of the secondary plasma separator and the Y-shaped pipeline on the venous pot.

The seventh step: all pressure monitoring lines are connected to the pressure sensor protective cover and the pressure monitoring is maintained in a monitoring state by using a three-way valve (which end the OFF arrow points to indicates that the end is in a closed state) carried on the line. (arterial pressure, venous pressure, filtration pressure, external pressure)

Eighth step: and connecting the metering kettle with the pressure sensor protective cover. (replacement fluid, filtrate)

(II) DFAPP Pre-flush

The amount of the washing solution is 3000ml of liquid, wherein the amount of the washing solution is 2000ml of physiological saline and 5% of 1000% of heparin physiological saline.

A washing step:

1. the needle for replenishing replacement fluid is inserted into the physiological saline, and the replacement fluid empty monitor and the dialysate empty detector are placed.

2. Connecting the infusion tube on the arterial line to 1000ml of normal saline, pre-flushing the blood leading end of the arterial line by using gravity, and closing the blood leading end of the arterial line by using a hemostatic clamp after the arterial line is fully filled.

3. The blood pump speed was set at 50ml/min, and the other pump speeds were set at 0.

4. Pressing (linkage start) to flush an arterial pipeline, taking down an arterial kettle from a machine when liquid enters the arterial kettle, inverting the arterial kettle for pre-flushing, adjusting the arterial kettle when the pre-flushing liquid reaches the kettle 3/4, putting the arterial kettle on the machine again, and clamping a liquid outflow end by using hemostatic forceps when the liquid flows out from an inlet end of a arterial filter to press (linkage stop).

5. And connecting all ports of the separator, and loosening all hemostatic forceps on the pipeline after the separator is well connected with all pipelines.

6. Setting the blood pump speed at 100ml/min, the dialysate speed at 3000ml/h, and other pump speeds at 0, pressing (linkage start) and starting priming. When the liquid enters the filtering liquid pot, the filtering liquid pot is taken off from the machine, the filtering liquid pot is inverted for pre-flushing, when the pre-flushing liquid reaches the pot 3/4, the filtering liquid pot is adjusted, and is placed on the machine again for continuous pre-filling. When the liquid flows out of the pipeline, the liquid outflow end is closed by using the hemostatic forceps. Press [ stop in linkage ].

7. Each port of the plasma component separator was connected to a tubing set and after connection all the forceps were released from the tubing set.

8. The substitution pump was set to 3000ml/h, the permeate pump speed was set to 2000ml/h, and priming was started by pressing [ start of linkage ].

9. When the liquid enters the venous pot, the venous pot is taken off from the machine, the venous pot is inverted for pre-flushing, when the pre-flushing liquid reaches the pot 3/4, the venous pot is adjusted, and the venous pot is placed on the machine again for continuous pre-filling.

10. The pre-flushing liquid on the artery side and the replacement liquid side is observed to prevent the liquid from being used up and air from entering.

11. When the priming solution is replaced, touch [ stop in linkage ]. And (4) restarting the pre-charging touch [ linkage start ] until the pre-charging is finished, and pressing again [ linkage stop ].

12. After the preflush was completed, press monitor [ OFF ].

Priming and connecting an HA 330-II type resin blood perfusion device: the primary plasma separator (four ports are disinfected and sealed) can be taken out by an infusion pipeline or an external pipeline with a clamping membrane, and the two ends of the arteriovenous pipeline are connected with the arteriovenous end of the perfusion device, (1) caps at the two ends of the perfusion device are unscrewed to discharge liquid in the perfusion device, so that the arterial tube of the blood circuit is connected with the arterial end of the perfusion device after being filled with pre-flushing liquid. After the perfusion device is filled with the pre-flushing liquid, the venous end of the perfusion device is connected with the venous tube of the blood loop. The perfusion apparatus is vertically fixed on the bracket with the artery end facing downwards and the vein end facing upwards. (2) 500mL (selected) of 5% glucose injection and 2500mL of normal saline containing 1250-one 1875 units/500 mL of normal heparin are sequentially used for pre-flushing the perfusion device and the pipeline from bottom to top, and the pump flow rate is 100 mL/min. The irrigator and the pipeline are tapped to exhaust the gas in the pipeline and the irrigator in the pre-flushing process. (3) 500mL of normal saline containing 12500 units of normal heparin is used for slow pre-flushing at the flow rate not exceeding 50mL/min, and air in a pipeline and an perfusion apparatus is exhausted, so that the perfusion apparatus achieves full heparinization. (can also use containing ordinary heparin 12500 units of normal saline 500mL pre-flush perfusion device and pipeline, when more than 90% heparin saline enters the pipeline, stop the pump, keep heparin saline and stand for 20 minutes: (4) use a bottle of heparin-free normal saline 500mL to flush into pipeline, perfusion device finally, discharge the normal saline containing heparin therein, can be with perfusion device artery end towards the end of the vein upwards vertical fixation on the support to prepare to draw blood, pay attention to make, the intravenous pot interior liquid level slightly higher, reserve some room for catching air.

14. All pump speeds are set to 0.

15. And clamping and closing the connecting ends of the dynamic and static blood vessels to wait for connection treatment.

(III) treatment

Adopts arteriovenous separated connection:

1. the artery blood sampling pipeline is closed by a hemostatic forceps clamp, and the artery blood sampling pipeline is connected with the artery end of the double-cavity catheter, so that air bubbles do not enter the artery blood sampling pipeline when the artery blood sampling pipeline is connected.

2. The blood pump is started for 10mL/min, the speed is gradually increased to 30-50mL/min, when blood enters the venous pot, the blood pump is closed, the venous pipeline is closed by the hemostatic forceps, the venous pipeline is connected to the venous end of the double-lumen catheter, and air bubbles are prevented from entering during connection.

3. After confirming the tight connection, all hemostats are released, the blood pump is turned on and the flow rate is set at 30-50 mL/min.

4. Press monitor [ ON ] key to start treatment.

5. The speed of a dialysate pump, a displacement pump and a filtrate pump are set according to the flow rate of a blood pump of a therapist. The proportion relation is as follows:

the speed of the dialysate pump/blood pump is 20-30% multiplied by 60

The speed of the filtered solution is 0-10% of the speed of the dialysate pump,

the displacement pump speed was the same as the permeate pump speed.

The usage amount of the anticoagulant and the target treatment amount are calculated individually according to the specific condition of the patient.

6. After the blood pump is operated for 10 minutes, the blood pump speed is preferably 30ml/min, and the blood pump is pressed (start of linkage).

7. The permeate pump speed can be adjusted over time as the external pressure (secondary intra-membrane pressure) increases after treatment begins, but the ratio does not exceed 20% of the dialysate pump speed at maximum. The replacement liquid pump is a supplement liquid, the filtrate pump is a discard liquid, and the supplement liquid and the discard liquid are required to be equal in quantity for treatment.

8. During the treatment process, the speed of the blood pump is kept at 50-150 ml/min.

9. The treatment time is 4-6 hours.

10. During the treatment process, if the triglyceride is too high, the pipeline is blocked, the TMP is rapidly increased, and the like, the physiological saline needs to be used for sub-pre-charging.

(IV) Return blood

1. Touch monitor [ OFF ]. Firstly, the blood at the blood sampling end is returned to the body of a patient by using normal saline by using gravity, and the blood sampling end is clamped and closed after the return of the section of pipeline is finished.

2. Returning blood: and (3) regulating the speed of the blood pump to about 50-100 mL/min, starting the blood pump, returning the blood in the plasma separator membrane by using normal saline until the liquid in the venous kettle is pink, and closing the blood pump. ② returning blood plasma: the A, B and C D ports are respectively clamped by pliers, the four ports are separated, the B port is connected with the C port, then the B port and the C port pliers are opened again, air is injected by a replacement fluid pump to return plasma outside a membrane of a secondary plasma separator (EC series), and the speed of the replacement fluid pump is set to be 1200 mL/h. And opening the replacement liquid pump and starting slurry return. Until complete plasma return, treatment is complete.

THE ADVANTAGES OF THE PRESENT INVENTION

1. The technology only needs one-time operation for treatment for 4-6 hours, does not need fractional and alternate-day operations, simultaneously solves the pathogenesis of hypertriglyceridemia and cytokine storm which cause pancreatitis, reduces the risk of serious illness deterioration and even death, and improves the clinical treatment rate.

2. The technology only needs 1 set of blood purification channel, 1 primary plasma separator, 1 secondary plasma separator and 1 perfusion apparatus, and has the advantages of low cost, simple operation, low time consumption, manpower and financial resources and the like.

Alternative 1: the single-mode plasma replacement and hemodialysis perfusion are adopted abroad, the alternative scheme needs 2-3 operations to finish the treatment requirement, 4000-6000ml of fresh plasma is needed, but the treatment frequency is more frequent, the efficiency is low, the loss of useful components such as albumin in the plasma is caused, a large amount of allogenic plasma is supplemented, sufficient plasma resources are needed, and the occurrence of adverse transfusion events and the risk of spreading infectious diseases through a blood path are increased.

Alternative 2: the recommended scheme of the domestic latest domestic acute pancreatitis diagnosis and treatment guideline in 12 months in 2019 is Continuous Plasma Filtration Adsorption (CPFA), the alternative scheme needs 2-3 times to meet the treatment target requirement, hypertriglyceridemia cannot be solved in a short period, and the risk of disease deterioration and progression can be increased due to the continuation of pathogenesis problems such as fatty acid toxicity, pancreatic microcirculation disturbance and the like.

Alternative 3: pure drug therapy, such as low molecular heparin, insulin, bezafibrate, hormones and the like, has poor treatment effect on severe hypertriglyceridemia and cytokine storm formation, and increases the risk of disease-oriented multi-organ failure and even death.

It will be apparent to those skilled in the art that various changes and modifications may be made in the present invention without departing from the spirit and scope of the invention. Thus, if such modifications and variations of the present invention fall within the scope of the claims of the present invention and their equivalents, the present invention is also intended to include such modifications and variations.

Claims (10)

1. A double filtration adsorption plasmapheresis system is characterized by comprising a set of blood purification passage, a primary plasma separator (3), a secondary plasma separator (5) and a perfusion device (9), wherein the blood purification passage connects the primary plasma separator (3), the secondary plasma separator (5) and the perfusion device (9); the primary plasma separator (3) is used for separating plasma, the secondary plasma separator (5) is used for filtering triglyceride in the plasma, and the perfusion device (9) is used for separating, filtering and adsorbing cytokines in the plasma.

2. A dual filtration adsorption plasmapheresis system according to claim 1, wherein the primary plasma separator (3) separates plasma using OP-08 membrane with pore size of 0.3 μm.

3. A double filtration adsorption plasmapheresis system according to claim 1, characterized in that the secondary plasma separator (5) filters the triglycerides in the plasma with an EC-50 membrane, the EC-50 membrane having a pore size of 0.035 μm.

4. The dual filtration adsorption plasmapheresis system of claim 1, characterized in that the perfusion device (9) uses ion exchange resin adsorbent to adsorb middle molecules for plasma separation, filtration and adsorption, and the ion exchange resin uses BS 330.

5. A double filtration adsorption plasmapheresis system according to claim 1, characterized in that said blood purification circuit is provided with an anticoagulant injection micropump (1), an arterial pump, a dialysis pump (4), said anticoagulant injection micropump (1) being in communication with said arterial pump, said arterial pump being in communication with said primary plasma separator (3), said arterial pump being adapted to deliver the blood to be separated to said primary plasma separator (3); one end of the dialysis pump (4) is communicated with the primary plasma separator (3), the other end of the dialysis pump (4) is communicated with the secondary plasma separator (5), and the dialysis pump (4) is used for conveying the blood plasma in the primary plasma separator (3) to the secondary plasma separator (5).

6. A dual filtration adsorption plasmapheresis system according to claim 1, further comprising a filtrate pump (6) and a waste bag (8), wherein one end of the filtrate pump (6) is communicated with the outlet end of the inner membrane of the secondary plasmapheresis device (5), the other end of the filtrate pump (6) is communicated with the waste bag (8), and the filtrate pump (6) is used for conveying the waste liquid separated by the secondary plasmapheresis device (5) to the waste bag (8).

7. A dual filtration adsorption plasmapheresis system according to claim 1, further comprising a replacement fluid bag and a replacement pump (10), one end of said replacement pump (10) is communicated with the venous input end of said blood purification pathway, the other end of said replacement pump (10) is communicated with said replacement fluid bag, said replacement pump (10) delivers replacement fluid in the replacement fluid bag to said blood purification venous pot for supplementing the lost amount of filtrate.

8. A dual filtration adsorption plasmapheresis system according to claim 1, wherein the inlet port of the perfusion apparatus (9) is in communication with the secondary plasmapheresis apparatus extramembranous line, while the outlet port is in communication with the venous pot port.

9. A dual filtration adsorption plasmapheresis system according to claim 1, characterized in that the primary plasma separator (3) communicates with the output of the blood purification circuit.

10. Use of a dual filtration adsorption plasmapheresis system according to any one of claims 1-9, characterized in that it comprises the following steps:

the method comprises the following steps: starting the power pump (2) and conveying the blood to be filtered into the primary plasma separator (3) through the power pump (2);

step two: separating the blood to be filtered by the primary plasma separator (3), wherein the primary plasma separator (3) adopts OP-08 membranes to separate out plasma;

step three: turning on the dialysis pump (4) and transferring the plasma separated in the primary plasma separator (3) to the secondary plasma separator (5) by means of the dialysis pump (4);

step four: separating plasma by means of the secondary plasma separator (5), the secondary plasma separator (5) filtering triglycerides from the plasma using an EC-50 membrane;

step five: opening the filtrate pump (6), wherein the filtrate pump (6) is used for conveying the waste liquid separated by the secondary plasma separator (5) to the waste liquid bag (8);

step six: conveying the plasma separated, replaced and purified by the secondary plasma separator (5) to the perfusion device (9);

step seven: the perfusion device (9) adopts an ion exchange resin adsorbent to adsorb cytokines, performs plasma separation, filtration and adsorption to obtain plasma after separation, filtration, adsorption and purification, and adopts an ion exchange resin adsorbent to adsorb middle molecules, performs plasma separation, filtration and adsorption to obtain plasma after separation, filtration and adsorption;

step eight: the replacement pump (10) is opened, the speed is adjusted to be the same as that of the filtrate pump (6), and the in-out balance is kept; and meanwhile, an anticoagulant injection micro pump (1) is started, and the separated, filtered, adsorbed and purified blood plasma is returned to the venous pot and returned to the human body through the venous end.

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