CN115887807A - Connecting device for ECMO interventional therapy and using method thereof - Google Patents

Abstract

The invention discloses a connecting device for ECMO interventional therapy and a using method thereof, wherein the connecting device comprises a main catheter and a side branch catheter; the two ends of the main conduit are used for connecting the existing ECMO pipeline; the collateral branch catheter comprises a sealing sheet, a fixed tube and a plugging cap, one end of the fixed tube is integrally formed with the side wall of the main catheter, the other end of the fixed tube is connected with the plugging cap in a sealing manner, and the plugging cap is used for sealing the collateral branch catheter; the fixed pipe is communicated with the main guide pipe and is connected with the main guide pipe in an inclined mode; the gasket sets up fixed pipe is close to the one end of shutoff cap, it is used for preventing that external gas from getting into fixed pipe. The invention relates to the technical field of medical devices, and can solve the technical problems of easy bleeding and air intake, complex operation, influence on blood flow rate, poor adaptability to the existing ECMO pipeline and the like in the prior art.

Description

Connecting device for ECMO interventional therapy and using method thereof

Technical Field

The invention relates to the field of medical connecting devices, in particular to a connecting device for ECMO interventional therapy and a using method thereof.

Background

Extracorporeal membrane oxygenation (ECMO), abbreviated as extracorporeal membrane oxygenation, is a new advanced life support technology for rescuing critically ill patients. The device can be used for external respiration and/or circulation support of patients with sudden cardiac arrest (sudden death), patients with acute severe cardiopulmonary failure and patients with other serious threats to respiratory circulation functions, and valuable time is won for the treatment of the etiology of the critically ill patients. At present, an ECMO connecting pipe used clinically has a single function, and a multifunctional ECMO connecting pipe which is good in adaptability with the existing ECMO connecting pipe does not exist, so that the requirement of clinical actual work is difficult to meet.

The existing ECMO side branch catheters and patent designs have the following problems: 1. because ECMO patients often need to carry out distal perfusion treatment, so as to avoid avascular necrosis of the distal limb at the side of the arterial intravascular cannula, the ECMO patients are usually connected by a three-way infusion connector clinically at present; 2. the cause of most patients with cardiac arrest is cardiogenic, so that when ECMO is used to maintain the function of heart and lung, the patients need to undergo endovascular intervention such as percutaneous coronary artery intervention and intra-aortic balloon counterpulsation. Currently, the aorta of a patient needs to be repositioned clinically for puncture interventional operation. Patients usually have cardiogenic shock, poor radial artery perfusion, low blood pressure and weak pulsation, and the radial artery has great puncture difficulty as an access route due to vasospasm contraction and tenuous after a large amount of vasoactive drugs are applied. The ECMO artery catheterization is already placed in the femoral artery on one side, and if the opposite femoral artery is selected, the ECMO vein catheterization is also placed close to the femoral vein, so that adhesive dressing needs to be removed again and disinfected when the artery is punctured, and the risk of blood flow infection is increased; in addition, due to heparinization of the whole body of a patient, if puncture artery related complications such as local hematoma and arteriovenous fistula occur, the risk of lower limb ischemia on the same side is increased, and the conditions can bring great technical difficulty, time cost and related complication probability for interventional operation treatment; 3. the blood vessel suturing device is often used for suturing a large blood vessel when an ECMO patient is taken out, but a guide wire cannot be preset in an existing pipeline, a puncture needle is used for penetrating through an ECMO connecting pipe to be placed into the guide wire after an ECMO connecting pipeline is generally disinfected clinically, the infection and bleeding risks are high, the guide wire is easy to separate during tube drawing, the operation is complex and irregular, and serious complications are easy to cause.

Therefore, how to provide an oil flow meter transportation device which can effectively avoid transportation damage of the oil flow meter calibration device becomes a technical problem which needs to be solved urgently in the field.

Disclosure of Invention

The invention aims to provide a connecting device for ECMO interventional therapy and a using method thereof, which are used for solving the technical problems in the prior art, can be used for distal perfusion therapy, percutaneous coronary intervention and intra-aortic balloon counterpulsation of ECMO patients, can preset a guide wire when the ECMO patients withdraw machines, and can suture a great vessel by using a vessel suturing device.

According to an aspect of the present invention, there is provided a connection device for ECMO interventional therapy, comprising a main catheter and a side branch catheter;

the two ends of the main conduit are used for connecting the existing ECMO pipeline;

the collateral branch catheter comprises a sealing sheet, a fixed tube and a plugging cap, one end of the fixed tube is integrally formed with the side wall of the main catheter, the other end of the fixed tube is connected with the plugging cap in a sealing manner, and the plugging cap is used for sealing the collateral branch catheter; the fixed pipe is communicated with the main guide pipe, and the fixed pipe and the main guide pipe are connected in an inclined manner; the gasket sets up fixed pipe is close to the one end of shutoff cap, it is used for preventing that external gas from getting into fixed pipe.

Optionally, according to the connection device for ECMO interventional therapy provided by the invention, one end of the main conduit is a hard base, an outer surface of the hard base is in a stepped shape, and a maximum outer diameter of the hard base is larger than an inner diameter of an existing ECMO connection pipeline, so that the hard base can be fixedly sleeved with the inside of the ECMO connection pipeline.

Optionally, according to the connection device for ECMO interventional therapy of the present invention, the other end of the main catheter is a soft cannula, and the soft cannula is in a hollow cylindrical shape, and the maximum inner diameter of the soft cannula is smaller than the outer diameter of the tail end of the existing ECMO placement catheter, so that the soft cannula can be fixed to the outer part of the tail end of the ECMO placement catheter in a sleeved manner.

Optionally, according to the connection device for ECMO interventional therapy of the present invention, the sealing sheet is a one-way valve, and the middle portion of the sealing sheet is provided with a bevel-cut m-shaped slit, which can pass through a three-way infusion joint or a guide wire.

Optionally, according to the connection device for ECMO interventional therapy of the present invention, an outer side of one end of the fixed tube away from the main tube is provided with a thread, and the plugging cap is screwed with the thread of the fixed tube.

Optionally, according to the connection device for ECMO interventional therapy of the present invention, the inclination angle of the fixed tube and the main tube is 25 ° to 35 °, and both the inner side and the outer side of the connection part of the fixed tube and the main tube are rounded.

According to a second aspect of the present invention, there is also provided a method of using a connection device for ECMO interventional therapy, using the connection device of any one of the above embodiments, and the steps of:

s10, sleeving and fixing the main guide pipe between the ECMO connecting pipeline and the tail end of the ECMO pipe;

s11, enabling the opening end of the side branch catheter to face the direction of the far end of the patient;

s12, removing the plugging cap, and placing a guide wire along the sealing piece;

s13, placing a guide catheter along the guide wire to a corresponding coronary ostium;

s14, removing the guide wire, carrying out contrast examination, and further placing a balloon or a stent.

According to a third aspect of the present invention, there is also provided a method of using a connection device for ECMO interventional therapy, using the connection device of any one of the above embodiments, and the steps of:

s20, sleeving and fixing the main guide pipe between the ECMO connecting pipeline and the tail end of the ECMO pipe;

s21, enabling the opening end of the side branch catheter to face the direction of the far end of the patient;

s22, removing the plugging cap, and placing a guide wire along the sealing piece to reach the aortic arch;

s23, placing an intra-aortic balloon counterpulsation catheter to the aortic arch along the guide wire;

and S24, removing the guide wire, connecting the high-pressure connecting pipe and then connecting the high-pressure connecting pipe to a counterpulsation pump machine.

According to a fourth aspect of the present invention, there is also provided a method of using a connection device for ECMO interventional therapy, using the connection device of any one of the above embodiments, and the steps of:

s30, sleeving and fixing the main guide pipe between the ECMO connecting pipeline and the tail end of the ECMO pipe;

s31, enabling the opening end of the side branch catheter to face the far-end direction of the patient;

s32, removing the plugging cap, and placing a guide wire along the sealing piece;

s33, removing the ECMO tube, placing a blood vessel stitching instrument along the guide wire, and stitching the large blood vessel of the tube.

According to a fifth aspect of the present invention, there is also provided a method of using a connection device for ECMO interventional therapy, using the connection device of any one of the above embodiments, and the steps of:

s40, sleeving and fixing the main guide pipe between the ECMO connecting pipeline and the tail end of the ECMO pipe placing;

s41, enabling the opening end of the side branch catheter to face the far end direction of the patient;

s42, removing the blocking cap, screwing one side of the three-way infusion joint on the thread of the fixed pipe, and determining that the inner protrusion of the three-way infusion joint penetrates through the sealing sheet;

s43, connecting the other side of the three-way infusion joint with a far-end infusion catheter;

and S44, adjusting the far-end perfusion flow rate through the three-way infusion joint according to the percutaneous blood oxygen saturation of the far-end perfusion limb and the blood vessel B ultrasonic.

Compared with the prior art, the ECMO pipe comprises a main pipe and a side branch pipe, wherein one end of the main pipe is a stepped hard base and can be fixedly sleeved with the conventional ECMO connecting pipeline, and the other end of the main pipe is a soft sleeve and can be fixedly sleeved with the tail end of the conventional ECMO pipe; the side branch catheter comprises a sealing sheet, a fixing tube and a plugging cap, the sealing sheet is a one-way valve, a beveled cross-shaped cutting seam is formed in the middle of the sealing sheet, the sealing sheet can be fixed at the far end of the side branch catheter by the fixing tube, threads are arranged on the outer side of the far end of the fixing tube, and the plugging cap is screwed and sealed with the far end of the fixing tube.

The invention can be used for the distal perfusion treatment, percutaneous coronary intervention and intra-aortic balloon counterpulsation of ECMO patients, and can preset a guide wire when the ECMO patients withdraw the machine and use a blood vessel stitching instrument to stitch the large blood vessel. The invention has the advantages of various functions, convenient operation, flexible use and low cost, can effectively improve the clinical practicability and is beneficial to further popularization and application.

Other features of the present invention and advantages thereof will become apparent from the following detailed description of exemplary embodiments of the invention, which proceeds with reference to the accompanying drawings.

Drawings

The accompanying drawings, which 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.

FIG. 1 is a schematic view of the overall structure of the present invention;

FIG. 2 is a schematic long-axis cross-sectional view of the present invention;

FIG. 3 is an exploded view of a side branch catheter of the present invention;

FIG. 4 is a schematic illustration of the present invention used for distal perfusion treatment;

FIG. 5 is a schematic representation of the present invention used in percutaneous coronary intervention or intra-aortic balloon counterpulsation;

fig. 6 is a schematic diagram of tube drawing after guide wire presetting during machine withdrawing.

Description of reference numerals: 1. a main duct; 11. a connection base; 12. a soft sleeve; 2. a side branch catheter; 21. sealing the sheet; 22. a fixed tube; 23. a plugging cap; 3. an ECMO connecting pipeline; 4. placing an ECMO pipe; 5. a three-way infusion connector; 6. a guide wire; 7. a distal irrigation catheter; 8. a guide catheter; 9. an intra-aortic balloon counterpulsation catheter.

Detailed Description

Various exemplary embodiments of the present invention will now be described in detail with reference to the accompanying drawings. It should be noted that: the relative arrangement of the components and steps, the numerical expressions and numerical values set forth in these embodiments do not limit the scope of the present invention unless it is specifically stated otherwise.

The following description of at least one exemplary embodiment is merely illustrative in nature and is in no way intended to limit the invention, its application, or uses.

Techniques, methods, and apparatus known to those of ordinary skill in the relevant art may not be discussed in detail but are intended to be part of the specification where appropriate.

In all examples shown and discussed herein, any particular value should be construed as merely illustrative, and not limiting. Thus, other examples of the exemplary embodiments may have different values.

It should be noted that: like reference numbers and letters refer to like items in the following figures, and thus, once an item is defined in one figure, further discussion thereof is not required in subsequent figures.

According to fig. 1 to 3, the present invention provides a connection device for ECMO interventional therapy, comprising a main catheter 1 and a side branch catheter 2;

the main duct 1 is used at both ends for connecting existing ECMO pipes.

Collateral branch pipe 2 includes gasket 21, fixed pipe 22 and shutoff cap 23, and the one end of fixed pipe 22 is formed with the lateral wall integration of main conduct 1, the other end and shutoff cap 23 sealing connection, and shutoff cap 23 is used for closing collateral branch pipe 2, and when collateral branch pipe 2 was in not using state, shutoff cap 23 was in the normal close state, guaranteed fixed pipe 22's leakproofness. The fixed pipe 22 is communicated with the main duct 1 and is connected with the main duct in an inclined way; a sealing fin 21 is provided at an end of the fixing tube 22 near the plugging cap 23 for preventing external air from entering the fixing tube 22.

Further, one end of the main conduit 1 is a hard base 11, the outer surface of the hard base 11 is stepped, and the maximum outer diameter is larger than the inner diameter (namely 9.5 mm) of the existing ECMO connecting pipeline 3, and the two are in interference fit, so that the main conduit can be fixedly sleeved with the inside of the ECMO connecting pipeline 3.

Furthermore, the other end of the main conduit 1 is a soft sleeve 12, the soft sleeve 12 is a hollow cylinder, the maximum inner diameter of the soft sleeve 12 is smaller than the outer diameter of the tail end of the existing ECMO placing tube 4, and the soft sleeve and the existing ECMO placing tube are in interference fit, so that the soft sleeve and the ECMO placing tube 4 can be fixedly sleeved outside the tail end.

Furthermore, the sealing sheet 21 is a one-way valve, the middle part of which is provided with a bevel-cutting m-shaped cutting seam which can pass through the three-way transfusion joint 5 or the guide wire 6. The flap of the sealing sheet 21 can only be opened towards the main catheter 1, i.e. the guide wire 6 and the three-way infusion head can only be extended towards the main catheter 1.

Furthermore, the outer side of one end of the fixing pipe 22 far away from the main pipe 1 is provided with a thread, and the plugging cap 23 is screwed with the fixing pipe 22, so that the sealing performance and the safety are further enhanced.

Further, the inclination angle of the fixed tube 22 and the main catheter 1 is 25-35 °, and the inner side and the outer side of the joint of the fixed tube 22 and the main catheter 1 are both rounded, and the inclined arrangement helps the guide wire 6 to effectively extend into the main catheter 1. The rounded design prevents the guide wire 6 from being broken at the corners.

Referring to fig. 5, a method of using the present invention for percutaneous coronary intervention, using the connection device of any of the above embodiments, and the steps of:

s10, sleeving and fixing the main guide pipe 1 between the ECMO connecting pipeline 3 and the tail end of the ECMO placing pipe 4;

s11, enabling the opening end of the side branch catheter 2 to face the direction of the far end of the patient;

s12, when the percutaneous coronary intervention operation is carried out, the blocking cap 23 is taken down, and the guide wire 6 is placed along the sealing piece 21;

s13, placing the guide catheter 7 along the guide wire 6 to a corresponding coronary artery orifice, wherein the guide catheter 7 is sleeved on the guide wire 6 and extends along the guide wire 6;

s14, removing the guide wire 6, carrying out contrast examination, and further placing a balloon or a stent.

Referring again to fig. 5, there is shown a method of use of the invention for intra-aortic balloon counterpulsation, using the connection device of any of the above embodiments, and the steps of:

s20, sleeving and fixing the main guide pipe 1 between the ECMO connecting pipeline 3 and the tail end of the ECMO placing pipe 4;

s21, enabling the opening end of the side branch catheter 2 to face the far end direction of the patient;

s22, when the intra-aortic balloon counterpulsation is operated, the blocking cap 23 is taken down, and the guide wire 6 is placed along the sealing piece 21 to reach the aortic arch;

s23, placing an intra-aortic balloon counterpulsation catheter 8 to the aortic arch along the guide wire 6, wherein the intra-aortic balloon counterpulsation catheter 8 is mainly sleeved on the guide wire 6 and extends along the guide wire 6;

and S24, removing the guide wire 6, connecting a high-pressure connecting pipe, and then connecting to a counterpulsation pump machine.

The method for using the predisposed guide wire 6 for withdrawing an ECMO patient, shown in fig. 4, uses the connection device according to one of the preceding embodiments and the following steps:

s30, the main pipe 1 is fixedly sleeved between the ECMO connecting pipeline 3 and the tail end of the ECMO arranging pipe 4;

s31, enabling the opening end of the side branch catheter 2 to face the far end direction of the patient;

s32, when the ECMO patient is taken out, the blocking cap 23 is taken down, and the guide wire 6 is placed along the sealing piece 21;

s33, the ECMO tube placing 4 is pulled out, a blood vessel stitching instrument is placed along the guide wire 6, and the large blood vessel of the tube is stitched.

In a method according to fig. 6 for use in distal perfusion therapy of ECMO patients, the connection device of any of the above embodiments is used, and the steps of:

s40, the main pipe 1 is sleeved and fixed between the ECMO connecting pipeline 3 and the tail end of the ECMO arranging pipe 4;

s41, enabling the opening end of the side branch catheter 2 to face the far end direction of the patient;

s42, removing the plugging cap 23, screwing one side of the three-way infusion joint 5 on the thread of the fixed pipe 22, and determining that the inner protrusion of the three-way infusion joint 5 penetrates through the sealing sheet 21;

s43, connecting the other side of the three-way infusion joint 5 with a far-end perfusion catheter 7;

and S44, adjusting the far-end perfusion flow rate through the three-way transfusion joint 5 according to the percutaneous blood oxygen saturation of the far-end perfusion limb and the blood vessel B ultrasonic.

The invention can be used for the distal perfusion treatment, percutaneous coronary intervention and intra-aortic balloon counterpulsation of ECMO patients, and can preset the guide wire 6 when the ECMO patients withdraw the machine and use the vascular suturing device to suture the great vessels. The multifunctional medical nursing bed has the advantages of multiple functions, convenience and quickness in operation, flexibility in use and low cost, and can effectively improve clinical practicability and facilitate further popularization and application.

Although some specific embodiments of the present invention have been described in detail by way of examples, it should be understood by those skilled in the art that the above examples are for illustrative purposes only and are not intended to limit the scope of the present invention. It will be appreciated by those skilled in the art that modifications can be made to the above embodiments without departing from the scope and spirit of the invention. The scope of the invention is defined by the appended claims.

Claims (10)

1. A connection device for ECMO interventional procedures, comprising a main catheter and a side branch catheter;

the two ends of the main conduit are used for connecting the existing ECMO pipeline;

the side branch catheter comprises a sealing sheet, a fixing tube and a plugging cap, one end of the fixing tube is integrally formed with the side wall of the main catheter, the other end of the fixing tube is connected with the plugging cap in a sealing mode, and the plugging cap is used for sealing the side branch catheter; the fixed pipe is communicated with the main guide pipe and is connected with the main guide pipe in an inclined mode; the gasket sets up fixed pipe is close to the one end of shutoff cap, it is used for preventing that external gas from getting into fixed pipe.

2. The connection device for ECMO interventional therapy according to claim 1, wherein one end of the main conduit is a hard base, the outer surface of the hard base is stepped, and the maximum outer diameter of the hard base is larger than the inner diameter of the existing ECMO connection pipeline, so that the main conduit can be fixedly sleeved with the interior of the ECMO connection pipeline.

3. The connection device of claim 2, wherein the other end of the main conduit is a soft sleeve, and the soft sleeve is hollow and cylindrical, and has a maximum inner diameter smaller than the outer diameter of the end of the existing ECMO tube, so that the soft sleeve can be fixedly sleeved with the outside of the end of the ECMO tube.

4. The connection device of claim 1, wherein said sealing piece is a one-way flap, and a bevel-cut slit is formed in the middle of said sealing piece, and said slit can pass through a three-way infusion connector or a guide wire.

5. The connection device for ECMO interventional therapy according to claim 1, wherein the fixing tube is provided with a thread at an outer side of an end thereof away from the main tube, and the plugging cap is screwed with the thread of the fixing tube.

6. The connection device for ECMO interventional therapy according to claim 1, wherein the inclination angle of the fixed pipe to the main pipe is 25 ° to 35 °, and the inner side and the outer side of the connection part of the fixed pipe to the main pipe are both rounded.

7. Method for using a connection device for ECMO interventional procedures, characterized in that a connection device according to any one of claims 1-6 is used, and in that the following steps are performed:

s10, sleeving and fixing the main guide pipe between the ECMO connecting pipeline and the tail end of the ECMO pipe;

s11, enabling the opening end of the side branch catheter to face the direction of the far end of the patient;

s12, removing the plugging cap, and placing a guide wire along the sealing piece;

s13, placing a guide catheter along the guide wire to a corresponding coronary ostium;

s14, removing the guide wire, carrying out contrast examination, and further placing a balloon or a stent.

8. Method for using a connection device for ECMO interventional procedures, characterized in that a connection device according to any one of claims 1-6 is used, and in that the following steps are performed:

s20, sleeving and fixing the main guide pipe between the ECMO connecting pipeline and the tail end of the ECMO pipe;

s21, enabling the opening end of the side branch catheter to face the far-end direction of the patient;

s22, removing the plugging cap, and placing a guide wire along the sealing sheet to reach the aortic arch;

s23, placing an intra-aortic balloon counterpulsation catheter to the aortic arch along the guide wire;

and S24, removing the guide wire, connecting the high-pressure connecting pipe and then connecting the high-pressure connecting pipe to a counterpulsation pump machine.

9. Method for using a connection device for ECMO interventional procedures, characterized in that a connection device according to any one of claims 1-6 is used, and in that the following steps are performed:

s30, sleeving and fixing the main guide pipe between the ECMO connecting pipeline and the tail end of the ECMO pipe;

s31, enabling the opening end of the side branch catheter to face the far-end direction of the patient;

s32, removing the plugging cap, and placing a guide wire along the sealing piece;

s33, removing the ECMO tube, placing a blood vessel stitching instrument along the guide wire, and stitching the large blood vessel of the tube.

10. Method for using a connection device for ECMO interventional procedures, characterized in that a connection device according to any one of claims 1-6 is used, and in that the following steps are performed:

s40, sleeving and fixing the main guide pipe between the ECMO connecting pipeline and the tail end of the ECMO pipe placing;

s41, enabling the opening end of the side branch catheter to face the far end direction of the patient;

s42, removing the blocking cap, screwing one side of the three-way infusion joint on the thread of the fixed pipe, and determining that the inner protrusion of the three-way infusion joint penetrates through the sealing sheet;

s43, connecting the other side of the three-way infusion joint with a far-end infusion catheter;

and S44, adjusting the far-end perfusion flow rate through the three-way transfusion connector according to the percutaneous blood oxygen saturation of the far-end perfusion limb and the blood vessel B ultrasonic.

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