CN215740869U - ECMO catheter for continuous dynamic blood temperature monitoring - Google Patents

Abstract

The application discloses an ECMO catheter for continuous dynamic blood temperature monitoring, wherein one end of the catheter is a tip, and the other end of the catheter is connected with a thermometer body; the inner wall of the conduit is provided with a groove along the length direction, and the tip end of the conduit is provided with a temperature sensor; one end of the lead is connected with the temperature sensor, the other end of the lead is connected with the thermometer body along the groove, and the inner diameter of the groove is matched with the outer diameter of the lead; the side wall of the thermometer body is provided with a PCB circuit board and a power supply module; the surface of the thermometer body is provided with a display screen; the PCB is provided with a microcontroller and a multi-channel AD converter, and the multi-channel AD converter, the power supply module and the display screen are respectively connected with the microcontroller; the catheter can accurately reflect the central blood temperature of the patient, and is convenient for medical staff to read the central temperature of the patient at any time.

Description

ECMO catheter for continuous dynamic blood temperature monitoring

Technical Field

The application relates to the field of medical equipment, in particular to an ECMO (interstitial-free) catheter for continuously and dynamically monitoring blood temperature.

Background

According to Statistics, traditional cardiopulmonary resuscitation (CCPR) rescues Cardiac Arrest (CA) caused by various reasons, and the autonomous rhythm of Heart (ROSC) success rate of CA patients reaching high-quality cardiopulmonary resuscitation treatment is only 47% (Mozaffarian D, Benjamin EJ, Go AS, et al. Heart Disease and Stroke Statistics-2016 upper: a orthogonal American Heart Disease [ J ] Circulation, 2016,133 (e) 38-e 360.), and the hospital discharge survival rate is only 2-11%, so how to further improve the survival rate of CA patients, until the clinical and scientific research focus of the cardiopulmonary field is still the global resuscitation point of concern.

ROSC can reach 95% in CA patients treated by extracorporeal cardiopulmonary Resuscitation (ECPR), and the neurological recovery rate and the survival rate after discharge of the patients are obviously improved (Siao FY, Chiu CC, Chiu CW, et al. the managed cardiac area with the regenerative neural tissue in the experimental generation department: the concerned cardiac respiratory recovery over the regenerative recovery [ J ]. the usage recovery, 2015 (92): 70-76). ECPR is an assisted cardiopulmonary resuscitation (ECMO) technique using extracorporeal membrane oxygenation (ECMO) to replace the cardiopulmonary function of patients who cannot recover spontaneous heart Rhythm (ROSC) after traditional CCPR (cardiac pulmonary resuscitation) of cardiac arrest that can be removed by underlying reversible causes or who cannot maintain spontaneous heart rhythm after repeated cardiac arrest, and can improve the 1-year survival rate and the 1-year prognosis survival rate of patients. (Patrick J. Coppler, Benjamin S. Abella, David F. Gaieski1, et al. variabilty of exogenous nuclear medicine restriction availability for reflex adult-out-of-physiological cardiac arm: an international scientific study. clinExpErmergg Med 2018;5(2): 100-. In recent years, with miniaturization, mobility, maturity of percutaneous tube placement technology, and the like of necessary devices, the ECMO technology has been increasingly applied to external sudden cardiac arrest treatment.

Successful ECPR is not only a recovery of the patient's own heart rate, but its ultimate goal is to preserve or possibly restore complete brain function. Cryotherapy is a brain protection treatment strategy widely used in many disease areas (Kirkegaard H, Soreode E, de Haas I, et al. Targeted temporal management for 48 vs.24 hours and neurological Out of clinical outer after of the regional cardiac preservation [ J ]. JAMA, 2017, 318 (4): 341-350; Tadahiro Goto, Sachiko Morita, Tatsuro Kai, et al. Impact of extracellular cardiac preservation on times of the regional cardiac preservation of BMJ Open 2018; E019811: 20183/20183. temporal survival of the regional cardiac preservation of the regional neural preservation of the regional preservation of the disease of the human, particularly of the regional preservation of the regional preservation of the regional preservation of the regional, 2018, 391(10124): 989-998.). The survival of the patient was improved by 30% with cryotherapy compared to without cryotherapy (Arrich J, Holzer M, Havel C, et al. hyperthermia for neuroprotection in additives after cardiac pathophysiology restriction [ J ]. Cochrane Database Syst Rev, 2016, 2: CD 004128.). The concept of "hypothermia" in the scope of hypothermia treatment is currently replaced by "Target Temperature Management (TTM)," which is adopted by the guidelines for Post-cardiac arrest temperature management issued by the International Resuscitation Union & American Heart Association in 2015 (calcium CW, Donnino MW, Fink EL, et al, Post ⁃ cardiac arm care: 2015 American Heart association guidelines for cardiac arrest compliance for cardiac arrest and expression cardiac arm care [ J ]. Circulation 2015, 132 (18 Suppl 2): S465-S468.) and recommends a constant value with a target temperature controlled between 32-36 ℃, foreign studies show that patients receiving TTM treatment in the "hypothermia" (34-36 ℃) range have less acute complications than patients receiving TTM treatment [ acute temperature management J ]. 32-36 ℃ and that the target temperature management (K-temperature management J-34. management, K.) -34. varies from the clinical temperature range of calcium therapy [ K., [ K-temperature management J., [ K ] of acute temperature management, K-calcium therapy J.) -34. and calcium therapy [ K., 2019, 48 (4): 273-.

At present, a central body temperature monitoring method is adopted in a clinical accurate body temperature monitoring method, and comprises the steps of monitoring intravascular temperature, bladder temperature, rectal temperature, tympanic membrane temperature, oral cavity temperature, esophageal temperature, nasopharynx temperature and the like, wherein the intravascular temperature is monitored by placing a pulmonary artery floating catheter and utilizing a temperature sensor at the tip of the catheter, and the intravascular temperature is taken as a gold standard of body core temperature in clinic; meanwhile, when Pulse Index Continuous Cardiac Output (PICCO) is monitored, femoral artery catheterization is utilized to monitor the blood temperature of a patient. Krizanac et al showed that pulmonary artery temperature and femoral artery temperature during sub-hypothermic treatment of sudden cardiac arrest patients differ by only 0.0 ℃. + -. 0.1 ℃, and thus pulmonary artery blood temperature was considered to accurately reflect in vivo temperature. Although both core body temperatures enable real-time dynamic monitoring, both monitoring methods require the placement of a central venous or arterial catheter in the patient, which undoubtedly increases the risk of puncture bleeding and catheter-related blood flow infection in ECMO patients.

Currently, the central temperature of ECMO patients is generally monitored clinically by bladder temperature measurement, rectal temperature measurement and the like, and when the patients use diuretics or diarrhea and the like, the central temperature monitoring has large errors and even cannot be implemented clinically; the blood temperature monitoring device structure of the ECMO machine is arranged in a circulating pipeline outside a central venous cannula of a patient, and a temperature measuring position is away from a human body, so the monitored blood temperature is influenced by factors such as the water temperature of a water temperature tank, the length of the circulating pipeline, the treatment environment and the like, and the central body temperature of the patient cannot be accurately reflected. Therefore, how to do

The accurate measurement of the core body temperature of the patient without adding an additional intubation tube still remains a technical problem to be solved urgently in the clinical care of ECRP.

Disclosure of Invention

In view of the above, the present application provides an ECMO catheter with continuous dynamic blood temperature monitoring to accurately detect core body temperature of ECMO patients.

The application is realized by the following technical scheme:

an ECMO catheter for continuously and dynamically monitoring blood temperature comprises a catheter, wherein one end of the catheter is a tip, and the other end of the catheter is connected with a thermometer body; the inner wall of the conduit is provided with a groove along the length direction, and the tip end of the conduit is provided with a temperature sensor (such as a thermistor); one end of the lead is connected with the temperature sensor, the other end of the lead is connected with the thermometer body along the groove, and the inner diameter of the groove is matched with the outer diameter of the lead;

the thermometer body is a hollow hard tube (made of polyvinyl chloride and PVC), and a PCB circuit board and a power supply module are arranged on the side wall of the thermometer body; the surface of the thermometer body is provided with a display screen (1 cm x 0.5 cm); a PCB circuit board is arranged in the thermometer body; the PCB is provided with a microcontroller and a multi-channel AD converter, and the multi-channel AD converter, the power module and the display screen are respectively connected with the microcontroller.

Further, in the present application, the distance of the catheter between the thermometer body and the tip is 60 cm; in a particular application, the depth of entry of the ECMO catheter into the body is: the limb vein is 45-50cm, and the jugular vein is 15-18cm, so that the arrangement of the thermometer body does not affect the intubation and ensures that the body temperature is displayed immediately.

Further, the temperature sensor is arranged in the PVC sleeve, and an epoxy resin layer is arranged between the inner wall of the PVC sleeve and the outer surface of the temperature sensor for sealing and fixing.

Furthermore, an epoxy resin layer is arranged between the lead and the groove for sealing and fixing.

The utility model adds a temperature detection module on the basis of the existing ECMO extracorporeal circulation intubation tube (such as an extracorporeal circulation intubation tube produced by MAQUET company, model BE-PVL 2155,) and the thermistor parameter is 2252 omega at 25 ℃, the test temperature is 0-50 ℃, and the precision is + 0.2-0.2 ℃;

the thermistor changes along with the temperature change resistance value, the lead converts the resistance value change signal into a digital signal through the multi-channel AD adapter, and the microcontroller reads the digital signal and displays the temperature change with the display screen in real time.

The ECMO catheter for continuously and dynamically monitoring the blood temperature is designed on the basis of the conventional ECMO catheter, the core body temperature of an ECPR patient is continuously, dynamically and accurately monitored, a scientific basis is provided for the optimal implementation and monitoring method of the target temperature management of the ECPR patient, the optimal starting time, the cooling speed in unit time and the prevention of complications, and the establishment of a standard target temperature management flow of the ECPR patient, and the ECPR catheter is also a problem which needs to be solved clinically urgently in the core body temperature monitoring of the ECRP patient at present. Compared with the prior art, the method has the following beneficial effects:

1) the ECMO patient puncture is used for detecting the blood temperature by using an ECMO special vein indwelling tube which is required to be indwelling for ECMO puncture (a central venous catheter which draws blood from the patient body is generally indwelling in a femoral vein or an internal jugular vein cannula), and no additional puncture is generated for the patient;

2) the utilization can accurately reflect the central blood temperature of the patient from the internal direct blood drainage of the patient, and can facilitate the medical staff to read the central temperature of the patient at any time.

Drawings

Fig. 1 is a schematic structural view of an ECMO catheter for continuous dynamic blood temperature monitoring in example 1.

FIG. 2 is a schematic view showing the structure of the tip of the catheter in example 1.

Fig. 3 is a schematic diagram of a PCB circuit board module connection structure.

1. A conduit; 2. a tip; 3. a thermometer body; 4. a power supply module; 5. a temperature sensor; 6. a wire; 7. display screen, 8, PCB circuit board.

Detailed Description

Example 1

As shown in figure 1, the ECMO catheter for continuous dynamic blood temperature monitoring comprises a catheter 1, wherein one end of the catheter is a tip 2, and the other end of the catheter is connected with a thermometer body 3; the inner wall of the catheter is provided with a groove along the length direction, as shown in figure 2, the tip 2 of the catheter is provided with a temperature sensor 5 (PT 100 thermal resistance temperature sensor); one end of a lead 6 is connected with the temperature sensor 5, and the other end is connected with the thermometer body 3 along a groove, and the inner diameter of the groove is matched with the outer diameter of the lead 6; the thermometer body 3 is a hollow hard tube (PVC), and a PCB (printed Circuit Board) 8 and a power module 4 are arranged on the side wall of the thermometer body 3; a display screen 7 (the length and the width are 1cm x 0.5 cm) is arranged on the surface of the thermometer body 3;

as shown in fig. 3, a microcontroller and a multi-channel AD adapter are arranged in the PCB circuit board 8; the multi-channel AD converter, the power module 4 and the display screen 7 are respectively connected with the microcontroller; in this embodiment, the distance of the tube between the thermometer body 3 and the tip 2 is 60 cm.

In this embodiment, temperature sensor 5 sets up in the PVC cover, is equipped with epoxy layer between PVC cover inner wall and the 5 surfaces of temperature sensor and seals fixedly, is equipped with epoxy layer between wire 6 and the recess and seals fixedly.

The catheter used in this example was an existing ECMO extracorporeal circulation cannula catheter, model BE-PVL 2155.

The ECMO catheter for continuous dynamic blood temperature monitoring obtained in this example was used as follows:

1. inserting the core into the catheter and fixing it in the cap of the catheter;

2. under the strict requirement of aseptic operation, the catheter is indwelling by adopting a Setyinger or surgical implantation mode;

3. inserting the J-end of the guide wire into the blood vessel through the puncture needle, ensuring that the guide wire can freely enter, advancing the guide wire to the expected position of the top end of the catheter, and taking the puncture needle out of the blood vessel of the patient along the guide wire;

4. beginning vasodilation using a minimum gauge vascular dilator;

5. implanting a core along a guidewire, the catheter slowly advancing along the core to a predetermined position;

6. taking out the guide wire;

7. removing the core from the catheter and clamping the catheter jaws in the identified location of the tube jaws;

8. the arteriovenous cannula is connected with an ECMO circulating pipeline to start extracorporeal circulation;

9. the catheter is safely fixed on the blood vessel or the peripheral tissues;

10. the thermistor at the tip of the catheter changes along with the resistance value of the temperature change, the thermistor is converted into a digital signal through the multi-channel AD adapter, and the display screen displays the temperature change in real time.

The above-mentioned embodiments, objects, technical solutions and advantages of the present invention are further described in detail, it should be understood that the above-mentioned embodiments are only illustrative of the present invention and are not intended to limit the present invention, and any modifications, equivalents, improvements and the like made within the spirit and principle of the present invention should be included in the protection scope of the present invention.

Claims (5)

1. An ECMO catheter for continuously and dynamically monitoring blood temperature comprises a catheter, and is characterized in that one end of the catheter is a tip, and the other end of the catheter is connected with a thermometer body; the inner wall of the conduit is provided with a groove along the length direction, and the tip end of the conduit is provided with a temperature sensor; one end of the lead is connected with the temperature sensor, the other end of the lead is connected with the thermometer body along the groove, and the inner diameter of the groove is matched with the outer diameter of the lead;

the thermometer body is a hollow hard tube, a PCB (printed circuit board) and a power supply module are arranged on the side wall of the thermometer body, and a display screen is arranged on the surface of the thermometer body;

the PCB circuit board is provided with a microcontroller and a multi-channel AD adapter; the multi-channel AD converter, the power supply module and the display screen are respectively connected with the microcontroller.

2. The continuous dynamic blood temperature monitoring ECMO catheter of claim 1, wherein the distance of the catheter between the thermometer body and the tip is 60 cm.

3. The ECMO catheter for continuous dynamic blood temperature monitoring according to claim 1, wherein the temperature sensor is disposed in a PVC sheath, and an epoxy layer is disposed between an inner wall of the PVC sheath and an outer surface of the temperature sensor for sealing and fixing.

4. The ECMO catheter for continuous dynamic blood temperature monitoring of claim 1, wherein the wire is sealed and secured to the groove with an epoxy layer.

5. The ECMO catheter for continuous dynamic blood temperature monitoring according to claim 1, wherein the display screen is 1cm x 0.5cm in size.

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