FR2528313A1 - IMPROVEMENT TO A INFUSION PUMP - Google Patents

Abstract

THE INFUSION APPARATUS OF THE INVENTION INCLUDES A CASING 12 INCLUDING A CHAMBER FOR INFUSING LIQUID 26 AND MEANS 34, 36 FOR CONDUCTING THE LIQUID TO INFUSING FROM THE CHAMBER TO A SMALL ADDITIONAL CHAMBER 42 THROUGH D 'AN EXIT PASSAGE 38 INCLUDING A LIQUID RESTRICTING ELEMENT 38A, THE SMALL CHAMBER INCLUDING AN INPUT PORT 44 CLOSED BY A PENETRABLE DIAPHRAGM 18 WITH SELF-CLOSING. AN OUTLET TUBE 43 FROM THE SMALL CHAMBER CONDUCTED DIRECTLY TO A CANNULA 14 LOCATED AT THE INFUSION LOCATION SO THAT LIQUID CAN BE INJECTED INTO THE SMALL CHAMBER THROUGH ITS DIAPHRAGM AND DELIVERED DIRECTLY TO THE LOCATION OF 'INFUSION WITHOUT REFLUX UNTIL THE INFUSING LIQUID CHAMBER 26. APPLICATION TO THE INFUSION OF MEDICINES SUCH AS INSULIN.

Description

The invention relates to an infusion apparatus It relates especially to a

  infusion device that can be implanted, refilled and reloaded periodically

  so that he can remain in the patient's body

  for an extended period. Relatively recently, infusion machines have been developed to implant them in the body and leave them there for an extended period of time.

  can be refilled with liquid to infuse without

  having to remove the device from the body This new filling

  ge is performed by injecting liquid to infuse

  in the device via a diaphragm

  penetrable, this diaphragm being placed directly under

  the skin of the patient In some cases, the operation of new

  calf filling the device with a liquid to infuse also allows to recharge the power source of

  the device so that the device can function

  continuously to administer a product to be infused such as insulin, heparin or a chemotherapeutic agent at a very small rate over a long period of time. Examples of infusion apparatus of this general type are described in US patents A.

  Nos. 3,951,147 and 4,258,711 filed by the Applicant.

  Some infusion apparatus of this type such as that described in the last cited patent have the ability

  to administer a continuous basal dose of product to

  to the patient as well as larger bolus doses when the circumstances require it For example, a patient can receive a continuous dose of insulin based on the average glucose level in his blood So just after

  meal time, when the glucose level rises

  usually, a pump can be used to administer a dose

  of insulin to compensate for this level of glucose.

  believed to to ingestion of food In order to provide for this dual dosage capability for a period of time

  reasonably long, it is necessary to provide the pump with a

  see liquid to infuse big to satisfy both

  the requirements for basal or bolus doses or two

  small ones, one of which contains the liquid to be

  at the basal concentration and the other contains the

  to infuse at a higher bowl concentration. In each case, the inclusion of the bowl delivery means increases the overall dimensions of the envelope

pump.

  However, in some cases, a supplement of

  liquid flow to infuse basal is necessary relative-

  For example, it may not be introduced

  only to add an angiographic solution to the

  to infuse so that the range of distribution

  -bution of the infused liquid in the body may be con-

  from time to time It would be desirable in some cases

  some cases to provide this means in a pump having overall dimensions or minimum envelope It is

  essential that this additional means be pre-

  without adversely affecting the liquidation of

  to infuse basal content in the device or its flow

of administration to the patient.

  The present invention aims to provide a

advanced brewing apparatus.

  The object of the present invention is to provide an infusion apparatus which can administer a liquid to be infused at a low basal rate to add a dose of the same infusing liquid or other liquid whenever this is

desirable.

  Another object of the invention is to provide an apparatus for in-

  fusion of this type which occupies a minimum of space in the

body of the patient.

  Another object of the invention is to provide a pump for

  fusion, the liquid to be infused with the output sent to the

  lade may also include when this is necessary.

  a variety of other liquids without affecting a

  adversely the administration of the liquid to be infused.

  According to the present invention, a pump can be

  placed outside or inside the Fondamen body

  it comprises a reservoir of liquid to infuse, a pump for bringing the liquid to infuse from this reservoir to a catheter placed at an infusion site in the body of the patient and an orifice closed by a diaphragm

  in communication with the liquid with the flow path

  the reservoir downstream of the pump which allows the

  pump outlet to have a supplement of

  liquid injected into the orifice through its diaphragm.

  The invention applies in particular to a device for in-

  As a result, it will be described later in this context. However, it should be noted that

  the invention may also be applied to devices

external infusion plants.

  The pump of the invention comprises a housing containing

  a reservoir of liquid to be infused, preferably

  in the form of a capsule with a metal bellows

  fice entry into the interior of the bellows is closed by a penetrable diaphragm mounted in the housing wall of

  such that, when the apparatus is implanted, the dia-

  diaphragm is placed directly under the patient's skin An outlet port from the inside of the bellows capsule communicates with an outlet tube that extends outside the housing. The bellows capsule is filled with liquid to be infused by injection subcutaneous through

the penetrable diaphragm.

  Means are provided inside the housing and

  out of the bellows to compress the bellows, which allows

  to expel the liquid to be infused from within the

  The preferred means for exerting a compressive force on the bellows capsule is a mechanical fluid pressure cell such as

  described in the patents cited above. It is obvious that

  It is possible to use various other battery or mechanical devices for progressively compressing the bellows. The flow rate of the liquid to be infused out of the capsule is kept constant by a means of restriction.

  flow rate in the outlet tube.

  Instead of driving directly to a catheter

  ter at the infusion site as described in the cited patents, the outlet tube has a means of restrictive

  from the bellows tank leads to

  a small chamber placed inside or outside the housing The chamber has an orifice

  with a diaphragm which is also placed directly

  under the patient's skin when the device is

  Various types of liquid can be introduced into this chamber by subcutaneous injection through its diaphragm. These liquids mix with the liquid to be infused administered from the reservoir.

  bellows and ', are brought by the catheter to the same level

  Infusion placement in the patient's body These added liquids may include a radio-opaque substance, infusion liquid at higher concentrations or various other types of liquids depending on the particular medical problem of the patient.

  downstream of the flow restricting means from the

  see liquid to infuse, almost anything

  the liquid injected into this chamber flows through the

  tea to the brewing site.

  The pump of the invention is thus able to ad-

  to infuse liquid to be infused during a period

  This liquid is to be infused with additional drops of other liquids desirable for proper treatment of the patient when necessary. This result is obtained by means of a single device which is contained in a small envelope so that its implantation in the body of the patient does not cause

unwanted discomfort for the patient.

  Other features and advantages of the pre-

  invention will be highlighted in the description

  following, given by way of non-limiting example, in

  FIG. 1 is a schematic view showing the implanted infusion apparatus of the invention, and FIG. 2 is a much larger scale sectional view of the elements of the apparatus of FIG. are shown in more detail.

  In Figure 1, the infusion apparatus of the invention

  tion indicated as a whole by 10 is shown

  implanted in a subcutaneous pocket in the abdominal wall

  The apparatus comprises a cylindrical casing 12 as a whole which contains a reservoir of liquid to be infused. This liquid to be infused is administered from the apparatus through an unrestricted dispensing cannula 14 leading from the housing 12 to the casing 12. 'has a

  In this case, the cannula is

  felt as being implanted in the hepatic artery H via the gastroduodenal artery G. When the reservoir of liquid to be infused into the housing 12 is empty, the apparatus can be refilled by subcutaneous injection through a diaphragm 16 with self-sealing in the housing 12 When the device is

  suitably implanted, this diaphragm is placed directly

  It is thus possible for a syringe needle to fit under the patient's skin. In certain pumps of this general type, this refilling operation also makes it possible to recharge the supply source by which the liquid to be infused is expelled from the housing.

12 to the sick.

  For some patients, the doctor may wish to deliver a dose of a bowl of liquid to infuse the patient or momentarily infuse another substance such as a substance opaque to the radio for an angiogram, o the microspheres tinted by tracer are opaque to the

  X-rays or gamma rays In the apparatus of the invention

  tion, this is done by subcutaneous injection through

  towards a second diaphragm 18 placed in an extension

  12 of the housing 12 The diaphragm 18 is spaced from the diaphragm

  me 16 on the same side of the housing 12 As a result, it is also placed directly under the skin and it is also

  accessible for penetration by a syringe needle.

  ford. The substance injected through the diaphragm 18 does not mix with the liquid to be infused into the chamber 12. Instead, it is delivered directly.

  to the cannula 14 so that it flows immediately

  at the infusion site by the cannula accordingly.

  this, the patient immediately benefits from this substance

  after its injection The inclusion of the diaphragm 18

  The apparatus allows the apparatus 10 to deliver a drop of liquid to infuse or other liquid when necessary without materially increasing the dimensions.

  As a result, it makes the ap-

  this is very useful in cases where it is desirable

  to administer a second substance to an occasional patient

  sionally. Referring now to Figure 2, it will be seen that the housing 12 is a cylindrical box as a whole which is about the size of a small hockey puck. The box is made of a suitable material.

  such as titanium which is compatible with the human body

  A capsule bellows 24 is placed in the box, this capsule having an open end mounted on

  a hat 12b at the top of the box 12 and an opposite end

  posed that is closed The bellows thus defines a pre-

  first chamber 26 inside the bellows and a second chamber 28 on the outside of the bellows, but on the inside

of the housing 12.

  An inlet port 32 is formed in the cap

  1 2b and extends from the chamber 26 through the cap 12b.

  The outer end of the orifice 32 is closed by the diaphragm 16 A porous needle stopper 33 is placed at the inner end of the orifice 32. An outlet orifice 34 containing a filter 36 is also formed in the cap. port communicates with an outlet tube 38 having a liquid restriction member 38a whose opposite end communicates with an inlet tube leading to a small chamber 42 located in

  the casing extension 12 has an outlet tube 43 con-

  from the chamber 42 to the cannula 14 An inlet port 44 is also formed in the upper part of the

  chamber 42, this orifice being closed by the diaphragm 18.

  In addition, a needle stop 46 is placed in the bottom of

the room 42.

  Normally, the chamber 26 is filled with liquid to be infused by injection of the liquid to be infused through the diaphragm 16 The chamber 28 is also filled

  a two-phase liquid that vaporizes at temperatures

  physiological conditions so that it exerts

  -sion on the bellow capsule 24 tending to deform,

  which allows to expel the liquid to be infused by the ori-

  this output 34 and the restrictive element output tube

  38 of this chamber, the liquidation of

  to infuse flows through the cannula 14 to the location

  infusion, that is, artery H (Figure 1).

  When the reserve of liquid to be infused into the room

  26 is exhausted, it can be renewed by injecting

  both of the additional infusion liquid through the dia-

  phragm 16 using a hypodermic syringe The ex-

  tension of the bellows capsule 24 during this operation.

  new filling puts pressure on the

  two-phase quid in room 28 which condenses this

  liquid by recharging the mechanical cell of li-

  The operation of this cell is fully described in the two patents cited above as well as

  in US Pat. No. 3,731,681.

  being in room 26 can thus be administered

  administered to the patient at a very low flow rate to

  long-term needs, the device being refilled periodically, e xample, every thirty

days, as it should be.

  In cases where it is desirable to infuse a higher concentration of the same liquid to infuse or a different liquid together to the artery H of

  sick, this is accomplished by injecting this extra liquid

  directly in room 42 through the

  diaphragm 18 using a hypodermic syringe

  than classical as represented by dashes in N in Figure 2 This liquid flows then directly

  to the unrestricted infusion

  to the outlet tube 43 and the cannula 14 Since the chamber

  42 is located downstream of the restriction element 38a,

  this extra substance is forced to flow

  by the cannula There is a very small

  upstream in the restriction element tube 38

  down to the brewing liquid chamber 26

  quence, essentially the whole volume (ie 99.99%)

  the substance injected into chamber 42 flows

  mediately to the infusion site as a

  drop, instead of being administered to the patient on a

  longer period at the same time as the liquid to be infused

from bedroom 26.

  In devices such as the apparatus 10 comprising

  as a very weak restriction element 38 has in the

  outlet tube 38, this reflux of the chamber can be prevented.

  42 in the chamber 26 by means of a control valve placed in the outlet tube upstream of the chamber 42 This valve is indicated at 48 by dashes

in Figure 2.

  Therefore, it will be appreciated that the introduction of the chamber 42 with its diaphragm 18 into the apparatus

  downstream of the exit restriction element tube in particular

  both the liquid infusion reservoir 26 provides a

  convenient way to inject liquid directly into the

  in the arterial system of the patient each

  time it is necessary The introduction of this room

  additional capacity in the device does not increase

  the volume of the housing 12 nor the overall cost

  nor the complexity of the apparatus It nevertheless makes the ap-

like a lot more flexible.

  So we see that the objects mentioned above,

  among those which emerge from the foregoing description,

  are achieved effectively. It is also possible to

  certain modifications to the construction of the apparatus de-

  above without departing from the scope of the invention. For example, a mechanical pump such as a

  peristatilque pump instead of the pressure pump

  used to drain the liquid to be infused from the chamber 26 to the catheter 16 Therefore, any

  contained in the preceding description or

  shown in the attached drawings should be considered

  As an example of the present invention by no means

tative.

Claims (5)

  Infusion apparatus, characterized in that it comprises: A liquid infusion reservoir (12);   B an inlet (32) in said reservoir of li- who to infuse;   C a self-sealing penetrable diaphragm (16)   born to close said inlet port; A small room (42); E an inlet port (44) in said chamber (42); F a second self-sealing penetrable diaphragm (18) for closing the inlet port (44) in said chamber; G means (38) defining a liquid passage extending from said reservoir (12) to said chamber; Means (24) for moving the contents of said reservoir to the chamber; and   Means (43) defining an output passage of   using the chamber and connecting it to a cannula (14)   which leads to an infusion site.   Infusion apparatus, characterized in that it comprises: A housing (12); B a box (24) mounted inside the housing, this bolt defining with the housing a first chamber (26) inside the box and a second chamber (28) outside the boot, but to inside the crankcase; C an inlet port (32) in one of said chambers;   A penetrable diaphragm (16) which is self-sealing and   born to close the inlet port; E a third small volume chamber (42); F an inlet port (44) in the third chamber; G a second self-sealing penetrable diaphragm (18) for closing the inlet port in the third chamber; H means (38) defining a liquid passage extending from said chamber (26) to the third chamber (42); I a means in the other of said first and second   chambers for moving the contents of the first chamber   (26) to the third chamber (42); and   J.a means (43) defining an output passage of li-   of the third chamber and connecting it to a   (14) which leads to an infusion site.   Brewing apparatus according to claim 2, characterized in that said means (38) defining a   passage comprises a liquid restriction element (38a).   Brewing apparatus according to claim 2, characterized in that said means defining a passage   includes a control valve (48) to prevent hearing loss   liquid from the third chamber to the first first room.   Infusion apparatus according to claim 2,   characterized in that said moving means is con-   staged by a mechanical cell of liquid included in   said other chamber (28) for deforming the box (24).   Brewing apparatus according to claim 2, characterized in that the first and second diaphragms   (16, 18) are spaced from each other on the same outer wall. the crankcase.