JP2000070361A - Artificial heart and lung device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To reduce load on patient by placing an artificial lung in a blood feed line for feeding blood in a main reservoir connected with a blood discharge line, providing a plurality of sub reservoirs capable of sucking and reserving blood above the main reservoir, and connecting a blood suction line with each sub reservoir. SOLUTION: When a device body 1 is operated, blood is guided into a main reservoir 5 through a blood discharge line 9 connected with the vein side of a heart of a patient, and is reserved. Because a controller 8 sets inside pressure of each of reservoirs 12a-12d for aorta vent, left atrium-left ventricle vent, and for suction to be negative, blood guided through suction lines 13a-13d, after their solid matters are removed with a sub filter in each of the reservoirs 12a-12d, is guided into the main reservoir 5. Blood in this reservoir 5 is fed to an artificial lung 7 through a blood feed line 10 having a centrifugal pump 6, here oxygen is added to the blood, gas such as carbon dioxide is removed, and the blood is returned to the patient.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention substitutes a heart pump function and a pulmonary gas exchange function outside a patient's body during open heart surgery, and aspirates and collects and reuses blood in a surgical field. To an artificial heart-lung machine.

[0002]

2. Description of the Related Art The main function of a heart-lung machine is to store blood removed from a patient in a reservoir, send out the blood stored in the reservoir using a roller pump, and exchange heat with the blood sent out. Keep it at an appropriate temperature with temperature control means using means, etc.,
Further, blood is sent to the patient after gas exchange with an artificial lung.

[0003] When performing open heart surgery, bleeding occurs in the operative field, and blood stagnates in the heart, the heart, the aorta and the like. Blood bleeding into the operative field and blood stagnating in the atrium, heart, aorta and the like were discarded without being reused in the early stage of open heart surgery.

On the other hand, in recent years, blood that has bleeding into the operative field or blood that has stagnated in the heart, the heart, the aorta, and the like due to improvements in the performance of roller pumps and the like has been recovered using a sub-roller pump. The blood is collected in a bag or the like and sent to the patient again.

[0005]

However, in addition to the roller pump for blood supply, one or more sub-rollers are provided.
If a pump is used, it is difficult to make the heart-lung machine compact, and an operating room, such as disposing a blood-feeding roller pump or a suction sub-roller pump at a position away from the patient. , The proportion occupied by the heart-lung machine increases.

As described above, when the proportion of the heart-lung machine in the operating room increases, the following problem occurs. In other words, the heart-lung machine may obstruct the operator performing the open heart surgery or obstruct the operation of the caregiver, which may hinder a smooth operation. Further, since the total length of the tube through which blood flows becomes long, the amount of the electrolyte solution or the like to be filled in the apparatus is large, and as a result, the burden on the patient is increased. Further, it is difficult for an operator who operates the heart-lung machine to monitor the entire heart-lung machine in detail. Further, the size of the heart-lung machine is increased, and the cost of the conventional heart-lung machine is increased.

In the conventional heart-lung machine, a roller pump is used for the main pump for blood supply and the sub-pump for suction as described above.
In addition, since it is necessary to perform a proper closing test and a functional test of the engagement between the tube and the roller, a long preparation time is required before performing the open heart surgery. For this reason, problems such as an inability to immediately start an operation for an emergency have occurred. In addition, the roller pump has a
There is also a problem that the blood is greatly damaged due to the action of crushing the blood in the tube or an excessive load due to the mechanical drive.

The present invention has been made in view of the above circumstances, and has as its object the purpose of achieving high safety, a small burden on the patient, excellent visibility and operability, and low cost. It is an object of the present invention to provide a heart-lung machine which can be used.

[0009]

In order to achieve the above object, the heart-lung machine of the present invention is provided so as to be capable of storing blood supplied from a blood removal line, and guides the stored blood to a blood supply line. A main reservoir, a pump provided in the blood supply line for supplying blood stored in the main reservoir, and a pump provided in the blood supply line for adding oxygen to blood flowing through the blood supply line and removing carbon dioxide gas An artificial lung, placed above the main reservoir,
A plurality of sub-reservoirs capable of aspirating and storing blood with a negative pressure inside, a blood suction line connected to each of the plurality of sub-reservoirs, and guiding blood supplied into the plurality of sub-reservoirs to the main reservoir A guide means and a controller for independently adjusting the negative pressure in each of the plurality of sub-reservoirs are provided.

Furthermore, in the above-described heart-lung machine, the plurality of sub-reservoirs have a hydrophobic film inside, and blood is sucked through the hydrophobic film.

In the above-described artificial heart-lung machine, a check valve may be provided between the plurality of sub-reservoirs and the main reservoir separately from the respective reservoirs, or a check valve may be provided integrally with the plurality of sub-reservoirs. Preferably, the main reservoir is connected to the main reservoir, or a check valve is provided integrally with the main reservoir and connected to the plurality of sub-reservoirs.

[0012]

Next, a heart-lung machine of the present invention will be described.
Description will be made based on the embodiment shown in the drawings. 1 and 2
1 shows an embodiment employing the present invention. FIG. 1 is a schematic block diagram of a heart-lung machine, and FIG. 2 is a structural diagram of a sub-reservoir with a check valve.

As shown in FIG. 1, a main body 1 of the heart-lung machine according to the present invention comprises a main reservoir 5, a pump 6, an artificial lung 7, an arterial filter (not shown), and four sub-reservoir valves for a check valve. 12 (aortic vent reservoir 12 described below)
a, left atrial-left ventricular reservoir 12b, first suction reservoir 12c, second suction reservoir 12
d), a controller 8 for independently adjusting the negative pressure in the main reservoir 5 and the four sub-reservoirs 12, and each component of the apparatus body 1 of the heart-lung machine is
It is incorporated in a dedicated gantry (not shown) arranged near an operation bed (not shown). Although not shown in the present embodiment, a myocardial protection circuit for performing myocardial protection and a filtration circuit for performing ultrafiltration on a part of blood are connected.

The main reservoir 5 is a closed container for temporarily storing blood of a patient. A blood removal line 9 connected to the vein side of the patient's heart is connected to the upper portion of the main reservoir 5 to perform siphon action due to the weight of the blood in the blood removal line 9 and a negative pressure in the main reservoir 5. Due to the pressure (suction negative pressure by the action of the pump 6 and negative pressure regulated by the controller 8), blood on the venous side of the heart is supplied into the main reservoir 5. At the lower end of the main reservoir 5, a blood supply line 10 for returning the blood stored therein to the artery side of the patient's heart is connected. The blood supply line 10 has a pump 6, an artificial lung 7, and an arterial filter ( (Not shown).

In the figure, a bypass tube 3 which connects the blood removal line 9 and the blood supply line 10 and is provided so as to bypass the components of the apparatus body 1 is connected to the apparatus body 1.
Is closed by Konko 4 or the like when using.

The pump 6 is provided in the blood supply line 10 to aspirate the blood stored in the main reservoir 5 and send it to the patient via the artificial lung 7 and the arterial filter. A centrifugal pump is used. The centrifugal pump 6 applies a centrifugal force to blood by rotating and driving a rotor having a substantially conical shape by a motor (not shown), and sends out blood using the viscosity of the blood.

The oxygenator 7 is provided in the blood supply line 10 and controls the temperature of the blood sent to the patient appropriately. The oxygenator 7 adds oxygen to the blood sent to the patient and removes carbon dioxide. And a gas exchange unit 7b.

The arterial filter is provided in the blood supply line 10 through which the blood that has passed through the pump 6 and the artificial lung 7 flows, and includes coagulated blood, fine impurities, air bubbles, etc. contained in the blood returned to the patient. Is to remove.

The four sub-reservoirs 12 (12a, 12a)
b, 12c, 12d) are sealed containers capable of storing blood therein, which are disposed above the main reservoir 5 and are used for aortic vent reservoirs for sucking blood stagnated in the aorta.
A reservoir 12b for aspirating blood stagnated in the left atrium and left ventricle, and a first suction for aspirating blood bleeding outside the pericardium covering the heart. It comprises a reservoir 12c and a second suction reservoir 12d for aspirating blood bleeding into the pericardium.

The four sub-reservoirs 12a, 12b,
Each of 12c and 12d has a suction line 13 (13a, 13a, 1b) for guiding the patient's blood into each sub-reservoir 12.
3b, 13c, and 13d) are continued, and the suction into the sub reservoir 12 is performed through the hydrophobic film 14 provided in the sub reservoir 12, as shown in FIG. As the hydrophobic film 14, a film (membrane or the like) that allows only gas such as air to pass without passing liquid such as blood is used. In each of the sub-reservoirs 12, a sub-filter 15 for removing bone fragments and solids introduced from the respective suction lines 13 is provided.

At the lower part of the sub-reservoir 12, there is provided a roto-shaped guide means 16 for guiding the blood supplied into each of the sub-reservoirs 12a, 12b, 12c and 12d to the lower main reservoir 5. I have. Further, a check valve 17 is provided further below the sub reservoir.

The check valve 17 is connected to each of the sub-reservoirs 12a, 1
It is provided separately or integrally with each reservoir between 2b, 12c, 12d and the main reservoir 5. Also, a check valve 17 is provided integrally with these four sub-reservoirs 12,
Connect to main reservoir 5 or main reservoir 5
And a check valve 17 is provided integrally with the plurality of sub reservoirs 12. Further, the apparatus main body 1 is configured by integrally providing the sub reservoir 12, the check valve 17 and the main reservoir 5.

The four sub-reservoirs 12a, 12
b, 12c, and 12d each have three negative pressure lines 11
Is connected to the controller 8 via the. That is,
The controller 8 comprises two sub reservoirs 1 for venting.
Negative pressure is applied to each of the insides 2a and 12b independently, and the negative pressure in the two suction sub-reservoirs 12c and 12d is adjusted collectively. The circuit of the negative pressure line 11 of the controller 8 is increased to independently adjust the negative pressure of the suction sub-reservoirs 12c and 12d, and also adjust the negative pressure in the main reservoir 5. You may be able to.

The controller 8 includes a connection tube (not shown) connected to a negative pressure source provided on a wall surface of an operating room or the like, a vacuum pump, or the like, and is connected via the connection tube. The sub-reservoirs 12a, 12b,
The negative pressure in each of the reservoirs 12c and 12d is, for example,
Adjust within the range of 0 to 50 mmHg. In addition, control
As a negative pressure source to be supplied to the controller 8, a negative pressure source provided on a wall or the like of an operating room, a separate negative pressure generator may be used, or a negative pressure may be provided in the controller 8. A generator may be incorporated.

The controller 8 adjusts the negative pressure by connecting a target reservoir and a circuit in accordance with each circuit of the reservoir for which the negative pressure is to be adjusted. Control
Since the specifications such as the negative pressure and the operation method in each circuit of La 8 are all the same, the connection of each reservoir can be changed as appropriate according to the use situation.

Further, a controller (not shown) for controlling the negative pressure of each of the reservoirs 12a, 12b, 12c and 12d in the controller 8 can set the negative pressure in a stepless manner. It has a display unit (not shown) for displaying the flow rate indicating the suction state.

Next, the main body 1 of the heart-lung machine of the present invention.
Is operated, the function of the apparatus main body 1 is operated by operating the artificial lung 7 and the like composed of the pump 6, the controller 8, the temperature control section 7a, and the gas exchange section 7b.

When the apparatus main body 1 is operated, a siphon action due to its own weight of blood, a suction negative pressure of the pump 6 and a suction negative pressure of the controller 8 are performed from the blood removal line 9 connected to the vein side of the patient's heart. Due to the negative pressure in the main reservoir 5, the removed blood is guided into the main reservoir 5, and the blood is stored in the main reservoir 5.

On the other hand, the aortic vent control section, the left atrial-left ventricular vent control section, and the respective suction control sections of the control section of the controller 8 are set to a negative pressure, respectively. Sub reservoir 1 of vent reservoir 12a, left atrial-left ventricular vent reservoir 12b, and suction reservoirs 12c, 12d
The inside of 2 becomes the set negative pressure.

Then, blood stagnated in the aorta, blood stagnated in the left atrium and left ventricle, blood bleeding out of the pericardium covering the heart, and blood bleeding in the pericardium are supplied to the respective suction lines 13a. , 13b, 13c, 13d, reservoir 12a for aortic vent, reservoir for left atrium-ventricular vent
It is sucked into the bath 12b and the suction reservoirs 12c and 12d.

And an aortic vent reservoir 12a,
The blood guided into each of the left atrial / left ventricular vent reservoir 12b and the suction reservoirs 12c and 12d passes through the respective sub-filters 15 to remove solids, and then is temporarily stored in the sub-reservoir 12 It is stored inside, and then guided into the main reservoir 5 via the guide means 16 and the check valve 17.

The blood stored in the main reservoir 5 is guided to a blood supply line 10 and sent out to the patient's arterial side by a centrifugal pump 6 provided in the blood supply line 10, and a temperature control section 7 a of the oxygenator 7. After the temperature is adjusted to a suitable temperature, oxygen is added to the blood sent to the patient in the gas exchange section 7b, and gases such as carbon dioxide are further removed. During the operation of the heart-lung machine of the present invention, the above-described operations are continuously performed.

Next, the operation of the above embodiment will be described. Blood supplied from the blood removal line 9 is stored in the main reservoir 5. On the other hand, the inside of each of the sub-reservoirs 12a, 12b, 12c, and 12d is made negative pressure by the controller 8, so that blood (bleeding to the operative field) is drawn by the suction line 13 without passing through an external pump as in the related art. Blood, blood stagnated in the heart, the heart, the aorta, etc.) is stored in each of the sub-reservoirs 12a, 12b, 12c, 12d.
Supplied directly into The blood supplied into the sub-reservoir 12 passes through the check valve 17 via the guide means 16 and is guided to the main reservoir 5.

The blood stored in the main reservoir 5 is thereafter led to a blood supply line 10. In the blood supply line 10,
A centrifugal pump 6 and an artificial lung 7 are provided. Blood is sent by the centrifugal pump 6, and the sent blood adds oxygen to blood flowing through the blood sending line 10 by the artificial lung 7, The gas that has been removed and gas exchanged is sent to the patient.

Further, the apparatus body 1 of the heart-lung machine according to the present embodiment can remove blood bleeding into the operation field or blood stagnating in the heart, aorta, etc. without using an external pump as in the prior art. Can be directly sucked into the sub-reservoir 12,
The structure of each of the sub-reservoirs 12a, 12b, 12c, and 12d is such that the suction connection port 18 sucks the water through a hydrophobic film 14 such as a membrane.
Even if the inside is filled with blood, it is not necessary to cut off the suction circuit because the blood does not enter the suction line 13. When blood is filled in the sub-reservoir 12, by setting the installation height of the sub-reservoir 12 lower than the operation field height, it is possible to immediately perform suction by the siphon effect.

Therefore, when there is air in the sub-reservoir 12, blood is sucked into the sub-reservoir 12 by the negative pressure set by the controller 8, and when blood is filled in the sub-reservoir 12, the sub-reservoir 12 -Ba 12
By setting the installation height lower than the operation field height, suction is performed by the head due to the siphon effect as described above, and as a result, continuous suction is possible.

Further, as described above, by providing the hydrophobic membrane 14 in the sub-reservoir 12, blood does not enter the suction line 13, so that the safety of the heart-lung machine can be further improved and the main reservoir can be improved. The negative pressure in each of the reservoirs including the pressure 5 can be set at a low negative pressure that can be suctioned from the operative field, and does not need to be constantly monitored unlike a conventional external pump, so that the burden on the operator can be reduced. , Operation can be simplified.

Further, the use of the hydrophobic membrane 14 makes it possible to make the sub-reservoir 12 simpler and smaller, and as a result, the whole body 1 of the heart-lung machine can be made smaller, so that the cost is reduced. Can be.

In the main reservoir 5, when the negative pressure in the reservoir 5 is provided so as to be controllable by the controller 8, the four sub-reservoirs 12a, 12b, 12c, 1
When the blood stored in the 2d is sent to the main reservoir 5, the controller 8 increases the falling speed of the blood, and further adjusts the negative pressure in the main reservoir 5, thereby bleeding into the operation field sucked into the main reservoir 5. Extracorporeal circulating blood, such as collected blood and blood stagnated in the heart sac, heart, aorta, etc., can be sent quickly, and the extracorporeal circulating blood volume can be reduced, resulting in a burden on the patient. Can be reduced.

Further, the negative pressure in the sub-reservoir 12 is set to a pressure different from the pressure in the main reservoir 5 (sub-reservoir 1).
2 is made lower than the internal pressure of the main reservoir 5. If a check valve 17 is provided between the main reservoir 5 and the sub reservoir 12 separately from the main reservoir 5 so as to be adjustable, the check valve 17 separates the main reservoir 5 from the sub reservoir 1.
Because it can prevent blood from flowing back to 2,
The negative pressure in the sub reservoir 12 can be controlled precisely.

The check valve 17 may be provided integrally with the plurality of sub reservoirs 12, may be provided integrally with the main reservoir 5, or may be provided integrally with the sub reservoir 12 and the check valve 17 and the main reservoir. By integrally providing 5, the device body 1 of the heart-lung machine can be made simple and compact. Therefore, the visibility and operability of the operator can be improved.

Further, by providing the sub-filter 15 for removing bone fragments and solid matter in the sub-reservoir 12, the blood in the sub-reservoir 12 is surely guided into the main reservoir 5 provided at the lower part. In addition, the check valve 17 and the guide means 1
6, the possibility of clogging with bone fragments and solid matter can be reduced.

In this embodiment, the negative pressure lines 11c and 11d connected to the suction reservoirs 12c and 12d are used.
d is controlled collectively by the controller 8, but the number of circuits of the negative pressure line of the controller 8 is changed,
The negative pressure may be controlled individually for each reservoir,
The adjustment of the negative pressure of one sub-reservoir 12a, 12b, 12c, 12d may be controlled collectively, or may be divided into groups and controlled for each group.

[0044]

As is evident from the above, according to the present invention, the heart-lung machine of the present invention can be made compact, so that a smooth operation can be performed, and furthermore, the safety is high. There are excellent effects such as providing a small-sized artificial heart-lung machine with small burden on the patient, excellent visibility and operability, and reduced cost.

[Brief description of the drawings]

FIG. 1 is a schematic view showing an example of a heart-lung machine of the present invention.

FIG. 2 is a longitudinal sectional view of a sub reservoir in FIG.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Main body 5 Main reservoir 6 Pump 7 Artificial lung 8 Controller 9 Blood removal line 10 Blood supply line 12 Sub reservoir 13 Suction line 14 Hydrophobic membrane 16 Guide means 17 Check valve

 ────────────────────────────────────────────────── ─── Continued on the front page (72) Inventor Manabu Hiroura 3363-4 Tamagawa Kodomi, Chino City, Nagano F-term (reference) 4C077 AA02 BB06 DD08 DD11 DD13 DD26 EE01 KK23 KK25

Claims (6)

[Claims] 1. A main reservoir that is provided so as to be able to store blood supplied from a blood removal line and guides the stored blood to a blood supply line, and is provided in the blood supply line and stored in the main reservoir. A pump for sending blood, an artificial lung provided on the blood sending line, for adding oxygen to blood flowing through the blood sending line and removing carbon dioxide gas,
A plurality of non-return valve-equipped sub-reservoirs disposed above the main reservoir and capable of suctioning and storing blood by applying a negative pressure to the inside thereof, and blood suction connected to each of the plurality of sub-reservoirs; A line, guide means for guiding blood supplied into the plurality of sub-reservoirs to the main reservoir,
A heart-lung machine having a controller for independently adjusting the negative pressure in each of the plurality of sub-reservoirs. 2. The heart-lung machine according to claim 1, wherein the plurality of sub-reservoirs have a hydrophobic film inside, and blood is sucked through the film. 3. The heart-lung machine according to claim 1, wherein a check valve is provided between the plurality of sub-reservoirs and the main reservoir separately or integrally with each of the reservoirs. An artificial heart-lung machine, comprising: 4. The artificial heart-lung machine according to claim 1, wherein a check valve is provided integrally with said plurality of sub-reservoirs and connected to said main reservoir. apparatus. 5. The artificial heart-lung machine according to claim 1, wherein a check valve is provided integrally with said main reservoir and connected to said plurality of sub-reservoirs. apparatus. 6. The artificial heart-lung machine according to claim 1, wherein said plurality of sub-reservoirs, a check valve and said main reservoir are provided integrally.