JP2000245829A - Artificial cardiopulmonary device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To reduce burden applied to a patient by connecting a bubble removing chamber to the downstream side of a suction pipe that sucks and collects blood emitted in an operation site and connecting a negative pressure device that keeps the interior of the bubble removing chamber at a negative pressure to the bubble removing chamber. SOLUTION: A negative pressure device 16 that keeps the interior of a bubble removing chamber 14 at a negative pressure is disposed on the top portion of the bubble removing chamber 14 that stores temporarily blood and removes bubbles, and a negative pressure device 17 that keeps the interior of a vein reservoir 15 at a negative pressure is disposed on the top portion of the vein reservoir 15 that stores temporarily blood from the bubble removing chamber 14 and venous blood removed from a patient H by a venous line 11, and the negative pressure devices 16 and 17 are connected to a negative pressure source 18. When using the artificial cardiopulmonary device, a suction line 13 is inserted into an operation site of the patient H, and if blood suction is necessary, an operator holds a grip and compresses the grip compression section. Then the compressive force is transmitted to the negative pressure device 16 through a grip compression line 19 from a grip compression section, the negative pressure device 16 generates a negative pressure corresponding to the strength of the compressive force in the bubble removing chamber 14 for suction of blood.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a heart-lung machine for use in cardiac surgery and the like.

[0002]

2. Description of the Related Art For example, in cardiac surgery, it is necessary to temporarily block blood flowing into and out of the heart and the like. In order to maintain blood circulation throughout the whole body, an artificial heart pump and an artificial lung equipped with an artificial heart are used. Cardiopulmonary devices are used.
FIG. 7 shows an example of such a conventional heart-lung machine.

[0003] This artificial heart-lung machine includes a suction line 3 and a vent line 4 in addition to a venous line 1 and an arterial line 2 for directly receiving and circulating blood flowing into and out of the heart and the like. The suction line 3 and the vent line 4 mainly prevent blood bleeding in the surgical field from covering the lesion and becoming invisible, making it impossible to continue the operation, and minimizing blood loss due to bleeding. The purpose is to collect the blood in order to keep it. Reference numeral 5 denotes an apparatus main body, which includes a plurality of roller pumps 6 for generating negative pressure for suctioning each line of suction and vent, and a cardio for defoaming, filtering and temporarily storing blood passing through the roller pumps 6. It consists of a Tommy reservoir 7, a venous reservoir R for temporarily storing venous blood, a roller pump 6 'for sending blood to the patient, a gas exchange oxygenator OX with a built-in heat exchanger for temperature control, and a cold / hot water tank W. Have been.

[0004]

By the way, because of the use of the roller pump 6, the above-described artificial heart-lung machine uses the blood coming out of the patient H placed on the operating table B having a height from the floor surface. Before the blood is introduced into the cardiotomy reservoir 7, it is necessary to guide the blood to the floor where the roller pump 6 is located, so that the suction line 3 and the vent line 4 become long. In addition, cardiotomy reservoir 7
Has a certain height from the floor in order to send the blood sucked at the pressure drop to the venous reservoir R via the suction line 3 ", so that the blood exiting the roller pump 6 It is necessary to be guided again by a plurality of suction lines 3 'to the level at which the reservoir 7 is located, since the length of the venous line 1 has been drained from the patient to the venous blood reservoir R using the head. Need a length plus α to guide from the operating table to near the floor,
Since the length of the arterial line 2 is to be transmitted to the patient by gas exchange of the venous blood, the length of the artery line 2 also needs to be added to the length from the floor surface to the operating table plus α.

[0005] As described above, since blood is evacuated using a head and must pass through the roller pump 6 on the floor, the venous line 1 and the arterial line 2, which are paths through which the blood flows, are provided. Since the length of each line such as the suction line 3, vent line 4, and each suction line 3 'becomes long, a lot of blood remains in each line along with the length. Further, the vein line 1 and the arterial line 2 have large inner diameters in order to reduce pressure loss, so that the volume of space in the flow path is large, so that a large amount of blood tends to remain inside. ing.
For these reasons, the amount of blood taken out from the patient H is increased, so that there is a problem that a burden is easily applied to the body of the patient H. Another problem of the heart-lung machine is that a large area is occupied on the floor because a plurality of roller pumps 6 are used. In addition, since blood and air are in contact with the suction line 3, it is bad for the patient that the blood damage is long.

The heart-lung machine of the present invention has been made in view of the above circumstances, and has the following objects.
That is, it is an object of the present invention to provide a heart-lung machine that can minimize the amount of blood taken out of a patient's body and reduce blood damage during cardiac surgery or the like, thereby reducing the burden on the patient. It is another object of the present invention to provide a heart-lung machine that occupies as little space as possible on the floor.

[0007]

Means for Solving the Problems The heart-lung machine of the present invention employs the following means to solve the above problems.
That is, an artificial heart-lung machine according to claim 1 is an artificial heart-lung machine used for cardiac surgery or the like, comprising: a suction tube for sucking and collecting bleeding in an operation field; and a defoaming chamber connected to a downstream side of the suction tube. And a first negative pressure device connected to the defoaming chamber to maintain the inside thereof at a negative pressure.

[0008] According to the heart-lung machine of the first aspect, the blood is directly guided into the defoaming chamber which is made negative by the first negative pressure device, without passing through a conventional roller pump. Therefore, since it is not necessary to temporarily drop the blood flow to the floor, the length of each line such as a suction line through which the blood flows can be shortened.

According to a second aspect of the present invention, there is provided an artificial heart-lung machine.
In the cardiopulmonary bypass device according to the above, a venous reservoir for temporarily storing blood from the defoaming chamber and venous blood from a patient is connected below the defoaming chamber, and the vein reservoir has an internal portion. A second negative pressure device is connected to maintain negative pressure, and the first negative pressure device sets the pressure in the defoaming chamber to P
1. If the pressure in the venous reservoir is P2, P2
It is characterized by having a pressure regulation function of adjusting P1 so as to satisfy <P1.

According to the second aspect of the present invention, the pressure in the defoaming chamber is maintained at a negative pressure by the first negative pressure device, and the pressure in the venous reservoir is maintained at the negative pressure by the second negative pressure device. It is. In addition, blood is removed by the pressure P2, and a head is not required, the venous reservoir can be arranged at the height of the operating table, and the venous line and the like can be shortened. Then, a pressure difference of P2 <P1 is always maintained by the pressure adjusting mechanism between the internal pressures. Due to this pressure difference, the blood accumulated in the lower part in the defoaming chamber can flow smoothly into the vein chamber without backflow.

According to a third aspect of the present invention, there is provided an artificial heart-lung machine.
The heart-lung machine according to claim 1, wherein the defoaming chamber includes:
A blood level meter for measuring a blood level is provided, and between the defoaming chamber and the venous reservoir, the flow of blood from the defoaming chamber to the venous reservoir is determined based on a value indicated by the blood level meter. A switch for permitting or blocking is provided.

According to the third aspect of the present invention, when the blood level meter confirms that the blood level in the defoaming chamber has reached a preset upper limit blood level, the switch is activated. Is opened and blood flows from the defoaming chamber to the vein. When it is confirmed by the blood level meter that the preset lower limit blood level has been reached, the switch is closed to stop the blood flow. Thus, the blood in the defoaming chamber does not overflow during aspiration, and automatically flows to the venous reservoir. This makes it possible to adjust P1 and P2 independently while maintaining the relationship of P2 <P1 between the adjustment of the suction speed by P1 and the adjustment of the blood removal speed by P2. Further, since P1 can be adjusted with a negative pressure weaker than P2, it is not necessary to increase the suction speed by P1 more than necessary, so that drying of blood in the suction line can be prevented and blood damage can be reduced.

[0013]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS An embodiment of the present invention will be described below with reference to the drawings. The heart-lung machine according to the present embodiment is used, for example, in cardiac surgery. As shown in FIG. 1, the heart-lung machine is used to aspirate a venous line 11 that removes blood from the vena cava of a patient H and a bleeding in a surgical field. And the downstream side of the suction line 13 is connected to the upper part to temporarily store blood therefrom and defoam. A defoaming chamber 14 to be operated, and a defoaming chamber 1 connected below and downstream of the defoaming chamber 14.
4 and a venous reservoir 15 for temporarily storing the venous blood removed from the patient H via the venous line 11.

Further, the above-mentioned heart-lung machine is connected to the upper part of each defoaming chamber 14 to keep the inside at a negative pressure, and connected to the upper part of the venous reservoir 15 to make the inside thereof negative pressure. , And each of the negative pressure devices has a function of setting a negative pressure in each of the defoaming chamber 14 and the venous reservoir 15. The negative pressure referred to here indicates a pressure lower than the atmospheric pressure. Each of the first negative pressure device 16 and the second negative pressure device 17 includes:
A negative pressure source 18 is connected, which is
By suctioning the air in the vein reservoir 15 separately, the respective negative pressures are formed. The negative pressure source 18 may be a negative pressure source provided on the wall of the operating room or an independent suction pump. It is also conceivable that the suction pump is built in the negative pressure device. In addition, downstream of the vein reservoir 15, a pump oxygenator for sending blood passing therethrough, an arterial line for returning blood to the patient, and the like are connected. In FIG. These are omitted.

The operator side of each suction line 13 is a suction tube, and is provided with a grip for holding the suction tube by hand. A grip pressing portion (not shown) for transmitting to the negative pressure device 16 is provided. Thus, by increasing or decreasing the gripping force of the grip pressing portion, this is transmitted to the first negative pressure device 16 via the grip pressure line 19, and the negative pressure in the first negative pressure device 16, that is, the defoaming chamber 1
The negative pressure in 4, that is, the suction speed can be adjusted. Further, the blood removal speed of the venous line 11 can be adjusted by the negative pressure in the second negative pressure device 17, that is, the negative pressure in the venous reservoir 15.

Each of the defoaming chambers 14 is, for example, 200 to 6
It is a container having a capacity of about 00 ml, and is provided with a blood level meter 20 for measuring a blood level. And
Between each defoaming chamber 14 and the venous reservoir 15, based on the indicated value of the blood level meter 20, each defoaming chamber 14 is provided.
A switch 21 having a function of permitting or blocking the flow of blood from the vein reservoir 15 to the vein reservoir 15 is provided. FIG.
As shown in the figure, each defoaming chamber 14 and each switch 21
Is provided for each suction line 13. The same applies to the first negative pressure device 16 and the suction line 1
Three units are provided according to the number of three units.

The blood level meter 20 shown in FIG. 1 detects an upper limit blood level which is an upper limit of a blood level and a lower limit blood level which is a lower limit of the blood level. The switch 21 is interlocked so that the blood level is located at the first position.

That is, when it is confirmed by the blood level meter 20 that the blood level in the defoaming chamber 14 has reached the upper limit blood level, the switch 21 is opened to move the defoaming chamber 14 to the vein reservoir 15. Blood flows. If it is confirmed by the blood level meter 20 that the blood level has reached the lower limit blood level, the switch 21 is closed to stop the flow of blood. Thus, the blood in the defoaming chamber 14 automatically flows to the vein reservoir 15 without overflowing during the suction.

The venous reservoir 15 is a container having a built-in blood suction filter 22 therein. The venous reservoir 15 is, for example, -100 mmHg so as to withstand the negative pressure applied by the second negative pressure device 17 for adjusting the blood removal rate instead of the differential pressure. It has a strength that does not cause any problem even if a certain degree of negative pressure is applied inside. In addition,
The blood that has passed through the defoaming chamber 14 and the switch 21 always passes through the suction blood filter 22 (shown in FIG. 1). The suction blood filter 22 may be incorporated in each defoaming chamber 14. In addition, each first negative pressure device 16
Sets the pressure in each defoaming chamber 14 to P1, the second negative pressure device 1
When the pressure in the vein reservoir 15 by P7 is P2,
A pressure adjusting function is provided for adjusting P1 so that P2 <P1. As described above, adjustment of the suction speed by P1 and P2
Adjustment of the blood removal rate by P while maintaining the relationship of P2 <P1
1 and P2 can be adjusted independently of each other.

The plurality of negative pressure devices shown in FIG. 3 are three first negative pressure devices for setting and displaying the negative pressure in each of the defoaming chambers 14 and setting and displaying the upper limit blood level. The setting devices 25, 26, and 27 and the vein reservoir setting device 28, which is a second negative pressure device for setting and displaying the negative pressure in the venous reservoir 15 and setting and displaying the blood storage amount alarm, are unitized. Things. Each is provided with negative pressure display sections 16a and 17a for displaying each negative pressure in the defoaming chamber 14 and the vein reservoir 15 in real time, and input sections 16b and 17b for inputting each set negative pressure. .

Further, an upper blood level setting display section 16c for displaying the upper blood level setting value and an upper blood level setting are input to the defoaming chamber setters 25, 26 and 27 which are the first negative pressure devices. Upper limit blood level setting unit 16d
And each is provided. The venous reservoir setting device 28, which is the second negative pressure device, has a blood storage amount display unit 17e that displays the blood storage amount in real time, and an input unit 17f that sets and inputs a lower limit alarm of the blood level in the vein reservoir 15.
And blood level alarm set value display section 17g for displaying the
And are provided. Reference numerals 16h and 17h are power switches.

By adopting the above-described configuration, the heart-lung machine of the present embodiment is partially provided to the vicinity of the patient H lying on the operating table B as shown in FIGS. Can be approached. In other words, since a conventional roller pump that is installed on the floor surface is unnecessary,
As shown in FIG. 4, the installation position can be raised to the height of the patient H by reducing the size of the device, and a part of the device is also removed from the patient because the suction roller pump is not necessary even in a planar arrangement. It can be approached.

A method for sucking blood from a surgical field using the heart-lung machine having the above-described configuration will be described below. First,
The suction line 13 is inserted into the operation field of the patient H, and when blood suction is required, the operator grasps the grip and presses the grip pressing portion. Then, the compression pressure is transmitted from the grip compression unit to the first negative pressure device 16 via the grip pressure line 19. Then, the first negative pressure device 16
Generates a negative pressure in the defoaming chamber 14 in accordance with the strength of the compression pressure to suck blood. This suction force can be adjusted by the strength of the compression pressure. In other words, the operator can obtain a suction at a necessary suction speed when necessary.

Also, the first negative pressure device 16 can be set so that a slight negative pressure is always maintained even when the grip is not pressed, so that the suction port of the suction line 13 only needs to be brought into contact with the operating field. It is also possible to continuously suck a small amount of blood. What is important here is that since a relatively large flow rate is not suctioned unless the grip pressing portion is pressed, it is possible to prevent the blood from being dried and damaged by continuing to inhale a large amount of air. Is a point.

The blood is stored in the defoaming chamber 14, and when the blood reaches the upper limit blood level, the switch 21 is opened, and the stored blood passes through the suction blood filter 22 and is guided into the venous reservoir 15. . And the defoaming chamber 14
When the blood level in the inside falls to the lower limit blood level, the switch 21 is closed. At this time, the blood in the defoaming chamber 14 does not become empty, and a small amount of blood remains at the lower part. In addition, since the switch 21 is closed, the above-described pressure difference of P2 <P1 is maintained between the defoaming chamber 14 and the vein reservoir 15. Thereby, the operator gives a necessary suction speed while maintaining the relationship of P2 <P1, and obtains a necessary venous blood removal speed.

According to the heart-lung machine of the above-described embodiment, the first negative pressure device 16 is employed in place of the conventional suction roller pump, and this is connected to the defoaming chamber 14, so that each line such as the suction line 13 is provided. The length can be shortened, and a second negative pressure device is adopted instead of the conventional bleeding of venous blood using a head, and this is connected to a venous reservoir, thereby shortening each line length such as the venous line 11. Therefore, it is possible to provide an artificial heart-lung machine capable of reducing the amount of blood taken out of the patient as much as possible and reducing the burden on the patient with less blood damage. In addition, since a plurality of suction roller pumps as in the related art are not required, it is possible to provide an artificial heart-lung machine having as small an area occupied on the floor as possible. Although not shown, it is desirable to use a centrifugal pump using an external motor or the like as the blood feeding pump in order to further reduce the length of the arterial line and the like and make the heart-lung machine smaller.

A second negative pressure device 17 different from the first negative pressure device 16 connected to the defoaming chamber 14 is connected to the vein reservoir 15.
And the pressure P1 in the defoaming chamber 14 is increased by the pressure regulating function of the first negative pressure
By maintaining the pressure higher than that of the venous reservoir 15, the height between the defoaming chamber 14 and the vein reservoir 15 is increased in order to provide a pressure difference between the defoaming chamber 14 and the venous reservoir 15, as in the conventional case. Since it is not necessary to provide the blood, the length of the line for removing blood from the defoaming chamber 14 to the venous reservoir 15 can be shortened and the inner diameter can be reduced, so that the amount of blood taken out of the patient's body can be further reduced and the burden on the patient can be reduced. It is possible to further reduce.

According to the calculation by the inventor, for example, in a conventional artificial heart-lung machine, a line on the blood removal side is 2 m in length and 1 / inner diameter.
2 inches, the line on the blood sending side is 2m in total length and 3 /
In the case of 8 inches, the total blood volume in the line on the blood removal side and the blood supply side is about 395 ml (the blood removal side is about 253 ml,
The blood sending side is about 142 ml). In contrast, in the heart-lung machine of the present embodiment, the line on the blood removal side has an inner diameter of 3/8 inch at a total length of 1 m, and the line on the blood supply side has a total length of 1 m.
And the total blood volume in the line on both the blood removal side and the blood supply side is about 142 ml (about 7 ml on the blood removal side).
With 1 ml, the blood sending side is about 71 ml). Therefore,
The difference between the two is 395 ml-142 ml = 253 ml,
Significant blood volume reduction is possible.

The defoaming chamber 14 and the venous reservoir 1
A switch 21 is provided between the vein reservoir 5 and the vein reservoir 15 automatically without overflowing the blood in the defoaming chamber 14 by opening and closing the switch based on the value indicated by the blood level meter 20. Flows. In addition, since P1 can be set to be weaker while maintaining the relationship of P2 <P1, the suction speed can be adjusted appropriately, and more air than necessary can be prevented from flowing into the suction line, so that the blood is dried and damaged by the flow of air. Can be prevented.

In the above embodiment, the blood level meter 20 measures the upper limit blood level which is the upper limit of the blood level,
Although a system that detects two points, that is, the lower limit blood level, which is the lower limit, is employed, a pipe differential pressure system may be employed as shown in FIG. In this pipe differential pressure type blood level meter 20, the pressure applied to the air in the pipe changes according to the amount of blood in the defoaming chamber 14, so that a change in the pressure is read by a pressure sensor (not shown). The level is detected. Also, as shown in the figure, a similar pipe differential pressure type blood level meter 20 may be used for measuring the blood level in the vein reservoir 15.

[0031]

According to the heart-lung machine of the present invention, the first negative pressure device is employed in place of the conventional roller pump for suction, and is connected to the defoaming chamber, so that the suction line and the like through which blood flows can be provided. The length of each line can be shortened, and a second negative pressure device is used instead of the conventional bleeding of venous blood using a head, and this is connected to a venous reservoir, so that the length of each line such as the venous line 11 can be reduced. Therefore, it is possible to provide an artificial heart-lung machine capable of minimizing the amount of blood taken out of the patient's body and reducing the burden on the patient. In addition, since a plurality of suction roller pumps as in the related art are not required, it is possible to provide an artificial heart-lung machine having as small an area occupied on the floor as possible.

Further, a second negative pressure device, which is different from the first negative pressure device connected to the defoaming chamber, is connected to the venous reservoir, and the pressure P1 in the defoaming chamber is adjusted by the pressure regulating function of the first negative pressure device. By always keeping the pressure higher than the internal pressure P2, the height between the defoaming chamber and the vein reservoir is increased in order to provide a differential pressure between the defoaming chamber and the venous reservoir as in the conventional case. There is no need to provide it, and the length of the blood removal line for removing blood from the defoaming chamber to the venous reservoir can be shortened and the inner diameter can be reduced, so that the amount of blood taken out of the patient's body can be further reduced and the burden on the patient can be reduced. It is possible to further reduce.

Further, a switch is provided between the defoaming chamber and the venous reservoir so as to open and close based on the indication value of the blood level meter, so that the blood in the defoaming chamber does not overflow. Automatically flows into vein reservoir. In addition, since P1 can be set to a relatively small value while maintaining the relationship of P2 <P1, the suction speed can be appropriately set, so that more air than necessary can be prevented from flowing into the suction line instead.
It is possible to prevent the blood from drying and being damaged by the flow of air.

[Brief description of the drawings]

FIG. 1 is a diagram illustrating an embodiment of the present invention, and is a schematic configuration diagram of a main part of a heart-lung machine.

FIG. 2 is a perspective view showing a main part of the heart-lung machine.

FIG. 3 is a front view showing a main part of the heart-lung machine.

FIG. 4 is a side view showing a use state of the heart-lung machine.

FIG. 5 is a plan view showing a use state of the heart-lung machine.

FIG. 6 is a view showing a modification of the embodiment of the heart-lung machine, and is a schematic configuration diagram of a main part.

FIG. 7 is a perspective view showing a conventional heart-lung machine.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 13 ... Suction line (suction pipe) 14 ... Defoaming chamber 15 ... Venous reservoir 16 ... 1st negative pressure device 17 ... 2nd negative pressure device 20 ... Blood level meter 21 ... Switch H ... Patient

Claims (3)

[Claims] 1. An artificial heart-lung machine for use in cardiac surgery or the like, comprising: a suction tube for sucking and collecting bleeding from an operation field; a defoaming chamber connected downstream of the suction tube; and a connection to the defoaming chamber. And a first negative pressure device for maintaining the inside of the device at a negative pressure. 2. The heart-lung machine according to claim 1, wherein a venous reservoir for temporarily storing blood from the defoaming chamber and venous blood from a patient is connected below the defoaming chamber, The venous reservoir is connected to a second negative pressure device that keeps the inside thereof at a negative pressure, and the first negative pressure device sets the pressure in the defoaming chamber to P1,
When the pressure in the venous reservoir is P2, P2 <P
An artificial heart-lung machine having a pressure adjusting function of adjusting P1 to be 1. 3. The heart-lung machine according to claim 2, wherein a blood level meter for measuring a blood level is provided in the defoaming chamber, and the blood is provided between the defoaming chamber and the vein reservoir. An artificial heart-lung machine, comprising a switch for permitting or blocking the flow of blood from the defoaming chamber to the venous reservoir based on a level meter reading.