JP2010063644A - Blood purifying apparatus - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a blood purifying apparatus capable of accurately monitoring the temporal variation of a blood index by appropriately setting an appropriate range considering the start-up time. <P>SOLUTION: The blood purifying apparatus comprises: a detecting means 5 for temporally detecting the blood index in a patient's blood extracorporeally circulating in a blood circuit 1; a storage means 12 for storing the temporal appropriate range of the blood index predicted to be detected by the detecting means 5 if appropriate; and a monitoring means 13 for temporally monitoring the blood index whether the blood index is within the appropriate range or not by comparing the stored appropriate range of the blood index with the blood index actually detected by the detecting means 5. The blood purifying apparatus sets the temporally appropriate range of the blood index stored in the storing means 12 after the elapse of the start-up time T1 till the temporal variation of the blood index detected by the detecting means 5 is stabilized, and makes the monitoring means 13 monitor the blood index. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to a blood purification apparatus for purifying a patient's blood while circulating it outside the body.

  In general, in blood purification therapy such as dialysis treatment, a blood circuit composed of a flexible tube is used to circulate a patient's blood extracorporeally. This blood circuit is mainly composed of an arterial blood circuit in which an arterial puncture needle for collecting blood from a patient is attached to the tip, and a venous blood circuit in which a venous puncture needle for returning blood to the patient is attached to the tip. The blood purification means (dialyzer) is interposed between the arterial blood circuit and the venous blood circuit to purify blood circulating outside the body.

  In such a dialyzer, a plurality of hollow fibers are arranged inside, and blood passes through the inside of each hollow fiber, and on the outside thereof (between the outer peripheral surface of the hollow fiber and the inner peripheral surface of the housing). It is set as the structure which can flow a dialysate. The hollow fiber has a blood purification membrane with micropores (pores) formed in the wall surface, and waste products of blood passing through the hollow fiber permeate the blood purification membrane and are discharged into the dialysate. At the same time, waste blood is discharged and purified blood returns to the patient's body. In the dialysis machine, a water removal pump for removing water from the patient's blood is disposed, and water removal is performed during dialysis treatment.

  However, when the amount of water to be removed (water removal amount) is large, it is necessary to increase the rate of water removal. Therefore, depending on the health condition of the patient, shock symptoms such as hypotension can often be caused. Conventionally, in order to grasp the signs of such shock symptoms, the hematocrit value of the patient's blood during dialysis treatment (volume fraction of blood cell components in the blood) is detected, and the change rate of the patient's circulating blood volume from this hematocrit value ( An apparatus for calculating and monitoring (ΔBV%) has been proposed.

That is, the rate of change in the circulating blood volume (ΔBV%) of a patient usually decreases with the lapse of treatment time due to water removal, but when a sudden decrease in ΔBV% occurs, shock symptoms such as hypotension Therefore, it is thought that it is possible to prevent shock symptoms in advance by performing some kind of treatment (such as fluid replacement or dialysis treatment) when the rapid decrease in ΔBV% occurs. Thus, for example, Patent Document 1 discloses a dialysis treatment apparatus capable of sequentially measuring a patient's hematocrit value during dialysis treatment and detecting the change rate (ΔBV%) of the patient's circulating blood volume from the hematocrit value. ing.
Japanese Patent Application Laid-Open No. 2004-97781

  However, in stable maintenance dialysis patients who have been undergoing dialysis treatment for a relatively long period of time, parameters such as the blood volume change rate ΔBV%, which are related to the concentration of blood circulating extracorporeally in the course of dialysis treatment, are usually measured in time series. It has been found that time series data (particularly standardized) obtained by measuring at a plurality of time points has reproducibility. Thus, the present applicant has studied a hemodialysis apparatus that can grasp in real time whether or not dialysis treatment is appropriate in the dialysis treatment process by using the reproducibility of time series data.

  However, in that case, immediately after the start of treatment (this is called “rise time”), patient-specific circumstances such as vascular access recirculation, hyponatremia, hypoproteinemia, or from standing to supine position. The blood index to be detected such as the hematocrit value may be unstable due to the treatment state such as the movement of water accompanying the change of body position. In this case, the reproducibility is lost. Thus, when the detected blood index is unstable, it becomes difficult to set an appropriate appropriate range.

  The present invention has been made in view of such circumstances, and by setting an appropriate range appropriately in consideration of the rise time, blood purification capable of accurately monitoring a change in blood index over time. To provide an apparatus.

  According to the first aspect of the present invention, there is provided a blood circuit comprising an arterial blood circuit and a venous blood circuit for circulating the patient's blood extracorporeally, and the blood connected between the arterial blood circuit and the venous blood circuit. Blood purification means for purifying blood flowing through the circuit, detection means for detecting blood indicators in the blood of a patient extracorporeally circulating in the blood circuit over time, and detection by the detection means if appropriate A storage means for storing an appropriate range of the blood index over time; an appropriate range of the blood index stored in the storage means; and an actual blood index actually detected by the detecting means; And a blood purification device that can monitor over time whether or not the blood pressure is within the proper range, and the rise time until the change over time of the blood index detected by the detection means becomes stable After, before Set temporal proper range of the stored blood indication in the storage means, characterized in that to perform monitoring by said monitoring means.

  According to a second aspect of the present invention, in the blood purification apparatus according to the first aspect, the rising time is a time set in advance by an operator.

  According to a third aspect of the present invention, in the blood purification apparatus according to the first aspect, the rise time is obtained by a predetermined arithmetic expression based on the actual blood index detected by the detecting means.

  According to a fourth aspect of the present invention, in the blood purification apparatus according to the third aspect, the rising time is an allowable range in which the rate of change or amount of change per predetermined time of the actual blood index value detected by the detecting means is predetermined. It is a time until it is determined to be within.

  According to the first aspect of the present invention, after the rise time until the change over time of the blood index detected by the detecting means becomes stable, the appropriate time range of the blood index stored in the storage means is set and monitored. Since the monitoring by means is performed, the change over time of the blood index can be accurately monitored by appropriately setting an appropriate range in consideration of the rise time.

  According to the invention of claim 2, since the rise time is set in advance by the operator, the rise time unique to the patient is set easily and smoothly while taking into account past trends in a specific patient. be able to.

  According to the invention of claim 3, since the rise time is obtained by a predetermined arithmetic expression based on the actual blood index detected by the detecting means, the appropriate range of the blood index after the rise time is set over time. Can be automated.

  According to the invention of claim 4, the rise time is the time until the rate of change or amount of change of the actual blood index value detected by the detecting means per predetermined time is determined to be within a predetermined allowable range. Therefore, the automation can be achieved while setting the proper range of the blood index over time after the rise time has elapsed more reliably and smoothly.

Hereinafter, embodiments of the present invention will be specifically described with reference to the drawings.
The blood purification apparatus according to the present embodiment is for purifying a patient's blood while circulating it extracorporeally, and is applied to a hemodialysis apparatus used in hemodialysis treatment. As shown in FIG. 1, the hemodialysis apparatus mainly includes a blood circuit 1 to which a dialyzer 2 as blood purification means is connected, and a dialyzer body 6 that removes water while supplying dialysate 2 to the dialyzer 2. Has been.

  As shown in the figure, the blood circuit 1 is mainly composed of an arterial blood circuit 1a and a venous blood circuit 1b made of a flexible tube. The arterial blood circuit 1a and the venous blood circuit 1b A dialyzer 2 is connected between them. An arterial puncture needle a is connected to the tip of the arterial blood circuit 1a, and an iron-type blood pump 3, a drip chamber 4a for defoaming, and a detecting means 5 are disposed on the way. On the other hand, a venous puncture needle b is connected to the distal end of the venous blood circuit 1b, and a drip chamber 4b for defoaming is connected midway. The detection means 5 constitutes the detection means of the present invention.

  When the blood pump 3 is driven with the patient punctured with the artery side puncture needle a and the vein side puncture needle b, the patient's blood passes through the artery side blood circuit 1a while being defoamed in the drip chamber 4a. To the dialyzer 2, blood purification is performed by the dialyzer 2, and defoaming is performed in the drip chamber 4 b to return to the patient's body through the venous blood circuit 1 b. That is, the blood of the patient is purified by the dialyzer 2 while circulating outside the body by the blood circuit 1.

  The dialyzer 2 is formed with a blood introduction port 2a, a blood outlet port 2b, a dialysate inlet port 2c, and a dialysate outlet port 2d in the casing. Among these, the blood inlet port 2a has an arterial blood circuit 1a. The base end of the venous blood circuit 1b is connected to the blood outlet port 2b. The dialysate introduction port 2c and the dialysate lead-out port 2d are connected to a dialysate introduction line 7 and a dialysate discharge line 8 extending from the dialyzer body 6, respectively.

  A plurality of hollow fibers are accommodated in the dialyzer 2, the inside of the hollow fibers is used as a blood flow path, and the flow of dialysate is between the hollow fiber outer peripheral surface and the inner peripheral surface of the housing. It is considered a road. A hollow fiber is formed in the hollow fiber by forming a large number of minute holes (pores) penetrating the outer peripheral surface and the inner peripheral surface, and waste products in blood are dialyzed through the membrane. It is configured to be able to penetrate inside.

  On the other hand, the dialysis machine main body 6 mainly includes a duplex pump P, a bypass line 9 that bypasses the duplex pump P in the dialysate discharge line 8, and a dewatering pump 10 that is connected to the bypass line 9. It is configured. The compound pump P is composed of a fixed-quantity pump in which the supply side and the drainage side are substantially equal.

  The compound pump P is disposed across the dialysate introduction line 7 and the dialysate discharge line 8 and introduces dialysate from the dialysate introduction line 7 to the dialyzer 2 (blood purification means). The dialysis fluid introduced into the dialysis fluid is discharged from the dialysis fluid discharge line 8. One end of the dialysate introduction line 7 is connected to the dialyzer 2 (dialyte introduction port 2c), and the other end is connected to a dialysate supply device (not shown) for preparing a dialysate having a predetermined concentration. Further, one end of the dialysate discharge line 8 is connected to the dialyzer 2 (dialysate outlet port 2d), and the other end is connected to a drainage means (not shown), and supplied from the dialysate supply device. After the dialysate reaches the dialyzer 2 through the dialysate introduction line 7, it is sent to the drainage means through the dialysate discharge line 8 and the bypass line 9.

  The dewatering pump 10 is for removing water from the blood of the patient flowing through the dialyzer 2. That is, when the dewatering pump 10 is driven, since the dual pump P is a fixed type as described above, it is discharged from the dialysate discharge line 8 rather than the dialysate amount introduced from the dialysate introduction line 7. The volume of liquid increases, and water is removed from the blood by that much volume. In addition, you may make it remove a water | moisture content from a patient's blood by means other than this water removal pump 10 (for example, what utilizes what is called a balancing chamber etc.).

  The detection means 5 detects a blood index in the blood of the patient circulating extracorporeally in the blood circuit 1 over time (real time). Specifically, the detection means 5 is disposed in the artery side blood circuit 1a and is connected to the artery side. The blood index (specifically, hematocrit value) in the blood of the patient flowing through the blood circuit 1a is detected. That is, the detection means 5 is composed of a hematocrit sensor, and the hematocrit sensor includes a light emitting element such as an LED and a light receiving element such as a photodiode, and irradiates light to the blood from the light emitting element and transmits the transmitted light. Alternatively, the hematocrit value indicating the blood concentration of the patient is detected by receiving the reflected light with a light receiving element.

  More specifically, a hematocrit value indicating the blood concentration is obtained based on the electrical signal output from the light receiving element. That is, each component such as red blood cell and plasma that constitutes blood has a specific light absorption characteristic, and by using this property, red blood cells necessary for measuring a hematocrit value are optically quantified. The hematocrit value can be obtained. More specifically, near infrared rays irradiated from the light emitting element are incident on blood, are affected by absorption and scattering, and are received by the light receiving element. The light absorption / scattering rate is analyzed from the intensity of the received light, and the hematocrit value is calculated.

  On the other hand, as shown in FIG. 2, the dialyzer body 6 includes ΔBV% calculation means 11, storage means 12, monitoring means 13, display means 14 including a display provided in the dialyzer body 6, and voice. An informing means 15 comprising a speaker capable of outputting is disposed. Of these, the ΔBV% calculating means 11 is electrically connected to the detecting means 5 described above, and calculates and determines the rate of change in circulating blood volume (ΔBV%) based on the hematocrit value transmitted from the detecting means 5. belongs to.

  That is, the hematocrit value, which is a parameter (blood index) related to the concentration of blood circulating extracorporeally in the dialysis treatment process, is sequentially measured by the detecting means 5 (hematocrit sensor), and the ΔBV% calculating means 11 is based on the hematocrit value. By calculating the circulatory blood volume change rate (ΔBV%), it is possible to obtain time-series data (data indicating a change tendency with time of the circulatory blood volume change rate during dialysis treatment) measured at a plurality of time points in time series. It can be done.

  Incidentally, if the hematocrit value obtained by the detection means 5 (hematocrit sensor) is set to Ht, the change rate ΔBV% of the circulating blood volume is (Ht at the start of dialysis−Ht at the time of measurement) / Ht × 100 at the time of measurement. It can obtain | require from the computing equation which becomes. Thereby, the change rate (ΔBV%) of the circulating blood volume of the patient can be sequentially detected as the dialysis treatment time elapses, and time series data in the dialysis treatment can be obtained.

  However, the ΔBV% calculating means 11 obtains the circulating blood volume change rate (ΔBV%) based on the measured hematocrit value, but instead circulates based on, for example, hemoglobin concentration or serum total protein concentration. The blood volume change rate (ΔBV%) may be used. Furthermore, in measuring a parameter (blood index) for determining the rate of change in circulating blood volume (ΔBV%), various forms such as optical or ultrasonic can be used.

  The storage unit 12 sets an appropriate range over time of a blood index (circulation blood volume change rate (ΔBV%) obtained from a hematocrit value in this embodiment) predicted to be detected by the detection unit 5 if appropriate. For example, it can be stored. This storage means 12 acquires only a plurality of time series data determined to have been appropriate dialysis treatment in the past dialysis treatment for a plurality or the same patient, and circulates from the accumulated time series data. An appropriate range of blood volume change rate (ΔBV%) over time is obtained and stored.

  For example, the time series data acquired by the storage unit 12 is standardized by performing a predetermined calculation, and is converted into universal time series data that is not related to specific patient-specific conditions such as patient weight or water removal amount. Change over time). Standardization of time series data is performed, for example, by calculating (ΔBV% / final ΔBW%) by dividing the ΔBV% value (variable) obtained by dialysis treatment by the rate of change in body weight (ΔBW%) before and after the dialysis treatment. The weight change rate (ΔBW%) can be calculated by the following equation 1.

ΔBW% = (BW1-BW2) / BW1 × 100 (%)
= (UFV) / BW1 × 100 (%) (Formula 1)

  Specifically, the target water removal amount in the dialysis treatment (appropriate dialysis treatment) is indicated in the term of integrated water removal value (UFV) in Equation 1, and the patient's previous weight (before dialysis treatment) is indicated in the previous weight (BW1) term. By substituting each of the weights, it is possible to obtain universal time-series data that is standardized and not related to conditions specific to a specific patient. The calculation for standardization of the time series data may be performed by an external unit that is separate from the storage unit 12.

  Thus, for example, a regression calculation is performed on the standardized time series data to perform a curve regression (that is, find a correlation), and an appropriate transition of the time series data expected in an appropriate dialysis treatment process is calculated. Can do. Furthermore, from the distribution of the standardized time-series data, from the lower limit value to the upper limit value at each measurement time point (each measurement time point of the parameter (ΔBV% in this embodiment) related to the concentration of blood circulating outside the body (blood index)) It is possible to calculate an appropriate range having a predetermined width (appropriate range over time of the blood index). The appropriate range obtained in this way is stored in the storage means 12, and when the appropriate range is graphed, as shown in FIG. 3, an upper limit function (α) and a lower limit function ( It is set as the site | part shown by hatching between (beta).

  The monitoring means 13 is composed of, for example, a microcomputer or the like disposed in the dialyzer body 6, and the appropriate range of the blood index (ΔBV%) stored in the storage means 12 and the actual blood actually detected by the detection means 5. An index (ΔBV% obtained from the actually detected hematocrit value Ht) is compared, and whether or not the actual blood index is within the appropriate range (between the upper limit α and the lower limit β) over time ( It can be monitored (in real time).

  When the dialysis treatment is performed by the hemodialyzer, the display unit 14 displays the appropriate transition range stored in the storage unit 12 as a graph while the circulated blood volume change rate (ΔBV) obtained by the ΔBV% calculation unit 11 is displayed. %) Is superimposed on the graph and displayed over time (in real time). Thereby, in the course of dialysis treatment, it is possible to visually determine whether or not the actual blood index is within an appropriate range (between the upper limit α and the lower limit β), and the circulating blood volume change rate ( A sign that ΔBV%) exceeds the upper limit value or the lower limit value can be detected.

  The notification unit 15 performs a predetermined notification when dialysis treatment is performed on the condition that the measured rate of change in circulating blood volume (ΔBV%) deviates from the appropriate transition range stored in the storage unit 12. For example, it is composed of a speaker that can output sound and the like, and a light source (such as LED) that can emit light. For example, in the dialysis treatment process, when the calculated rate of change in circulating blood volume (ΔBV%) exceeds the upper limit value or lower limit value of the appropriate transition range, guidance based on these can be performed.

  Thus, when performing dialysis treatment, a predetermined notification is performed on the condition that the obtained parameter (blood index) has deviated from the appropriate transition range stored in the storage means 12, so that the medical worker's attention Can be encouraged. Note that the notification by the notification means 15 and the contents of the guidance may be recorded and used for subsequent dialysis treatment.

  Here, in this embodiment, after the rise time until the time-dependent change of the blood index detected by the detection means 5 becomes stable, the blood index (ΔBV%) stored in the storage means 12 is appropriate over time. A range is set and monitoring by the monitoring unit 13 is performed. Such rise time is due to shunt recirculation, hyponatremia, hypoproteinemia, or the movement of water associated with the change of body position from standing to prone position, resulting in unstable blood indices such as hematocrit. Say time to become.

  The rise time is configured to be obtained by a predetermined arithmetic expression based on the actual blood index detected by the detection means 5. For example, the rise time is a time until it is determined that the rate of change or amount of change of the actual blood index value detected by the detection means 5 per predetermined time is within a predetermined allowable range. It refers to the time indicated by “T1” from the start of treatment shown in FIG.

  Hereinafter, as a specific method for determining whether or not the change over time of the blood index value (ΔBV%) in the present embodiment is stable, when the blood index value (ΔBV%) is detected over time as shown in FIG. One using an area (integrated value) in a certain section (V1 to Vn in the figure), one using an average value in a certain section (an average value of X0 to X1, X1 to X2 in the figure), or primary of a certain section Those using functional gradients (inclinations of approximate straight lines of X0 to X1, X1 to X2.

In the case of using an example using the above-described constant section area (integrated value) (V1 to Vn in the figure), it is determined whether or not the change over time of the blood index value (ΔBV%) is stable as follows. There are two approaches.
That is, using the area V1 detected first as a reference, the area V1 is compared with the area V2 detected next, for example, (V2−V1) / V1 × 100 (%). A value is obtained, and it is determined whether the increase / decrease value (corresponding to “change rate per predetermined time” in this case) is within a predetermined allowable range. If the result of the determination is an allowable range, the count is incremented by 1 and the area V1 is compared with the area V3 to determine an increase / decrease value. Let Hereinafter, similarly, the comparison based on the area V1 is sequentially performed.

  On the other hand, when the area V1 is compared with the area V2 to be detected next, and the increase / decrease value is outside the predetermined allowable range, the area V2 is compared with the area V3 without counting. It is determined whether the increase / decrease value is within a predetermined allowable range. If it is within the permissible determination, 1 is counted as described above, while if it is out of the permissible range, it is not counted. Note that the count is cleared (ie, becomes “0”) when it falls outside the permissible range.

  In this way, the determination is sequentially performed, and it is determined that the temporal transition of the blood index value (ΔBV%) is stable on the condition that the count reaches a predetermined number (for example, “3”). That is, the temporally detected values are divided into a plurality of sections, and when the increase / decrease value of the adjacent sections is continuously within the allowable range a predetermined number of times, the monitoring means 13 determines that the temporal transition is stable.

  Instead of the above method, for example, the area V1 is compared with the area V2 to be detected next to obtain an increase / decrease value, and when the increase / decrease value is within a predetermined allowable range, one count is performed and the next area An increase / decrease value may be obtained by comparing V2 and area V3 (hereinafter, area V3 and area V4...), And whether or not the increase / decrease value is within an allowable range may be sequentially determined and counted. Further, in the above, the increase / decrease value is the rate of change per predetermined time, but it may be configured to determine whether it is within the allowable range using the amount of change per predetermined time.

  According to the above-described embodiment, it is automatically determined whether or not the change over time (change over time) of the blood index (ΔBV%) obtained from the blood index value (hematocrit value) detected by the detection means 5 is stable. can do. Thus, after the rise time has elapsed, an appropriate range over time of the blood index (ΔBV%) stored in the storage unit 12 is set, and monitoring by the monitoring unit 13 is performed. A method for setting an appropriate range over time at that time will be described below.

  For example, as shown in FIG. 5, the actual blood index value at the rise time T1 (ΔBV% value obtained from the actually detected hematocrit value: the same applies hereinafter) is the upper limit (α) and lower limit (β) of the appropriate range. A method of translating the appropriate range only in the vertical direction (ΔBV% axis direction) in the graph so as to be in the middle of the position, or as shown in FIG. 6, the position of the actual blood index value at the rise time T1 is zero. As a point (at the start of treatment and imitation), there is a method of resetting the appropriate range.

  Further, as shown in FIG. 7, the actual blood index value at the rising time T1 is initialized to a zero point (the actual blood index value is moved to zero), and the zero point is the upper limit (α) and lower limit ( A method in which the appropriate range is translated only in the vertical direction (ΔBV% axis direction) in the graph so as to be in the middle position with respect to β), or the actual blood index value at the rise time T1 is initialized as shown in FIG. A zero point (moving the actual blood index value to zero), and setting an appropriate range from the zero point. In the graphs of FIGS. 5 to 8, the horizontal axis is time (treatment time), but this may be used as another parameter such as a dialysis achievement rate or a water removal achievement rate.

  According to the above embodiment, the storage means 12 stores the rise time T1 until the change over time of the blood index (ΔBV%) obtained from the blood index (hematocrit value) detected by the detection means 5 becomes stable. Since an appropriate range over time of the blood index (ΔBV%) is set and monitoring is performed by the monitoring means 13, the blood index (ΔBV%) is set by appropriately setting the appropriate range in consideration of the rise time T1. ) Over time can be accurately monitored.

  Further, since the rise time T1 is obtained by a predetermined arithmetic expression based on the actual blood index detected by the detecting means 5, it is possible to automate the setting of the appropriate range over time of the blood index after the rise time T1 has elapsed. Can do. Furthermore, the rise time T1 is a time until it is determined that the rate of change or change amount of the actual blood index value detected by the detection means 5 per predetermined time is within a predetermined allowable range. Automation can be achieved while setting the appropriate range of the blood index over time after the time T1 has elapsed more reliably and smoothly.

  Although the present embodiment has been described above, the present invention is not limited to this. For example, an input unit may be provided and the rise time T1 may be input by the input unit. Thus, if the rise time T1 is a time set in advance by the operator, the rise time unique to the patient can be set easily and smoothly while taking into account past trends in a specific patient. The monitoring target by the monitoring means 13 at the rising time T1 may be a hematocrit value or other blood index value in addition to ΔBV% as in the present embodiment.

  Further, the detection means 5 may be disposed in any part as long as it is the arterial blood circuit 1a and the venous blood circuit 1b, or may be disposed in both the arterial blood circuit 1a and the venous blood circuit 1b. You may comprise so that it may provide. Furthermore, in the present embodiment, the detection means detects the hematocrit value, but may detect other blood indices (parameters related to blood). In the present embodiment, the dialysis device body 6 is composed of a dialysis monitoring device that does not incorporate a dialysate supply mechanism, but may be applied to a personal dialysis device that incorporates a dialysate supply mechanism. .

  A blood purification device that sets an appropriate range over time of the blood index stored in the storage means and monitors by the monitoring means after the rise time until the change in the blood index detected by the detection means becomes stable If so, it can be applied to those used in other treatments (blood filtration therapy, hemofiltration dialysis therapy, etc.) that purify blood while circulating extracorporeally, or those to which other functions are added.

1 is an overall schematic view showing a blood purification apparatus according to an embodiment of the present invention. The block diagram which shows the connection relation of the detection means in the blood purification apparatus, (DELTA) BV% calculating means, a memory | storage means, a monitoring means, a display means, and an alerting | reporting means. The graph which shows the appropriate range of the blood parameter | index memorize | stored in the memory | storage means in the blood purification apparatus The graph for demonstrating the method of determining whether the time-dependent change of the blood parameter | index which was the blood parameter | index ((DELTA) BV%) detected with time by the detection means in the blood purification apparatus was stabilized. The graph for demonstrating the setting method of the appropriate range with time in the blood purification apparatus The graph for demonstrating the setting method of the appropriate range with time in the blood purification apparatus The graph for demonstrating the setting method of the appropriate range with time in the blood purification apparatus The graph for demonstrating the setting method of the appropriate range with time in the blood purification apparatus

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Blood circuit 1a ... Arterial side blood circuit 1b ... Vein side blood circuit 2 ... Dializer (blood purification means)
DESCRIPTION OF SYMBOLS 3 ... Blood pump 4a, 4b ... Drip chamber 5 ... Detection means 6 ... Dialyzer main body 7 ... Dialysate introduction line 8 ... Dialysis system discharge line 9 ... Bypass line 10 ... Dewatering pump 11 ... ΔBV% calculation means 12 ... Memory means 13 ... Monitoring means 14 ... Display means 15 ... Notification means P ... Double pump T1 ... Rise time

Claims (4)

A blood circuit comprising an arterial blood circuit and a venous blood circuit for extracorporeal circulation of the patient's blood;
Blood purification means connected between the arterial blood circuit and the venous blood circuit and purifying blood flowing through the blood circuit;
A detecting means for detecting a blood index in the blood of a patient circulating extracorporeally in the blood circuit over time;
Storage means for storing an appropriate range over time of a blood index that is predicted to be detected by the detection means if appropriate;
The appropriate range of the blood index stored in the storage means is compared with the actual blood index actually detected by the detection means, and it is monitored over time whether the actual blood index is within the appropriate range. Possible monitoring means;
A blood purification apparatus comprising:
After the rise time until the change over time of the blood index detected by the detection means becomes stable, an appropriate range over time of the blood index stored in the storage means is set, and monitoring by the monitoring means is performed. The blood purification apparatus characterized by the above-mentioned.   The blood purification apparatus according to claim 1, wherein the rise time is a time set in advance by an operator.   2. The blood purification apparatus according to claim 1, wherein the rise time is obtained by a predetermined arithmetic expression based on an actual blood index detected by the detection means.   The rise time is a time until it is determined that the rate of change or the amount of change per predetermined time of the actual blood index value detected by the detecting means is within a predetermined allowable range. The blood purification apparatus according to claim 3.

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