JP2016083003A - Extracorporeal circulation apparatus and priming method thereof - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an extracorporeal circulation apparatus of a novel configuration, and a priming method thereof capable of quickly filling an entire circulation flow passage with priming liquid and discharging air while suppressing stay of air in the circulation flow passage in priming.SOLUTION: An extracorporeal circulation apparatus 10 having a circulation flow passage 12 for circulating blood extracorporeally includes tank liquid level changing means 42 for increasing a liquid level height of priming liquid 40 stored in a fluid tank 38 connected to the circulation flow passage 12, following an increase in the liquid level in the circulation flow passage 12 of the priming liquid 40 introduced to the circulation flow passage 12.SELECTED DRAWING: Figure 1

Description

  The present invention relates to an extracorporeal circulation device provided with a circulation channel for circulating blood outside the body, and a priming method for discharging air in the circulation channel out of the channel before using the extracorporeal circulation device.

  2. Description of the Related Art Conventionally, there are extracorporeal circulation devices that are used to reduce or avoid damage to internal organs by rapidly recovering and maintaining blood flow to internal organs such as the brain during cardiopulmonary dysfunction or cessation. The extracorporeal circulation device is provided with a circulation channel for circulating blood outside the body as disclosed in Japanese Patent Laid-Open No. 2006-130078 (Patent Document 1), and the circulation channel is provided to the artery and vein of the patient. By connecting, blood taken out from the vein to the circulation channel is returned to the artery after processing such as gas exchange, so that blood flow can be maintained even when the heart rate is weak or even when the heart rate is stopped It is like that.

  By the way, the extracorporeal circulation device is primed before use in order to prevent air from entering the blood vessel from the circulation flow path. As is conventionally known, the priming is performed by connecting a fluid tank containing a priming solution such as physiological saline to the circulation flow path before connecting to the blood vessel, and using the priming solution contained in the fluid tank. This is an operation of discharging the air in the circulation channel to the outside by introducing it into the circulation channel and filling the circulation channel with the priming liquid.

  In some cases, the priming liquid is actively fed into the circulation flow path by a pump or the like, but bubbles may be caught in the liquid by the flow of the priming liquid, so that it circulates in the fluid tank. By supporting above the flow path in the direction of gravity, the fluid tank may be introduced into the circulation flow path by the action of gravity.

  However, when the priming liquid is introduced into the circulation flow path by gravity, the flow rate of the priming liquid introduced into the circulation flow path changes as the amount of liquid stored in the fluid tank changes. Therefore, it is difficult to quickly fill the entire circulation flow path with the priming liquid while preventing air from being mixed into the priming liquid and air remaining in the circulation flow path. That is, if the liquid level in the fluid tank is set at a high position with respect to the circulation flow path, the introduction speed of the priming liquid into the circulation flow path is increased, so that air entrainment tends to occur at the initial stage of introduction. Thus, a large amount of air may enter and remain in the circulation flow path and the pump. On the other hand, if the liquid level in the fluid tank is made too low with respect to the circulation channel, not only will it take a long time for priming, but it will be difficult for the priming solution to be introduced into the entire circulation channel by the action of gravity alone. Thus, the air at the upper end of the circulation flow path may remain without being discharged.

JP 2006-130078 A

  The present invention has been made in the background of the above-described circumstances, and the problem to be solved is to quickly apply the priming liquid to the entire circulation flow path while suppressing the residual air in the circulation flow path during priming. An object of the present invention is to provide an extracorporeal circulation device having a novel structure that can be filled and discharged.

  Another object of the present invention is to provide a novel priming method in the extracorporeal circulation apparatus as described above.

  Hereinafter, the aspect of this invention made | formed in order to solve such a subject is described. In addition, the component employ | adopted in each aspect as described below is employable by arbitrary combinations as much as possible.

  That is, according to the first aspect of the present invention, in the extracorporeal circulation apparatus including a circulation flow path for circulating blood outside the body, the liquid surface height of the priming liquid stored in the fluid tank connected to the circulation flow path is set. A tank liquid level changing means is provided for increasing the liquid level of the priming liquid introduced into the circulation flow path in the circulation flow path.

  According to the extracorporeal circulation device having the structure according to the first aspect, when the introduction of the priming liquid into the circulation flow path is started, the liquid surface height of the priming liquid stored in the fluid tank is set to the circulation flow path. On the other hand, by setting it relatively low, the difference in height from the fluid tank to the introduction position to the circulation channel is reduced. Therefore, at the initial stage of introduction of the priming liquid into the circulation flow path, the introduction speed of the priming liquid set according to the gravitational acceleration and height is reduced, and air remains in the circulation flow path due to air entrainment. Is reduced or avoided.

  Furthermore, the liquid level height of the priming liquid stored in the fluid tank is increased by the tank liquid level changing means as the introduction of the priming liquid into the circulation channel progresses and air entrainment is less likely to occur. Priming can be completed quickly while suppressing a decrease in the introduction speed of the priming liquid due to the lowering of the liquid level in the fluid tank.

  In addition, since the liquid surface height of the priming liquid stored in the fluid tank is increased as the priming progresses by the tank liquid surface changing means, the liquid surface height in the fluid tank is increased when the priming is started. Even if it is lower than the upper end of the circulatory flow, if it is made higher than the upper end of the circulation flow passage when priming is completed, the entire circulation flow passage can be filled with the priming liquid while effectively suppressing air entrainment. it can. Accordingly, it is possible to set the flow velocity at the start of priming sufficiently low to prevent air from being caught by a fast flow of priming liquid.

  According to a second aspect of the present invention, in the extracorporeal circulation apparatus described in the first aspect, pump means is provided on the circulation flow path.

  In the structure in which the pump means is provided on the circulation flow path as in the second aspect, in addition to the remaining air in the circulation flow path, the remaining air in the pump means is likely to be a problem. Therefore, if the present invention capable of reducing the flow velocity at the initial stage of introduction of the priming liquid is applied, air hardly remains in the pump means, and the entire circulation flow path including the inside of the pump means is made of the priming liquid. Can be satisfied.

  Moreover, by filling the circulation channel with the priming liquid and then operating the pump means to circulate the priming liquid in the circulation channel, the fine bubbles remaining in the circulation channel and the pump means are pushed away, It can also be discharged.

  According to a third aspect of the present invention, in the extracorporeal circulation device described in the first or second aspect, the tank liquid level changing means reduces the weight of the priming liquid stored in the fluid tank. Accordingly, the liquid level of the priming liquid stored in the fluid tank is increased.

  According to the third aspect, by utilizing the change in weight due to the priming liquid flowing from the fluid tank into the circulation flow path, the liquid level height of the priming liquid stored in the fluid tank can be set to a special level for medical personnel. It can be automatically changed without requiring a lot of work. Accordingly, it is possible to shorten the time that the medical worker spends for priming, and the medical worker can perform another operation while filling the circulation channel with the priming liquid.

  Moreover, since the liquid level in the fluid tank is changed according to the mass of the priming liquid stored in the fluid tank, the liquid level in the fluid tank can be used even when an unexpected change in introduction speed occurs. The height is appropriately changed, and prompt introduction of the priming liquid into the entire circulation channel is realized while preventing air from remaining in the circulation channel.

  According to a fourth aspect of the present invention, in the extracorporeal circulation device described in the first or second aspect, the tank liquid level changing means has elapsed time from the start of introduction of the priming liquid into the circulation flow path. As the length increases, the liquid level of the priming liquid stored in the fluid tank is increased.

  According to the fourth aspect, the liquid surface height of the priming liquid stored in the fluid tank is automatically changed according to the elapsed time from the start of priming, so that the introduction to the circulation channel is performed. Sometimes no special work is required by health care workers. Therefore, the time required for priming by the medical staff can be shortened, and the medical staff can perform another operation while filling the circulation channel with the priming liquid.

  According to a fifth aspect of the present invention, in the extracorporeal circulation device described in the first or second aspect, the tank liquid level changing means is based on a detection result of the flow of the priming liquid flowing through the circulation flow path. The liquid surface height of the priming liquid stored in the fluid tank is increased.

  According to the fifth aspect, the height of the priming liquid stored in the fluid tank is automatically changed based on the result of detecting the flow of the priming liquid flowing through the circulation flow path, the flow rate, and the like. By doing so, the special work of the medical staff becomes unnecessary at the time of introduction into the circulation channel. Therefore, the time required for priming by the medical staff can be shortened, and the medical staff can perform another operation while filling the circulation channel with the priming liquid.

  In addition, since the flow of the priming liquid that actually flows through the circulation flow path is detected, the liquid level in the fluid tank can be increased even when there is an unexpected change in the introduction speed due to constriction due to the bending of the circulation flow path. The priming liquid can be promptly introduced into the entire circulation flow path while appropriately preventing the entry of air.

  According to a sixth aspect of the present invention, there is provided a priming method for an extracorporeal circulation apparatus that introduces a priming solution contained in a fluid tank into a circulation channel that circulates blood outside the body and discharges air in the circulation channel. In the circulation channel, the fluid level from the fluid tank to the circulation channel is increased while increasing the level of the priming solution stored in the fluid tank as the liquid level height of the priming solution increases in the circulation channel. It is characterized by introducing the priming solution.

  According to the priming method of the extracorporeal circulation device according to the sixth aspect, the flow rate of the priming liquid introduced into the circulation flow path is suppressed at the initial stage of priming in which air is easily caught by introduction of the priming liquid into the circulation flow path. Thus, it is possible to prevent air from remaining in the circulation channel. Further, as the priming progresses, the liquid level in the fluid tank is increased by the tank liquid level changing means, so that the priming liquid introduced into the circulation flow path is introduced at the latter stage of the priming period where air entrainment hardly occurs. A rapid introduction of the priming liquid into the circulation channel can be realized while suppressing a decrease in the flow rate. Therefore, priming in a short time by prompt introduction of the priming liquid into the circulation channel can be realized without increasing the burden on the medical staff while preventing air from remaining in the circulation channel.

  According to the present invention, at the initial stage of priming in which air is easily caught when the priming liquid is introduced into the circulation flow path, the liquid level in the fluid tank is set low so that the priming liquid introduced into the circulation flow path The entrainment of air can be suppressed by reducing the flow rate. Further, as the priming progress makes it difficult for air to be introduced at the time of introduction, the tank liquid level changing means increases the liquid level in the fluid tank so that the priming liquid introduced into the circulation channel The decrease in the flow rate is suppressed, and the priming liquid can be quickly introduced into the circulation channel.

It is a figure which shows the extracorporeal circulation apparatus as the 1st Embodiment of this invention, Comprising: The state at the time of a priming start is shown. The figure which shows the state which priming completed in the extracorporeal circulation apparatus of FIG. FIG. 2 is an enlarged longitudinal sectional view showing a fluid introduction part constituting the extracorporeal circulation device of FIG. 1, wherein (a) shows a state at the start of priming, and (b) shows a state at the completion of priming. The figure which shows the state in which the blood removal port and the blood return port were formed after completion of priming in the extracorporeal circulation apparatus of FIG. The figure explaining the use condition in which the circulation circuit of the extracorporeal circulation apparatus of FIG. 1 was connected to the cannula. It is a figure which shows the fluid introduction part which comprises the extracorporeal circulation apparatus as the 2nd Embodiment of this invention, Comprising: (a) shows the state at the time of priming start, (b) shows the state at the time of completion of priming, respectively. .

  Embodiments of the present invention will be described below with reference to the drawings.

  1 and 2 show an extracorporeal circulation device 10 as a first embodiment of the present invention. The extracorporeal circulation device 10 is provided with a circulation channel 12 for extracting and circulating blood outside the patient's body. In addition, in this embodiment, the up-down direction means the up-down direction in FIG.

  More specifically, the circulation flow path 12 is formed by a tubular cylinder and extends continuously in an annular shape. In addition, the upper end part and lower end part of the circulation flow path 12 extending in the left-right direction in FIG. 1 have a downwardly convex bent shape or a horizontally extending linear shape, and an upwardly convex part in the middle. Desirably not formed. In FIG. 1, the circulation flow path 12 is shown as being bent in a rectangular shape. However, the circulation flow path 12 is configured by a flexible tube formed of resin or the like, and is substantially curved. It extends.

  Further, a centrifugal pump 14 as a pump means is connected to the circulation flow path 12. The centrifugal pump 14 has a known structure that pumps liquid by centrifugal force. The centrifugal pump 14 includes a drive device 16 such as an electric motor, and a control device 18 is connected to the drive device 16. The centrifugal pump 14 is controlled by the control device 18 by controlling the operation of the drive device 16 by the control device 18. Then, with the power switch 19 of the control device 18 being switched on, the drive device 16 is controlled to be in an activated state by the control device 18, whereby the centrifugal pump 14 is activated and fills the circulation flow path 12. The priming solution 40 (described later), blood, and the like are allowed to flow in the circulation channel 12 at a predetermined flow rate and direction. As the pump means, in addition to the centrifugal pump 14, pumps of various known structures such as a roller pump that pumps the liquid to squeeze the liquid by crushing the tube connected to the circulation flow path 12 with a roller. It can be selected and adopted as appropriate. The centrifugal pump 14 is connected to the circulation channel 12 in a communicating state, and constitutes a part of the circulation channel 12. Furthermore, it is desirable that the centrifugal pump 14 is disposed below the center of the upper and lower sides in the circulation flow path 12, whereby a high hydraulic pressure acts in the centrifugal pump 14 when priming described later is completed. Residual air in the pump 14 can be more effectively prevented.

  Furthermore, an artificial lung 20 is connected to the circulation flow path 12. The artificial lung 20 includes a plurality of hollow fiber membranes (not shown) bundled together, for example, by bringing the surface of the hollow fiber membrane into contact with venous blood and bringing the back surface into contact with oxygen gas, Gas exchange that removes carbon dioxide from blood and adds oxygen to blood is performed. In the present embodiment, the artificial lung 20 is disposed above the centrifugal pump 14 in the direction of gravity. In addition, in the extracorporeal circulation device 10, a removing means such as a filter for removing a specific substance from blood instead of or in addition to the artificial lung 20, an adding means for adding a specific substance to blood, A temperature adjusting means for adjusting the blood temperature to a predetermined value may be employed as the blood processing unit. Similarly to the centrifugal pump 14, the artificial lung 20 is connected to the circulation channel 12 in a communicating state and constitutes a part of the circulation channel 12.

  Furthermore, a detection unit 22 is provided in the circulation channel 12. The detection unit 22 includes a flow sensor or the like, is disposed above the oxygenator 20, and is electrically connected to the control device 18. Then, the detection unit 22 detects the flow rate and flow rate of the priming liquid 40 and blood flowing in the circulation flow path 12, whether the priming liquid 40 has reached the detection height, and the detection result signal to the control device 18. It is designed to output.

  An air discharge unit 24 is connected to the circulation channel 12. The air discharge portion 24 has an end opening of an air vent channel 26 connected in communication with the upper end of the circulation channel 12 connected to a case 28 that opens upward and is accommodated in the case 28. The structure covered with the hydrophobic filter 30 is provided. Further, an open / close cock 32 is disposed on the air vent channel 26, and communication and blocking of the air vent channel 26 can be switched by the open / close cock 32. Furthermore, the air discharge part 24 is located above the oxygenator 20 and is connected to the uppermost part of the circulation flow path 12.

  The hydrophobic filter 30 has a porous structure, for example, so that the surface tension is reduced and water droplets are easily repelled. The priming described later is performed while ensuring air permeability and allowing air to be discharged. It is possible to restrict the passage of the liquid 40. Further, the material of the hydrophobic filter 30 is obtained by polymerizing or copolymerizing monomers such as cellulose, polytetrafluoroethylene resin, ethylene, propylene, 4-methylpentene-1, 1-butene alone. A polyolefin resin or the like to be used is preferably employed.

  In addition, a fluid introduction part 34 is connected to the circulation channel 12. The fluid introduction part 34 has a structure in which a bag 38 as a fluid tank is connected to an introduction flow path 36 connected in communication with the lower end of the circulation flow path 12, and is enclosed in the bag 38. A priming solution 40 such as physiological saline is introduced into the circulation channel 12 through the introduction channel 36. In the present embodiment, the introduction flow path 36 is connected to the lower end portion of the circulation flow path 12.

  Further, the bag 38 for storing the priming liquid 40 is supported at a position away from the floor surface on which the extracorporeal circulation device 10 is placed by a support pole 42 as tank support means. As shown in FIG. 3, the support pole 42 is supported on the floor surface directly or via a gantry and the like, and an outer cylinder member 44 constituting the lower part, and a lower end part of the outer cylinder member 44 is inserted into the upper part. An inner shaft member 46 is provided. Further, a suspension portion 48 that extends laterally is provided at the upper end of the inner shaft member 46, and a hook 50 is provided at the tip portion of the suspension portion 48. The hook 50 is inserted into a hole provided at the upper end of the bag 38, whereby the bag 38 is suspended from the hook 50 and supported by the support pole 42. In a state where the bag 38 is supported by the support pole 42, the liquid level in the bag 38 is located above the connection position of the introduction flow path 36 to the circulation flow path 12.

  Furthermore, the outer cylinder member 44 and the inner shaft member 46 are slidable in the axial direction. By changing the length of the portion of the inner shaft member 46 that protrudes from the outer cylinder member 44, the support pole 42 is changed. Can be stretched. Further, as shown in FIG. 3, a coil spring 52 as a spring means is disposed between the opposed surfaces of the bottom wall upper surface of the outer cylinder member 44 and the lower surface of the inner shaft member 46, and the inner shaft member 46. Is elastically supported by a coil spring 52. The initial relative position in the vertical direction of the inner shaft member 46 with respect to the outer cylinder member 44 is set according to the spring characteristics of the coil spring 52 and the mass of the inner shaft member 46, and the length of the support pole 42 is The coil spring 52 is changed by elastic deformation.

  The extracorporeal circulation device 10 having such a structure is subjected to a priming operation before use. Below, the priming method of the extracorporeal circulation apparatus 10 which concerns on this embodiment is demonstrated.

  That is, when using the extracorporeal circulation apparatus 10, first, various devices constituting the extracorporeal circulation apparatus 10 are prepared (see FIG. 5). In a state where various devices are prepared, the power switch 19 of the control device 18 is turned off, and the bag 38 is not connected to the introduction flow path 36.

  Further, as shown in FIG. 1, the bag 38 in which the priming liquid 40 is sealed is suspended from the hook 50 of the support pole 42. As a result, the inner shaft member 46 is displaced downward against the urging force of the coil spring 52 due to the weight of the bag 38 containing the priming liquid 40, and as shown in FIG. 1 and FIG. The priming preparation state in which the pole 42 is shortened in the axial direction is obtained. In the priming preparation state, since the coil spring 52 is compressed in the axial direction, the inner shaft member 46 is urged upward in the axial direction by the coil spring 52. In the priming preparation state, it is desirable that the liquid level of the priming liquid 40 in the bag 38 is located below the upper end of the circulation flow path 12.

  Next, the power switch 19 of the control device 18 is operated to turn on the power to the control device 18, and the tube constituting the introduction flow path 36 is connected to the bag 38 supported by the support pole 42 (puncture). ) Thereby, the priming liquid 40 accommodated in the bag 38 is introduced into the circulation flow path 12 through the introduction flow path 36, and the air in the circulation flow path 12 is discharged from the air discharge portion 24 to the outside by the introduction of the priming liquid 40. At the same time, the inside of the circulation channel 12 is filled with the priming liquid 40. The introduction flow path 36 extends downward from the bag 38 and is connected to the circulation flow path 12 below the bag 38 so that the priming liquid 40 is introduced into the circulation flow path 12 by gravity. ing. Further, at the start of priming, the control device 18 stops the driving device 16 and the centrifugal pump 14 is not operating. Moreover, in the air discharge part 24, leakage of the priming liquid 40 is prevented by the hydrophobic filter 30, and gas (air) passes through the hydrophobic filter 30 and is selectively discharged.

  At the start of priming, the liquid surface of the priming liquid 40 accommodated in the bag 38 is positioned below the upper end of the circulation flow path 12, so that the connection portion between the circulation flow path 12 and the introduction flow path 36, The distance from the liquid level in the bag 38 is reduced in the height direction. Thereby, the introduction speed of the priming liquid 40 into the circulation flow path 12 is slowed down, and air entrainment is reduced when the priming liquid 40 is introduced into the circulation flow path 12. In particular, in this embodiment, even when the connection part of the circulation flow path 12 and the introduction flow path 36 is set at the lowermost part close to the centrifugal pump 14, air entrainment when introducing the priming liquid 40 is reduced. This prevents the air from remaining in the centrifugal pump 14.

  Further, as the introduction of the priming liquid 40 from the bag 38 to the circulation flow path 12 proceeds, the priming liquid 40 in the bag 38 decreases and the level of the priming liquid 40 in the circulation flow path 12 increases. Since the weight of the bag 38 containing the priming liquid 40 supported by the hook 50 is reduced by reducing the priming liquid 40 in the bag 38, the total mass on the inner shaft member 46 side and the biasing force of the coil spring 52 are reduced. And the inner shaft member 46 is gradually displaced upward in the axial direction with respect to the outer cylinder member 44 as shown in FIGS. 2 and 3B. Thereby, as the priming progresses and the liquid level height of the priming liquid 40 in the circulation flow path 12 increases, the mass of the priming liquid 40 in the bag 38 decreases and the bag 38 moves upward. Since it is lifted, the liquid level in the bag 38 increases. As described above, in the extracorporeal circulation device 10, the support pole 42 in which the coil spring 52 is disposed between the axially opposed surfaces of the inner shaft member 46 and the outer cylinder member 44 is provided with the priming liquid 40 accommodated in the bag 38. The tank liquid level changing means of the present embodiment is configured to automatically extend using the change in mass. As the priming progresses and the liquid level in the circulation channel 12 increases, the priming liquid 40 is supplied to the circulation channel 12 while automatically increasing the liquid level in the bag 38. Introduce.

  By such tank liquid level changing means, the liquid surface height of the priming liquid 40 accommodated in the bag 38 is introduced into the circulation flow path 12 when priming is completed when the circulation flow path 12 is filled with the priming liquid 40 to the upper end. The height of the priming liquid 40 is set higher than the liquid level. As a result, the priming liquid 40 fills the entire circulation flow path 12 by the action of gravity without requiring pumping by the centrifugal pump 14 or the like. The support height of the bag 38 at the completion of priming is set such that the liquid surface height of the accommodated priming liquid 40 is higher than the upper end of the circulation channel 12. The liquid level is set higher than that of the open / close cock 32 so that air does not remain in the circulation flow path 12 with the open / close cock 32 closing the circulation flow path 12. In addition, since the liquid level in the bag 38 changes and it is difficult to set the height with high accuracy, more preferably, the height of the liquid outlet at the lower end of the bag 38 is determined so that the circulation flow path is set when the priming is completed. The upper end of 12 is set to be higher than the opening / closing cock 32. However, when the circulation channel 12 is used after being cut off after priming, the support height of the bag 38 at the time of completion of priming is such that at least the liquid level of the accommodated priming liquid 40 is higher than the cutting site. It is sufficient if it is set to be higher.

In the present embodiment, the liquid level in the bag 38 at the completion of priming (h ₂ in FIG. 3B) is the liquid level in the bag 38 at the start of priming (FIG. 3A). h ₁₎ so as to be higher (h _2> h ₁₎ than in, tank liquid level changing means is adapted to change the vertical position of the bag 38. However, in the present invention, the tank liquid level changing means only needs to make the liquid level height in the bag 38 higher than that in the case where the tank liquid level changing means is not provided. The liquid level may be the same or lower than the liquid level in the bag 38 at the start of priming. In such a case, the liquid level in the bag 38 at the start of priming is positioned above the uppermost end of the circulation flow path 12.

  Further, the centrifugal pump 14 is operated in a state where the entire circulation channel 12 is filled with the priming liquid 40, and the priming liquid 40 is caused to flow in the circulation channel 12. Fine bubbles remaining in the lung may be discharged from the artificial lung 20 to the outside. In the extracorporeal circulation device 10 of the present embodiment, when the detection unit 22 detects that the liquid level of the priming liquid 40 in the circulation flow path 12 has reached a predetermined height, the detection unit 22 transmits a detection signal to the control device 18. To do. Then, after a predetermined time has elapsed since the control device 18 received the detection signal, the control device 18 automatically operates the centrifugal pump 14 after the priming liquid 40 is filled in the entire circulation flow path 12. Let Thus, the priming of the extracorporeal circulation device 10 is completed. Note that if the open / close cock 32 is closed after the priming liquid 40 is filled in the entire circulation flow path 12 and before the centrifugal pump 14 is operated, the priming liquid 40 in the circulation flow path 12 is forced by the centrifugal pump 14. Therefore, air can be prevented from entering the circulation flow path 12 from the outside through the hydrophobic filter 30.

  As described above, the extracorporeal circulation device 10 that has completed priming is attached to a patient with insufficient blood circulation in the body, such as heart failure, and is used to assist the blood circulation of the patient. That is, first, in the priming completion state in which the entire circulation channel 12 is filled with the priming liquid 40, as shown in FIG. 4, both sides of the connection portion of the air discharge part 24 in the circulation channel 12 are cut or removed. Thus, the circulation channel 12 is divided on the circumference. As a result, a blood removal port 54 is formed at one end of the divided circulation channel 12, and a blood return port 56 is formed at the other end.

  Further, as shown in FIG. 5, the blood removal port 54 is connected to a blood removal cannula 60 inserted percutaneously into the patient's femoral vein 58 and the blood return port 56 is percutaneously inserted into the patient's femoral artery 62. And is connected to a blood return cannula 66 that reaches the right atrium 64. The patient's venous blood is drawn into the circulation flow path 12 of the extracorporeal circulation device 10 from the blood removal port 54 and sent to the artificial lung 20 by the centrifugal pump 14 to remove carbon dioxide in the blood and into the blood. Add oxygen. Thereafter, the blood that has passed through the artificial lung 20 is sent from the blood return port 56 to the right atrium 64 of the patient, whereby the oxygen-added blood can be circulated into the patient's body as arterial blood.

  As shown in FIG. 5, it is desirable that the extracorporeal circulation device 10 is mounted on a gantry 70 having wheels 68 and can be easily moved on the floor surface. In addition, the extracorporeal circulation device 10 of the present embodiment includes, for example, a power supply device 74 that supplies power to the centrifugal pump 14 and the control device 18 in addition to an oxygen tank 72 that stores oxygen supplied to the artificial lung 20, and blood. A heat exchanger 76 for heating or cooling is provided.

  According to the extracorporeal circulation device 10 having the structure according to the present embodiment, the support pole 42 is compressed by the mass of the priming liquid 40 accommodated in the bag 38 at the start of priming, and the liquid in the bag 38 is compressed. The surface height is set low. This reduces the flow rate of the priming liquid 40 introduced into the circulation flow path 12 at the initial stage of priming before the connection portion between the circulation flow path 12 and the introduction flow path 36 is filled with the priming liquid 40. By preventing air from being entrained, it is possible to prevent a large amount of air from remaining in the circulation flow path 12.

  Furthermore, in the extracorporeal circulation device 10, as the priming progresses and the mixing of air due to the introduction of the priming liquid 40 into the circulation flow path 12 is reduced, the support pole 42 extends and the bag 38 is displaced upward. As a result, the liquid level in the bag 38 increases. Therefore, a decrease in the introduction speed of the priming liquid 40 due to the lowering of the liquid level in the bag 38 is suppressed, and the priming liquid 40 is quickly introduced into the circulation flow path 12, so that the time required for priming is reduced. Shortened.

  In addition, the support pole 42 uses the elasticity of the coil spring 52 disposed between the axially opposed surfaces of the outer cylinder member 44 and the inner shaft member 46, so that the priming liquid 40 contained in the bag 38 is reduced. It automatically extends as the mass decreases. Thus, since the tank liquid level changing means increases the liquid level in the bag 38 in accordance with the change in the mass of the priming liquid 40 accommodated in the bag 38, the medical worker The priming can be automatically and efficiently advanced without any special work. In addition, according to the structure of the present embodiment using the coil spring 52, the tank liquid level changing means can be realized at a low cost with a simple structure without requiring a special power source such as an electric motor.

  Further, the tank liquid level changing means of the present embodiment automatically changes and sets the liquid level in the bag 38 in accordance with the mass change of the priming liquid 40 accommodated in the bag 38. Even when a change in the introduction speed of the liquid occurs unintentionally, the liquid level in the bag 38 is automatically set to an appropriate position with respect to the liquid level in the circulation channel 12.

  Further, in this embodiment, since the centrifugal pump 14 is connected to the circulation flow path 12, residual air in the centrifugal pump 14 is likely to be a problem, but the introduction speed of the priming liquid 40 at the start of priming is high. By being reduced, entrainment of air into the centrifugal pump 14 is easily prevented. In addition, the centrifugal pump 14 is disposed below the center of the upper and lower sides of the circulation flow path 12 and is filled with the priming liquid 40 at the beginning of priming when the introduction speed of the priming liquid 40 is low. It is difficult to remain.

  Further, after the entire circulation channel 12 is filled with the priming liquid 40, the centrifugal pump 14 is operated to circulate the priming liquid 40 in the circulation channel 12, thereby circulating the circulation channel 12 and the centrifugal pump 14. Fine air bubbles that have entered can be swept away by the priming solution 40 and discharged from the air discharge unit 24 or the artificial lung 20 to the outside.

  FIG. 6 shows a fluid introduction part 80 constituting an extracorporeal circulation device as a second embodiment of the present invention. Note that in the extracorporeal circulation device of the present embodiment, the respective parts (not shown) other than the fluid introduction part 80 are substantially the same as those in the first embodiment, and thus the description thereof is omitted here. Moreover, in the fluid introduction part 80, about the member and site | part substantially the same as the fluid introduction part 34 of 1st Embodiment, description is abbreviate | omitted by attaching | subjecting the same code | symbol in a figure.

  More specifically, the fluid introduction part 80 has a structure in which a bag 38 connected to the introduction flow path 36 is supported by a support pole 82 as tank support means. The support pole 82 has a solid or hollow longitudinal shape, and its axial length is constant and cannot be changed. A coil spring 84 is attached to the tip of the suspension 48 provided at the upper end of the support pole 82 so as to extend downward. Further, a hook is provided at the lower end of the coil spring 84, the hook is inserted into a hole formed in the edge of the bag 38, and the bag 38 is suspended by the coil spring 84.

  At the start of priming with a large amount of the priming liquid 40 accommodated in the bag 38, the coil spring 84 is extended by the mass of the priming liquid 40 as shown in FIG. The position of is relatively low. On the other hand, when the priming progresses and the amount of the priming liquid 40 accommodated in the bag 38 decreases and the mass decreases, the amount of expansion and deformation of the coil spring 84 decreases accordingly, as shown in FIG. Thus, the position in the height direction of the bag 38 becomes high. In this way, as the priming progresses and the level of the priming liquid 40 introduced into the circulation flow path 12 increases, the bag 38 is lifted upward by a restoring force based on the elasticity of the coil spring 84. Thus, the liquid level of the priming liquid 40 accommodated in the bag 38 is increased. Thus, the tank liquid level changing means of the present embodiment is configured by the support pole 82 provided with the coil spring 84, and the liquid level height in the bag 38 according to the mass change of the priming liquid 40 in the bag 38. Has been changed automatically.

  According to the extracorporeal circulation apparatus configured according to this embodiment, the support pole 82 is configured to include the outer cylinder member 44 and the inner shaft member 46, rather than the extracorporeal circulation apparatus 10 of the first embodiment. Furthermore, the tank liquid level changing means can be configured with a simple structure.

  As mentioned above, although embodiment of this invention was explained in full detail, this invention is not limited by the specific description. For example, the tank liquid level changing means only needs to increase the liquid level in the bag 38 relative to the liquid level in the circulation flow path 12 as priming progresses. The bag 38 need not necessarily be lifted upward. Specifically, for example, the circulating flow path 12 may be relatively displaced downward with respect to the bag 38 to relatively increase the liquid level in the bag 38, or the priming liquid 40 in the bag 38 may be increased. It is also possible to employ one that increases the liquid level in the bag 38 by winding up the upper part of the liquid level. Further, the tank liquid level changing means in the present invention is not limited to one that changes the liquid level height in the bag 38 by relatively changing the position of the bag 38 and the circulation channel 12 in the height direction. For example, by providing supply means for supplying the priming liquid 40 from the outside to the bag 38 with a pump or the like, and adjusting the amount of the priming liquid 40 supplied to the bag 38 by the supply means, the liquid level in the bag 38 is increased. Can also be adjusted. Air bubbles generated when the priming liquid 40 is supplied into the bag 38 by a pump or the like disappears in the bag 38, so that no adverse effect is exerted upon priming. Further, by applying pressure to the peripheral wall of the bag 38 to narrow the peripheral wall of the deformable bag 38 and reducing the horizontal cross section, the priming liquid 40 accommodated in the bag 38 is not increased and the bag 38 is not increased. The liquid level in the bag 38 can also be raised, and the liquid level in the bag 38 can be controlled by adjusting the amount of squeezing of the peripheral wall of the bag 38.

  Further, the tank liquid level changing means is not construed as being limited to the specific structure shown in the embodiment, and various structures can be adopted. Specifically, for example, the tank liquid level changing means may be configured by converting a generated output of an electric motor or the like into a linear motion output in the vertical direction by a screw, a cam, a belt or the like and transmitting it to the bag 38. it can. Further, as the tank liquid level changing means, for example, by filling air or oil between the inner shaft member 46 and the outer cylinder member 44, the relative displacement in the axial direction of the inner shaft member 46 and the outer cylinder member 44 is changed. Instead of the elasticity of the coil spring 52, it can be realized by air pressure or hydraulic pressure, and the support pole can be expanded and contracted, thereby constituting the tank liquid level changing means.

  When the tank liquid level changing means having power as described above is adopted, the tank liquid level changing means, for example, the detection result of the flow of the priming liquid 40 in the circulation channel 12 or the elapsed time from the start of priming. For example, the liquid level in the bag 38 may be increased. That is, based on the detection result of the flow (flow rate, flow rate, etc.) of the priming liquid 40 detected by the detection unit 22, the control device 18 controls the electric motor and the like so that the liquid level in the bag 38 is automatically set. It may be changed as desired. Further, the control device 18 is provided with a time measuring means, and the elapsed time from the start of introduction of the priming liquid 40 into the circulation flow path 12 is measured by the time measuring means, and the electric motor, air pressure, hydraulic pressure, etc. of the tank liquid level changing means are output. The liquid level in the bag 38 can be automatically changed by controlling the means according to the elapsed time.

  Further, the arrangement of the centrifugal pump 14, the artificial lung 20, and the detection unit 22 on the flow path of the circulation flow path 12 is merely an example, and can be changed as appropriate. In the embodiment, the centrifugal pump 14, the artificial lung 20, and the detection unit 22 arranged on the flow path of the circulation flow path 12 are not essential, and are selectively adopted alone or in any combination. Alternatively, other blood processing means such as a heat exchanger or a filter may be employed.

  The introduction flow path 36 is preferably connected to the lowermost end of the circulation flow path 12 in order to effectively prevent the bubbles from remaining during priming, but is connected to the middle portion in the vertical direction of the circulation flow path 12. May be. In addition, when a pump such as the centrifugal pump 14 is provided on the circulation flow path 12, if air tends to remain in the pump for structural reasons, the priming liquid 40 is first introduced into the pump. For the purpose of increasing the air discharge efficiency, the position of the pump is set in the vicinity of the lowermost end on the circulation channel 12, or the position of the introduction channel 36 is set further below the connection position to the circulation channel 12. May be.

10: extracorporeal circulation device, 12: circulation flow path, 14: centrifugal pump (pump means), 38: bag (fluid tank), 40: priming liquid, 42, 82: support pole (tank liquid level changing means), 44: Outer cylinder member (tank liquid level changing means) 46: Inner shaft member (tank liquid level changing means) 52: Coil spring (tank liquid level changing means) 84: Coil spring (tank liquid level changing means)

Claims (6)

In the extracorporeal circulation apparatus having a circulation channel for circulating blood outside the body,
A tank that raises the liquid level of the priming liquid stored in the fluid tank connected to the circulation flow path as the liquid level rises in the circulation flow path of the priming liquid introduced into the circulation flow path An extracorporeal circulation apparatus characterized in that liquid level changing means is provided.   The extracorporeal circulation apparatus according to claim 1, wherein pump means is provided on the circulation flow path.   The tank liquid level changing means increases the liquid level of the priming liquid stored in the fluid tank as the weight of the priming liquid stored in the fluid tank decreases. 2. The extracorporeal circulation apparatus according to 2.   The tank liquid level changing means increases the liquid level height of the priming liquid stored in the fluid tank as the elapsed time from the start of introduction of the priming liquid into the circulation channel becomes longer. Item 3. The extracorporeal circulation apparatus according to Item 1 or 2.   The tank liquid level changing means increases the liquid level height of the priming liquid stored in the fluid tank based on the detection result of the flow of the priming liquid flowing through the circulation channel. The extracorporeal circulation device described. In the priming method of the extracorporeal circulation device for introducing the priming liquid stored in the fluid tank to the circulation flow path for circulating blood outside the body and discharging the air in the circulation flow path,
Priming from the fluid tank to the circulation channel while increasing the level of the priming solution contained in the fluid tank as the level of the priming solution in the circulation channel increases. A priming method for an extracorporeal circulation device, characterized by introducing a liquid.

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