JP2020036964A - 流体平衡システム - Google Patents
流体平衡システム Download PDFInfo
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- JP2020036964A JP2020036964A JP2019211077A JP2019211077A JP2020036964A JP 2020036964 A JP2020036964 A JP 2020036964A JP 2019211077 A JP2019211077 A JP 2019211077A JP 2019211077 A JP2019211077 A JP 2019211077A JP 2020036964 A JP2020036964 A JP 2020036964A
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- Prior art keywords
- dialysate
- fluid
- pump
- cassette
- user interface
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Abstract
Description
図36A乃至36Eに、底部プレート1100を示す。図36Aおよび36Bに、底部プレート1100の内側表面を示す。内側表面は、図34Eに示すミッドプレート(ここには図示しない)の底面に接触する側である。底部プレート1100は、エアライン(図示しない)に取り付けられる。図34Eに示すポッドポンプ820,828および弁(ここには図示しない)を駆動させる空気のための対応する入口の穴1106は、ミッドプレートに設けられる。穴1108,1110は、図34Cに示す、第2流体入口824、および第2流体出口826にそれぞれ対応する。流路のための溝1112のように、ポッドポンプ820,828および平衡ポッド812,822の対応する半分を更に示す。頂部プレートとは異なり、ポッドポンプ820,828および平衡ポッド812,822に対応する底部プレートの半分は、ポッドポンプ820,828および平衡ポッド812、822間の違いを明瞭にする。ポッドポンプ820,828は、底部プレートに第2半分に空気の通路を備え、平衡ポッド812,822は、頂部プレートで半分と同一の構造を備える。更に、平衡ポッド812,822は、流体の平衡を保持し、これによって図示しない隔壁の両側は、液体の流路を含み、ポッドポンプ820,828は、液体を汲出す圧力ポンプであり、これによって一方の側は、液体流路を含み、底部プレート1100に示す他方の側は、空気駆動のチャンバまたは空気流体路を含む。
powerHeater=massFlow*((tankPGain*errorTank)+(UFPGain*errorUF)
PowerHeater=ヒータの使用率命令(0乃至100%);
MassFlow=流体質量流速度;
TankPGain=タンクまたは入口の温度センサのための比例ゲイン;
ErrorTank=タンクまたは入口の温度センサおよび望ましい温度の間の差異;
UFPGain=限外濾過膜または出口の温度センサのための比例ゲイン;ErrorUF=ufまたは出口の温度センサおよび望ましい温度の間の差異。
透析液は、更にたとえば限外濾過膜を使用して汚染物、感染性の生物、病原体、発熱物質、残骸等を取除くべく濾過される。フィルタは、図3Aに示すように配向回路と平衡回路の間にて、透析液流路の好適な位置に配置され、且つ/または限外濾過膜は、配向回路か平衡回路に組み込まれる。限外濾過膜が使用される場合に、フィルタを通して上記タイプを防止する網寸法を有すべく選択される。たとえば網寸法は、約0.3マイクロメートル以下、約0.2マイクロメートル以下、約0.1マイクロメートル以下、あるいは約0.05マイクロメートル以下等である。当業者は、限外濾過膜のようなフィルタは、多くの場合、市場にて容易に入手可能であることを認識するだろう。
上述したように、図11Aの空気の駆動システム110の正の供給弁117、および負の供給弁118は、二通りのオンオフ弁に対して好適に可変的な制限弁である。可変的な弁の使用によって、駆動チャンバ112および隔壁109に作用される圧力は、隔壁に完全なタンク圧力を作用させることに代えてタンク121,122の僅かな圧力によって容易に制御することができる。従ってポッドポンプを駆動させるための圧力がポッドポンプによって異なっても、異なるポッドポンプに対して、同じタンクやタンクの組が使用可能である。タンク圧力は、様々なポッドポンプの隔壁に作用される好適な圧力と比較してより大きい必要があるが、1つのポッドポンプは、半分のタンク圧力によって駆動され、別のポッドポンプは、同じタンクによって駆動されるが、四分の一のタンク圧力によって駆動する。従って、透析システムの別のポッドが異なった圧力にて駆動するように設計されても、これらのポッドポンプは、全て同じタンクか同じ組のタンクを共有するが、様々な弁を使用して異なった圧力にて駆動される。ポッドポンプにて使用される圧力は、透析の工程において生じるか、あるいは変化する状況に応じて変化する。たとえば管が歪むことによってシステムの管が圧縮された場合に、ポッドポンプにおいて使用される正または負の圧力、あるいはその両者が制限の上昇を補うために高められる。
部品を「熱い」セクションと、「冷たい」セクションとに分けることには、複数の利点がある。電装品の使用寿命、信頼性、または使用効率が挙げられる。たとえば部品を「熱い」セクションと「冷たい」セクションに分けることによって、ホットボックス全体が加熱される。これによって、より優れたエネルギー有効システムを実現するために熱が有効的に使用される。これは、熱のよりエネルギー効率が良いシステムをもたらすより有効な使用を可能にする。これは、また低価格に実現すための標準的な、在庫中の電子部品の使用を可能にする。
図57は、コネクタ4401の基盤4301に示す。頂部プレート4302は、コネクタ4303と共に示されている。センサプローブ4501は、流路4503に頂部プレート4302を介して伸びる。センサプローブ4501は、本明細書中でも述べたセンサプローブを含む様々な形状のセンサである。
一連の実施例において、停電時には、可能な限り多くの血液を患者に戻すことが好ましい。血液透析システムの一実施例では、使用される様々なポンプや弁を駆動させるために圧縮された気体を使用するため、他の実施例では、このような圧縮された気体を利用して、停電時にシステムの血液を患者へ戻すことができる。この方法に従うと共に、図29Aを参照して、透析装置14を横切って透析液を注入して、血流回路19内の血液を浄化して患者に戻す。圧縮空気を使用して透析液を透析装置14内へ注入する。弁77が圧縮空気を解放するとこの機能を始動する。この方法は、停電や他の障害によって、透析装置が処置の終わりに通常行う方法で患者の血液を浄化して戻すことが妨げられた場合に、使用することが可能である。
システムおよび方法の一実施例の実施は、図29Aに示されており、使用される材料の親水性を利用して透析装置14内に細い管を形成する。この材料が湿潤していると、透析液は通過できるが、空気は通過できない。図29Aに示す実施例を実行する場合には、空気は透析装置14に進入できるが、血流回路10を越えて通過しない。
and Methods)」;2007年4月13日に出願された米国特許出願第11/787,112号、発明の名称「熱および伝導度感知システム、装置および方法(Thermal and Conductivity Sensing Systems,Devices and Methods)」;2007年10月12日に出願された米国特許出願第11/871,680号、発明の名称「ポンプカセット(Pumping Cassette)」;2007年10月12日に出願された米国特許出願第11/871,712号、発明の名称「ポンプカセット(Pumping Cassette)」;2007年10月12日に出願された米国特許出願第11/871,787号、発明の名称「ポンプカセット(Pumping Cassette)」;2007年10月12日に出願された米国特許出願第11/871,793号、発明の名称「ポンプカセット(Pumping Cassette)」;および2007年10月12日に出願された米国特許出願第11/871,803号、発明の名称「カセットシステム統合装置(Cassette System Integrated Apparatus)」。更に、以下は、全体を参照によって本明細書に組み込まれるものである:1989年2月28日に特許付与された米国特許第4,808,161号、発明の名称「圧力測定フロー制御システム(Pressure−Measurement Flow Control System)」;1989年5月2日に特許付与された米国特許第4,826,482号、発明の名称「強化された圧力測定フロー制御システム(Enhanced Pressure−Measurement Flow Control System)」;1990年12月11日に特許付与された米国特許第4,976,162号、発明の名称「強化された圧力測定フロー制御システム(Enhanced Pressure−Measurement Flow Control System)」;1992年2月18日に特許付与された米国特許第5,088,515号、発明の名称「取り外し可能な流体インタフェースを備えた弁システム(Valve System with Removable Fluid Interface)」;1994年9月27日に特許付与された米国特許第5,350,357号、発明の名称「重力流に逆らう流体の配分およびポンプカセットを用いる腹膜透析システム(Peritoneal Dialysis Systems
Employing a Liquid Distribution and Pumping Cassette that Emulates Gravity Flow)」。更に、全体を参照によって本明細書に組み込まれるものは、本願と同日付けで出願された米国特許出願、発明の名称「センサ装置システム、デバイスおよび方法(Sensor Apparatus Systems, Devices and Methods)」(整理番号F63、米国特許出願第12/038,474号)、および本願と同日付けで出願された米国特許出願、発明の名称「カセットシステム統合装置(Cassette System Integrated Apparatus)」(整理番号F62)である。
Hemodialysis System)」;米国特許出願第12/199,068号、発明の名称「可搬型血液透析システム用モジュラー型アセンブリ(Modular Assembly for a Portable Hemodialysis System)」;米国特許出願第12/199,077号、発明の名称「血液透析システム用血液回路アセンブリ(Blood Circuit Assembly for a Hemodialysis System)」;米国特許出願第12/199,166号、発明の名称「医療注入装置用エアトラップ(Air Trap for a Medical Infusion Device)」;米国特許出願第12/199,176号、発明の名称「医療注入装置用血液ラインコネクタ(Blood Line Connector for a Medical Infusion Device)」;米国特許出願第12/199,196号、発明の名称「血液透析システム用試薬供給(Reagent Supply for a Hemodialysis System)」;および2008年8月27日に出願された米国特許出願第12/199,452号、発明の名称「血液透析システムおよび方法(Hemodialysis System and Methods)」。
essentially of)」のみが、特許審査手続きに関する米国特許庁便覧セクション2111.03に規定されるように、それぞれ閉鎖性、半閉鎖性の移行句である。
Claims (33)
- 透析ユニットとユーザインタフェースユニットとを備える血液透析システムであって、
前記透析ユニットは、自動化コンピュータと透析器とを備え、
前記ユーザインタフェースユニットは、ユーザインタフェースコンピュータとユーザインタフェースとを備え、前記ユーザインタフェースは、情報を表示し且つ入力を受信するように構成され、
前記自動化コンピュータは、前記ユーザインタフェースコンピュータから安全重視情報の要求を受信するように構成され、前記自動化コンピュータは、前記ユーザインタフェースコンピュータの代わりに前記安全重視情報にアクセスするように構成され、
前記ユーザインタフェースコンピュータは、前記安全重視情報を使用することで前記ユーザインタフェースを介して透析プロセスに関する情報を表示するように構成されることを特徴とする血液透析システム。 - 前記安全重視情報は、前記ユーザインタフェースの表示の状態に関係し、
前記表示の状態は、少なくとも一部が前記透析プロセスの状態に基づく、
請求項1記載の血液透析システム。 - 前記安全重視情報は、前記透析プロセスから収集したデータを含む、
請求項1記載の血液透析システム。 - 前記ユーザインタフェースコンピュータは、表示モードを指定する入力を受信するとともに、前記指定された表示モードに基づき、前記透析プロセスに関する情報の表示に使用するための前記安全重視情報のサブセットを選択するように構成される、
請求項1記載の血液透析システム。 - 前記自動化コンピュータは、透析器とのインタフェースである透析器インタフェースを備え、
前記ユーザインタフェースコンピュータは、要求される前記透析プロセスに関する入力を受信し、前記入力を前記自動化コンピュータに送信するように構成され、
前記自動化コンピュータは、前記入力の受信に応答して、前記透析プロセスを開始するためのコマンドを前記透析器インタフェースに発行するように構成される、
請求項1記載の血液透析システム。 - 前記自動化コンピュータはさらに、前記コマンドの発行に先立って、前記入力を検証するように構成される、
請求項5記載の血液透析システム。 - 前記ユーザインタフェースコンピュータはさらに、前記ユーザインタフェースコンピュータが直接アクセスする画面設計情報を使用することで、前記透析プロセスに関する情報を前記ユーザインタフェースを介して表示するように構成される、
請求項1記載の血液透析システム。 - 前記自動化コンピュータは、前記血液透析システムに記憶されるすべての前記安全重視情報を制御するように構成される、
請求項1記載の血液透析システム。 - 前記血液透析システムは、前記安全重視情報を記憶するためのデータベースを備え、
前記自動化コンピュータは、前記データベースへの前記安全重視情報の記憶を制御するように構成される、
請求項1記載の血液透析システム。 - 前記ユーザインタフェースコンピュータは、前記データベースへの情報の書込が禁止されている、
請求項9記載の血液透析システム。 - 前記透析器は、混合回路と、血流回路と、平衡回路と、外部透析液回路とを備える、
請求項1記載の血液透析システム。 - 前記自動化コンピュータは、透析器に連動する少なくとも1つのセンサによって異常状態が検出されたときに、アラーム状態をトリガするように構成される、
請求項1記載の血液透析システム。 - 前記ユーザインタフェースコンピュータは、アラーム状態を表すアラーム情報の表示を、前記ユーザインタフェースを介して制御するように構成される、
請求項12記載の血液透析システム。 - 血液透析システムにおいてユーザインタフェースを管理するユーザインタフェース管理方法であって、前記ユーザインタフェース管理方法は、
ユーザインタフェースコンピュータに連動するユーザインタフェースによって、透析プロセスに関する入力を受信する工程と;
前記入力に応答して、安全重視情報の要求を前記ユーザインタフェースコンピュータから、透析器に連動する自動化コンピュータに送信する工程と;
前記ユーザインタフェースコンピュータの代わりに、前記安全重視情報にアクセスする工程と;
前記安全重視情報を使用することで、前記透析プロセスに関する情報を、前記ユーザインタフェースを介して表示する表示工程と
を含むことを特徴とする、ユーザインタフェース管理方法。 - 前記安全重視情報は、前記ユーザインタフェースの表示の状態に関係し、
前記表示の状態は、少なくとも一部が前記透析プロセスの状態に基づく、
請求項14記載のユーザインタフェース管理方法。 - 前記安全重視情報は、前記透析プロセスから収集したデータを含む、
請求項14記載のユーザインタフェース管理方法。 - 前記ユーザインタフェース管理方法はさらに、
前記ユーザインタフェースによって、表示モードを指定する入力を受信する工程と;
前記ユーザインタフェースコンピュータを使用することで、前記指定された表示モードに基づき前記安全重視情報のサブセットを選択する工程と;
前記安全重視情報のサブセットを、前記ユーザインタフェースを介して表示する工程とを含む、
請求項14記載のユーザインタフェース管理方法。 - 前記ユーザインタフェース管理方法はさらに、
前記ユーザインタフェースで要求される前記透析プロセスに関する入力を、受信する工程と;
前記入力を、前記ユーザインタフェースコンピュータから自動化コンピュータに送信する工程と;
前記入力を検証する工程と;
前記入力の検証に応答して、前記透析プロセスを開始するように透析器に命じる工程とを含む、
請求項14記載のユーザインタフェース管理方法。 - 前記ユーザインタフェース管理方法はさらに、
前記ユーザインタフェースコンピュータ内に記憶される画面設計情報に、アクセスする工程を含み、
前記表示工程は前記画面設計情報を使用することで、前記透析プロセスに関する情報を、前記ユーザインタフェースを介して表示する工程を含む、
請求項14記載のユーザインタフェース管理方法。 - コンピュータに以下の手順を時効させるためのプログラムを記録したコンピュータ読取可能な記憶媒体であって、前記手順としては、
ユーザインタフェースコンピュータに連動するユーザインタフェースから、透析プロセスに関する入力を受信する手順と;
前記入力に応答して、安全重視情報の要求を、前記ユーザインタフェースコンピュータから、透析器に連動する自動化コンピュータに送信する手順と;
前記ユーザインタフェースコンピュータの代わりに、前記安全重視情報にアクセスする手順と;
前記安全重視情報を、前記ユーザインタフェースコンピュータに送信する手順と;
前記ユーザインタフェースコンピュータ内に記憶されている画面設計情報に、アクセスする手順と;
前記安全重視情報と前記画面設計情報とを使用することで、前記透析プロセスに関する情報を前記ユーザインタフェースに表示させる手順と
を含む、コンピュータ読取可能な記憶媒体。 - 少なくとも1つの流体入口と;
少なくとも1つの流体出口と;
前記流体入口を前記流体出口に連結する流路と
を備える透析ポンプカセットであって、
前記流路は、平衡チャンバを通過するように構成され、さらに抗凝血剤の供給源に連結される第2流体入口を通過するように構成され、
前記流体入口に進入する流体は、前記平衡チャンバに進入する前に、前記第2流体入口を通るように構成されていることを特徴とする、透析ポンプカセット。 - スパイクが中空である、
請求項21記載の透析ポンプカセット。 - 第1入口を、第1出口に連結する第1流路と;
第2入口を、第2出口に連結する第2流路と;
制御流体路と:
隔壁を含む堅固な容器をそれぞれ備える少なくとも2つのポンプであって、それぞれ前記隔壁は、前記堅固な容器を第1区画と第2区画とに分割し、それぞれ前記第1区画は前記制御流体路に流体連通し、前記第2区画は前記第2流路に流体連通していることと;
前記第1流路と前記第2流路との間の流れの平衡を保つ平衡チャンバと;
前記平衡チャンバ内の流体を直接制御する少なくとも1つの弁を、パルス幅変調を利用することで開放する制御装置と
を備えることを特徴とする、血流カセット。 - 前記隔壁は、可撓性である、
請求項23記載の血流カセット。 - 未処置の血液を、患者から汲出して透析装置に通過させる血流路と;
透析液を、透析液供給体から前記透析装置に流す透析液流路であって、前記透析液流路は前記血流路に流体連通していることと;
前記透析液流路内の透析液を、強制的に前記血流路に流し込む圧力装置と
を備える血液透析システムであって、
前記透析装置を出る透析液の圧力が、前記透析装置を出る血液の圧力よりも低くなるように、前記圧力装置内の圧力は制御されることを特徴とする、血液透析システム。 - 前記血流路は、血流カセットで画定される、
請求項25記載の血液透析システム。 - 前記透析液流路は、少なくとも1つのカセットで画定される、
請求項25記載の血液透析システム。 - 未処置の血液を、患者から汲出して透析装置に通過させる血流路と;
透析液を透析液供給体から前記透析装置に流す透析液流路であって、前記透析液流路は前記血流路に流体連通することと;
前記透析液流路内の透析液を、強制的に前記血流路に流し込む圧力装置と
を備える血液透析システムであって、
前記透析装置に入る透析液の圧力が、前記透析装置に入る血液の圧力よりも高くなるように、前記圧力装置内の圧力は制御されることを特徴とする、血液透析システム。 - 前記血流路は、血流カセットで画定される、
請求項28記載の血液透析システム。 - 前記透析液流路は、少なくとも1つのカセットで画定される、
請求項28記載の血液透析システム。 - 血液透析システムの作動方法であって、
前記血液透析システムは、
患者から血液を汲出して、透析装置に通過させる血流路と;
透析液を、透析液供給体から前記透析装置に流す透析液流路と
を備え、
前記透析液流路は、
前記透析装置を通過する前記透析液の量を制御する平衡カセットと;
水から前記透析液を形成する混合カセットと;
水供給体から前記混合カセットに水を通すとともに、前記混合カセットから前記平衡カセットに前記透析液を通す配向カセットと
を備え、
前記作動方法は、
前記血液透析システムを提供する工程と;
透析液ポンプのストローク毎に前記透析液を、前記透析装置を通して前記血流路に圧送し且つ引き返すように、前記透析装置に前記透析液を通過させる工程と
を含むことを特徴とする、血液透析システムの作動方法。 - 前記血流路は、血流カセットで画定される、
請求項31記載の作動方法。 - 前記透析液流路は、少なくとも1つのカセットで画定される、
請求項31記載の作動方法。
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JP5576377B2 (ja) | 2014-08-20 |
JP6622752B2 (ja) | 2019-12-18 |
EP3689390A2 (en) | 2020-08-05 |
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WO2010027435A1 (en) | 2010-03-11 |
JP2014236996A (ja) | 2014-12-18 |
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JP2012501210A (ja) | 2012-01-19 |
JP6502030B2 (ja) | 2019-04-17 |
MX2022011243A (es) | 2022-11-08 |
US20160175506A1 (en) | 2016-06-23 |
US8357298B2 (en) | 2013-01-22 |
MX2022004596A (es) | 2022-05-06 |
MX2011002254A (es) | 2011-05-19 |
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