JP3180309B2 - Continuous blood purification device - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a self-protection mechanism, in which blood removed from a vein or artery is introduced into a blood purifier, and after water, metabolites, electrolytes, etc. are separated by filtration, useful substances are supplied. The present invention relates to a continuous blood purification apparatus that assists or substitutes for organ functions of a living body by activating and retaining the same.

[0002]

2. Description of the Related Art Conventionally, as blood purification methods, whole blood exchange, plasma exchange, blood adsorption, hemodialysis, hemofiltration, hemodiafiltration, peritoneal dialysis and the like have been widely applied to clinical practice. Improve serious conditions, such as patients with renal insufficiency or other conditions that are severe enough to show signs of renal insufficiency or who have become hyperhydric due to postoperative infusions Performing hemodialysis and hemofiltration in a clinical setting has been practically used for a long time. Hemodialysis here refers to the principle of dialysis of waste in blood through a membrane, ie, the solute between the blood side and the dialysate side through a membrane (metabolic waste in blood, such as urea, uric acid, creatinine, (Electrolyte substances such as NaCl and KCl) using a concentration difference and a charge difference to selectively remove solutes through a membrane by the so-called Donan membrane equilibrium principle.In this case, there is no solvent movement, and only the solutes are removed. It moves through the membrane.

[0003] On the other hand, blood filtration has pores in a membrane, and a solvent itself containing a solute moves from the blood side to the other side through the pores of the membrane due to a pressure difference applied between the membranes. The solute passing through is regulated by solute size and membrane pore size, which, unlike dialysis, allows for selective removal by the principle of filtration. In this case, the body fluid component of the normally removed water is supplied as a replenisher (hereinafter referred to as a replenisher). Whether dialysis or filtration is used to treat patients who have accumulated waste in the blood or patients with hyperhydria has been determined and selected by clinicians in consideration of the condition of each patient. That is, according to the prior art, alternative methods of dialysis or filtration have been exclusively used. The method of combining the two is quite new. If this therapy is administered for a short time, the patient's fluid balance will fluctuate rapidly and the patient's condition will change abruptly, and this will adversely affect the patient. Blood purification therapies are rapidly spreading due to their recognition of minimizing adverse effects on patients. In this case, the flow rate of the dialysate is about one-tenth that of normal hemodialysis therapy. The effectiveness of this method is becoming clear, especially for critically ill patients, and it is mainly implemented in ICUs and CCUs while strictly controlling the fluid balance.
In continuous blood purification therapy, it is necessary to gradually perform blood purification over a long period of time, and therefore more strict management of the patient's body fluid balance is required. Therefore, the emergence of a highly accurate device that goes beyond conventional wisdom has become necessary.

[0004]

When a part of a body fluid is removed from a patient's body fluid by hemodiafiltration to remove water and unnecessary substances, a useful substance such as an electrolyte is used to maintain the balance of the body fluid. Replenish as a replacement fluid. The replacement fluid volume is balanced with the volume of fluid removed from the blood by the membrane filter, and if both volumes are substantially the same or the difference between the volumes is not within a predetermined range, the volume of the body fluid may rapidly decrease. The rapid increase creates problems in managing the condition of the patient. In the case of a patient receiving treatment in an intensive care unit or the like, it is particularly necessary to strictly control the fluid balance.

[0005] In the conventional hemodiafiltration treatment, the management of the dialysate volume, the filtrate volume removed from the blood, and the replacement fluid volume is, as one method, performed by directly setting the flow rate set values of the dialysate pump and the replacement fluid pump. The volume of the filtrate removed from the blood is adopted assuming that it is the same as the flow rate value, and the volume of the waste fluid, which is the sum of the volume of the dialysate passed through the filter and the volume of the filtrate removed from the blood, is measured with a graduated cylinder. Calculated by subtracting the dialysate volume from the waste fluid volume. In this case, a roller pump is usually used for the dialysate pump and the waste liquid pump, but there are variations in the tube diameter,
Since the tube cross-sectional area fluctuates due to a change in tube pressure due to a change in the pressure inside the tube during pumping, a difference occurs between the pump set value and the actual amount, and the error is generally ± 5% to ± 15.
%. In addition, there is a difference in the degree of error in each circuit used. In particular, in the case of the waste liquid pump, the influence of the pressure change is greatest. In other words, the blood purifier, with the course of treatment,
Blood clots and proteins in body fluids gradually adhere, and the filtration resistance gradually increases. When the waste liquid pump is rotating at a constant rotational speed, the pressure on the filtration side of the blood purifier decreases with an increase in filtration resistance, thereby causing deformation of the tube (reduction in cross-sectional area) and a decrease in flow rate. This is well known in the treatment field, and in practice, the waste liquid is received in a measuring container such as a measuring cylinder, the volume is measured sequentially, and the number of rotations of the waste liquid pump is maintained so that the waste liquid amount is kept constant. Has been adjusted. However, the measurement accuracy with the measuring cylinder is not high,
In addition, there is a case where a measurement error occurs, such as a case where a measurer forgets to measure and a filtrate overflows a measuring cylinder.

[0006] A roller pump or a finger pump is used as the replacement fluid pump. Finger pumps are generally said to be more accurate than roller pumps by using special tubing to prevent errors, but in practice, errors can range from ± 5% to ± 10%, similar to roller pumps There is also. Therefore, the relative error between the drainage pump and the rehydration pump can be up to 20%, so that continuous blood purification treatment over a long period of time results in a considerable increase in the accumulated fluid error, resulting in an unexpected increase in the patient's body fluid volume. May increase or decrease, thereby adversely affecting the condition of the patient. In order to avoid this, sufficient monitoring of the condition by the practitioner is required, and the burden on the practitioner increases.

As another method, there is a case where a weight management method is employed in which the total weight of the dialysate and replacement fluid is made equal to the weight of the waste fluid so that the weight of the body fluid does not change. Despite being able to balance, it is not possible to accurately and sequentially grasp how much each of the dialysate and replacement fluid was actually supplied, and it is not clear how much active ingredient in the replacement fluid was replenished in the patient's body There's a problem.

[0008] In any case, in the conventional technology, in the continuous blood purification therapy, the flow rate control of the dialysate, replacement fluid, and waste fluid is difficult, and if the observer is not always attached to it,
Not only did the patient undergo large fluctuations and could not exhibit the features of continuous blood purification therapy, but could even put the patient in a serious condition. Therefore,
In order to perform reliable flow control, that is, the main therapy, there has been a long-awaited demand for a device that automatically and reliably controls the actual flow rate so that the actual flow rate approaches a preset set flow rate value.

[0009]

Means for Solving the Problems The present inventors have proposed a hemodiafiltration therapy for slowly adjusting body fluid as described above.
As a result of intensive research on the means for automatically and accurately measuring and controlling the three fluid volumes to be measured (dialysate fluid volume, replacement fluid volume, and waste fluid volume), hemodialysis and hemofiltration were performed slowly and simultaneously in parallel. The inventor has found that the mechanism for performing the adjustment has a higher accuracy than conventional common sense, and has accomplished the present invention.

That is, the present invention relates to a continuous blood purification apparatus for extracting blood from a patient's vein or artery, purifying the blood, and returning the blood to the patient's vein. A blood purifier (hemodiafiltration filter) is provided in the extracorporeal circulation circuit, and has a function of simultaneously performing hemodialysis and hemofiltration. For this purpose, the dialysate is supplied from the dialysate tank to the blood in the apparatus. It has a circuit leading to the purifier and a dialysate pump for transferring dialysate into the circuit,
And a circuit for introducing a replacement fluid from the replacement fluid tank for replenishing the body fluid after blood filtration into a part of the extracorporeal blood circulation circuit, and a replacement fluid pump for transferring the replacement fluid into the circuit, for blood purification (dialysis and filtration) A device for continuous blood purification characterized by comprising a circuit for discharging the waste liquid subjected to the above and a device having three pumps of a waste liquid pump in the circuit, wherein each of the pumps is independently provided. It is equipped with volume measuring means that measures the dialysate flow rate, replacement fluid flow rate, and waste fluid flow rate independently and intermittently, and adjusts the rotation speed of each pump so that the obtained measured value matches the set value. An apparatus for continuous blood purification characterized in that it can be adjusted. In addition, the transfer capacity of each of the above dialysate pumps, replacement fluid pumps, and waste fluid pumps is 100 to 2,000 ml / hour, and 50 to 1,000
It is a continuous blood purification device with 0 ml / hour, 75-3,000 ml / hour. Further, the present invention relates to a continuous blood purification apparatus in which each of the dialysate pump, replacement fluid pump, and waste fluid pump has a flow rate error of ± 1% or less.

The measuring means of the present apparatus uses a measuring container having a constant volume, and measures the liquid volume at predetermined time intervals to accurately calculate the flow rate of the target liquid. If this value is lower than the set pump flow rate value, the pump rotation speed is increased, and if it is higher than the set value, the pump rotation speed is reduced so that the true liquid flow rate approaches the set value. It is adjusted to. While the error of a normal roller pump is about ± 5% to ± 15%, by adjusting the flow rate by this method, the flow rate error during 10 hours of operation is ± 1%.
% Or less.

[0012]

The measuring means of the present apparatus uses a measuring container having a constant volume, and measures the liquid volume at predetermined time intervals to accurately calculate the liquid flow rate of the target liquid. If this value is lower than the set pump flow rate value, the pump rotation speed is increased, and if it is higher than the set value, the pump rotation speed is reduced so that the true liquid flow rate approaches the set value. It is adjusted to. By adopting this control mechanism, a highly accurate apparatus that performs blood diafiltration therapy that slowly adjusts body fluids can be provided that exceeds conventional common sense.

[0013]

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a typical flow chart of the present invention. Figure 1
This will be specifically described. Extracorporeal blood circulation between venous (arterial) pulse and vein
Circuit 25 draws blood from the patient's vein or artery
From the side, pressure detection pillow 24, blood pump 2, blood purification
Converter 12 (hemodiafiltration filter), bubble sensor 23,
Pump 19 and blood purifier 1
2 and between the blood purifier 12 and the bubble sensor 23.
The pressure sensor 20 and the pressure sensor 22 are connected between them.
The syringe is connected between the patient and the pressure detection pillow 24.
Pump 1 is connected. Dialysate to blood purifier 12
A dialysis circuit 26 for introducing a dialysate from the ink tank is provided.
The analysis circuit is a dialysate tank, dialysate level sensor 9a,
Blood purification in the order of lamp 14, dialysate pump 5, and warmer
Of the clamp 14 and the dialysate pump 5
Clamp 13, upper dialysate level sensor 9 c,
Analyzed liquid measuring container 6 and lower dialysate level sensor 9b in this order.
The circuit to be provided is connected. Replenish body fluid after hemofiltration
Replenisher circuit 28 for introducing replenisher from replenisher tank
Is the blood purifier 12 and the bubble sensor of the extracorporeal blood circuit 25.
Fluid replenishing circuit 28 is provided between
Fluid, fluid replacement level sensor 10a, clamp 16, replacement fluid port
Pump 4 and the clamp 16 and the rehydration pump 4
Clamp 15, upper fluid replacement level sensor 10c,
The liquid measuring container 7 and the lower replacement fluid level sensor 10b are installed in this order.
Circuit is connected. Blood purification (dialysis and filtration
A waste liquid circuit 27 is provided for discharging the waste liquid which has been subjected to the above.
And the waste liquid circuit 27 discharges the waste liquid and clamps the waste liquid.
18, connected to the blood purifier 12 in the order of the waste liquid pump 3,
Clamp 17, upper part between waste liquid pump 3 and clamp 18
Waste liquid level sensor 11b, waste liquid measuring container 8, lower waste liquid
The circuit provided in the order of the level sensor 11a is connected,
A pressure sensor 21 is provided between the liquid pump 3 and the blood purifier 12.
Is provided. Dialysate circuit 26 and waste fluid circuit 27
Regarding connection to the blood purifier 12, the dialysate circuit 26 is abolished.
The blood is returned to the patient's vein of the blood purifier 12 from the liquid circuit 27.
It is provided on the side. In FIG. 1, the blood collection amount and the anticoagulant injection amount are set in accordance with the condition of the patient, the anticoagulant is injected by the syringe pump 1, and the blood is injected into the blood circulation circuit 25 including the blood purifier 12 by the blood pump 2. Circulate. The amount of dialysate and the amount of filtrate filtered by the blood purifier 12 are determined in accordance with the condition of the patient, and the dialysate pump 5 flow rate and the waste liquid pump 3 flow rate are set. The waste liquid flow rate corresponds to the sum of the dialysate flow rate and the filtrate flow rate. Since the dialysate flow rate, waste fluid flow rate, and replacement fluid flow rate are precisely controlled according to the set values, each pump, each level sensor, and each clamp operate as follows.

Dialysate flow rate; rotating dialysate pump 5;
The clamps 13 and 14 are opened. Dialysate is dialysate circuit 2
The dialysate flows into the measuring container 6 at the same time as the liquid is sent to the measuring container 6 due to a height drop between the liquid surface of the dialysate container and the liquid surface in the measuring container. When the liquid level reaches the upper dialysate level sensor 9c, the clamp 13 opens and the clamp 14 closes, and the liquid in the measuring container flows out of the container and is sent to the dialysate pump side. The liquid level in the measuring container is lower dialysate level sensor 9b.
, The clamp 14 is opened and the clamp 13 is closed, and the feeding of the dialysate is continued. After a predetermined time, when the clamp 13 is opened, the dialysate flows into the container again, and when the liquid level passes through the upper dialysate level sensor 9c, the clamp 13 is opened and the clamp 14 is closed, and the liquid is discharged from the container. leak. Such an operation is repeated every predetermined time. The time T1 required for the outflow of the liquid from the measuring container is measured as the time required for the liquid level to pass through the upper dialysate level sensor 9c and pass through the lower dialysate level sensor 9b. Since the dialysate measuring container 6 is manufactured by a plastic molding die and it is confirmed in advance that there is almost no error, the dialysate measuring container 6 has a constant volume V1, and the dialysate flow rate L1 flowing through the dialysate pump 5
Is L1 = V1 / T1. When the dialysate flow rate L1 is lower than the set value, the rotation speed of the pump 5 is increased, and when the dialysate flow rate L1 is higher, the flow rate is controlled to be closer to the set value by lowering the rotation speed of the pump 5. In the case where the measurement is performed again immediately after the outflow of the liquid is completed for a short period of time, the measurement can be repeated without closing the clamp 13.

When the waste liquid pump 3 is rotated, the clamp 17 is opened and the clamp 18 is closed, the waste liquid flows into the waste liquid measuring container 8. Liquid level is lower waste liquid level sensor 1
When passing through 1a and reaching the upper waste liquid level sensor 11b, the clamp 17 is opened and the clamp 18 is opened, and the waste liquid in the waste liquid measuring container 8 flows out of the container due to the height drop. After a predetermined time, when the clamp 18 is closed, the waste liquid flows into the measuring container 8 again, and when the liquid level passes through the lower waste liquid level sensor 11a and reaches the upper waste liquid level sensor 11b, the clamp 18 is opened, and the inside of the measuring container is opened. The waste liquid flows out of the container. Such an operation is repeated every predetermined time. Time T ₂ required for the inflow to the weighing container liquid level is measured as the time to reach the waste liquid level sensor 11b of the upper through the lower waste level sensor 11a. Since the measuring container 8 is manufactured by a plastic molding die and it is confirmed in advance that there is almost no error, the measuring container 8 has a constant volume V ₂ , and the waste liquid flow rate L ₂ flowing through the waste liquid pump 3 is L ₂ = V ₂ / T ₂ It is. In this case the flow rate L ₂ is lower than the set value increases the rotation speed of the waste liquid pump 3, is higher is controlled to be a flow rate closer to the set value by reducing the rotational speed of the waste pump 3.

Replenisher flow rate: The replenisher pump 4 is rotated, and the clamps 15 and 16 are opened. The replacement fluid is sent to the replacement fluid circuit 28 by the pump, and at the same time, the replacement fluid flows into the replacement fluid measuring container 7 due to the height difference between the liquid surface of the replacement fluid container and the liquid surface in the replacement fluid measuring container 7. When the liquid level reaches the upper replacement fluid level sensor 10c, the clamp 15 is opened and the clamp 16 is closed, and the fluid in the replacement fluid measuring container flows out of the container and is sent to the replacement fluid pump 4. When the liquid level in the replacement fluid measuring container passes through the lower replacement fluid level sensor 10b, the clamp 16 is opened and the clamp 15 is closed, and the supply of replacement fluid is continued. After a predetermined time, the clamps 15 and 16 are opened, the replacement fluid flows into the replacement fluid measuring container 7 again, and the fluid level is changed to the upper replacement fluid level sensor 1.
When passing through 0c, the clamp 15 is opened and the clamp 16 is closed, and the liquid flows out from the replacement fluid container. Such an operation is repeated every predetermined time. The time T ₃ required for the replacement fluid to flow out of the replacement fluid measuring container 7 is measured as the time from when the liquid level passes through the upper replacement fluid level sensor 10 c to the lower replacement fluid level sensor 10 b. Replacement fluid measuring container 7
Is manufactured with a plastic mold and it is confirmed in advance that there is almost no error. Therefore, the constant volume V ₃ is obtained, and the replacement fluid flow rate L ₃ flowing through the replacement fluid pump 4 is L ₃ = V ₃ / T ₃ . In this case the flow rate L ₃ is lower than the set value increases the rotational speed of the replacement fluid pump 4, is higher is controlled to be closer to the flow rate by the setting value by lowering the rotational speed of the pump 4. In the case where the measurement is performed again immediately after the liquid has flowed out after the predetermined time is short, the measurement can be repeated without closing the clamp 15.

The predetermined time depends on the flow rate of the liquid, but is preferably set every 1 to 20 minutes so that the accuracy is sufficiently improved, and is preferably set to be longer when the flow rate is small and shorter when the flow rate is large.

In the system of the present invention, the dialysate pump flow rate is actually set to 500 ml / hour, the predetermined time is set every three minutes, and the integrated flow rate when the liquid (for example, tap water) is continuously supplied for 10 hours is calculated. It was 5013 grams when measured with an electronic balance, with an error of 0.
26%. In addition, with this system, the flow rate of the waste liquid pump was set to 500 ml / hour and the predetermined time was set every three minutes.
The integrated flow rate of the liquid (tap water) discharged per minute was measured by an electronic balance, and was 1756 g, with an error of 0.34%. In addition, the pressure in the sealed container had dropped from the atmospheric pressure before the start of suction to -322 mmHg after 3 hours and 30 minutes.

Further, in order to compare with the effect of the system of the present invention, the flow rate of the waste liquid pump 3 is set to 500 ml by not using the measuring container 8 and therefore not controlling the rotation speed of the waste liquid pump 3 based on the measurement result. / Hour, and the liquid (for example, tap water) contained in the closed container was sucked and discharged by the waste liquid pump 3. At this time, the integrated flow rate of the liquid (tap water) discharged for 3 hours and 30 minutes was measured by an electronic balance to be 1433 grams,
The error was -18.1%. In addition, the pressure in the closed vessel was reduced from the atmospheric pressure before the start of suction to -271 mmHg after 3 hours and 30 minutes.

[0020]

According to the continuous blood purification apparatus of the present invention, the dialysate flow rate, the replenishment flow rate, and the waste liquid flow rate set by the operator are intermittently measured by independent volume measuring means, and the measured values are rotated by each pump. By reflecting the numerical control, the flow rate according to each set value is automatically realized with high precision. Therefore, in a continuous blood purification device for a serious patient who needs strict body fluid balance control. In addition, it is possible to reduce the burden of managing the patient's body fluid balance on the practitioner who had to be constantly monitored until now, and since the accuracy is high, there is no possibility of causing a serious problem in treatment.

[Brief description of the drawings]

FIG. 1 is a typical flowchart of the present invention.

[Explanation of symbols]

 1 Syringe pump 2 Blood pump 3 Waste fluid pump 4 Refill pump 5 Dialysate pump 6 Dialysate measuring container 7 Refill fluid measuring container 8 Waste liquid measuring container 9a, 9b, 9c Dialysate level sensor 10a, 10b, 10c Refill fluid level sensor 11a, 11b Waste liquid Level sensor 12 Blood purifier 13-19 Clamp 20-22 Pressure sensor 23 Bubble sensor 24 Pressure detection pillow 25 Blood circulation circuit 26 Dialysate circuit 27 Waste fluid circuit 28 Fluid replacement circuit

Continuation of the front page (58) Field surveyed (Int.Cl. ⁷ , DB name) A61M 1/14-1/34 B01D 61/32

Claims (9)

(57) [Claims] An apparatus for continuously purifying blood which derives blood from a patient's vein or artery, purifies the blood, and returns the blood to the patient's vein. A blood pump and a blood purifier (hemodiafiltration filter) are arranged in the inside, and a function to perform hemodialysis and hemofiltration at the same time is provided. It has a circuit leading to the purifier and a dialysis pump for transferring the dialysate into the circuit,
And a circuit for introducing a replacement fluid from the replacement fluid tank for replenishing the body fluid after blood filtration into a part of the extracorporeal blood circulation circuit, and a replacement fluid pump for transferring the replacement fluid into the circuit, for blood purification (dialysis and filtration) A device for discharging the waste liquid subjected to the above and a waste liquid pump in the circuit, the pumps each function independently,
Dialysate flow, replacement fluid flow, and waste fluid flow are individually and independently controlled.
Liquid volume at predetermined time intervals using a measuring container with a fixed volume
Comprising intermittently measured volumetrically metering means, characterized in that measuring the actual measurement values obtained with the set value, characterized in that to be able to adjust the rotational speeds of the pumps corresponding to match Equipment for continuous blood purification. 2. Derivation of blood from a patient's vein or artery
Continuous blood purification that returns to the patient's vein after purifying the blood
Device, the above-mentioned extracorporeal blood between the venous (venous) pulse and the vein
Blood pump and blood purifier (hemodialysis filter)
And hemodialysis and hemofiltration at the same time
It is equipped with a function that can be performed in parallel.
The circuit that guides the dialysate from the tank to the blood purifier and its circuit
Equipped with a weighing container and a dialysis pump for transferring dialysate in the channel
Replacement fluid for replenishing body fluids after hemofiltration
Introduce replacement fluid from the tank to a part of the extracorporeal blood circuit
Circuit and a refilling fluid port for transferring the replenishing fluid into the circuit.
Blood purification (dialysis and filtration)
A circuit for draining waste liquid and a measuring container and waste
An apparatus equipped with three types of liquid pumps,
The pumps function independently, and the dialysate flow rate and replacement fluid flow rate
With independent and constant volume for wastewater and wastewater flow
Characterized by measuring the liquid volume at predetermined time intervals using a container
With intermittently-measured volume measuring means
Turn each pump so that the measured value matches the set value.
Continuous blood characterized by being able to control the number of turns
Liquid purification device. (3) Extract blood from patient's vein or artery
Continuous blood purification that returns to the patient's vein after purifying the blood
Device, the above-mentioned extracorporeal blood between the venous (venous) pulse and the vein
The circulation circuit includes the blood pump 2, the blood purifier 12 (the hemodialysis filter).
And hemodialysis and hemofiltration at the same time.
With the ability to perform For this purpose, dialysate is transferred from the dialysate tank to the blood
A dialysis circuit 26 leading to the purifier 12 is provided, The dialysis circuit is composed of a dialysate tank and a dialysate level sensor 9
a, the clamp 14 and the dialysate pump 5 in this order.
2 between the clamp 14 and the dialysate pump 5.
Lamp 13, upper dialysate level sensor 9c, dialysate meter
The volume container 6 and the lower dialysate level sensor 9b are provided in this order.
The circuit is connected, From the rehydration tank to replenish body fluids after blood filtration
Rehydration circuit 28 for introducing rehydration fluid to a part of extracorporeal blood circulation circuit
Is provided, The refilling circuit is a refilling tank, a refilling level sensor 10
a, the clamp 16 and the replacement fluid pump 4 in this order.
After the blood is returned to the patient's vein after purification,
Clamp 15 between lamp 16 and rehydration pump 4
Fluid level sensor 10c, fluid replacement measuring container 7, lower fluid replacement level
A circuit provided in the order of the bell sensor 10b is connected, For draining waste liquid after blood purification (dialysis and filtration)
Waste liquid circuit 27 is provided, The end where the waste circuit discharges waste, the clamp 18, the waste
Connected to the blood purifier 12 in the order of the liquid pump 3 and
Between the clamp 3 and the clamp 18, the upper waste liquid level
Sensor 11b, waste liquid measuring container 8, lower waste liquid level sensor
Circuits provided in the order of the sensors 11a are connected, Each of the pumps functions independently, Dialysate flow, replacement fluid flow, and waste fluid flow are individually and independently controlled.
Liquid volume at predetermined time intervals using a measuring container with a fixed volume
Of intermittently measuring, characterized by measuring Weighing
So that the measured value and the set value match
Adjustable rotation speed of each corresponding pump
An apparatus for continuous blood purification characterized by the following. (4) Measurement of dialysate flow, replacement fluid flow and waste fluid flow
The contract is characterized by the following (1) to (3)
The device for continuous blood purification according to any one of claims 1 to 3.
Place. (1) Measurement of dialysate flow rate: The dialysate pump 5 is rotated,
The clamps 13 and 14 are opened. Dialysate is dialysate circuit 2
And at the same time the dialysate container liquid level and the liquid in the measuring container
The dialysate flows into the measuring container 6 due to the height drop with respect to the surface.
You. When the liquid level reaches the upper dialysate level sensor 9c
The clamp 13 is opened, the clamp 14 is closed, and the measuring container
The liquid in the container flows out of the container and is sent to the dialysate pump side.
You. The liquid level in the measuring container is the lower dialysate level sensor 9b.
, The clamp 14 opens and the clamp 13 closes.
Then, the feeding of the dialysate is continued. After a predetermined time, clamp
When 13 is opened, dialysate flows into the container again,
Is clamped when it passes the upper dialysate level sensor 9c
13 is open, clamp 14 is closed and liquid flows out of the container
I do. Such an operation is repeated every predetermined time. Total
The time T1 required for liquid outflow from the volume container
The dialysate level sensor at the lower part passes through the
It is measured as the time required to pass through the sensor 9b. (2) Measurement of waste liquid flow rate: Rotate waste liquid pump 3 and
When the pump 17 is opened and the clamp 18 is closed, the waste liquid is
It flows into the quantity container 8. Liquid level is lower waste liquid level sensor 1
1a and reaches the upper waste liquid level sensor 11b.
Then, the clamp 17 opens and the clamp 18 opens,
The waste liquid in the measuring container 8 flows out of the container due to the height drop
You. After a predetermined time, when the clamp 18 is closed,
Flows into the measuring container 8 and the liquid level is the lower waste liquid level sensor.
-11a and reach the upper waste liquid level sensor 11b
Then, the clamp 18 is opened and the waste liquid in the measuring container is
Spills from inside. Such an operation is repeated every predetermined time.
Is done. The time T2 required to flow into the measuring container is lower than the liquid level.
Waste liquid level passing through the waste liquid level sensor 11a
Measured as the time to reach sensor 11b
You. (3) Measurement of replenisher flow rate: Rotate replenisher pump 4 and
The lamps 15 and 16 are opened. Fluid is replaced by pump
At the same time as the liquid is sent to the circuit 28, Liquid metering
Due to the height difference between the liquid level in the container 7 and the
Liquid flows in. The liquid level is on the upper replacement fluid level sensor 10c.
Upon reaching, the clamp 15 opens and the clamp 16 closes.
The liquid in the replenisher measuring container flows out of the container,
To the pump 4. When the liquid level in the replacement fluid measuring container is
After passing through the bell sensor 10b, the clamp 16 is opened and closed.
The lamp 15 is closed, and the supply of the replacement fluid is continued. At a given time
After a while, the clamps 15 and 16 are opened and the replacement fluid is replaced again.
It flows into the measuring container 7 and the liquid level is the upper replacement fluid level sensor 1
When passing through 0c, the clamp 15 is opened and the clamp 16 is closed.
And the liquid flows out from the replacement fluid container. Such behavior
Is repeated every predetermined time. Replenishment from replenisher measuring container 7
The time T3 required for liquid outflow is based on the replacement fluid level
Passing through the circulator 10c and the lower replenisher level sensor 10b
It is measured as the time to pass. (5) Measurement of dialysate flow, replacement fluid flow and waste fluid flow
The contract is characterized by the following (1) to (3)
The device for continuous blood purification according to any one of claims 1 to 3.
Place. (1) Dialysate flow rate: Rotate dialysate pump 5 and clamp
Steps 13 and 14 are opened. Dialysate is sent to dialysate circuit 26
At the same time, the dialysate container liquid level and the
The dialysate flows into the measuring container 6 due to the height drop. Liquid surface
Reaches the upper dialysate level sensor 9c and is clamped
13 is open, clamp 14 is closed, and the liquid in the measuring container is
It flows out of the container and is sent to the dialysate pump side. Weighing capacity
The liquid level in the vessel passes through the lower dialysate level sensor 9b
And clamp 14 are open, clamp 13 is closed and dialysate
The feeding continues. After a predetermined time, the clamp 13 is opened.
Then, the dialysate flows into the container again, and the liquid level rises to the upper dialysate.
After passing through the level sensor 9c, the clamp 13 opens and closes.
The lamp 14 is closed, and the liquid flows out of the container. This
Such an operation is repeated every predetermined time. From the weighing container
The time T1 required for the liquid outflow is determined by the dialysate level
Sensor 9c and the lower dialysate level sensor 9b
It is measured as the time to pass. Dialysate measuring container
Reference numeral 6 denotes a constant volume V1, which is a transparent volume flowing through the dialysate pump 5.
The precipitation liquid flow rate L1 is L1 = V1 / T1 It is. If the dialysate flow rate L1 is lower than the set value,
Increase the rotation speed of the pump 5, If high, increase the speed of the pump 5
Control so that the flow rate is closer to the set value.
You. Predetermined time is short, and measurement is performed again immediately after liquid outflow
When performing the above, repeat without closing the clamp 13.
Can also be. (2) Waste liquid flow rate: The waste liquid pump 3 is rotated and the clamp 1
7 is opened and the clamp 18 is closed.
Flow into 8. The liquid level is the lower waste liquid level sensor 11a.
When it passes and reaches the upper waste liquid level sensor 11b, it is closed.
The lamp 17 opens, the clamp 18 opens, and the waste liquid
The waste liquid in the vessel 8 flows out of the container due to a height drop. Predetermined
After the period of time, when the clamp 18 is closed, the waste liquid is again weighed.
Flows into the vessel 8 and the liquid level is lower waste liquid level sensor 11a.
Pass through and reach the upper waste liquid level sensor 11b.
The lamp 18 opens and the waste liquid in the measuring container flows from the container.
Put out. Such an operation is repeated every predetermined time.
The time T2 required for inflow into the measuring container is such that the liquid level is
Waste liquid level sensor at the top after passing through the bell sensor 11a
It is measured as the time to reach 11b. Weighing capacity
The vessel 8 has a constant volume V2 and waste water flowing through the waste liquid pump 3.
The liquid flow rate L2 is L2 = V2 / T2 It is. If the flow rate L2 is lower than the set value,
Increase the rotation speed of pump 3, and if high, increase the rotation speed of waste liquid pump 3.
Control so that the flow rate is closer to the set value by lowering
Is done. (3) Replenisher flow rate: Rotate replenisher pump 4 and clamp
15 and 16 are opened. Refill fluid is pumped by refill circuit 2
8 and at the same time the fluid level of the replacement fluid container and the replacement fluid measuring container 7
Due to the height drop from the inner liquid level, the replacement fluid flows into the replacement fluid measuring container 7.
Enter. The liquid level reaches the upper replacement fluid level sensor 10c.
Then, the clamp 15 opens and the clamp 16 closes.
The liquid in the measuring container flows out of the container and is sent to the replacement fluid pump 4.
Liquid. The liquid level in the replacement fluid metering container is
After passing through the circuit 10b, the clamp 16 is opened, and the clamp 1
5 is closed, and the supply of the replacement fluid is continued. After a predetermined time,
The lamps 15 and 16 are opened, and the replacement fluid is again supplied to the replacement fluid measuring container.
7, the liquid level passes through the upper replenisher level sensor 10c.
If it passes, the clamp 15 will open and the clamp 16 will close,
The liquid flows out from the replacement fluid container. When such an operation
Repeated every interval. For outflow of replacement fluid from replacement fluid measuring container 7
The required time T3 is the level of replacement fluid level Sir 10
c and through the lower replenisher level sensor 10b
It is measured as the time to Replenisher measuring container 7 is plus
It is pre-made that there is almost no error produced by the tick mold.
It has been confirmed that it has a constant volume V3
4, the replacement fluid flow rate L3 flowing through L3 = V3 / T3 It is. If the flow rate L3 is lower than the set value,
Increase the speed of pump 4 and lower the speed of pump 4 if higher.
Control so that the flow rate is closer to the set value.
You. Predetermined time is short, and measurement is performed again immediately after the liquid has flowed out.
When performing, repeat without closing the clamp 15.
Can be. 6. The measuring container is made from a plastic mold
6. Any one of claims 1 to 5, characterized by being made
2. The continuous blood purification device according to claim 1. 7. Set blood collection volume, blood purifier with blood pump
Blood is circulated through the blood circulation circuit containing
Determine the amount of filtrate to be filtered by the blood purifier and
Set the pump flow rate and the waste liquid pump flow rate.
Continuous blood purification according to any one of claims 1 to 6.
Equipment. 8. The transfer capacity of the dialysate pump, replacement fluid pump and waste fluid pump is 100 to 2,000 ml / hour, respectively.
50-1,000ml / hour, 75-3,000ml /
8. The method according to claim 1, wherein the time is a time.
Item 14. The continuous blood purification device according to Item . 9. dialysate pump, replacement fluid pump, for continuous blood purification according to Izu <br/> Re one of claims 1-8 each integrated flow rate error of the waste pump is less than 1% ± apparatus.