JP3771103B2 - Two tank blood reservoir - Google Patents

Description

[0001]
[Industrial application fields]
The present invention relates to a blood reservoir for extracorporeal circulation that can reduce the amount of blood filling without changing the reservoir capacity.
[0002]
[Prior art and problems]
In cardiac surgery for treating a valve inside the heart, a coronary artery on the surface of the heart, and the like, an operation under cardiac arrest is essential. In this operation, in order to maintain systemic circulation under cardiac arrest, the venous blood that has flowed back to the heart is led out of the body, temporarily stored in a blood reservoir, oxygenated, and then returned from the ascending aorta that hits the heart Circulation method is used together.
A conventional blood reservoir 1 has a structure in which venous blood a fed from a venous blood flow inlet 2 is filtered by a filter 3 and purified blood b is sent from a drain port 4 to an artificial lung 6 by a pump 5 (FIG. 1). The blood is oxygenated by the oxygenator 6 and then sent to the ascending aorta as oxygen-enriched blood c.
[0003]
As the blood reservoir 1, the extracorporeal circulation method requires an amount of blood that fills the entire circuit. Therefore, the components such as the artificial lung and the heat exchanger can be improved so that the extracorporeal circulation can be performed with the smallest possible filling amount. It has been advanced. As a result, the blood volume required for circuit filling for adults has now been reduced to about 1500 ml.
[0004]
Approximately 500 ml of the blood volume of 1500 ml is occupied by blood stored in the blood reservoir 1, and the outflow amount of blood b sent from the blood reservoir 1 through the drain port 4 is set to 4000 to 5000 ml / min. Therefore, even if 500 ml of blood is stored in the blood reservoir 1, if some trouble occurs in the path for leading venous blood to the outside of the body, the blood b is sent out from the blood reservoir 1, and the blood reservoir 1 is kept in a few seconds. It becomes empty. The hollowing out of the blood reservoir 1 induces air mixing into the blood circulation circuit, which leads to the most dangerous and evasive situation in the extracorporeal circulation. In order to prevent hollowing of the blood reservoir 1 and improve the safety level of the extracorporeal circulation method, blood storage corresponding to the extracorporeal circulation amount is required.
[0005]
On the other hand, the extracorporeal circuit is normally started after filling with Ringer's solution. Reducing the amount of Ringer's solution is directly effective in suppressing blood dilution and has the effect of reducing anemia during surgery. Various improvements have been made to reduce the filling amount of Ringer's solution, and the level has been reduced to the same level as the necessary blood volume. However, an improvement to the blood reservoir 1 that occupies about 1/3 of the blood circulation circuit has not been proposed so far because the reduction of blood volume in the blood reservoir 1 and the safety of extracorporeal circulation are contradictory.
[0006]
In cardiac surgery, the heart is filled with ice water during the operation, and a cardioplegia solution is used. Most of the ice water and cardioplegia is collected in the extracorporeal circuit, which also causes the blood to be highly diluted and cause anemia to progress. The blood concentrator 7 (Hemoconcentrator) may be used to remove excessively mixed water. In this case, a part of the oxygen-enriched blood c is sent to the blood concentrator 7 to separate water, cardioplegia, etc. as the crystalline liquid e. The blood d from which the crystalline liquid e has been separated is returned to the blood reservoir 1 through the suction port 8, and the crystalline liquid e is recovered in the waste liquid recovery container 9. The operation of the blood concentrator 7 is exclusively a manual operation, and is a complicated operation in which the waste liquid and the waste liquid suspension are repeated while looking at the liquid level in the blood reservoir 1.
[0007]
[Problems to be solved by the invention]
The crystalline liquid e separated by the blood concentrator 7 is recovered as it is in the waste liquid recovery container 9. However, when the crystalline liquid e is separated using the ultrafiltration membrane, the blood componentally becomes the same as the blood c flowing in the extracorporeal circulation system.
The present invention pays attention to the crystalline liquid separated by the blood concentrator, and by storing the crystalline liquid in the blood reservoir, the hollowing of the blood reservoir is prevented and the volume that should be occupied by the circulating blood is reduced and filled. It aims at providing the blood reservoir which enabled quantity reduction.
[0008]
[Means for Solving the Problems]
In order to achieve the object, the two-tank blood reservoir of the present invention divides the blood reservoir into a blood storage chamber and a crystalline liquid storage chamber, the blood storage chamber has a venous blood flow inlet, a filter for filtering venous blood, and a filtration A drain port for delivering the blood to the artificial lung is provided, the crystal liquid storage chamber is connected to the blood concentrator via the crystal liquid inflow tube, and a floating valve that is pressed against the valve seat by the buoyancy of the blood in the blood storage chamber It is provided at the bottom of the crystalline liquid storage chamber.
It is preferable to open a waste liquid pipe leading to a waste liquid recovery container at a predetermined height position on the side wall of the crystalline liquid storage chamber. When the amount of the crystalline liquid stored in the crystalline liquid storage chamber becomes excessive, the excess amount overflows into the waste liquid pipe, so that the liquid level in the crystalline liquid storage chamber is maintained constant.
[0009]
Embodiment
As shown in FIG. 2, for example, the two-tank blood reservoir according to the present invention divides the blood reservoir 1 into two tanks, a blood reservoir 10 and a crystal solution reservoir 11, and the crystal quality of the blood concentrator 7. The liquid inflow pipe 12 is connected to the crystalline liquid storage chamber 11. A floating valve 13 is provided at the bottom of the crystalline liquid storage chamber 11 to prevent blood flow from the blood storage chamber 10 to the crystalline liquid storage chamber 11. A waste liquid pipe 14 is opened at an appropriate height on the side wall of the crystal liquid storage chamber 11, and excess crystal liquid e in the crystal liquid storage chamber 11 passes through the waste liquid pipe 14 to the waste liquid recovery container 9. Discharged.
[0010]
The total capacity of the blood storage chamber 10 and the crystalline liquid storage chamber 11 is set to substantially the same capacity as that of the one tank type blood reservoir 1 (FIG. 1) in order to avoid a dangerous state due to the hollowing of the blood reservoir 1. . In this two-tank blood reservoir, the crystal liquid e separated from the blood concentrator 7 is fed into the crystal liquid storage chamber 11 and used as a reservoir-liquid capacity, so that the same liquid as the conventional one-tank blood reservoir is used. Maintain capacity.
[0011]
In a state where a normal amount of blood b is stored in the blood storage chamber 10, the floating valve 13 is pushed up by the blood b and contacts the valve seat 15, the valve opening is closed, and the blood storage chamber 10 and the crystalline liquid storage are stored. The chamber 11 is shut off (FIG. 3a). Therefore, after the venous blood a passes through the filter 3 and the foreign matter is removed, a path through which the purified blood b is sent to the oxygenator 6 is formed.
If the blood b stored in the blood storage chamber 10 decreases for some reason, the buoyancy acting on the floating valve 13 decreases. As a result, the floating valve 13 is lowered and a gap is formed between the floating valve 13 and the valve seat 15. That is, since the valve opening is opened, the crystalline liquid e in the crystalline liquid storage chamber 11 flows into the drain port 4 through the valve opening, and compensates for the shortage of blood b (FIG. 3b).
[0012]
In a state where a large amount of the crystalline liquid e has accumulated in the crystalline liquid storage chamber 11, the liquid surface of the crystalline liquid e approaches the opening of the waste liquid pipe 14 provided on the side wall of the crystalline liquid storage chamber 11. The amount of the crystalline liquid e exceeding the opening overflows into the waste liquid pipe 14 and is recovered in the waste liquid recovery container 9 (FIG. 3c). Therefore, the liquid level in the crystalline liquid storage chamber 11 is maintained constant.
Thus, since the blood reservoir 1 is of the two-tank type, that is, the blood reservoir 10 and the crystalline liquid reservoir 11, the capacity of the blood reservoir and thus the blood filling amount can be greatly reduced. In addition, there is no problem even when blood transfusion is performed as necessary during extracorporeal circulation.
[0013]
【The invention's effect】
As described above, the two-tank blood reservoir of the present invention has two blood reservoir chambers and a crystalline liquid reservoir chamber, so that the blood filling amount can be greatly reduced. Since the blood filling volume of the blood reservoir is very large, about 1/3 of the entire blood circulation circuit, reducing the blood filling volume in this part suppresses the excessive dilution of blood in the extracorporeal circulation, and the degree of anemia The amount of blood transfusion can also be reduced. Moreover, since the excess amount of crystal liquid can be automatically controlled according to the amount of crystal liquid stored in the crystal liquid storage chamber, it is compared with the conventional method in which waste liquid and waste liquid are stopped while looking at the liquid level in the blood reservoir. This reduces the work burden during surgery.
[Brief description of the drawings]
FIG. 1 is a schematic diagram of an extracorporeal circuit having a conventional one-tank blood reservoir. FIG. 2 is a schematic diagram of an extracorporeal circuit having a two-tank blood reservoir according to the present invention. Standard state (a), state (b) in which crystal liquid flows from the crystal liquid storage chamber into the drain port, and the fact that the crystal liquid in the crystal liquid storage chamber is maintained at a constant amount (c) Figure [Explanation of symbols]
2: Venous blood flow inlet 3: Filter 4: Drain port 6: Artificial lung 7: Blood concentrator 9: Waste liquid collection container 10: Blood reservoir 11: Crystalline fluid reservoir 12: Crystalline fluid inlet tube 13: Floating valve 14: Waste pipe 15: Valve seat

Claims (2)

The blood reservoir is divided into a blood storage chamber and a crystalline liquid storage chamber. The blood storage chamber is provided with a venous blood flow inlet, a filter for filtering venous blood, and a drain port for sending filtered blood to the artificial lung. The crystal liquid storage chamber is connected to the blood concentrator through an inflow pipe, and a floating valve that is pressed against the valve seat by buoyancy due to blood in the blood storage chamber is provided at the bottom of the crystal liquid storage chamber Two tank blood reservoir. The two-tank blood reservoir according to claim 1, wherein a waste liquid pipe reaching the waste liquid recovery container is opened at a predetermined height position on the side wall of the crystalline liquid storage chamber.

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