JP4265466B2 - Blood purification apparatus and automatic priming method for blood circuit - Google Patents

Description

  The present invention relates to a blood purification apparatus that assists or substitutes for organ functions of a living body by purifying blood taken out from a blood vessel outside the body, and supplementing it with useful substances if necessary. It is possible to automatically prime a blood circulation path (hereinafter referred to as a blood circuit) including a path, and to automatically return blood remaining in the blood circuit after blood purification treatment. It is characterized by that. The present invention also relates to an automatic priming method and an automatic blood return method performed using the blood purification apparatus.

Conventionally, hemodialysis and blood filtration using a blood purification apparatus have been performed in order to improve a serious condition such as a patient with renal failure or a patient with hyperhydration due to postoperative surgical fluid injection. In general, when the blood purification apparatus is used, a priming solution (generally, physiological saline) is introduced and filled in the blood circuit to remove foreign substances and air in the circuit (referred to as priming). And about the automatic priming method and processing device of the blood purification device, the arterial blood circuit and the venous blood circuit are connected to form a circulation circuit, the blood pump is operated to circulate the priming liquid to the circulation circuit, By supplying the priming liquid from the priming liquid storage container to the circulation circuit at a predetermined flow rate, an artificial dialysis apparatus (for example, for performing priming by discharging a part of the priming liquid from the overflow tube provided in the drip chamber) In the devices of Patent Document 1) and Patent Document 1, the priming liquid from the priming liquid supply system is used upstream of the blood pump (upstream side in the blood flow direction during blood purification) using its own head. The side is shown as downstream. The same shall apply hereinafter.) The venous side washing and discharging process to flow into the system, the priming liquid from the priming liquid supply system and the arterial side to flow from the arterial circuit portion downstream of the blood pump to the overflow system using the head and the blood pump There has been proposed an automatic priming method and apparatus (for example, Patent Document 2) including a washing and discharging step and a whole washing and circulating step in which the staying liquid in the circulation circuit by both steps is circulated through the whole circulation circuit by a blood pump. .
No. 5-19075 Japanese Patent Publication No. 2659914

  However, the above-described conventional blood purification apparatus forms a circulation circuit by connecting an arterial blood circuit and a venous blood circuit, and requires an arterial drip chamber and a venous drip chamber. Need. This overflow line is formed by detachably connecting an overflow tube having a length of about 1 meter to the liquid level adjustment line of the venous drip chamber, and it is difficult to adjust the liquid level during treatment. During the treatment, it was necessary to remove the overflow tube. Therefore, it takes extra effort to connect and disconnect, and the remaining spent priming solution that adheres to the tube adheres to the hand and drips on the floor. There is an infection problem.

  The present invention has been made in view of the above circumstances, and can automatically prime a blood circuit, and can automatically return blood remaining in the blood circuit after blood purification treatment. In addition, the blood circuit does not require an arterial drip chamber or a venous drip chamber (thus, no overflow tube is required for priming, and the capacity in the blood circuit is reduced, reducing the burden on the patient. It is an object to provide a blood purification apparatus.

That is, the present invention
(1) A blood purifier comprising a blood purifier and a blood circuit, a blood pump, a priming liquid supply line connected to the arterial blood circuit upstream of the blood pump, and a bubble sensor provided in the venous blood circuit In the apparatus, a blood collection connector is provided in the arterial blood collection unit, a vein connector connectable to the blood collection connector is provided in a vein blood circuit between the blood purifier and the bubble sensor, and the priming Opening / closing means is provided in the arterial blood circuit upstream from the connection portion with the liquid supply line, and the opening / closing means is opened to connect the venous side connector and the blood collection side connector, so that the priming liquid line Blood purification that enables priming of the arterial blood circuit upstream of the connecting portion and the venous blood circuit downstream of the venous connector Apparatus and,
(2) The blood purification apparatus according to (1), wherein a blood sensor is provided upstream of the opening / closing means,
(3) The blood purification apparatus according to the above (1) or (2), wherein an opening / closing means is provided in the priming liquid supply line, and a liquid shortage sensor is provided upstream of the opening / closing means;
(4) The blood purification apparatus according to (3) above, wherein a priming liquid injection means is provided downstream of the opening / closing means,
(5) The blood purification device according to any one of (1) to (4) above, wherein an opening / closing means is provided in the venous blood circuit downstream from the bubble sensor;
(6) The priming liquid injection line is connected to the priming liquid supply line between the liquid shortage sensor and the opening / closing means, and the opening / closing means is provided between the connection portion with the priming liquid injection line and the liquid shortage sensor. The blood purification device according to any one of 1) to (5), and
(7) Driving the blood pump to prime the arterial blood circuit and the venous blood circuit downstream from the connection with the priming liquid supply line, and using the drop or injection means for priming liquid A step of priming the arterial blood circuit upstream of the connection portion with the liquid supply line and the venous blood circuit downstream of the venous connector; and after completion of both steps, the blood pump is driven to The blood purification described in (1) above, comprising the step of circulating the remaining priming solution in the closed circuit returning from the arterial blood circuit to the blood purifier and the venous connector to the arterial blood circuit vessel about the priming how the blood circulation path with.

  According to the present invention, the following effects can be expected. That is, the blood purification apparatus of the present invention can automatically prime the blood circuit, and can automatically return the blood remaining in the blood circuit after the blood purification treatment. In addition, since neither an arterial drip chamber nor a venous drip chamber is required, an overflow tube is not required for priming, and therefore, it is possible to save time and labor of connecting / disconnecting the drained spent adhering to the tube. Contamination of the floor due to the remaining priming solution and infection problems can be avoided. Furthermore, since the capacity in the blood circuit is reduced, the burden on the patient can be reduced.

  In a blood purification apparatus comprising a blood purifier and a blood circuit, a blood pump, a priming liquid supply line connected to an arterial blood circuit upstream of the blood pump, and a bubble sensor provided in a venous blood circuit, A blood collection connector is provided in the arterial blood collection unit, a vein connector that can be connected to the blood collection connector in the vein blood circuit between the blood purifier and the bubble sensor, and further upstream from the connection with the priming fluid supply line Opening and closing means is provided in the arterial blood circuit. In addition, a blood sensor is provided upstream of the opening / closing means, and a liquid shortage sensor, opening / closing means, and priming liquid injection means are provided in order from the upstream side in the priming liquid supply line, and the venous blood circuit downstream of the bubble sensor is opened / closed Means are provided.

Next, Example 1 of the present invention will be described with reference to the drawings. FIG. 1 is a schematic explanatory view of a blood purification apparatus of the present invention.
As shown in FIG. 1, the blood purification apparatus of the present invention includes a blood purification device 1, blood circuits 21 and 22, a blood pump 23, and a priming solution supply connected to the arterial blood circuit 21 upstream of the blood pump 23. It includes a bubble sensor 25 provided in the line 3 and the venous blood circuit 22. A blood collection connector 211 is provided at the arterial blood collection section (the base end portion of the arterial blood circuit 21), and the venous blood circuit 22 between the blood purifier 1 and the bubble sensor 25 is usually blood purification. A venous connector 222 that can be connected to the blood collection connector 211 is provided near the blood vessel 1, and an open / close means V 1 is provided in the arterial blood circuit 21 upstream from the connection portion 26 to the priming fluid supply line 3. Is provided. With this configuration, the arterial blood circuit 21 and the venous connector 222 upstream from the connection portion 26 with the priming fluid supply line 3 are opened by opening and closing means V1 and connecting the venous connector 222 and the blood collection connector 211. The venous blood circuit 22 on the downstream side can be primed.

In FIG. 1, the blood circulation path includes a blood passage of the blood purifier 1, an arterial blood circuit 21, and a venous blood circuit 22, and is located at the proximal end of the arterial blood collection unit that is the proximal end portion of the arterial blood circuit 21. A blood collection connector 211 is provided. The arterial blood circuit 21 includes, in order from the upstream side, a blood sensor 24 for detecting whether or not the blood up to the arterial blood collection part is properly replaced with the priming liquid for blood return during the blood return operation, and the on-off valve V1. A blood pump 23 is provided. A priming fluid supply line 3 is connected to the arterial blood circuit 21 between the blood pump 23 and the opening / closing means V1. The priming fluid storage line 31 is connected to the priming fluid supply line 3 in order from the upstream side. In addition, a liquid shortage sensor 32 and an opening / closing means V3 for confirming the end of priming are provided. If necessary, the priming liquid supply line 3 may be provided with a priming liquid injection means 33 downstream of the opening / closing means V3.
On the other hand, the venous blood circuit is provided with a bubble sensor 25 and an opening / closing means V2 for detecting the presence or absence of bubbles in the venous blood circuit in order from the upstream side, and the discharged priming liquid is a waste liquid. It flows into the container 4. The vein side blood circuit 22 between the blood purifier 1 and the bubble sensor 25 is provided with a vein side connector 222 that can be connected to the blood collection side connector 211. The connector 222 is closed with a cap (not shown) or the like during blood purification processing such as dialysis treatment.
As the blood sensor 24, an optical sensor is usually used, and as the liquid shortage sensor 32, an ultrasonic sensor is usually used.
Moreover, as the injection means 33, a tubing pump, a finger pump, etc. are employable.

Next, Example 2 will be described with reference to FIG.
In the second embodiment, the priming liquid injection line is not directly provided in the priming liquid supply line 3 but the priming liquid injection line 5 is connected to the priming liquid supply line 3 between the liquid shortage sensor 32 and the opening / closing means V3. In addition, an opening / closing means V4 is provided between the connecting portion 34 to the priming liquid injection line 3 and the liquid shortage sensor 32. The priming liquid injection line 5 is provided with an opening / closing valve V5. In this case, the syringe pump 51 can be employed as the priming liquid injection means. When the syringe pump 51 is employed, the on-off valves V4 and V5 are opened, the on-off valve V3 is closed, and the priming liquid is transferred from the priming liquid storage container 31 to the syringe. It is possible to inhale the pump 51, then close the on-off valve V4 and open the on-off valve V3 to discharge the priming liquid from the syringe pump 51.

Next, Example 3 (a blood circuit priming method using the blood purification apparatus of Example 1) will be described. The blood circuit priming method of the present invention follows the priming flow diagrams shown in FIGS.
First, when the blood purification apparatus is set to the priming mode and the priming amount is set, the on-off valve V1 is closed, the on-off valves V2, V3 are opened, the blood pump 23 is driven, and the priming liquid storage container 31 is driven as shown in FIG. The priming liquid therein passes through the arterial blood circuit 21B downstream from the connection portion 26 with the priming liquid supply line 3, passes through the blood flow path of the blood purifier 1, the venous blood circuit 22, and the circuits 21B, 22 Then, the blood flow path of the blood purifier 1 is washed and discharged from the venous blood return section 221 to the waste liquid container 4 (priming step 1). When the set time of the priming stroke 1 has elapsed (priming stroke 1 ends), the blood pump 23 stops, the on-off valve V1 opens, and the priming liquid in the priming liquid storage container 31 drops as shown in FIG. Alternatively, the injection means 33 allows the circuits 21A and 22A to pass through the arterial blood circuit 21A upstream from the connection portion 26 with the priming fluid supply line 3 and through the venous blood circuit 22A downstream from the venous connector 222. It is washed and discharged from the venous side blood return part 221 to the waste liquid container 4 (priming step 2). When the set time of the priming stroke 2 elapses (priming stroke 2 ends), the on-off valves V2 and V3 are closed and the blood pump 23 is driven, and the priming liquid remaining in the blood circulation path as shown in FIG. Circulates in a closed circuit returning from the arterial blood circuit 21B to the arterial blood circuit 21A via the blood purifier 1 and the vein connector 222 (priming step 3). When the set time of the priming stroke 3 has elapsed (priming stroke 3 ends), the on-off valve V1 is closed, the on-off valves V2, V3 are opened, the blood pump 23 is driven, and thereafter the priming stroke 1 to the priming stroke 3 are repeated. The priming operation ends when the priming target amount is reached or when the priming liquid is exhausted by the liquid shortage sensor 32.

Next, a description will be given of the Kaechikata method of blood in the blood circuit using the blood purification device of the actual Example 1. Blood methods return follows the blood return flow diagram shown in FIGS. 5-7.
First, after the blood treatment operation is completed (the blood pump 23 is stopped, the on-off valves V1 and V2 are opened, and the on-off valve V3 is closed), the blood purifier is set to the blood return mode, and the blood return amount (precisely the blood return operation) When the priming liquid supply amount at (1) is set, the on-off valve V1 is closed and the on-off valve V3 is opened. In this state, when the blood pump 23 is driven, the thrombus generated in the connection portion 26 between the arterial blood circuit 21 and the priming fluid supply line 3 is transferred to the arterial blood circuit 21B downstream from the connection portion 26 by the priming fluid. Moving. (Blood return stroke 1) When the above-mentioned thrombus moves to a desired position and the blood return stroke 1 is completed, the on-off valve V1 is opened, the blood pump 23 is stopped, and as shown in FIG. The priming fluid in 31 is supplied to the arterial blood circuit 21A upstream from the connection portion 26 with the priming fluid supply line 3 by the injecting means 33, and is pushed out by this priming fluid to enter the arterial blood circuit 21A. The blood is returned from the arterial blood collection part (portion where the connector 211 is provided) (blood return process 2). When it is detected by the blood sensor 24 that the blood up to the artery side blood collection part is completely replaced with the priming solution for returning blood, the returning stroke 2 is finished, the on-off valve V1 is closed, and the blood pump 23 is driven. As shown in FIG. 7, the priming liquid in the priming liquid storage container 31 passes through the arterial blood circuit 21 </ b> B and the blood purifier 1 on the downstream side of the connection portion 26 with the priming liquid supply line 3. The blood in the arterial blood circuit 21B, the blood purifier 1, and the venous blood circuit 22 is returned to the circuit 22 from the venous blood return unit 221 (blood return process 3). At this time, mixing of bubbles into the venous blood circuit 22 is detected by the bubble sensor 25, and the blood pump 23 stops when bubbles are detected. When the blood return target amount is reached or when the priming liquid is exhausted by the liquid shortage sensor 32, the blood return operation ends.

It is a schematic explanatory drawing which shows the Example of the blood purification apparatus of this invention. It is explanatory drawing of the priming method performed using the blood purification apparatus of this invention. It is explanatory drawing of the priming method performed using the blood purification apparatus of this invention. It is explanatory drawing of the priming method performed using the blood purification apparatus of this invention. It is explanatory drawing of the blood return method performed using the blood purification apparatus of this invention. It is explanatory drawing of the blood return method performed using the blood purification apparatus of this invention. It is explanatory drawing of the blood return method performed using the blood purification apparatus of this invention. It is a schematic explanatory drawing which shows the other Example of the blood purification apparatus of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Blood purifier 21 Arterial side blood circuit 21A Arterial side blood circuit upstream from the connection part with priming liquid supply line 21B Arterial side blood circuit downstream from the connection part with priming liquid supply line 211 Blood collection side blood return part 22 Vein side blood circuit 22A Venous side blood circuit downstream from vein side connector 23 Blood pump 24 Blood sensor 25 Bubble sensor 26 Connection portion with priming liquid supply line 3 Priming liquid supply line 31 Priming liquid storage container 32 Liquid running sensor 33 Priming Liquid injection means 34 Connection portion with priming liquid injection line 4 Waste liquid container 5 Priming liquid injection line 51 Syringe pump V1, V2, V3, V4, V5 Opening / closing means

Claims (7)

In a blood purification apparatus comprising a blood purifier and a blood circuit, a blood pump, a priming liquid supply line connected to an arterial blood circuit upstream of the blood pump, and a bubble sensor provided in a venous blood circuit, An arterial blood collection unit is provided on the arterial side of the blood circuit, a venous blood return unit is provided on the venous side of the blood circuit , a blood collection connector is provided on the arterial blood collection unit, and the blood collection side A venous side connector connectable to the connector is provided in the venous side blood circuit between the blood purifier and the bubble sensor, and further, a waste liquid container is provided downstream of the venous side blood return unit, and the blood collecting side connector When the venous connector and the venous connector are connected, the priming liquid supplied from the priming liquid supply line into the blood circuit is discharged from the venous blood return section to the waste liquid container. Blood purification apparatus was composed to be.
The blood purification apparatus according to claim 1 , wherein an opening / closing means is provided in an arterial blood circuit upstream of a connection portion with the priming solution supply line, and a blood sensor is provided upstream of the opening / closing means.
The blood purification apparatus according to claim 1 or 2, wherein an opening / closing means is provided in the priming liquid supply line, and a liquid shortage sensor is provided upstream of the opening / closing means.
The blood purification apparatus according to claim 3, wherein a priming liquid injection means is provided downstream of the opening / closing means.
The blood purification apparatus according to any one of claims 1 to 4, wherein an opening / closing means is provided in a venous blood circuit downstream of the bubble sensor.
A priming liquid injection line is connected to a priming liquid supply line between the liquid shortage sensor and the opening / closing means, and an opening / closing means is provided between the connection portion with the priming liquid injection line and the liquid shortage sensor. The blood purification apparatus according to any one of the above.
Priming fluid supply line using a step of priming the arterial blood circuit and the venous blood circuit downstream of the connection portion with the priming fluid supply line by driving the blood pump, and using a priming fluid drop or injection means Priming the arterial blood circuit upstream of the connecting portion and the venous blood circuit downstream of the venous connector, and after the completion of both steps, the blood pump is driven and remains in the blood circulation circuit. The blood using the blood purifier according to claim 1, further comprising a step of circulating the priming liquid in the closed circuit returning from the arterial blood circuit to the blood purifier and the venous connector to the arterial blood circuit. How to prime the circuit.

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