JP4890761B2 - 腹膜透析を実施するためのシステムおよび方法 - Google Patents
腹膜透析を実施するためのシステムおよび方法 Download PDFInfo
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Description
本発明は、全体として透析システムに関する。より具体的には、本発明は、再生透析システムおよび持続注入透析システムに関する。本発明はまた、透析治療を行う方法にも関する。
全体として、本発明は、改善された透析システムおよび透析を行う改善された方法を提供する。より詳細には、本発明は、持続注入透析(「CFD」)および再生型透析、ならびに組み合わせられた持続注入再生型透析(「CFRD」)用のシステムおよび方法を提供する。本発明はまた、血液透析を行うための改善されたシステムおよび方法をも含む。
全体として、本発明は、透析システムおよび透析を行う方法に関する。一実施形態では、本発明は、持続注入再生腹膜透析システムおよび方法に関する。別の実施形態では、本発明は、非持続注入再生腹膜透析、および持続注入型であり且つ非持続注入型の両方である再生血液透析に関する。
ここで図面、特に図1を参照すると、透析治療を必要とする患者にそれを提供するシステム10が示されている。図1に示すように、2つのループ、すなわち患者ループ(患者の流体流路を再循環する)12および再生ループ14(透析液流体の流路を再循環する)が提供されている。しかしながら、本発明は、1つのみまたは2つより多いループを含むシステムに用いることができることに留意されたい。患者ループ12は、腹膜透析の実施形態において患者16を透析液で透析するために用いられる。再生ループ14も透析液を含んでおり、患者ループ12内の透析液を再生するために用いられる。血液透析の実施形態では、患者ループ12が患者の血液を搬送し、再生ループ14が血液を透析し且つループ14内の透析液を再生する。
ここで図2を参照すると、本発明の二重管腔患者流体コネクタ20の一実施形態が、さらに詳細に説明されている。上述したように、二重管腔コネクタ20は、患者管腔に流体を供給するための管腔72および患者から流体を除去するための別個の管腔74を有するハウジング70を含む。各々が管腔72および74のうちの1つを有する別個のハウジングを提供してもよい。患者流入管腔72は、患者ループ12の患者流入チューブ76に接続している。同様に、患者流出管腔74は、患者ループ12の患者流出チューブ78に接続している。ハウジング70によって規定されるキャビティ82を密封するために、除去可能なエンドキャップ80が提供されている。キャビティ82は、管腔72および74を取り囲むかまたはそれらに隣接しており、二重管腔カテーテル22(図1)がキャビティ82内に入って管腔72および74と結合するための接続領域を提供する。
ここで図3を参照すると、患者に透析治療を施すためのシステム100が示されている。図3のシステム100は、図1のシステム10と同じ多くの構成要素を含む。例えば、システム100は、2つのループ、患者ループ12および再生ループ14を含む。患者ループ12は、医療用流体、透析液または血液を患者16を往復して送る。腹膜透析の実施形態では、患者ループ12および再生ループ14は、最初に透析液バッグ18からの透析液で充填ならびにプライミングされる。患者ループ12は、図2に関連して上述した多管腔患者流体コネクタ20によって患者16に流体接続する。腹膜透析の実施形態では、多管腔コネクタ20は、二重管腔カテーテル22に接続する。血液透析の実施形態では、患者ループ12は、多管腔血液透析針または他の患者血液アクセス装置に流体接続する。
ここで図4を参照すると、本発明のシステム110が示されている。図4のシステム110は図3のシステム100に類似しており、閉鎖ループシステムである。システム110は、前述したシステム100の種々の構成要素を含む。システム110は、ポンプ30と共に作動する一対のチャンバ75によって作り出される一対のバランスのとれた(balanced)透析液流体ポンプを有する再生ループ14を有する。各バランスチャンバ75は、膜で分離された一対のチャンバを含む。ポンプ30のうちの1つがバランスチャンバ75の一方のチャンバに医療用流体を充填する場合、膜が他方のチャンバに向けて押され、それにより流体がそのチャンバの外に押し出される。このようにして、膜が再生ループ14内の透析液流体の流れのバランスをとる働きをし、その結果、限外濾過液ポンプ19によって除去される流体と入れ代わるために必要な流れを除き、透析器の膜を通過する流体の正味の流れがなくなる。
ここで図5を参照すると、本発明に従う使い捨てカセット120を有する透析システムが示されている。図3のシステム100のこのバリエーションでは、システム120のポンプ30が、アキュムレータA4およびA6から流体を吸引し、アキュムレータA3およびA5内に排出する。アキュムレータA3〜A6は、ポンピング中の圧力変動を抑制することによって透析液の流れをスムーズにする。一実施形態では、上述した多くの流れの論理および流れ装置の少なくとも幾つかの部分が使い捨てカセット120に備えられている。一実施形態では、カセット120は、種々の流体流チャネルを有する硬質プラスチックの本体122および本体122内に規定された流体チャンバを有する。可撓性の膜が、図5に示すカセット本体122の正面に結合されている。膜は、流体チャネルおよび流体チャンバを覆いかつチャネルおよびチャンバの周りで本体122に密封されている。従って、膜は、流体流経路および流体チャンバの壁を形成している。同様に、カセット本体122の背面も膜で覆うことができる。
ここで図8を参照すると、代替的閉鎖ループ再生システム160が示されている。システム160は概略的に示されているが、システム160は、使い捨てカセット、流体ポンプ、種々のセンサ、バルブおよび制御装置などの上述した使い捨てセットを採用することができる。システム160は、患者流体ループ12および再生ループ14を含む。
ここで図9を参照すると、システム170が示されている。先の図1、図3および図4のシステム10、100および110の各々はそれぞれ、腹膜透析または血液透析に用いることができる。しかしながら、上述のシステムの各々は、主として腹膜透析を使用し説明および図示してきた。すなわち、透析溶液を使用する患者ループを示してきた。システム170は、二重管腔カテーテルまたは2つの単管腔カテーテルを、患者16の腕(もしくは他の適した部位)に接続して血液透析針171を通じて血液を吸引する血液透析針171に代えることができることを示している。
ここで図10を参照すると、一体型の吸収剤カートリッジ、ポンプおよびバルブのシステムが、1つの容器、例えばキャニスタ、カートリッジまたはカセット190内に収納されている。一体型容器190は特に図9のシステム170で説明した構成要素を収容した状態で示されている。しかしながら、一体型容器190は、上述のシステム、すなわちシステム10、100および110のいずれの構成要素の収容に対しても適応可能である。キャニスタ、カートリッジまたはカセットは、プラスチックもしくは金属などの任意の材料から製造するのに適応可能である。容器190は、上述したように構成された吸収剤カートリッジ32を含む。代替的に、容器は、吸収剤カートリッジ32およびガス分離器50を備える一体型装置102を含む。
Claims (23)
- 腹膜透析システムであって、
患者流体ループであって、該患者流体ループは、第1のポンプおよび患者の多管腔を含み、該患者流体ループを通って腹膜透析流体が循環している、患者流体ループと、
第2の流体ループであって、該第2の流体ループは、第2のポンプおよび医療用流体を再生するためのウレアーゼを含む吸収剤カートリッジを含む、第2の流体ループと、
該患者流体ループおよび該第2の流体ループに流体接触した透析器であって、ここで、該透析器は、該第2の流体ループから該患者流体ループを分離し、ここで、該透析器は、該患者流体ループ中の該流体の少なくとも1つの選択された成分が該第2の流体ループへ移動することを可能にするように構成され、ここで、該第2の流体ループは、該透析器を介した該選択された成分の移動を除いて、閉鎖ループを規定する、透析器と、
該患者流体ループおよび第2の流体ループからガスを除去する、患者流体ループおよび第2の流体ループのためのガス排気口と、
制御装置であって、該制御装置は、該第1のポンプおよび第2のポンプを作動させて該患者ループおよび該第2のループ内に流体を再循環させるように構成される、制御装置とを備える、システム。 - 前記透析器の両側に圧力勾配が存在する、請求項1に記載の腹膜透析システム。
- 前記患者ループは、前記透析器を介する前記選択された成分の移動を除いて閉鎖されている、請求項1に記載の腹膜透析システム。
- 前記第2の流体ループは、前記患者流体ループから前記第2の流体ループへ通過する尿素を濾過するナノフィルタを備える、請求項1に記載の腹膜透析システム。
- 前記吸収剤カートリッジは、尿毒症毒素吸収剤を含む、請求項1に記載の腹膜透析システム。
- 前記吸収剤カートリッジは、リン酸ジルコニウム、酸化ジルコニウム、および炭素のうちの少なくとも1つをさらに含む、請求項1に記載の腹膜透析システム。
- 前記患者流体ループおよび第2の流体ループのうちの少なくとも1つからガスを除去する前記排気口に接続されたガス分離器を含む、請求項1に記載の腹膜透析システム。
- 前記ガス分離器および前記吸収剤カートリッジが、単一の装置内に備えられている、請求項7に記載の腹膜透析システム。
- 前記患者ループを前記第2のループに接続するガスラインをさらに備える、請求項1に記載の腹膜透析システム。
- 前記第2の流体ループは、前記医療用流体内の電解質の濃度を監視する多検体センサを含む、請求項1に記載の腹膜透析システム。
- 前記患者流体ループおよび前記第2の流体ループの少なくとも部分が使い捨て装置内に備えられる、請求項1に記載の腹膜透析システム。
- 前記第2の流体ループは、前記第2の流体ループ内の流れのバランスをとるバランスチャンバを含む、請求項1に記載の腹膜透析システム。
- 前記制御装置は、流体が前記患者の多管腔を通って反対方向に流れることを可能にする、請求項1に記載の腹膜透析システム。
- 前記患者の多管腔を規定する二重管腔カテーテルを含む、請求項1に記載の腹膜透析システム。
- 前記患者流体ループおよび前記第2の流体ループのうちの少なくとも1つは、インライン流体ヒータを含む、請求項1に記載の腹膜透析システム。
- 前記インライン流体ヒータは、放射ヒータおよびプレートヒータを含む、請求項15に記載の腹膜透析システム。
- アンモニア、アンモニウムおよびpHからなる群から選択される少なくとも1つの指標を感知する少なくとも1つの医療用流体センサを含む、請求項1に記載の腹膜透析システム。
- 前記患者流体ループおよび第2の流体ループのうちの少なくとも1つに流体量センサを含む、請求項1に記載の腹膜透析システム。
- 前記流体量センサは、前記患者流体ループおよび第2ループのうちの少なくとも1つと流体連通するチャンバを用いるキャパシタンス流体量センサを含む、請求項18に記載の腹膜透析システム。
- 前記チャンバは、ポンプチャンバである、請求項19に記載の腹膜透析システム。
- 前記患者流体ループおよび第2の流体ループのうちの少なくとも1つと流体連通する限外濾過液容器を含む、請求項1に記載の腹膜透析システム。
- 前記患者流体ループおよび第2の流体ループのうちの少なくとも1つと流体連通する流体濃縮液容器を含む、請求項1に記載の腹膜透析システム。
- 前記制御装置は、前記第1のポンプを持続的に作動させて患者の内外へ流体をポンプ輸送する、請求項1に記載の腹膜透析システム。
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JP2013176633A (ja) * | 2007-02-27 | 2013-09-09 | Deka Products Lp | センサ装置システム、機器及び方法 |
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