JP5214731B2 - 胃食道逆流制御システム及びポンプ - Google Patents
胃食道逆流制御システム及びポンプ Download PDFInfo
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- A—HUMAN NECESSITIES
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- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/03—Detecting, measuring or recording fluid pressure within the body other than blood pressure, e.g. cerebral pressure; Measuring pressure in body tissues or organs
- A61B5/036—Detecting, measuring or recording fluid pressure within the body other than blood pressure, e.g. cerebral pressure; Measuring pressure in body tissues or organs by means introduced into body tracts
- A61B5/037—Measuring oesophageal pressure
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/41—Detecting, measuring or recording for evaluating the immune or lymphatic systems
- A61B5/412—Detecting or monitoring sepsis
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/42—Detecting, measuring or recording for evaluating the gastrointestinal, the endocrine or the exocrine systems
- A61B5/4211—Diagnosing or evaluating reflux
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61J15/00—Feeding-tubes for therapeutic purposes
- A61J15/0003—Nasal or oral feeding-tubes, e.g. tube entering body through nose or mouth
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- A—HUMAN NECESSITIES
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- A61J15/00—Feeding-tubes for therapeutic purposes
- A61J15/0026—Parts, details or accessories for feeding-tubes
- A61J15/008—Sensor means, e.g. for sensing reflux, acidity or pressure
- A61J15/0084—Sensor means, e.g. for sensing reflux, acidity or pressure for sensing parameters related to the patient
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Description
Claims (18)
- 経腸栄養装置であって、
栄養溶液を送達するように構成された自動化可能な栄養ポンプと、
患者の胃内圧と患者の食道内圧間の圧力勾配を感知するためのフィードバックセンサを有する制御装置とを含み、
前記制御装置が、前記患者への前記ポンプの栄養投与速度を、前記圧力勾配の関数として、患者の胃内圧と患者の食道内圧間のシールに十分な圧力勾配を連続的に維持するように制御しかつモニタするように構成されていることを特徴とする経腸栄養装置。 - 前記制御装置が、前記栄養投与速度を制御するように構成されたデリバリー時間制御機構を含み、
前記デリバリー時間制御機構が、前記圧力勾配及び前記患者に補給される栄養溶液の量の関数として、手作業で、あるいは電子的に、調整されることができることを特徴とする請求項1の経腸栄養装置。 - 予め設定された圧力勾配の限界値をΔPとしたとき、前記患者の食道内圧が、
前記患者の胃内圧+ΔP値
の如く計算されることを特徴とする請求項1若しくは2の経腸栄養装置。 - 前記フィードバックセンサが胃バルーンを含み、
前記制御装置が、経腸栄養法の過程を通して継続的に前記患者の胃及び食道内の圧力の変化を補償するように、前記栄養ポンプの前記栄養投与速度を制御することによって前記胃バルーン内の圧力を調整するように構成されていることを特徴とする請求項1ないし3のいずれかの経腸栄養装置。 - 前記制御装置が、所定の期間にわたって投与される所望の栄養投与量をユーザが入力することができるように構成されており、それによって、前記所望の栄養投与療法を達成するために体積及び時間値を別々に規定しかつプログラミングすることができるようにしたことを特徴とする請求項1ないし4のいずれかの経腸栄養装置。
- 前記制御装置が、初期栄養投与時間間隔にわたって送達される栄養投与量の実際の栄養投与速度を決定するコンピュータソフトウェアを含むことを特徴とする請求項1ないし5のいずれかの経腸栄養装置。
- 前記制御装置が、患者に補給される栄養物の実際及び所望の体積/単位時間(V/h)を表示し、かつ、所望の栄養投与時間間隔を入力し、プリセット単位時間内または選択された連続的な栄養投与期間全体にわたって送達される栄養溶液の体積を計算するようにユーザによってプログラミングされることを特徴とする請求項1ないし6のいずれかの経腸栄養装置。
- 前記制御装置が記憶システムを有し、該記憶システムは、前記制御装置がソフトウェアによるプリセット栄養投与速度値またはユーザ定義栄養投与速度値を適用して前記栄養投与量に対する患者の胃の相対的圧力増加を決定できるようにするものであることを特徴とする請求項1ないし7のいずれかの経腸栄養装置。
- 前記制御装置が、デリバリー時間中の患者の胃内圧を連続的または断続的に決定し、外挿された時間当たり圧力曲線の傾きを決定し、外挿された時間当たり圧力曲線の傾きから求められる所定の時間内での患者の胃内圧が、所望の圧力値に達しない場合は、前記制御装置が、前記所定の時間内に所望の体積に到達するように前記栄養投与速度を自動的に増加させることを特徴とする請求項1ないし8のいずれかの経腸栄養装置。
- 患者の胃内圧が前記所望の圧力値に達した場合、前記制御装置が、前記患者への栄養投与を再開するべく前記ポンプを制御する前に、胃内圧が所定の栄養投与レベル内まで十分に減少するまで前記栄養ポンプを一時停止することになることを特徴とする請求項9の経腸栄養装置。
- 前記制御装置が、選択された時間間隔で、1時間当たりの栄養投与量及び期待される栄養投与量を連続的に計算しかつ決定するように構成されていることを特徴とする請求項1ないし10のいずれかの経腸栄養装置。
- ダブルルーメン、胃バルーン及び食道ブラダーを有するチューブをさらに含み、
前記胃バルーンが、第1の導管によって前記制御装置に接続され、前記患者の胃内に留置されて胃内の胃圧を感知するように構成されており、
前記食道ブラダーが、第2の導管によって前記制御装置に接続され、前記食道ブラダーが、圧縮可能な体積を有しかつ患者の食道壁構造と互いにかみ合うように構成された複数のひだのある外面を有し、
前記制御装置が、経腸栄養装置が使用中であるときに、前記食道ブラダー内の圧力を、前記胃バルーンに及ぼされる胃圧より大きなレベル内に維持するように構成されていることを特徴とする請求項1ないし11のいずれかの経腸栄養装置。 - ダブルルーメンを有するチューブと、
前記患者の胃内に留置されて胃内の胃圧を感知するように構成され、経腸栄養法が進行中のときに胃圧をモニタするように構成された胃圧センサと、
圧縮可能な体積を有しかつ患者の食道壁構造と互いにかみ合うように構成された複数のひだのある外面を有する食道ブラダーとをさらに含み、
前記制御装置が、第1の導管を介して前記食道ブラダーに接続されかつ前記食道ブラダー内の流体圧力を調整するように構成されており、
前記胃圧センサが、前記制御装置と連通して接続されており、
前記制御装置が、前記胃圧センサから受信した複数の信号から平均化された信号を供給するように構成されたフィルタアルゴリズムを含み、
前記制御装置が、相対的な食道シール圧力レベルを規定するために前記平均化された信号にプリセット勾配値を加えるように構成されており、前記制御装置が、前記胃食道逆流防止装置が使用中であるときに前記食道ブラダー内の前記相対的な食道シール圧力レベルを維持するように構成されていることを特徴とする請求項1ないし11のいずれかの経腸栄養装置。 - 前記栄養ポンプが、或る栄養投与速度で或る時間間隔にわたって栄養溶液を送達するように構成されており、前記栄養ポンプが、患者の胃内圧の相対量及び患者の食道内圧の相対量を感知し、前記経腸栄養装置が使用中であるときに、前記患者の胃内圧の相対量及び前記患者の食道内圧の相対量に従って前記栄養投与速度を調整するように構成されていることを特徴とする請求項1ないし11及び13のいずれかの経腸栄養装置。
- 前記フィードバックセンサが、胃バルーン及び食道ブラダーを含むことを特徴とする請求項1の経腸栄養装置。
- 前記制御装置は、ひとたび前記胃バルーン内の圧力が胃内充填圧力の安定した読みに達したら、コンピュータソフトによって計算されるかまたはユーザによって規定される所定値で、前記食道ブラダー内の圧力を調整するように構成されていることを特徴とする請求項15の経腸栄養装置。
- 前記制御装置は、前記ブラダーを、前記食道ブラダーの最大膨張体積よりも小さい体積まで充填するために、規定量の流体を前記食道ブラダー内へ送達するように構成されていることを特徴とする請求項15または16のいずれかの経腸栄養装置。
- 前記食道ブラダーが、本体の拡張なしで自由膨張時の体積の最大約75〜80%膨張することを特徴とする請求項15ないし17のいずれかの経腸栄養装置。
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US11/846,888 US7967780B2 (en) | 2007-08-29 | 2007-08-29 | Gastro-esophageal reflux control system and pump |
US11/846,888 | 2007-08-29 | ||
PCT/IB2008/052510 WO2009027864A1 (en) | 2007-08-29 | 2008-06-24 | Gastro-esophageal reflux control system and pump |
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EP (1) | EP2190512B1 (ja) |
JP (1) | JP5214731B2 (ja) |
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AU2008291781B2 (en) | 2013-05-02 |
JP2010537693A (ja) | 2010-12-09 |
CA2694035A1 (en) | 2009-03-05 |
WO2009027864A1 (en) | 2009-03-05 |
MX2010001056A (es) | 2010-03-01 |
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