JP5230379B2 - Liquid level adjustment method and liquid level adjustment mechanism of drip chamber - Google Patents

Description

  The present invention relates to a drip chamber liquid level adjustment method for an extracorporeal circuit and a liquid level adjustment mechanism thereof.

  In general, a drip chamber for capturing bubbles or blood aggregates is connected to the upstream side of a venous circuit of a blood extracorporeal circuit used in blood purification treatment by extracorporeal circulation or a blood purifier. If the liquid level in the drip chamber is low, air may be injected into the patient's body and serious accidents such as air embolization, etc., or air may be introduced into the blood purifier and the blood purifier may become clogged.

  Therefore, several methods for adjusting the liquid level of the drip chamber have been studied. For example, Patent Literature 1 discloses a blood purification device that detects a liquid level by a liquid level sensor and drives a blood pump and two on-off valves to adjust the liquid level. Patent Document 2 discloses a method for adjusting the liquid level by detecting that the drip chamber internal pressure has reached a predetermined pressure by press-fitting a liquid into the sealed drip chamber. Furthermore, in Patent Document 3, an air filter is connected on the pressure measurement line of the drip chamber, a liquid level adjustment pump and pressure measuring means are installed upstream of the air filter, and liquid is supplied to the pressure measurement line by the liquid level adjustment pump. However, a liquid level detecting device and a liquid level detecting method for detecting a pressure change caused by the liquid level reaching the air filter by a pressure measuring means are disclosed.

JP-A-8-57043 JP-A-9-164197 JP 2006-263136 A

  However, the invention of Patent Document 1 requires a liquid level detection sensor to adjust the liquid level, but the capacitance sensor and ultrasonic sensor used as the liquid level detection sensor are expensive. The detection sensitivity varies depending on the distance from the drip chamber. In particular, the ultrasonic sensor has a problem in use that it is required to contact the drip chamber. The invention of Patent Document 2 grasps the liquid level of the drip chamber as a function of the pressure in the drip chamber, so that the liquid level cannot be adjusted accurately unless the liquid level before the liquid level adjustment is made constant. There is. Further, the invention of Patent Document 3 has a problem that the air filter gets wet because the liquid reaches the air filter every time the liquid level is adjusted. Once a wet air filter is difficult to regenerate and must be replaced, the pressure measurement line must be cut off, making it difficult to reconnect aseptically.

  In view of the above-mentioned problems of the prior art, the present invention does not require a liquid level detection sensor, does not relate to the liquid level before the liquid level adjustment, and further does not wet the air filter. It is an object to provide a method. It is another object of the present invention to provide a drip chamber liquid level adjustment mechanism suitable for carrying out the method.

  As a result of intensive studies to solve the above problems, the present inventors have provided a component that induces a pressure change at the liquid level detection position on the line connected to the air storage area of the drip chamber body. Since the pressure change occurs when the liquid level of the drip chamber reaches the liquid level detection position on the line by the pump or the liquid feeding means, it has been found that the liquid level of the drip chamber can be easily adjusted. It came to. That is, if a narrowed portion is provided on a line connected to the air storage area of the drip chamber main body or a line branched from the liquid lead-out circuit connected to the air storage area of the drip chamber, the pump or the liquid feeding means When the liquid level of the drip chamber rises and passes through the constriction on the line, a pressure change occurs. If the pressure change means detects the pressure change and stops the pump or liquid feeding means, the air filter will not be wetted, and it will not be affected by the amount of liquid in the drip chamber before adjusting the liquid level. The liquid level of the chamber can be created. If the pump or the liquid feeding means is reversed after detecting the pressure change, the liquid level can be adjusted by lowering the liquid level. That is, the present invention includes the following.

(1) A drip chamber liquid level adjustment method including a drip chamber body in which a liquid introduction circuit and a liquid outlet circuit of an extracorporeal circulation circuit communicate with each other, and a line in communication with an air storage region of the drip chamber body, , Having a narrowed portion whose inner diameter is narrower than other parts of the line, and with the liquid outlet circuit closed, driving a pump in the line causes liquid to flow from the liquid introduction circuit through the drip chamber body The section that occurs when liquid is introduced into the stenosis part of the line by detecting the pressure in the section of the line sandwiched between the pump and the stenosis part downstream from the stenosis part while being introduced into the line When a pressure drop of a predetermined speed or more is detected, the driving of the pump is stopped or reversely fed to the inside of the drip chamber body or the And adjusting the liquid level in the in-drip chamber of the liquid surface adjusting method.
(2) A drip chamber liquid level adjustment method comprising a drip chamber body in which a liquid introduction circuit and a liquid outlet circuit of an extracorporeal circulation circuit communicate with each other, and a line in communication with an air storage region of the drip chamber body, , Having a narrowed portion whose inner diameter is narrower than other portions of the line, and in the state where the liquid lead-out circuit is closed by the closing means, the liquid feeding means in the liquid introduction circuit is driven to introduce the liquid into the liquid The circuit is introduced into the line through the drip chamber body, and the pressure in the section of the extracorporeal circulation circuit sandwiched between the liquid feeding means and the closing means upstream from the narrowed portion is detected, and the narrowed portion of the line is detected. When detecting a pressure increase over a predetermined speed in the section that occurs when the liquid is introduced, the driving of the liquid feeding means is stopped or reversely fed, And adjusting the liquid surface of the lip within the chamber body or the line, drip chamber of the liquid surface adjusting method.
(3) The drip chamber liquid level adjustment method according to (1) or (2), wherein an inner diameter of the narrowed portion is 50% or less of an inner diameter of another portion of the line.
(4) The drip chamber liquid level adjustment method according to (3), wherein an inner diameter of the narrowed portion is 0.1 mm or more.
(5) A drip chamber liquid level adjustment mechanism installed in the extracorporeal circuit, wherein a liquid introduction circuit and a liquid extraction circuit communicate with the drip chamber body, and a line communicates with an air storage area of the drip chamber body. A closing means for closing the lead-out circuit; a pump provided in the line; provided in the line between the drip chamber main body and the pump; an inner diameter of 0.1 mm or more; A drip chamber liquid level adjustment comprising: a constriction that is 50% or less of an inner diameter of a portion; and pressure measuring means for measuring a pressure in a section between the constriction and the pump of the line mechanism.
(6) A drip chamber liquid level adjustment mechanism installed in the extracorporeal circuit, wherein the liquid introduction circuit and the liquid extraction circuit communicate with the drip chamber body, and the line communicates with the air storage area of the drip chamber body. Closing means for closing the lead-out circuit, liquid feeding means provided in the liquid introduction circuit, provided in the line, and having an inner diameter of 0.1 mm or more and 50% of the inner diameter of the other part of the line A drip chamber liquid level adjustment mechanism, comprising: a constriction portion as described below; and a pressure measuring means for measuring a pressure in a section of an extracorporeal circuit sandwiched between the liquid feeding means and the closing means.

  According to the present invention, it is possible to easily adjust the liquid level of the drip chamber by detecting the pressure change when the liquid level passes through the narrow portion of the line communicating with the air storage region of the drip chamber body. . Furthermore, according to the drip chamber liquid level adjustment method of the present invention, a liquid level detection sensor dedicated to drip chamber liquid level adjustment is unnecessary.

A preferred embodiment of the present invention will be described below.
The drip chamber in the present embodiment is installed in the extracorporeal circuit, the drip chamber main body in which the liquid introduction circuit and the liquid outlet circuit of the extracorporeal circuit communicate with each other, and the line in communication with the air storage region of the drip chamber main body have.

  The extracorporeal circuit in the present embodiment is a conduit for circulating a body fluid such as blood, plasma, lymph, ascites, urine, or a treatment fluid such as dialysis fluid or physiological saline, for example, blood filtration therapy, hemodialysis Therapy, hemofiltration dialysis therapy, continuous hemodialysis therapy, continuous hemofiltration therapy, continuous hemofiltration dialysis therapy, plasma exchange therapy, plasma adsorption therapy, double filtration plasma exchange therapy, blood adsorption therapy, blood cell component removal therapy, This circuit is used in extracorporeal circulation therapy such as ascites filtration concentration reinfusion therapy and percutaneous cardiopulmonary support. As the circuit material, for example, vinyl chloride, silicon rubber, olefin resin, or the like can be used. Among them, soft vinyl chloride is preferably used. The diameter of a general circuit is about 0.5 to 10 mm in inner diameter and about 0.2 to 3 mm in thickness. This circuit includes, for example, a drip chamber, a pump tube, a connector, a three-way stopcock, a pressure measuring branch tube, an anticoagulant injection connection port, a replacement fluid connection port, a priming solution connection port, a filtrate discharge tube, and a temporary body fluid. Parts such as a storage container, an external clamp, and a body fluid sampling port can be attached as necessary.

  The drip chamber main body in the present embodiment is a container for storing liquid and separating air and liquid, and is attached to the extracorporeal circuit. In addition, the air side which isolate | separated air and the liquid is called the air storage area | region of a drip chamber main body, and the liquid side is called the liquid storage area | region of a drip chamber main body. The drip chamber body communicates with at least two circuits of a liquid introduction circuit for introducing liquid into the drip chamber and a liquid extraction circuit for extracting liquid from the drip chamber, and further communicated with a line for measuring pressure. ing. Further, the drip chamber main body may communicate with a circuit for injecting a chemical solution. As the material of the drip chamber body, for example, vinyl chloride, silicon rubber, olefin resin, or the like can be used, and among them, soft vinyl chloride is preferably used.

  The narrowed portion in the present embodiment is a portion that is formed in a part of the line, has an inner diameter smaller than that of the other part of the line, and increases the flow resistance. Here, the inner diameter of the line is usually 0.5 to 10 mm. If the inner diameter of the constricted portion is less than 0.1 mm, minute dust is clogged and the circuit is blocked, which is not preferable. On the other hand, even if the inner diameter of the constricted portion is too thick, the flow resistance is too low, and as a result, the generated pressure change is reduced and the detection accuracy is lowered. Therefore, it is preferable that the inner diameter of the narrowed portion is 0.1 mm or more and 50% or less of the inner diameter of the other part of the line.

  Or you may form a constriction part so that it may become a flow resistance equivalent to a thin diameter by pressing and flattening a part of line from the outside. Examples of the means for compressing the line include a roller clamp, a Robert clamp, and a pinch valve.

  The line in the present embodiment is, for example, a conduit used for pressure measurement branched from the drip chamber body of the extracorporeal circuit, and communicates directly or indirectly with the air storage area of the drip chamber body. The line can be branched from the extracorporeal circuit as long as it can be branched from the extracorporeal circuit, either directly or through a part such as a drip chamber, T-tube, cross tube, or three-way stopcock. Any means can be used.

  The closing means in the present embodiment is means that can be closed by narrowing the circuit, and examples thereof include a pinch valve, a roller clamp, a Robert pump, or a rotary tube pump. Among them, pinch valves and rotary tube pumps are recommended because they can be easily controlled by electrical output from the control means.

  The pump in the present embodiment is a means capable of taking air in and out of the drip chamber, and examples thereof include an air pump and a rotary tube pump (roller pump), but are not limited thereto.

  The liquid feeding means in the present embodiment is a means capable of feeding the liquid in the extracorporeal circulation circuit, and examples thereof include an air pump, a rotary tube pump (roller pump), and a drop, but are not limited thereto. is not.

  The pressure measuring means in the present embodiment is a means for measuring a pressure of, for example, about −500 mmHg to 500 mmHg, and examples thereof include a semiconductor pressure sensor, a Bourdon tube, and a manometer. Among them, a semiconductor pressure sensor can be recommended because it can obtain pressure data as an electric output and can easily control a pump, a valve, and the like.

  1 and 3 are explanatory views of a liquid level adjusting mechanism of a drip chamber of a blood purification apparatus having an extracorporeal circuit.

  The drip chamber body 5a communicates with the liquid introduction circuit 2a and the liquid lead-out circuit 1a, and the air storage area above the drip chamber body 5a communicates with a line 3a including a pump 12a capable of supplying air. Pressure measuring means 11a is connected to the line 3a between the pump 12a and the drip chamber body 5a. Further, a blocking means 13a is installed on the liquid lead-out circuit 1a. A narrowed portion 4a is formed in a line 3a between the pump 12a and the drip chamber body 5a. Further, the pressure measuring means 11a, the pump 12a and the closing means 13a are connected to the control means 10. In the above configuration, the pump 12a installed on the line 3a is driven in a state where the circuit is closed by the closing means 13a installed on the liquid lead-out circuit 1a, and the liquid is introduced from the liquid introduction circuit 2a to the drip chamber body 5a. Is introduced, and the liquid is further supplied to the line 3a. At this time, the pressure in the section on the pump 12a side downstream of the narrowed portion 4a of the line 3a is measured by the pressure measuring means 11a. Then, when the pressure measuring means 11a detects a pressure drop in the above section when the liquid level passes through the constriction 4a on the line 3a, the control means 10 electrically connected to the pressure measuring means 11a is pumped. By stopping 12a, the liquid level can be adjusted to the position of the narrowed portion 4a of the line 3a. Also, when the pressure measuring means 11a detects a pressure drop, the control means 10 reversely drives the pump 12a for a certain period of time to send air into the line 3a so that the liquid level reaches a desired position in the drip chamber body 5a. Can also be adjusted.

  In addition, on the liquid lead-out circuit 1a and the liquid introduction circuit 2a, a drip chamber, a pump tube, a connector, a three-way stopcock, a pressure measurement branch tube, an anticoagulant injection connection port necessary for blood purification treatment, Replacement fluid connection port, priming fluid connection port, filtrate discharge tube, temporary body fluid storage container, external clamp, body fluid sampling port, and other parts for pressure measurement, fluid delivery, and liquid level adjustment A pump, a blocking means, or a blood treatment device may be connected. An air filter 6 may be installed on the line 3a. The air filter 6 is not particularly limited, but is a filter used for preventing contamination of germs in the extracorporeal circulation circuit, and a membrane filter using a hydrophobic membrane having a pore size of 0.45 μm or less is preferable. Further, the liquid lead-out circuit 1a and the liquid introduction circuit 2a may be connected to either the lower liquid storage area or the upper air storage area of the drip chamber body 5a.

  2 and 4, the narrowed portion 4a of FIG. 1 (or FIG. 3) is formed not at the middle of the line 3a but at the connection portion with the air storage region side of the drip chamber main body 5a, and the narrowed portion 4a is formed at the drip chamber main body. It is a figure which shows the example directly connected to 5a. Also in this case, the pump 12a is driven in a state where the liquid lead-out circuit 1a is closed by the closing means 13a installed on the same circuit, and the liquid is introduced into the liquid introduction circuit 2a, the drip chamber body 5a, and further the constriction on the line 3a Supply liquid to part 4a. Then, when the pressure measuring means 11a detects a pressure drop when the liquid level passes through the constriction 4a, the liquid level in the drip chamber body 5a or the line 3a is reduced by stopping or reversely rotating the pump 12a. Can be adjusted.

  FIG. 5 is an explanatory diagram showing an example in which the liquid lead-out circuit 1a is connected to the air storage region of the drip chamber body 5a, and further, the line 3a is branched from the liquid lead-out circuit 1a. Also in this case, the liquid lead-out circuit 1a is closed by the closing means 13a installed on the same circuit, the pump 12a installed on the line 3a is driven, and the liquid is introduced into the liquid introduction circuit 2a, the drip chamber body 5a, the liquid The liquid is supplied to the derivation circuit 1a and further to the narrowed portion 4a on the line 3a. When the pressure drop when the liquid level passes through the constriction 4a is detected by the pressure measurement means 11a connected to the other side of the line 3a via the air filter 6, the pressure measurement means 11a is electrically The connected control means 10 stops the pump 12a or reversely drives the pump 12a for a predetermined time, so that the liquid level in the drip chamber body 5a or the line 3a can be adjusted. The liquid introduction circuit 2a may be connected to either the liquid storage area or the air storage area of the drip chamber body 5a.

  FIG. 6 is a diagram illustrating an example in which the narrowed portion 4a in FIG. 5 is formed not at the middle of the line 3a but at the connection portion between the line 3a and the liquid lead-out circuit 1a. Also in this case, the liquid level in the drip chamber main body 5a or the line 3a can be adjusted as in FIG.

  FIG. 7 and FIG. 9 show another explanatory diagram regarding the liquid level adjustment mechanism of the drip chamber of the blood purification apparatus having the extracorporeal circuit. The drip chamber body 5a communicates with the liquid introduction circuit 2a and the liquid lead-out circuit 1a, and the air storage area of the drip chamber body 5a communicates with the line 3a including the atmosphere release valve 14a and the pressure measuring means 11a. . Further, a blocking means 13a is installed on the liquid lead-out circuit 1a. A line 3b communicates with the liquid introduction circuit 2a, and the line 3b is a liquid supply means upstream of the constriction 4a of the extracorporeal circuit including the liquid lead-out circuit 1a, the drip chamber body 5a, and the liquid introduction circuit 2a. Pressure measuring means 11b for measuring the pressure in the closed section sandwiched between 15a and closing means 13a is connected. Further, the pressure measuring means 11a, 11b, the liquid feeding means 15a, the air release valve 14a, and the closing means 13a are connected to the control means 10. In the above configuration, the liquid lead-out circuit 1a is closed by the closing means 13a installed on the same circuit, and the line 3a is opened by the atmosphere release valve 14a on the same line, and the liquid supply circuit 1a is installed on the liquid introduction circuit 2a. The liquid means 15a is driven, the liquid is introduced from the liquid introduction circuit 2a into the drip chamber body 5a, and further supplied to the line 3a. The pressure measuring means 11b detects the pressure rise when the liquid level passes through the constriction 4a on the line 3a, and the control means 10 electrically connected to the pressure measuring means 11b By stopping, the liquid level can be adjusted in the narrowed portion 4a of the line 3a. At this time, it is also possible to adjust the liquid level in the drip chamber body 5a by discharging the liquid from the line 3a and the drip chamber body 5a by rotating the liquid feeding means 15a for a predetermined time. The air filter 6 may be installed on the lines 3a and 3b. The liquid lead-out circuit 1a and the liquid introduction circuit 2a may be connected to either the liquid storage area or the air storage area of the drip chamber body 5a.

  8 and 10, the narrowed portion 4a of FIG. 7 (or FIG. 9) is formed not at the middle of the line 3a but at the connection portion of the drip chamber body 5a of the line 3a with the air storage region, and directly to the drip chamber body 5a. It is a figure which shows the example connected. Also in this case, the liquid lead-out circuit 1a is blocked by the blocking means 13a installed on the same circuit, and the liquid is supplied by the liquid feeding means 15a in a state where the line 3a is opened by the atmosphere release valve 14a installed on the same circuit. The liquid is supplied to the liquid introduction circuit 2a, the drip chamber main body 5a, and further to the narrowed portion 4a on the line 3a. Then, when the pressure measuring means 11b detects an increase in pressure when the liquid level passes through the constricted portion 4a, the liquid feeding means 15a is stopped or reversely rotated, so that the liquid in the drip chamber body 5a or the line 3a The surface level can be adjusted.

  FIG. 11 is a diagram showing an example in which the liquid lead-out circuit 1a is connected to the air storage area of the drip chamber body 5a, and further, the line 3a is branched from the liquid lead-out circuit 1a. Also in this case, the liquid derivation circuit 1a is blocked by the blocking means 13a installed on the same circuit, and the line 3a is installed on the liquid introduction circuit 2a with the atmosphere open valve 14a installed on the circuit opened. The liquid supply means 15a is driven to supply liquid from the liquid introduction circuit 2a to the drip chamber body 5a, the liquid outlet circuit 1a, and further to the constriction 4a on the line 3a. The pressure measuring means 11b detects the pressure rise when the liquid level passes through the constriction 4a on the line 3a, and the control means 10 electrically connected to the pressure measuring means 11b The liquid level in the drip chamber body 5a or the line 3a can be adjusted by stopping or reversely driving for a certain time. The liquid introduction circuit 2a may be connected to either the liquid storage area or the air storage area of the drip chamber body 5a.

  FIG. 12 is a diagram showing an example in which the constriction 4a in FIG. 11 is formed not at the middle of the line 3a but at the connection between the line 3a and the liquid lead-out circuit 1a. Also in this case, the liquid level in the drip chamber main body 5a or the line 3a can be adjusted as in FIG.

  FIG. 13 shows an example of continuous hemofiltration dialysis therapy as one embodiment of the present invention. The blood purification device 150 includes a blood pump (liquid feeding means) 115a, a filtration pump (liquid feeding means) 115b, a dialysate pump (liquid feeding means) 115c, a replacement fluid pump (liquid feeding) electrically connected to the control means 10. Means) 115d, clamp valve 113, pressure sensors 111a to 111c, and pumps 112a and 112b. Connected to the upstream side of the blood purifier 120 of the extracorporeal circuit are an arterial circuit downstream side 101a, an arterial drip chamber body (drip chamber body) 105a, and an arterial circuit upstream side 102a, and further an arterial drip chamber body (drip chamber body) An arterial pressure measurement line 103a having a stenosis 104a is connected to the air storage area 105a. The venous circuit upstream side 102b, the venous drip chamber body (drip chamber body) 105b, and the venous circuit downstream side 101b are connected to the downstream side of the blood purifier 120, and the air storage area of the venous drip chamber body (drip chamber body) 105b A venous pressure measuring line 103b having a stenosis 104b is connected to the stencil 104b. Further, the replacement fluid circuit 132 branches from the venous circuit upstream side 102b. A filtration circuit 130 is connected to the filtration side of the blood purifier 120, and a filtration pressure measurement line 103 c is branched from the filtration circuit 130. A dialysate circuit 131 is connected to the dialysate side of the blood purifier 120. A blood pump 115a is arranged on the upstream side 102a of the arterial circuit, and a filtration pump 115b is arranged on the side opposite to the blood purifier 120 of the filtration pressure measuring line 103c branching part of the filtration circuit 130, The dialysis pump 115c is disposed, the replacement fluid pump 115d is disposed on the replacement fluid circuit 132, and the clamp valve 113 is disposed on the venous circuit downstream side 101b. Further, the pressure sensor 111a and the pump 112a are arranged on the arterial pressure measurement line 103a via the air filter 6, and the pressure sensor 111b and the pump 112b are arranged on the venous pressure measurement line 103b via the air filter 6. A pressure sensor 111c is connected to the filtration pressure measuring line 103a via an air filter (not shown). If necessary, an air filter may be connected to the atmosphere side of the pumps 112a and 112b.

  The above is the configuration of the blood purification apparatus 150. However, the specifications of pumps and chambers associated with the blood circuit are not particularly limited, and any specification can be used as long as it is generally used in extracorporeal circulation therapy. In addition, although not shown in the drawings, accessory items that are naturally used in the extracorporeal circuit such as an anticoagulant injection circuit and a sampling port may be appropriately arranged.

  Next, an example of a method for adjusting the liquid level of the venous drip chamber using the blood purification apparatus 150 of FIG. 13 having the above configuration will be described.

  In the initial state, the arterial circuit upstream side 102a where the blood pump 115a is disposed, the filtration circuit 130 where the filtration pump 115b is disposed, the dialysate circuit 131 where the dialysate pump 115c is disposed, and the replacement fluid pump 115d are disposed. The replacement fluid circuit 132, the arterial pressure measurement line 103a to which the pump 112a is connected, and the venous pressure measurement line 103b to which the pump 112b is connected bring the pumps 115a to 115c, 112a and 112b to a stop state. As a result, a part of the circuit is blocked. That is, each of the pumps 115a to 115c, 112a, and 112b functions as a closing unit that temporarily shuts off the circuit. In addition, the clamp valve 113 is open to supply liquid into the circuit. From the initial state, the pump 112b is driven to the venous circuit downstream side (liquid introduction circuit) 101b, the venous drip chamber body (drip chamber body) 105b, and further to the constriction 104b on the venous pressure measurement line (line) 103b. And supply liquid. Then, when the pressure drop when the liquid level passes through the constriction 104b is detected by the pressure sensor (pressure measuring means) 111b, the pump 112b is stopped to bring the liquid level to the position of the constriction 104b in the line 103b. Can be adjusted. Also, if necessary, the pump 112b is driven reversely for a certain period of time to send air into the venous pressure measurement line 103b, and the liquid level in the venous drip chamber body (drip chamber body) 105b is lowered to adjust the liquid level. Also good.

  In addition, when the liquid level of the arterial drip chamber body (drip chamber body) 105a is adjusted by the blood purification device 150 of FIG. 13, the pump is started from the same initial state as in the case of the venous drip chamber body (drip chamber body) 105b. 112a is driven, venous circuit downstream side 101b, venous drip chamber body 105b, venous circuit upstream side 102b, blood purifier 120, arterial circuit downstream side (liquid introduction circuit) 101a, arterial drip chamber body (drip chamber body) 105a, Further, the liquid is supplied to the narrowed portion 104a on the arterial pressure measurement line (line) 103a. When the pressure measurement means 111a detects a pressure drop due to the constriction 104a, the liquid level in the artery drip chamber body (drip chamber body) 105a or the line 103a is adjusted by stopping or reversing the pump 112a. be able to.

  FIG. 14 is a diagram in the case where the pump 112a of FIG. 13 is changed to the atmosphere release valve 114a and the pump 112b is changed to the atmosphere release valve 114b. If necessary, an air filter may be connected to the atmosphere side of the atmosphere release valve.

  Next, a method for adjusting the liquid level of the venous drip chamber body 105b using the blood processing apparatus 150 of FIG. 14 will be described. In the initial state, the blood pump 115a, the filtration pump 115b, the dialysate pump 115c, and the replacement fluid pump 115d are stopped, and a part of the circuit in which the pump is disposed is closed. Further, the clamp valve 113 and the atmosphere release valves 114a and 114b are closed to block a part of the circuit. From the initial state, with the air release valve 114b opened, the blood pump 115a, the filtration pump 115b, the dialysate pump 115c, the replacement fluid pump 115d, or a combination of these pumps is driven to the upstream side of the venous circuit (liquid (Introduction circuit) 102b, venous drip chamber body (drip chamber body) 105b, and venous pressure measurement line 103b. Then, when the pressure measuring means 111a or the pressure measuring means 111c detects an increase in pressure when the liquid level passes through the constriction 104b on the venous pressure measuring line 103b, the pump that has been driven is stopped. The liquid level can be adjusted to the narrowed portion 104b of the venous pressure measurement line 103b. If necessary, the liquid level in the venous drip chamber main body (drip chamber main body) 105b can be adjusted by reversing one of the pumps for a certain period of time.

  When adjusting the liquid level of the arterial drip chamber main body (drip chamber main body) 105a by the blood purification apparatus 150 of FIG. 14, from the initial state similar to the case of the venous drip chamber main body (drip chamber main body) 105b, Open the release valve 114a, drive the blood pump 115a, filtration pump 115b, dialysate pump 115c, replacement fluid pump 115d or a combination of these pumps, through the arterial circuit upstream side 102a or the arterial circuit downstream side 101a, The liquid is supplied to the arterial drip chamber main body 105a and further to the narrowed portion 104a of the arterial pressure measurement line 103a. Then, when the pressure measuring means 111b or the pressure measuring means 111c detects an increase in pressure when the liquid level passes through the constriction 104a on the arterial pressure measurement line 103a, the pump that has been driven is stopped to The liquid level can be adjusted to the narrowed portion 104a of the pressure measurement line 103a. If necessary, the liquid level in the arterial drip chamber body 105a can be adjusted by reversing one of the pumps for a certain period of time.

  Next, a change in pressure when the liquid level passes through the constriction will be described. The speed of this pressure change is the speed of the liquid level passing through the constriction (liquid level adjustment pump, flow rate of the liquid feeding means), the inner diameter and length of the constriction, and the downstream side of the constriction (liquid supply side). Therefore, the pressure change rate for detecting the liquid level may be determined by experimentally checking as appropriate. An example is described below.

  FIG. 16 shows a test system that simulates the priming of blood cell component removal therapy. The blood purifier 250 has a blood pump 215, a pressure measuring means 211, and a pump 212 that are electrically connected to the control means 210. An arterial circuit 201 is connected to the upstream side of the blood purifier 220, and an arterial drip chamber 205a is disposed on the circuit. A venous circuit 202 connected to the priming fluid storage bag 216 is connected to the downstream side of the blood purifier 220, and a venous drip chamber body (drip chamber body) 205b is disposed on the circuit. Further, a stenosis portion 204 connected to the vein pressure measurement line 203 is directly connected to the air storage area of the vein drip chamber body (drip chamber body) 205b. A blood pump 215 is disposed on the arterial circuit 201, and a pressure measuring means 211 and a pump 212 are connected to the venous pressure measuring line 203 via the air filter 6. The arterial circuit 201 (total length 1500 mm) corresponding to the liquid lead-out circuit, the venous circuit 202 (total length 1600 mm) corresponding to the liquid introduction circuit, and the venous pressure measurement line 203 (total length 200 mm) are a polyvinyl chloride tube having an inner diameter of 3.4 mm, The constriction 204 (20mm in total length) is 0.8mm inner diameter PVC tube, arterial drip chamber body (drip chamber body) 205a (capacity 10cc), venous drip chamber body (drip chamber body) 205b (capacity 10cc) are made of vinyl chloride The cell component remover 220 includes Cell Sorber EX (manufactured by Asahi Kasei Kuraray Medical Co., Ltd.), the blood pump 215 and the pump 212 are rotary tube pumps that can hold the circuit internal pressure when stopped, and the pressure measuring means 211 is a semiconductor. A sensor is used.

  FIG. 15 shows that in the test system of FIG. 16, with the blood pump 215 stopped and the arterial circuit 201 closed, the pump 212 is driven at a flow rate of 40 mL / min, and physiological saline is supplied to the priming fluid reservoir back 216. The measured values of the pressure measuring means 211 when the liquid is supplied to the venous circuit 202, the venous drip chamber main body (drip chamber main body) 205b, and further to the constriction 204. Since the venous circuit 202 is connected to the liquid storage region side of the venous drip chamber main body (drip chamber main body) 205b in a U shape from the priming liquid storage back 216 at a position 400 mm higher than the pressure measuring means 211, The pressure when the liquid level passes through the venous circuit 202 changes as in the venous circuit filling period of FIG. When the venous drip chamber body (drip chamber body) 205b is filled, the liquid level in the chamber gradually rises. Therefore, as in the venous drip chamber filling period in the figure, it is about -0.2mmHg / sec. It changes slowly. When the physiological saline liquid level passes through the constricted portion 204, a rapid pressure drop of about −25 mmHg / sec occurs due to the flow resistance of the constricted portion 204 after the liquid level reaching point in FIG. In the case of this test system, when the liquid level passes through the constriction 204, the pressure change rate is 100 times or more compared to the previous filling period of the venous drip chamber body (drip chamber body) 205b. For example, when a pressure drop of −2 mmHg / sec or less is detected, the stenosis portion 204 of the venous drip chamber main body (drip chamber main body) 205b or the venous pressure measuring line 203 is stopped by stopping or reversing the pump 212 for a certain time. The liquid level inside can be adjusted. For example, when the physiological saline is supplied from the venous circuit 202 side using the liquid feeding means and the pressure on the liquid feeding means side is measured from the stenosis part 204, the liquid level of the physiological saline passes through the stenosis part 204. A sudden pressure increase is detected when passing.

  The liquid level adjustment mechanism of the drip chamber for the extracorporeal circuit according to the present invention includes hemofiltration therapy, hemodialysis therapy, hemofiltration dialysis therapy, continuous hemodialysis therapy, continuous hemofiltration therapy, continuous hemofiltration dialysis therapy, plasma exchange Extracorporeal circuit of blood purification device for extracorporeal circulation therapy such as therapy, plasma adsorption therapy, double filtration plasma exchange therapy, blood adsorption therapy, blood cell component removal therapy, ascites filtration concentration reinfusion therapy, percutaneous cardiopulmonary adjuvant therapy It can be suitably used as a drip chamber. Moreover, the liquid level preparation method of the drip chamber for the extracorporeal circuit of the present invention can be suitably used as the liquid level preparation method of the drip chamber of the extracorporeal circuit of the blood purification device.

It is explanatory drawing of the liquid level adjustment mechanism which concerns on this Embodiment. It is explanatory drawing of another liquid level adjustment mechanism which concerns on this Embodiment. It is explanatory drawing of another liquid level adjustment mechanism which concerns on this Embodiment. It is explanatory drawing of another liquid level adjustment mechanism which concerns on this Embodiment. It is explanatory drawing of another liquid level adjustment mechanism which concerns on this Embodiment. It is explanatory drawing of another liquid level adjustment mechanism which concerns on this Embodiment. It is explanatory drawing of another liquid level adjustment mechanism which concerns on this Embodiment. It is explanatory drawing of another liquid level adjustment mechanism which concerns on this Embodiment. It is explanatory drawing of another liquid level adjustment mechanism which concerns on this Embodiment. It is explanatory drawing of another liquid level adjustment mechanism which concerns on this Embodiment. It is explanatory drawing of another liquid level adjustment mechanism which concerns on this Embodiment. It is explanatory drawing of another liquid level adjustment mechanism which concerns on this Embodiment. It is a schematic diagram of the continuous hemofiltration dialysis therapy which can implement the liquid level adjustment method of this Embodiment. It is another schematic diagram of the continuous hemofiltration dialysis therapy which can implement the liquid level adjustment method of this invention. It is a graph which shows pressure transition when the liquid level confirmed with the test system of FIG. 16 reaches | attains a constriction part. It is the schematic diagram of the test system which confirmed the pressure transition when a liquid level reaches | attains a constriction part.

Explanation of symbols

1a ... Liquid derivation circuit
2a ... Liquid introduction circuit
3a, 3b ... line
4a… Stenosis
5a… Drip chamber body
6… Air filter
10 ... Control means
11a, 11b ... Pressure measuring means
12a ... Pump
13a: Blocking means
14… Air release valve
15a ・ ・ ・ Liquid feeding means
101a ・ ・ ・ Downstream side of arterial circuit
101b ・ ・ ・ Downstream side of venous circuit
102a ・ ・ ・ Upstream side of arterial circuit
102b ・ ・ ・ Upstream side of venous circuit
103a ... Arterial pressure measurement line
103b ・ ・ ・ Line for measuring venous pressure
103c ・ ・ ・ Filtration pressure measurement line
104a, b ... Stenosis
105a ・ ・ ・ Arterial drip chamber body
105b ・ ・ ・ Venous drip chamber body
111a-111c ・ ・ ・ Pressure measuring means
112a, 112b ・ ・ ・ Pump
113 ・ ・ ・ Blocking means
114a, 114b ・ ・ ・ Air release valve
115a ... Blood pump (liquid feeding means, blocking means)
115b ... filtration pump (liquid feeding means, closing means)
115c ... Dialysate pump (liquid feeding means, blocking means)
115d ・ ・ ・ Replacement pump (liquid feeding means, closing means)
120 ・ ・ ・ Blood Purifier
130 ... filtration circuit
131 ・ ・ ・ Dialysis circuit
132 ... Fluid replacement circuit
150 ... Blood purification device
201 ... Arterial circuit (liquid introduction circuit, liquid extraction circuit)
202 ・ ・ ・ Venous circuit (liquid introduction circuit, liquid extraction circuit)
203 ... Venous pressure measurement line
204 ・ ・ ・ Stenosis
205a ・ ・ ・ Arterial drip chamber body
206a ・ ・ ・ Venous drip chamber body
210 ... Control means
211 ・ ・ ・ Pressure measuring means
212 ・ ・ ・ Pump
215 ... Blood pump (liquid feeding means, blocking means)
216 ... Priming liquid storage bag
220 ... Blood purifier
250 ... Blood purification device

Claims (6)

A drip chamber liquid level adjustment method having a drip chamber body in which a liquid introduction circuit and a liquid outlet circuit of an extracorporeal circulation circuit communicate with each other, and a line communicating with an air storage region of the drip chamber body,
The line has a narrowed portion whose inner diameter is narrower than other parts of the line,
In a state where the liquid lead-out circuit is closed, by driving a pump in the line, liquid is introduced from the liquid introduction circuit through the drip chamber body into the line, and the pump downstream of the constriction part and the pump Detect the pressure of the section of the line sandwiched between the stenosis,
When a pressure drop exceeding a predetermined speed in the section that occurs when liquid is introduced into the constricted portion of the line is detected, the pump is stopped or reversely driven to enter the drip chamber body or the line. The liquid level adjustment method of a drip chamber characterized by adjusting the liquid level. A drip chamber liquid level adjustment method having a drip chamber body in which a liquid introduction circuit and a liquid outlet circuit of an extracorporeal circulation circuit communicate with each other, and a line communicating with an air storage region of the drip chamber body,
The line has a narrowed portion whose inner diameter is narrower than other parts of the line,
In a state where the liquid lead-out circuit is closed by the closing means, the liquid feeding means in the liquid introduction circuit is driven to introduce liquid from the liquid introduction circuit to the line through the drip chamber body, and the constriction portion Detecting the pressure in the section of the extracorporeal circuit sandwiched between the liquid feeding means and the blocking means upstream.
When detecting a pressure increase over a predetermined speed in the section that occurs when the liquid is introduced into the constricted portion of the line, the driving of the liquid feeding means is stopped or reversely fed to the inside of the drip chamber main body or the A liquid level adjustment method for a drip chamber, characterized by adjusting a liquid level in a line.   3. The drip chamber liquid level adjustment method according to claim 1, wherein an inner diameter of the narrowed portion is 50% or less of an inner diameter of another portion of the line.   4. The drip chamber liquid level adjustment method according to claim 3, wherein an inner diameter of the narrowed portion is 0.1 mm or more. A drip chamber liquid level adjustment mechanism installed in the extracorporeal circuit, wherein the drip chamber main body is connected to the liquid introduction circuit and the liquid outlet circuit, and the line is connected to the air storage area of the drip chamber main body,
A closing means for closing the liquid lead-out circuit;
A pump provided in the line;
A constriction provided in the line between the drip chamber body and the pump and having an inner diameter of 0.1 mm or more and 50% or less of the inner diameter of the other part of the line;
A drip chamber liquid level adjustment mechanism comprising pressure measuring means for measuring a pressure in a section between the narrow portion of the line and the pump. A drip chamber liquid level adjustment mechanism installed in the extracorporeal circuit, wherein the drip chamber main body is connected to the liquid introduction circuit and the liquid outlet circuit, and the line is connected to the air storage area of the drip chamber main body,
A closing means for closing the liquid lead-out circuit;
Liquid feeding means provided in the liquid introduction circuit;
A constricted portion provided in the line, having an inner diameter of 0.1 mm or more and 50% or less of an inner diameter of another part of the line;
A drip chamber liquid level adjusting mechanism comprising: the liquid feeding means; and a pressure measuring means for measuring a pressure in a section of the extracorporeal circuit sandwiched between the closing means.

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