JP5231964B2 - Blood purification equipment - Google Patents

Description

  The present invention relates to a blood purification apparatus for purifying a patient's blood while circulating it outside the body.

  In general, in blood purification therapy such as dialysis treatment, a blood circuit composed of a flexible tube is used to circulate a patient's blood extracorporeally. This blood circuit is mainly composed of an arterial blood circuit in which an arterial puncture needle for collecting blood from a patient is attached to the tip, and a venous blood circuit in which a venous puncture needle for returning blood to the patient is attached to the tip. The dialyzer is interposed between the arterial blood circuit and the venous blood circuit to purify blood circulating outside the body.

  In such a dialyzer, a plurality of hollow fibers are arranged inside, and blood passes through the inside of each hollow fiber, and on the outside thereof (between the outer peripheral surface of the hollow fiber and the inner peripheral surface of the housing). It is set as the structure which can flow a dialysate. The hollow fiber has a blood purification membrane with micropores (pores) formed in the wall surface, and waste products of blood passing through the hollow fiber permeate the blood purification membrane and are discharged into the dialysate. At the same time, waste blood is discharged and purified blood returns to the patient's body.

By the way, during the dialysis treatment, the blood pressure of the patient flowing through the venous blood circuit is monitored, and when the pressure is significantly decreased or increased, the needle is removed (the needle is removed from the patient). It was determined that an abnormality had occurred and a medical worker was informed by an alarm or the like. Specifically, as disclosed in Patent Document 1, for example, a monitor tube is extended from the air layer side of the venous drip chamber disposed in the venous blood circuit and connected to the pressure sensor. The pressure of blood flowing through the venous blood circuit during dialysis treatment is always detected. Then, it is determined whether or not the pressure detected by the pressure sensor exceeds a preset upper limit value or lower limit value (alarm value). If any of these alarm values is exceeded, an abnormality such as a needle removal is detected. An alarm was given as there was a possibility that this occurred.
JP 2006-102237 A

  However, in the above-described conventional blood purification apparatus, even if there is no abnormality such as withdrawal of the needle, the pressure of blood flowing through the venous blood circuit is suddenly changed by the patient's body movement (for example, raising or lowering of the arm). There was a risk of exceeding the value, and false alarms were frequently performed. Thus, there has been a problem that such a frequent false alarm increases the burden on the medical staff. On the other hand, in order to suppress the above false alarms, in medical institutions such as hospitals, measures may be taken to increase the upper limit value or lower limit value of the alarm width and set the alarm width wider. Therefore, a problem arises that it becomes impossible to detect the fluctuation of the venous pressure that should be alarmed based on the above.

  The present invention has been made in view of such circumstances, and provides a blood purification apparatus capable of suppressing false alarms and accurately detecting abnormal situations such as needle withdrawal during blood purification treatment. is there.

  According to the first aspect of the present invention, there is provided a blood circuit including an arterial blood circuit and a venous blood circuit in which an arterial puncture needle and a venous puncture needle are attached to a distal end to circulate a patient's blood extracorporeally, and the arterial blood A blood pump disposed in a circuit; blood purification means connected between the arterial blood circuit and the venous blood circuit; and purifying blood flowing through the blood circuit; and a patient flowing through the venous blood circuit A blood purification device comprising a venous pressure detecting means capable of detecting blood pressure over time, wherein the blood pressure of a patient flowing between the tip of the arterial blood circuit and the blood pump is changed over time. The blood pressure detecting means that can be detected, and the time-dependent change of the pressure detected by the venous pressure detecting means is compared with the time-dependent change of the pressure detected by the blood pressure-decreasing blood pressure detecting means. Based on the other pressure Characterized in that a warning value updating means for sequentially updating the distribution value.

  According to a second aspect of the present invention, in the blood purification apparatus according to the first aspect, the alarm value update means adjusts the venous pressure detection means in accordance with the tendency and change amount of the detection value by the blood pressure removal detection means with time. The alarm value for the detected value is sequentially updated.

  According to a third aspect of the present invention, in the blood purification apparatus according to the first aspect, the alarm value update means adjusts the blood pressure removal detection means in accordance with the tendency and amount of change of the detected value with time by the venous pressure detection means. The alarm value for the detected value is sequentially updated.

  According to a fourth aspect of the present invention, in the blood purification apparatus according to any one of the first to third aspects, the alarm value updated by the alarm value update unit is the venous pressure detection unit or the blood pressure reduction detection unit. It consists of an upper limit value or a lower limit value with the detected pressure as a reference value.

  According to a fifth aspect of the present invention, in the blood purification apparatus according to any one of the first to fourth aspects, the pressure detected by the venous pressure detecting means or the blood pressure reducing means is updated by the alarm value updating means. It is characterized by comprising an informing means for informing that the alarm value has been exceeded.

  According to a sixth aspect of the present invention, in the blood purification apparatus according to any one of the first to fifth aspects, the pressure detected by the venous pressure detecting means or the blood pressure reducing means is updated by the alarm value updating means. The driving of the blood pump is stopped on condition that the alarm value is exceeded.

  According to the first aspect of the present invention, the alarm value updating means compares the time-dependent change of the pressure detected by the venous pressure detecting means with the time-dependent change of the pressure detected by the blood pressure removal detecting means, Since the alarm value of the other pressure is sequentially updated based on the change over time, an erroneous alarm can be suppressed and an abnormal situation (puncture trouble) such as a needle removal during blood purification treatment can be accurately detected.

  According to the invention of claim 2, the alarm value update means sequentially updates the alarm value for the detection value of the venous pressure detection means in accordance with the tendency and change amount of the detection value by the blood pressure removal detection means with time. It is possible to accurately detect the withdrawal of the venous puncture needle from the patient during the blood purification treatment.

  According to the invention of claim 3, the alarm value update means sequentially updates the alarm value for the detection value of the blood pressure removal detection means in accordance with the tendency and amount of change of the detection value by the venous pressure detection means over time. It is possible to accurately detect the withdrawal of the artery side puncture needle from the patient during the blood purification treatment.

  According to the invention of claim 4, since the alarm value updated by the alarm value updating means is composed of an upper limit value or a lower limit value based on the pressure detected by the venous pressure detection means or the blood pressure removal detection means, While further suppressing the alarm, it is possible to more accurately detect abnormal situations such as needle removal during blood purification treatment.

  According to the fifth aspect of the present invention, the blood purification apparatus includes the notification means for notifying that the pressure detected by the venous pressure detection means or the blood pressure reduction detection means exceeds the alarm value updated by the alarm value update means. Abnormal situations such as needle removal during treatment can be quickly grasped by surrounding medical staff, and subsequent treatments can be performed smoothly.

  According to the invention of claim 6, since the drive of the blood pump is stopped on condition that the pressure detected by the venous pressure detection means or the blood pressure reduction detection means exceeds the alarm value updated by the alarm value update means, When an abnormal situation such as withdrawal of a needle occurs, the extracorporeal circulation of blood can be immediately stopped to further improve safety.

Hereinafter, embodiments of the present invention will be specifically described with reference to the drawings.
The blood purification apparatus according to the present embodiment is for purifying a patient's blood while circulating it extracorporeally, and is applied to a dialysis apparatus used in dialysis treatment. As shown in FIG. 1, such a dialysis machine is mainly composed of a blood circuit 1 to which a dialyzer 2 as blood purification means is connected, and a dialysis machine body 6 for removing water while supplying dialysate 2 to the dialyzer 2. ing.

  As shown in the figure, the blood circuit 1 is mainly composed of an arterial blood circuit 1a and a venous blood circuit 1b made of a flexible tube. The arterial blood circuit 1a and the venous blood circuit 1b A dialyzer 2 is connected between them. An arterial puncture needle a is connected to the tip of the arterial blood circuit 1a, and an iron type blood pump 3 and defoaming drip chambers 4a and 4b are disposed in the middle. On the other hand, a venous puncture needle b is connected to the distal end of the venous blood circuit 1b, and a detecting means 5 and a drip chamber 4c for removing bubbles are connected in the middle.

  When the blood pump 3 is driven while the patient is punctured with the arterial puncture needle a and the venous side puncture needle b, the patient's blood is defoamed in the drip chambers 4a and 4b and the arterial blood circuit 1a. The blood is passed through the dialyzer 2, blood purification is performed by the dialyzer 2, and the blood is returned to the patient through the venous blood circuit 1b while being defoamed in the drip chamber 4c. That is, the blood of the patient is purified by the dialyzer 2 while circulating outside the body by the blood circuit 1.

  The dialyzer 2 is formed with a blood introduction port 2a, a blood outlet port 2b, a dialysate inlet port 2c, and a dialysate outlet port 2d in the casing. Among these, the blood inlet port 2a has an arterial blood circuit 1a. The base end of the venous blood circuit 1b is connected to the blood outlet port 2b. The dialysate introduction port 2c and the dialysate lead-out port 2d are connected to a dialysate introduction line 7 and a dialysate discharge line 8 extending from the dialyzer body 6, respectively.

  A plurality of hollow fibers are accommodated in the dialyzer 2, the inside of the hollow fibers is used as a blood flow path, and the flow of dialysate is between the hollow fiber outer peripheral surface and the inner peripheral surface of the housing. It is considered a road. A hollow fiber membrane is formed in the hollow fiber by forming a large number of minute holes (pores) penetrating the outer circumferential surface and the inner circumferential surface, and impurities in the blood are passed through the membrane in the dialysate. It is comprised so that it can permeate | transmit.

  On the other hand, the dialyzer body 6 includes a duplex pump P, a bypass line 9 that bypasses the duplex pump P in the dialysate discharge line 8, and a water removal pump 10 (water removal means) connected to the bypass line 9. ), A pressurizing pump 11 that causes the dialysate to flow from the dialyzer 2 to the drainage side Pb of the dual pump P, a bubble separation chamber 12, an air release line 13, and an electromagnetic valve 14.

  The compound pump P is disposed across the dialysate introduction line 7 and the dialysate discharge line 8 and introduces dialysate from the dialysate introduction line 7 to the dialyzer 2 (blood purification means). The dialysis fluid introduced into the dialysis fluid is discharged from the dialysis fluid discharge line 8. That is, the duplex pump P is composed of a fixed type pump in which the supply side Pa and the drainage side Pb are substantially equal, and the flow path of the dialysate from the supply side Pa to the drainage side Pb is as follows. In a state where the electromagnetic valve 14 is closed, a closed system (a state in which the sealing is maintained) is established.

  The pressurizing pump 11 is connected between the dialyzer 2 and the duplex pump P in the dialysate discharge line 8, and is used for flowing dialysate from the dialyzer 2 to the duplex pump P. One end of the dialysate introduction line 7 is connected to the dialyzer 2 (dialyte introduction port 2c), and the other end is connected to a dialysate supply device (not shown) for preparing a dialysate having a predetermined concentration. Furthermore, one end of the dialysate discharge line 8 is connected to the dialyzer 2 (dialysate outlet port 2d), and the other end is connected to a drainage means (not shown), and the dialysate supplied from the dialysate supply device After passing through the dialysate introduction line 7 to the dialyzer 2, the dialysate discharge line 8 and the bypass line 9 are sent to the drainage means.

  The water removal pump 10 is for removing water (water removal) from the blood of the patient passing through the dialyzer 2. That is, when the dewatering pump 10 is driven, since the dual pump P is of the fixed type, the volume of liquid discharged from the dialysate discharge line 8 is larger than the amount of dialysate introduced from the dialysate introduction line 7. Thus, water is removed from the blood by the large volume. In addition, you may make it remove a water | moisture content from a patient's blood by means other than this water removal pump 10 (for example, what utilizes what is called a balancing chamber etc.).

  The bubble separation chamber 12 is a so-called degassing chamber, and has a predetermined capacity connected between the pressurizing pump 11 and the dual pump P in the dialysate discharge line 8 to capture bubbles in the dialysate. It is comprised so that it can do. From the bubble separation chamber 12, the bypass line 9 described above is extended, and an air release line 13 is extended. The air release line 13 is open to the air at the tip, and an electromagnetic valve 14 is connected in the middle.

  The electromagnetic valve 14 can be opened and closed to open or close the atmosphere opening line 13 so that the bubble separation chamber 12 communicates with the outside air in the open state, and the bubble separation chamber 12 shuts off from the outside air in the closed state. It has become. Thus, before or after dialysis treatment, by operating the electromagnetic valve 14 to open the atmosphere release line 13, the bubbles trapped in the bubble separation chamber 12 can be released to the atmosphere.

  Here, monitor tubes H1 and H2 are extended from the air layer side of the drip chambers 4a and 4c, and a blood pressure-removing sensor 15 (blood pressure-reducing means) and a vein are provided at the tips of the monitor tubes H1 and H2. Pressure sensors 5 (venous pressure detection means) are connected to each other. Among these, the venous pressure sensor 5 is composed of a pressure sensor disposed in the dialysis apparatus main body 6, and during the dialysis treatment, the blood pressure (venous pressure) of the patient flowing through the venous blood circuit 1b is changed over time (real time). It is configured so that it can be detected. The blood pressure removal sensor 15 is composed of a pressure sensor disposed in the dialysis machine main body 6, and during the dialysis treatment, the tip of the artery side blood circuit 1a (the part to which the artery side puncture needle a is connected) and a blood pump. 3 is configured to detect the blood pressure (blood pressure-removal) of the patient flowing between 3 and 3 over time (real time).

  Further, an alarm value updating means 16 is electrically connected to the venous pressure sensor 5 and the blood pressure removal sensor 15, and the venous pressure and blood pressure detected by the venous pressure sensor 5 and blood pressure removal sensor 15 are electrically connected. The alarm value updating means 16 can be transmitted as a signal. The alarm value update means 16 is composed of, for example, a microcomputer for controlling various operations and displays in the hemodialysis apparatus.

  This alarm value update means 16 compares the change over time of the pressure detected by the venous pressure sensor 5 with the change over time of the pressure detected by the blood pressure reduction sensor 15, and based on the change over time of one pressure, the other The alarm value updating means 16 according to this embodiment detects the venous pressure sensor 5 in accordance with the tendency and change amount of the detection value with the blood pressure reduction sensor 15 over time. The alarm value for the value is updated sequentially.

  More specifically, the horizontal axis represents the treatment time (h), and the vertical axis represents the venous pressure (mmHg) detected by the venous pressure sensor 5 and the blood pressure removed (mmHg) detected by the blood pressure sensor 15. The change over time as shown in FIG. However, in the figure, the symbol α represents the change over time in the venous pressure (raw waveform), and the symbol β represents the change over time in the blood pressure removal (raw waveform). The alarm value updating means 16 calculates a moving average (moving average pressure) in accordance with the cycle of the blood pump 3 with respect to the venous pressure change α over time and the blood pressure change over time β.

  That is, as shown in FIG. 8, when one section of sampling data is set to 100 (ms) and the period of the blood pump 3 is set to four sections (that is, 400 (ms)) in FIG. 8, (A-1) Moving average pressure, (A-2) moving average pressure, (A-3) moving average pressure,... Are sequentially calculated. Then, when the calculation result (moving average pressure) is represented in a graph, the temporal change α ′ of the moving average pressure in the venous pressure leveled with respect to the raw waveform as shown in FIG. A change β ′ with time is obtained.

  However, the alarm value update means 16 updates the alarm value (alarm width) for the venous pressure at predetermined time intervals (for example, every 5 (s)) based on the change in blood pressure removal. That is, as shown in FIG. 4, first, an alarm value (alarm width: the same applies hereinafter) (1) is set with reference to the moving average pressure for blood pressure removal, and the alarm value (1) is set as the moving average pressure for venous pressure. The reference alarm value (1) ′ is set, and the alarm value (2) based on the moving average of blood pressure removal at that time is set. In the process of sequentially repeating this every predetermined time, when the moving average pressure of blood removal increases or decreases, the alarm value for the moving average pressure of venous pressure is changed up and down in the same direction as that.

  As a result, the alarm value for the detection value of the venous pressure sensor 5 is sequentially updated in accordance with the tendency (change direction of the detection value) and the change amount (movement amount of the detection value) of the detection value by the blood pressure reduction sensor 15 over time. As shown in FIG. 4, when the patient is moving by raising or lowering the arm that has been punctured with the puncture needles a and b (when there is no needle removal or the like), the temporal change in blood pressure removal is shown in FIG. Following the β (moving average pressure β ′ of blood pressure removal), the venous pressure alarm values ((1) ′, (2) ′, (3) ′...) are updated, and the detected value of the venous pressure sensor 5 Alarm values (upper limit and lower limit) are not exceeded.

  On the other hand, when the venous puncture needle b is removed from the patient during dialysis treatment, for example, as shown in FIG. 5, the temporal change α of the venous pressure rapidly decreases, but the temporal change β of the blood pressure decrease is almost constant. Will remain. When the moving average (moving average pressure) according to the cycle of the blood pump 3 is calculated and graphed with respect to the temporal change α of the venous pressure and the temporal change β of the blood pressure reduction, as shown in FIG. The time-dependent change α ′ of the moving average pressure in the venous pressure and the time-dependent change β ′ of the moving average pressure in the blood pressure removal are obtained.

  However, as described above, if the alarm value update means 16 updates the alarm value (alarm width) for venous pressure at predetermined time intervals (for example, every 5 (s)) based on the change in blood pressure reduction, FIG. As shown in FIG. 4, the time-dependent change α ′ of the moving average pressure in the venous pressure exceeds the alarm value (in this case, the lower limit value), and it can be determined that the venous puncture needle b has been removed from the patient. In the above embodiment, the alarm value updating unit 16 sequentially updates the alarm value for the detection value of the venous pressure sensor 5 in accordance with the tendency and change amount of the detection value with the blood pressure removal sensor 15 with time. However, instead of this, an alarm value for the detection value of the blood pressure removal sensor 15 (blood pressure removal detection means) is sequentially applied according to the tendency and change amount of the detection value by the vein pressure sensor 5 (venous pressure detection means) with time. You may comprise so that it may be updated.

  Therefore, the alarm value update unit 16 adjusts the vein according to the tendency and the amount of change β over time of the detected value by the blood pressure reduction sensor 15 (in this embodiment, the time-dependent change β ′ of the moving average pressure during blood removal). Since the alarm value for the detection value of the pressure sensor 5 is sequentially updated, it is possible to accurately detect the withdrawal of the venous puncture needle b from the patient during blood purification treatment (during dialysis treatment). On the contrary, the alarm value update means 16 matches the tendency and amount of change with time α of the detected value by the venous pressure sensor 5 (in this embodiment, change with time α ′ of moving average pressure in venous pressure). If the alarm value for the detection value of the blood pressure removal sensor 15 is sequentially updated, it is possible to accurately detect the withdrawal of the artery side puncture needle a from the patient during blood purification treatment (during dialysis treatment).

  Further, according to the present embodiment, the alarm value updated by the alarm value update means 16 is composed of an upper limit value or a lower limit value with the pressure detected by the venous pressure sensor 5 (or blood pressure removal sensor 15) as a reference value. Therefore, it is possible to further suppress an erroneous alarm and more accurately detect an abnormal situation such as a needle removal during blood purification treatment (during dialysis treatment). In the present embodiment, the alarm value is the upper limit value and the lower limit value. For example, only the lower limit value or the upper limit value based on the pressure detected by the venous pressure sensor 5 (or the blood pressure removal sensor 15) is used as the reference value. It is good only as well.

  The notification means 17 updates the pressure detected by the venous pressure sensor 5 (or the blood pressure reduction sensor 15) by the warning value updating means 16 when the warning value updating means 16 determines that the venous pressure has exceeded the warning value. This alerts the surrounding medical staff by alerting them that the alarm value has been exceeded, generates a predetermined sound from the speaker, flashes or lights a warning light, or displays on the display (both not shown) ) Or the like.

  In addition to the notification by the notification means 17, the blood pump 3 is driven on condition that the pressure detected by the venous pressure sensor 5 (or the blood pressure removal sensor 15) exceeds the alarm value updated by the alarm value update means 16. It is configured to stop. Therefore, the notification by the notification means 17 allows the surrounding medical staff to quickly grasp an abnormal situation such as a needle withdrawal during blood purification treatment (during dialysis treatment), and allows subsequent treatment to be performed smoothly. In addition, since the driving of the blood pump 3 is stopped at the time of notification, the extracorporeal circulation of blood can be stopped immediately when an abnormal situation such as needle withdrawal occurs, thereby further improving safety.

  According to the above embodiment, the alarm value update means 16 compares the change over time of the pressure detected by the venous pressure sensor 5 with the change over time of the pressure detected by the blood pressure removal sensor 15, Because the alarm value of the other pressure is updated sequentially based on changes over time, false alarms are suppressed, and abnormal conditions (puncture troubles) such as needle withdrawal during blood purification treatment (during dialysis treatment) are accurately detected. Can do. Further, since the time-dependent change α ′ of the moving average pressure in the venous pressure and the time-dependent change β ′ of the moving average pressure in the blood removal pressure are obtained and updated by the alarm value updating means 16 based on them, the blood pump 3 The influence by the pulsation of can be suppressed.

  Although the present embodiment has been described above, the present invention is not limited to this. For example, the alarm value update unit 16 may change the moving average pressure with time α ′ in the venous pressure and the moving average pressure with time in the blood pressure reduction over time. Without obtaining the change β ′, the raw waveforms detected by the venous pressure sensor 5 and the blood pressure reduction sensor 15 are directly compared, and the alarm value of the other pressure is sequentially updated based on the temporal change of one pressure. Also good.

  Further, only the lower limit value may be used as the alarm value, and the upper limit value may be a fixed value that is set constant over the entire dialysis treatment. However, when the venous puncture needle b is removed from the patient, the venous pressure usually decreases. Therefore, by updating the lower limit value every predetermined time and making the upper limit value a fixed value, the puncture needle can be removed from the patient. Control for monitoring can be simplified. In the present embodiment, the dialysis device body 6 is composed of a dialysis monitoring device that does not incorporate a dialysate supply mechanism, but may be applied to a personal dialysis device that incorporates a dialysate supply mechanism. . The present invention can be applied to other blood purification apparatuses such as hemofiltration therapy and hemofiltration dialysis therapy in addition to hemodialysis therapy as in the embodiment.

  Compares the change in pressure detected by the venous pressure detection means over time and the change in pressure detected by the blood pressure removal detection means, and sequentially updates the alarm value for the other pressure based on the change over time in one pressure Any blood purification apparatus provided with an alarm value updating means for applying can be applied even if it has a different appearance or is provided with other functions.

Schematic diagram showing a hemodialysis apparatus according to an embodiment of the present invention. Graph showing time-dependent change α and time-dependent change β detected by a venous pressure sensor and a blood pressure reduction sensor in the hemodialysis apparatus (at the time of body movement) The graph which shows the time-dependent change α ′ of the moving average pressure in the venous pressure and the time-dependent change β ′ of the moving average pressure in the blood removal pressure in the hemodialyzer The graph (at the time of body movement) which shows the time-dependent change α ′ of the moving average pressure in the venous pressure and the time-dependent change β ′ of the moving average pressure in the blood pressure reduction in the hemodialysis apparatus, in which the alarm value is updated Graph showing Graph showing time-dependent change α and time-dependent change β detected by the venous pressure sensor and de-blood pressure sensor in the hemodialysis device (when the venous needle is removed) Graph showing time-dependent change α ′ of moving average pressure in venous pressure and time-dependent change β ′ of moving average pressure in blood removal pressure in the same hemodialysis apparatus (when venous puncture needle is removed) FIG. 6 is a graph (when the venous puncture needle is removed) showing a change with time α ′ of moving average pressure in venous pressure and a change with time β ′ of moving average pressure in depressurization in the hemodialysis apparatus, in which an alarm value is updated. A graph showing the state made Explanatory drawing for demonstrating the calculation method of the moving average pressure in the hemodialysis apparatus

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Blood circuit 1a ... Arterial side blood circuit 1b ... Vein side blood circuit 2 ... Dializer (blood purification means)
3 ... Blood pumps 4a, 4b, 4c ... Drip chamber 5 ... Vein pressure sensor (venous pressure detection means)
DESCRIPTION OF SYMBOLS 6 ... Dialyzer main body 7 ... Dialysate introduction line 8 ... Dialysis system discharge line 9 ... Bypass line 10 ... Dewatering pump 11 ... Pressurization pump 12 ... Bubble separation chamber 13 ... Air release line 14 ... Solenoid valve 15 ... De-blood pressure sensor (Blood pressure reduction means)
16 ... alarm value update means 17 ... notification means a ... arterial puncture needle b ... venous puncture needle

Claims (6)

A blood circuit composed of an arterial blood circuit and a venous blood circuit each having an arterial puncture needle and a venous puncture needle attached to the tip of the patient for extracorporeal circulation;
A blood pump disposed in the arterial blood circuit;
Blood purification means connected between the arterial blood circuit and the venous blood circuit and purifying blood flowing through the blood circuit;
Venous pressure detecting means capable of detecting the blood pressure of the patient flowing through the venous blood circuit over time;
A blood purification apparatus comprising:
Blood pressure removal detecting means capable of detecting the blood pressure of the patient flowing between the tip of the arterial blood circuit and the blood pump over time;
The change over time of the pressure detected by the venous pressure detection means is compared with the change over time of the pressure detected by the blood pressure removal detection means, and the alarm value of the other pressure is calculated based on the change over time of one pressure. An alarm value updating means for sequentially updating;
A blood purification apparatus comprising:   2. The alarm value updating unit sequentially updates an alarm value for a detection value of the venous pressure detection unit in accordance with a tendency and a change amount of a detection value with time by the blood pressure removal detection unit. The blood purification apparatus as described.   2. The alarm value updating unit sequentially updates an alarm value for a detection value of the blood pressure removal detection unit in accordance with a tendency and a change amount of a detection value with time of the venous pressure detection unit. The blood purification apparatus as described.   4. The alarm value updated by the alarm value updating means is composed of an upper limit value or a lower limit value with reference to a pressure detected by the venous pressure detection means or blood pressure reduction detection means. The blood purification apparatus as described in any one of these.   5. The notification means for notifying that the pressure detected by the venous pressure detection means or the blood pressure reduction detection means exceeds the alarm value updated by the alarm value update means. The blood purification apparatus as described in any one.   2. The driving of the blood pump is stopped on the condition that the pressure detected by the venous pressure detecting means or the blood pressure reducing means exceeds the alarm value updated by the alarm value updating means. The blood purification apparatus as described in any one of -5.

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