JP6018698B2 - 体外血液処理用安全装置 - Google Patents
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
- A61M1/1601—Control or regulation
- A61M1/1603—Regulation parameters
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
- A61M1/1601—Control or regulation
- A61M1/1603—Regulation parameters
- A61M1/1605—Physical characteristics of the dialysate fluid
- A61M1/1609—Physical characteristics of the dialysate fluid after use, i.e. downstream of dialyser
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3607—Regulation parameters
- A61M1/3609—Physical characteristics of the blood, e.g. haematocrit, urea
- A61M1/361—Physical characteristics of the blood, e.g. haematocrit, urea before treatment
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3607—Regulation parameters
- A61M1/3609—Physical characteristics of the blood, e.g. haematocrit, urea
- A61M1/3612—Physical characteristics of the blood, e.g. haematocrit, urea after treatment
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3672—Means preventing coagulation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3672—Means preventing coagulation
- A61M1/3675—Deactivation
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B01—PHYSICAL OR CHEMICAL PROCESSES OR APPARATUS IN GENERAL
- B01D—SEPARATION
- B01D61/00—Processes of separation using semi-permeable membranes, e.g. dialysis, osmosis or ultrafiltration; Apparatus, accessories or auxiliary operations specially adapted therefor
- B01D61/24—Dialysis ; Membrane extraction
- B01D61/30—Accessories; Auxiliary operation
-
- B—PERFORMING OPERATIONS; TRANSPORTING
- B01—PHYSICAL OR CHEMICAL PROCESSES OR APPARATUS IN GENERAL
- B01D—SEPARATION
- B01D61/00—Processes of separation using semi-permeable membranes, e.g. dialysis, osmosis or ultrafiltration; Apparatus, accessories or auxiliary operations specially adapted therefor
- B01D61/24—Dialysis ; Membrane extraction
- B01D61/32—Controlling or regulating
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/18—General characteristics of the apparatus with alarm
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/33—Controlling, regulating or measuring
- A61M2205/3324—PH measuring means
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2230/00—Measuring parameters of the user
- A61M2230/20—Blood composition characteristics
- A61M2230/202—Blood composition characteristics partial carbon oxide pressure, e.g. partial dioxide pressure (P-CO2)
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2230/00—Measuring parameters of the user
- A61M2230/20—Blood composition characteristics
- A61M2230/208—Blood composition characteristics pH-value
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- F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
- F04—POSITIVE - DISPLACEMENT MACHINES FOR LIQUIDS; PUMPS FOR LIQUIDS OR ELASTIC FLUIDS
- F04C—ROTARY-PISTON, OR OSCILLATING-PISTON, POSITIVE-DISPLACEMENT MACHINES FOR LIQUIDS; ROTARY-PISTON, OR OSCILLATING-PISTON, POSITIVE-DISPLACEMENT PUMPS
- F04C2270/00—Control; Monitoring or safety arrangements
- F04C2270/04—Force
- F04C2270/042—Force radial
- F04C2270/0421—Controlled or regulated
Description
CO2+H2O <==> H2CO3 <==> H++HCO3−
二酸化炭素は、肺から吐き出され、水は、透析または濾過により除去される。最近では、主として重炭酸塩を用いて透析が行われている。また、重炭酸塩と酢酸塩との混合物も頻繁に用いられており、この場合の透析液は、ダイアライザ(透析フィルタ)通過前に、濃縮酢酸塩溶液(酸性成分)および濃縮重炭酸塩溶液(アルカリ成分)および水を混合して形成される。
図2は、追加的な構成要素を用いた、図1に示す血液浄化装置100の変形例である。図2に示す装置100’は、以下で特に明記しない限り、図1に示す装置に対応している。図示している追加部分は、個々に、または組み合わせての使用が可能である。
Claims (15)
- 体外血液浄化時に、アシドーシスまたはアルカローシスを含む、酸塩基バランスの乱れを抑止または処置するための血液浄化装置(100、100’、200、200’)であって、
患者から取り出した血液を透析ユニット(105、205)へ流入させるための血液流入路(103、203)と、患者へ戻す血液を前記透析ユニット(105、205)から流出させるための血液流出路(103、203)とを具備する体外血液回路を(102、202)備えており、前記透析ユニット(105、205)は透析液流入路(107、207)および透析排液流出路(108、208)を備え、前記血液浄化装置は、
血液の酸塩基バランスを制御するための制御ループを特徴とし、重炭酸塩水溶液によって重炭酸塩が血液へ供給され、血液緩衝パラメータを計測するための少なくとも1つの計測手段(124、124a、224、224a)は、前記制御ループと関連付けられており、前記血液緩衝パラメータは、重炭酸塩濃度およびCO2分圧からなるグループから選択され、計測された前記血液緩衝パラメータの実際値に対応する信号は、制御装置(125、225)へ供給可能であり、当該制御装置は、重炭酸塩の供給によって、前記血液緩衝パラメータの実際値を、予め設定可能な所望の値または所望の範囲に調整し、
少なくとも1つのpH計測手段(150a、250a)を更に特徴とし、当該pH計測手段は、前記体外血液回路(102、202)における前記透析ユニット(105、105)の上流に配置されており、前記pH値に対応する信号は警報装置(130、230)へ供給可能であり、当該警報装置は、予め設定可能なpH値またはpH値範囲を超えているか下回っている場合、警告信号を送信する、血液浄化装置。 - 前記重炭酸塩水溶液は透析液であることを特徴とする、請求項1に記載の血液浄化装置。
- 前記重炭酸塩水溶液は注入溶液であることを特徴とする、請求項1に記載の血液浄化装置。
- クエン酸塩抗凝血装置を特徴とし、前記透析ユニット(205)の上流に位置するクエン酸塩供給点(213)において、クエン酸塩が前記体外血液回路(202)へ供給され、前記透析ユニット(205)の下流に位置する置換媒体供給点(215)において、置換媒体が供給される、請求項1〜3のいずれか1つに記載の血液浄化装置。
- 前記少なくとも1つのpH計測手段(250a)は、前記体外血液回路(202)における前記クエン酸塩供給点(213)の上流に配置されていることを特徴とする、請求項4に記載の血液浄化装置。
- 血液緩衝パラメータを計測するための前記少なくとも1つの計測手段(124、224)は、前記体外血液回路(102、202)における前記透析ユニット(105、205)の上流に配置されていることを特徴とする、請求項1〜5のいずれか1つに記載の血液浄化装置。
- 血液緩衝パラメータを計測するための前記少なくとも1つの計測手段(224)は、前記体外血液回路(202)における前記クエン酸塩供給点(213)の上流に配置されていることを特徴とする、請求項4または6に記載の血液浄化装置。
- 血液緩衝パラメータを計測するための前記少なくとも1つの計測手段(124a、224a)は、透析液流出路(108、208)に配置されていることを特徴とする、請求項1〜5のいずれか1つに記載の血液浄化装置。
- 血液緩衝パラメータを計測するための少なくとも1つの追加的な計測手段(124a、224a)は、前記制御ループと関連付けられており、前記透析排液流出路(108、208)に配置されていることを特徴とする、請求項6または7に記載の血液浄化装置。
- 血液緩衝パラメータを計測するための少なくとも1つの追加的な計測手段(124、224)は、前記制御ループに関連付けられており、前記体外血液回路(102、202)における前記透析ユニット(105、205)の上流に配置されていることを特徴とする、請求項8に記載の血液浄化装置。
- 血液緩衝パラメータを計測するための前記少なくとも1つの追加的な計測手段(224)は、前記体外血液回路(202)における前記クエン酸塩供給点(213)の上流に配置されていることを特徴とする、請求項4または10に記載の血液浄化装置。
- 血液緩衝パラメータを計測するための少なくとも1つの追加的な計測手段(124b、224b)は、前記制御ループに関連付けられており、前記体外血液回路(102、202)における前記透析ユニット(105、205)の下流に配置されていることを特徴とする、請求項6〜11のうちいずれか1つに記載の血液浄化装置。
- 血液緩衝パラメータを計測するための前記少なくとも1つの追加的な計測手段(224b)は、前記透析ユニット(205)の下流で、かつ、前記体外血液回路(202)における前記置換媒体供給点(215)の上流に配置されていることを特徴とする、請求項4および12に記載の血液浄化装置。
- 少なくとも1つの追加的なpH計測手段(150b、250b)を特徴とし、当該pH計測手段は前記体外血液回路(102、202)における前記透析ユニット(105、205)の下流に配置されており、前記pH値に対応する信号は警報装置(130、230)へ供給可能であり、当該警報装置は、予め設定可能なpH値またはpH値範囲を超えているか下回っている場合、警告信号を送信する、請求項1〜13のいずれか1つに記載の血液浄化装置。
- 前記少なくとも1つの追加的なpH計測手段(250b)は、前記体外血液回路(202)における前記置換媒体供給点(215)の下流に配置されていることを特徴とする、請求項4または14に記載の血液浄化装置。
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EP12164284.7 | 2012-04-16 | ||
EP20120164284 EP2653178A1 (de) | 2012-04-16 | 2012-04-16 | Sicherheitseinrichtung für eine extrakorporale Blutbehandlung |
PCT/EP2013/057788 WO2013156435A1 (de) | 2012-04-16 | 2013-04-15 | Sicherheitseinrichtung für eine extrakorporale blutbehandlung |
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JP2015512731A JP2015512731A (ja) | 2015-04-30 |
JP6018698B2 true JP6018698B2 (ja) | 2016-11-02 |
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US (1) | US10245364B2 (ja) |
EP (2) | EP2653178A1 (ja) |
JP (1) | JP6018698B2 (ja) |
CN (1) | CN104394902B (ja) |
IN (1) | IN2014MN02004A (ja) |
WO (1) | WO2013156435A1 (ja) |
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- 2013-04-15 IN IN2004MUN2014 patent/IN2014MN02004A/en unknown
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- 2013-04-15 CN CN201380031623.9A patent/CN104394902B/zh active Active
- 2013-04-15 US US14/394,949 patent/US10245364B2/en active Active
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CN104394902B (zh) | 2016-11-09 |
EP2653178A1 (de) | 2013-10-23 |
JP2015512731A (ja) | 2015-04-30 |
EP2838579A1 (de) | 2015-02-25 |
US20150122712A1 (en) | 2015-05-07 |
US10245364B2 (en) | 2019-04-02 |
EP2838579B1 (de) | 2016-03-02 |
CN104394902A (zh) | 2015-03-04 |
WO2013156435A1 (de) | 2013-10-24 |
IN2014MN02004A (ja) | 2015-08-07 |
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