JP6215199B2 - 麻酔回路およびこの麻酔回路を使用するための方法 - Google Patents
麻酔回路およびこの麻酔回路を使用するための方法 Download PDFInfo
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- JP6215199B2 JP6215199B2 JP2014516143A JP2014516143A JP6215199B2 JP 6215199 B2 JP6215199 B2 JP 6215199B2 JP 2014516143 A JP2014516143 A JP 2014516143A JP 2014516143 A JP2014516143 A JP 2014516143A JP 6215199 B2 JP6215199 B2 JP 6215199B2
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- A61M16/08—Bellows; Connecting tubes ; Water traps; Patient circuits
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Description
流路と;
外部麻酔薬を流路内へ導入するために流路と流体連通する麻酔薬入口と;
少なくとも外部麻酔薬を患者へ与えるために流路と流体連通する流出出口と;
吐出流体混合物を患者から受けるための流入入口であって、
吐出流体混合物が、吐出酸素、吐出二酸化炭素、および、吐出分子麻酔薬を含み、流路が、吐出流体混合物を流入入口から受けるために流入入口と流体連通し、
膜が、少なくとも1つの高分子材料を含み、流路に流体連通し、流入入口よりも下流側に配置され、吐出流体混合物が膜と接触した後に吐出分子麻酔薬を流路内に少なくとも部分的に保持するために吐出分子麻酔薬を少なくとも部分的に透過させず、
1よりも大きい吐出酸素対吐出分子麻酔薬選択性を膜が有するように、膜が吐出酸素を透過させ、
1よりも大きい吐出二酸化炭素対吐出分子麻酔薬選択性を膜が有するように、膜が吐出二酸化炭素を透過させ、
吐出流体混合物よりも吐出二酸化炭素の量が少ない改質流体混合物を流路内に残すように、吐出流体混合物が膜と接触し、
流出出口は、膜よりも下流側に位置されるとともに、少なくとも改質流体混合物を患者に与える、流入入口と;
患者へ与えられる改質流体混合物に加えられるべき外部流体を流路内へ導入するための流体入口と;
を備える。
分子麻酔薬を含む外部麻酔薬を、流路を介して患者へ向けて患者内に導入するステップと、
吐出酸素、吐出二酸化炭素、および吐出分子麻酔薬を含む吐出流体混合物を患者から離れるように患者の外へと流路内へ方向付けるステップと、
高分子材料を含むとともに流路と流体連通する膜へ向けて、吐出流体混合物を流路を通じて進めて膜と接触させるステップと、
改質流体混合物を流路内に残すように吐出流体混合物が膜と接触した後に、吐出分子麻酔薬よりも多い吐出二酸化炭素を吐出流体混合物から膜を通じて流路の外へ移送するステップであって、改質流体混合物は吐出流体混合物よりも低い濃度の吐出二酸化炭素を有する、ステップと、
改質流体混合物を流路内に残すように吐出流体混合物が膜と接触した後に、吐出酸素を膜を通じて移送するステップであって、膜が1よりも大きい吐出酸素対吐出分子麻酔薬選択性を有する、ステップと、
少なくとも改質流体混合物を患者に与えるために、改質流体混合物を流路を通じて患者へと進めるステップと、
を含む。
12 流路
14 麻酔薬入口
16 外部麻酔薬
18 麻酔器
20 患者
22 流出出口
24 Y字状ピース
26 吐出流体混合物
28 吐出酸素
30 吐出二酸化炭素
34 吐出分子麻酔薬
36 流入入口
38 膜
40 膜ハウジング
42 改質流体混合物
44 ハウジング入口
46 ハウジング出口
48 流体の流れ方向
50 流体入口
52 外部流体源、外部空気源
56 外部酸素源
58 流れ発生器
59 圧縮性部材、圧縮性チャンバ
60 対向壁
61 プランジャ
62 弁
64 乱流誘発構成要素
65 二次酸素
66 二酸化炭素吸収材料
68 内面
70 流入方向
72 中空繊維
74 単一中実層
76 血液入口
78 血液出口
80 掃引入口
82 掃引出口
83 高密度層
84 掃引流体
85 多孔質支持層
86 高分子
87 中空繊維内部
88 溶媒
89 中空繊維外部
90 ミキサー
92 混合物
94 熱源
96 熱押出機
98 窒素流体源
100 空隙
102 紡ぎチャンバ
106 抽出チャンバ
108 高温アルコール
110 乾燥ステージ
112 スプール
Claims (22)
- 患者に揮発性分子麻酔薬を再循環させるための麻酔回路であって、
流路と;
外部揮発性分子麻酔薬を前記流路内へ導入するために前記流路と流体連通する揮発性分子麻酔薬入口と;
少なくとも前記外部揮発性分子麻酔薬を前記患者へ供給するための前記流路と流体連通する流出出口と;
吐出流体混合物を前記患者から受けるための流入入口であって、前記吐出流体混合物が、吐出酸素、吐出二酸化炭素、および吐出揮発性分子麻酔薬を含み、前記流路が、前記吐出流体混合物を前記流入入口から受けるために前記流入入口と流体連通する、流入入口と;
少なくとも1つの高分子材料を含む膜であって、前記流路に流体連通し、前記流入入口よりも下流側に位置し、前記吐出揮発性分子麻酔薬に対して少なくとも部分的に不透過性であって、それにより、前記吐出流体混合物が前記膜と接触した後に前記吐出揮発性分子麻酔薬を前記流路内に少なくとも部分的に保持し、前記膜は、高密度膜であり、かつ実質的に孔を有さず、1よりも大きい吐出酸素対吐出揮発性分子麻酔薬選択性を前記膜が有するように、前記膜は前記吐出酸素に対して透過性を有し、1よりも大きい吐出二酸化炭素対吐出揮発性分子麻酔薬選択性を前記膜が有するように、前記膜が前記吐出二酸化炭素に対して透過性を有し、前記吐出流体混合物が前記膜と接触して、前記吐出流体混合物よりも前記吐出二酸化炭素の量が少ない改質流体混合物を前記流路内に残し、前記流出出口は、前記膜よりも下流側に位置するとともに、少なくとも前記改質流体混合物を前記患者に提供し、前記膜は前記吐出揮発性分子麻酔薬に対して不活性であるとともに、前記吐出二酸化炭素に対して不活性である、膜と;
外部流体を、前記患者へ供給される前記改質流体混合物に加えるために前記流路内へ導入するための流体入口と;
を備える、麻酔回路。 - 前記膜が少なくとも2の吐出酸素対吐出分子麻酔薬選択性を有する請求項1に記載の麻酔回路。
- 前記膜が少なくとも2の吐出二酸化炭素対吐出分子麻酔薬選択性を有する請求項1または2に記載の麻酔回路。
- 前記膜が全体的に高分子材料からなる請求項1から3のいずれか一項に記載の麻酔回路。
- 前記膜は、前記流路の外部に位置する二次酸素が前記膜を通過して前記流路に入るように構成される請求項1から4のいずれか一項に記載の麻酔回路。
- 前記外部流体を外部酸素で富化させるための外部酸素源を更に備える請求項1から5のいずれか一項に記載の麻酔回路。
- 前記流路を通じた前記吐出流体混合物および前記改質流体混合物の流れを促進させるための少なくとも1つの流れ発生器を更に備える請求項1から6のいずれか一項に記載の麻酔回路。
- 前記吐出流体混合物と前記膜との間の接触を増やすように前記吐出流体混合物の乱流を前記膜において形成するための乱流誘発構成要素を前記流路内に更に備える請求項1から7のいずれか一項に記載の麻酔回路。
- 前記吐出揮発性分子麻酔薬がポリハロゲン化エーテルを含む請求項1から8のいずれか一項に記載の麻酔回路。
- 前記吐出揮発性分子麻酔薬は、セボフルラン、イソフルラン、またはデスフルランのうちの少なくとも1つを含む請求項1から9のいずれか一項に記載の麻酔回路。
- 前記吐出揮発性分子麻酔薬が168g/モルよりも大きい分子量を有する請求項1から10のいずれか一項に記載の麻酔回路。
- 二酸化炭素吸収材料が前記膜の、前記流路の外部にある側に位置し、前記膜は、前記二酸化炭素吸収材料を前記流路内に保持される前記吐出揮発性分子麻酔薬から分離して、前記吐出揮発性分子麻酔薬が前記二酸化炭素吸収材料と接触するのを妨げる請求項1から11のいずれか一項に記載の麻酔回路。
- 前記二酸化炭素吸収材料は、ソーダ石灰、アルカノ石灰、アルカノールアミン、アミノ化合物、アミノ酸のアルカリ塩、グリシン、DL−アラニン、β−アラニン、セリン、トレオニン、イソロイシン、DL−バリン、ピペラジン−2−カルボキシ酸、プロリン、アルギニン、γ−アミノ酪酸、オルニチン、グリシン酸カリウム、トレオン酸カリウム、タウリン、クレアチン、およびヒスチジンのうちの少なくとも1つを含む請求項12に記載の麻酔回路。
- 前記吐出流体混合物は、アセトアルデヒド、アセトン、エタン、エチレン、水素、イソプレン、メタン、メチルアミン、またはペンタンを含む代謝物質を含み、
前記膜が前記代謝物質に対して透過性を有し、
前記吐出流体混合物は前記膜と接触して、前記吐出流体混合物よりも前記代謝物質の量が少ない改質流体混合物を前記流路内に残す、請求項1から13のいずれか一項に記載の麻酔回路。 - 前記膜がポリハロカーボン膜である請求項1から14のいずれか一項に記載の麻酔回路。
- 前記膜がポリメチルペンテン膜である請求項1から15のいずれか一項に記載の麻酔回路。
- 前記膜がポリシロキサン膜である請求項1から14のいずれか一項に記載の麻酔回路。
- 前記膜がポリジメチルシロキサン膜である請求項1から14および17のいずれか一項に記載の麻酔回路。
- 前記膜は、多孔質支持層および高密度層を備える少なくとも1つの壁を有する中空繊維を備える非対称膜である請求項1から18のいずれか一項に記載の麻酔回路。
- 前記膜は、ガラス質高分子、高分子サイズ選択膜、または、複合高分子膜を備える請求項1から19のいずれか一項に記載の麻酔回路。
- 前記膜はアミノ酸を有しない請求項1から20のいずれか一項に記載の麻酔回路。
- 患者の麻酔処置のために用いられる請求項1〜21のいずれか一項に記載された麻酔回路の作動方法であって、
前記麻酔回路は、麻酔器18を備え、
前記方法は、 揮発性分子麻酔薬を含む外部麻酔薬を、流路と流体連通する麻酔薬入口に前記外部麻酔薬の供給源から供給するように、前記麻酔器によって前記麻酔回路を作動させるステップと、
前記患者からの吐出酸素、吐出二酸化炭素、および吐出揮発性分子麻酔薬を含む吐出流体混合物を前記患者の外へと前記流路内へ流すように、前記麻酔器によって前記麻酔回路を作動させるステップと、
前記吐出流体混合物を、高分子材料を含み前記流路と流体連通する膜であって、吐出揮発性分子麻酔薬に対して不活性であるとともに、吐出二酸化炭素に対して不活性であり、かつ実質的に孔を有さない、高密度膜である膜と接触させるように、前記麻酔器によって前記麻酔回路を作動させるステップと、
前記吐出流体混合物が前記膜と接触して改質流体混合物を前記流路内に残した後に、前記吐出揮発性分子麻酔薬よりも多い前記吐出二酸化炭素を前記吐出流体混合物から前記膜を通じて前記流路の外へ移送するように、前記麻酔器によって前記麻酔回路を作動させるステップであって、前記改質流体混合物は、前記吐出流体混合物よりも低い濃度の前記吐出二酸化炭素を有する、ステップと、
改質流体混合物を前記流路内に残すように、前記吐出流体混合物が前記膜と接触した後に、吐出酸素を、前記膜を通じて移送するように、前記麻酔器によって前記麻酔回路を作動させるステップであって、1よりも大きい吐出酸素対吐出揮発性分子麻酔薬選択性を前記膜が有する、ステップと、
前記改質流体混合物を、前記患者に供給するように前記流路に流すように、前記麻酔器によって前記麻酔回路を作動させるステップと、
を含む、麻酔回路の作動方法。
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2012
- 2012-06-20 JP JP2014516143A patent/JP6215199B2/ja active Active
- 2012-06-20 US US13/528,090 patent/US20130068222A1/en not_active Abandoned
- 2012-06-20 CA CA2839670A patent/CA2839670C/en active Active
- 2012-06-20 EP EP12803346.1A patent/EP2720744B1/en active Active
- 2012-06-20 WO PCT/CA2012/000605 patent/WO2012174649A1/en active Application Filing
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JP2014519928A (ja) | 2014-08-21 |
EP2720744A4 (en) | 2015-03-04 |
US20130068222A1 (en) | 2013-03-21 |
CA2839670A1 (en) | 2012-12-27 |
WO2012174649A1 (en) | 2012-12-27 |
CA2839670C (en) | 2016-05-24 |
EP2720744B1 (en) | 2017-09-06 |
EP2720744A1 (en) | 2014-04-23 |
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