JP6385095B2 - Blood purification equipment - Google Patents

Description

  The present invention relates to a blood purification apparatus.

  The treatment for removing blood from a patient, separating the etiological agent from the blood, purifying the blood, and returning it to the body is called blood purification therapy. The blood purification therapy is performed using a blood purification device, and the blood purification device uses a separation membrane such as a hollow fiber membrane to separate a predetermined component from the patient's blood, and the blood to the blood purification device. A blood circuit that supplies and returns the blood from the blood purifier to the patient, a separation circuit that flows the components separated by the blood purifier, and the like are provided. A blood purifier having a separation membrane includes a blood filter that mainly separates excess water and waste from blood according to the purpose of treatment, a plasma separator that mainly separates plasma from blood, and plasma in plasma There are plasma component separators that separate the albumin and globulin compartments of the components. For the therapies that mainly separate water in the blood, such as hemofiltration therapy, hemodialysis therapy, hemofiltration dialysis therapy, continuous hemodialysis therapy, continuous hemofiltration therapy and continuous hemofiltration dialysis therapy, a hemofilter is used. Plasma separators and plasma component separators are used for the exchange of plasma in blood, such as simple plasma exchange therapy, double membrane filtration plasma exchange therapy, and plasma adsorption therapy. In this way, different blood purifiers are used for each treatment, but generally, the connection specifications of these blood purifiers and blood circuits are unified.

JP 2013-022021 A

  As described above, there are various types of blood purifiers, but since the connection specifications for the blood circuit are unified, there is a possibility that an error in attaching the blood purifier may occur. If a blood purifier is misplaced, the therapeutic effect cannot be obtained.

  For example, if a plasma separator or plasma component separator is mistakenly connected instead of a hemofilter at the time of mainly separating water such as blood filtration therapy, not only the moisture in the patient's blood but also other plasma components Is also separated, and the balance of the components in the blood is lost. In addition, if a blood filter is connected by mistake instead of a plasma separator during plasma exchange therapy, the plasma will not be sufficiently removed from the patient's blood, resulting in no therapeutic effect and fresh frozen plasma in the blood. Since the fluid is replaced, the blood component balance is lost.

  This invention is made | formed in view of this point, and it aims at providing the blood purification apparatus which can detect the attachment mistake of a blood purifier.

  As a result of intensive studies to solve the above problems, the present inventors have found that the above problems can be solved by detecting the presence or absence of a predetermined plasma component in the liquid flowing through the separation circuit. It came to. That is, the present invention provides the following (1) to (7).

(1) A blood purifier that separates a predetermined component from blood, a separation circuit through which a liquid of the predetermined component separated by the blood purifier flows, a sensor that detects the amount of light transmitted through the separation circuit, and the sensor detects A plasma component detection unit that detects the presence or absence of a predetermined plasma component in the liquid of the separation circuit based on the amount of transmitted light, and the blood purification device includes blood in which the plasma component is contained in the liquid of the separation circuit A blood purification apparatus that performs a purification process and issues an alarm when the plasma component detection unit does not detect the plasma component during the blood purification process .
(2) A blood purifier that separates a predetermined component from blood, a separation circuit through which a liquid of the predetermined component separated by the blood purifier flows, a sensor that detects the amount of light transmitted through the separation circuit, and the sensor detects A plasma component detector that detects the presence or absence of a predetermined plasma component in the liquid of the separation circuit based on the amount of transmitted light, and the blood purification device does not contain the plasma component in the liquid of the separation circuit A blood purification apparatus that performs blood purification processing and issues an alarm when the plasma component is detected by the plasma detection unit during the blood purification processing .
(3) A blood purifier that separates a predetermined component from blood, a separation circuit through which a liquid of the predetermined component separated by the blood purifier flows, a sensor that detects the amount of light transmitted through the separation circuit, and the sensor detects A plasma component detector that detects the presence or absence of a predetermined plasma component in the liquid of the separation circuit based on the amount of transmitted light, and the blood purification device includes a plurality of blood purification processes according to a plurality of blood purification therapies When the blood purification process in which the plasma component is contained in the liquid of the separation circuit is performed, an alarm is issued when the plasma component is not detected by the plasma component detection unit, and the separation circuit A blood purification apparatus that issues an alarm when the plasma component is detected by the plasma component detection unit when a blood purification process in which the plasma component is not contained in the liquid is performed .
(4) The blood purification apparatus according to any one of (1) to (3) , wherein the sensor is a sensor that detects transmitted light having a wavelength of 200 nm to 550 nm.
(5) Blood purification treatment in which the plasma component is not contained in the liquid of the separation circuit includes ultrafiltration therapy, hemofiltration therapy, hemodialysis therapy, hemofiltration dialysis therapy, continuous hemodialysis therapy, and continuous hemofiltration therapy And (2) or (3) .
(6) The blood purification treatment in which the plasma component is contained in the liquid of the separation circuit is one of simple plasma exchange therapy, double membrane filtration plasma exchange therapy, and plasma adsorption therapy. (1) or (3) The blood purification apparatus as described.

  According to the present invention, it is possible to detect a mistake in attaching the blood purifier in the blood purification apparatus, and therefore it is possible to appropriately perform treatment suitable for the purpose.

It is explanatory drawing which shows the outline of the blood purification apparatus which performs ultrafiltration therapy. It is explanatory drawing which shows the outline of a structure of a plasma sensor. It is explanatory drawing which shows the outline of the blood purification apparatus which performs blood filtration therapy. It is explanatory drawing which shows the outline of the blood purification apparatus which performs hemodialysis therapy. It is explanatory drawing which shows the outline of the blood purification apparatus which performs hemofiltration dialysis therapy. It is explanatory drawing which shows the outline of the blood purification apparatus which performs simple plasma exchange therapy. It is explanatory drawing which shows the outline of the blood purification apparatus which performs double filtration plasma purification therapy. It is explanatory drawing which shows the outline of the blood purification apparatus which performs plasma adsorption therapy.

  Hereinafter, preferred embodiments of the present invention will be described with reference to the drawings. FIG. 1 is an explanatory diagram showing an outline of the configuration of a blood purification apparatus 1 that performs ultrafiltration therapy according to the present embodiment.

  The blood purification apparatus 1 includes, for example, a blood filter 10, a blood removal circuit 11 that sends blood taken from a patient to the blood filter 10, a blood return circuit 12 that returns blood to the patient from the blood filter 10, and a blood filter 10 has a separation circuit 13 for draining a predetermined component separated from blood by 10.

The blood filter 10 has, for example, a hollow fiber membrane 20 as a separation membrane that mainly separates water in blood. The blood filter 10 causes the blood flowing in from the blood removal circuit 11 to flow to the primary side of the hollow fiber membrane 20 and flow out to the blood return circuit 12, and at that time, mainly water in the blood is secondary to the hollow fiber membrane 20. To the side and separated.

  The blood removal circuit 11 and the blood return circuit 12 are configured by, for example, a soft tube. In the blood removal circuit 11, for example, a blood pump 30 for handling and feeding a tube of a flow channel from the outside, a drip chamber 31 for discharging bubbles, and an anticoagulant injecting blood into the blood flowing through the flow channel The syringe pump 32 and the like are provided. The drip chamber 31 is provided with an inlet pressure sensor 33 that measures the inlet pressure of the blood filter 10, for example.

  The blood return circuit 12 is provided with, for example, a drip chamber 40, a bubble detector 41, a clamp valve 42, a venous pressure sensor 43, and the like.

  The separation circuit 13 is constituted by a soft tube, for example. The separation circuit 13 is connected to the secondary side of the hollow fiber membrane 20 of the blood filter 10. The separation circuit 13 is provided with a filtration pressure sensor 50, an optical sensor 51, a pump 52, a waste liquid container 53, and the like.

  The optical sensor 51 detects the amount of light transmitted through the separation circuit 13. For example, as shown in FIG. 2, the optical sensor 51 includes a light emitting unit 60, a light receiving unit 61, a support member 62 that supports them, and a sensor control unit 63. A tube of the separation circuit 13 can be attached between the light emitting unit 60 and the light receiving unit 61.

  The light emitting unit 60 can output light having a predetermined wavelength including a peak of an absorption spectrum of a predetermined plasma component, such as protein, carbohydrate, lipid, and other inorganic ions (hereinafter simply referred to as “plasma component”). The light receiving unit 61 can receive transmitted light having a wavelength of, for example, 200 nm to 550 nm including the peak of the absorption spectrum of the plasma component that has been output from the light emitting unit 60 and passed through the separation circuit 13. The sensor control unit 63 controls the operation of the light emitting unit 60 and the light receiving unit 61, causes the light emitting unit 60 to emit light having a predetermined wavelength, and allows the light receiving unit 61 to detect the amount of transmitted light. The plasma has a composition of, for example, 91% water, 7% protein, 0.1% carbohydrate, 1% lipid, and 0.9% other inorganic ions.

  Information on the transmitted light amount of the separation circuit 13 detected by the optical sensor 51 can be output to the control device 70 as a plasma component detection unit. If the plasma component is not flowing through the separation circuit 13, the light transmitted through the separation circuit 13 is not attenuated. If the plasma component is flowing through the separation circuit 13, the light passing through the separation circuit 13 is absorbed and attenuated by the plasma component. To do. Therefore, the control device 70 can detect the presence or absence of plasma components in the liquid of the separation circuit 13 based on the transmitted light amount detected by the optical sensor 51.

  In the case of ultrafiltration therapy, when the blood filter 10 is correctly attached, the plasma component does not flow into the separation circuit 13, and the plasma separator or the plasma component separator is mistakenly attached. The plasma component flows into the separation circuit 13. Therefore, the control device 70 can determine whether or not the correct blood filter 10 is attached. In addition, the control device 70 can issue an alarm when a plasma component is flowing in the separation circuit 13, that is, when the correct blood filter 10 is not attached. Such an alarm may notify the user of an abnormality by, for example, sound, light, screen display, or the like. At this time, the control device 70 may control the blood purification device 1 to a safe state by automatically stopping the pumps 30 and 52 and closing the clamp valve 42. The control device 70 includes a determination unit 71 that determines whether or not the blood purifier is attached and an alarm output unit 72 that issues an alarm.

  In addition, the control device 70 controls the operation of each device such as the blood pump 30, the bubble detector 41, the pump 52, and the optical sensor 51 to execute blood purification processing. The control device 70 has a CPU, a memory, and the like, like a general-purpose computer, and can execute blood purification therapy by executing a program recorded in advance in the memory.

  In the ultrafiltration therapy performed in the blood purification apparatus 1 described above, the patient's blood is supplied to the blood separator 10, and water is mainly separated and returned to the patient. In the separation circuit 13, mainly separated water flows and is discharged to the waste liquid container 53. At this time, the amount of light transmitted through the separation circuit 13 is monitored by the optical sensor 51, and the information is output to the control device 70. The control device 70, based on the information on the amount of transmitted light, plasma components in the liquid of the separation circuit 13 The presence or absence of is detected. When a plasma component that should not be detected by the separation circuit 13 is detected in the ultrafiltration therapy, the control device 70 determines that an incorrect type of blood purifier is attached, and issues an alarm.

  According to the present embodiment, since the plasma component in the liquid of the separation circuit 13 can be detected by the optical sensor 51 and the control device 70, it is possible to detect a mistake in attaching the blood purifier. Therefore, treatment suitable for the purpose can be appropriately performed.

  In the above-described embodiment, the blood purification apparatus 1 performs ultrafiltration therapy. Similarly, blood filtration therapy using a blood filter that separates mainly water and waste products other than plasma components in blood, continuous The present invention can also be applied to blood purification apparatuses that perform static hemofiltration therapy, hemodialysis therapy, continuous hemodialysis therapy, hemofiltration dialysis therapy, continuous hemofiltration dialysis therapy, and the like.

  For example, in the blood purification apparatus 1 that performs blood filtration therapy, a replacement fluid circuit 80 is connected to the drip chamber 40 as shown in FIG. 3, for example, and a replacement fluid pump 81 and a replacement fluid reservoir 82 are provided in the replacement fluid circuit 80. Other configurations are the same as those of the blood purification device 1 that performs the ultrafiltration therapy described above, and the same components are denoted by the same reference numerals and description thereof is omitted. In blood filtration therapy, the blood is supplemented with the replacement fluid from the replacement fluid reservoir 82 through the replacement fluid circuit 80 during blood processing. Also in the blood purification apparatus 1, when the blood filter 10 is correctly attached, no plasma component is contained in the liquid of the separation circuit 13, and when a plasma separator or the like is erroneously attached, Since the plasma component is contained in the liquid of the separation circuit 13, it is possible to detect an erroneous attachment of the blood purifier by detecting the presence or absence of the plasma component in the liquid of the separation circuit 13 by the optical sensor 51 and the control device 70.

  The blood purification device 1 that performs continuous blood filtration therapy has the same basic configuration, although there are differences such as a lower pump flow rate than the blood purification device 1 that performs blood filtration therapy.

  In the blood purification apparatus 1 that performs hemodialysis therapy, for example, as shown in FIG. 4, a dialysate circuit 90 is connected to the secondary side of the hollow fiber membrane 20 of the hemofilter 10, and the dialysate circuit 90 includes a dialysate pump. 91, a dialysate reservoir 92 is provided. In hemodialysis therapy, dialysate is supplied from the dialysate reservoir 92 to the secondary side of the hollow fiber membrane 20 through the dialysate circuit 90 during blood treatment. The dialysate supplied to the secondary side of the hollow fiber membrane 20 is drained through the separation circuit 13 together with mainly water and waste products separated by the blood filter 10. Also in the blood purification apparatus 1, when the blood filter 10 is correctly attached, no plasma component is contained in the liquid of the separation circuit 13, and when a plasma separator or the like is erroneously attached, Since the plasma component is contained in the liquid of the separation circuit 13, it is possible to detect a mistake in attaching the blood purifier by detecting the presence or absence of the plasma component in the liquid of the separation circuit 13 by the optical sensor 51 and the control device 70.

  The blood purification apparatus 1 that performs continuous hemodialysis therapy has the same basic configuration, although the pump flow rate is lower than the blood purification apparatus 1 that performs hemodialysis therapy.

  In the blood purification apparatus 1 that performs hemofiltration dialysis therapy, for example, as shown in FIG. 5, the dialysate circuit 90 is connected to the secondary side of the hollow fiber membrane 20 of the hemofilter 10, and the replacement fluid circuit 80 is connected to the drip chamber 40. Has been. Others have the same configuration as the blood purification apparatus 1 that performs blood filtration therapy and the blood purification apparatus 1 that performs hemodialysis treatment. In hemofiltration dialysis, dialysate is supplied from the dialysate reservoir 92 to the secondary side of the hollow fiber membrane 20 through the dialysate circuit 90 during blood treatment. The dialysate supplied to the secondary side of the hollow fiber membrane 20 is drained through the separation circuit 13 together with mainly water and waste products separated by the blood filter 10. Further, in the blood treatment, the replacement fluid is replenished to the blood from the replacement fluid reservoir 82 through the replacement fluid circuit 80. Also in the blood purification apparatus 1, when the blood filter 10 is correctly attached, no plasma component is contained in the liquid of the separation circuit 13, and when a plasma separator or the like is erroneously attached, Since the plasma component is contained in the liquid of the separation circuit 13, it is possible to detect an erroneous attachment of the blood purifier by detecting the presence or absence of the plasma component in the liquid of the separation circuit 13 by the optical sensor 51 and the control device 70.

  The blood purification apparatus 1 that performs continuous hemodiafiltration therapy has the same basic configuration, although there are differences such as a lower pump flow rate than the blood purification apparatus 1 that performs hemofiltration dialysis therapy.

  In the above embodiment, the blood purification apparatus 1 performs therapy using a blood filter that separates mainly water and waste products other than plasma components in blood. However, the present invention provides simple plasma exchange therapy. It can also be applied to the blood purification apparatus 1 that performs a therapy for exchanging plasma in blood, such as a double membrane filtration plasma exchange therapy and a plasma adsorption therapy. Hereinafter, a blood purification apparatus that performs such therapy will be described.

  The blood purification apparatus 1 shown in FIG. 6 performs simple plasma exchange therapy. The blood purification apparatus 1 has substantially the same configuration as that for performing the blood filtration therapy shown in FIG. 3 described above, but a plasma separator 100 that separates plasma in blood instead of the blood filter 10 is provided. And a fresh frozen plasma storage unit 101 instead of the replacement fluid storage unit 82. The plasma separator 100 has, for example, a hollow fiber membrane 20 as a separation membrane for separating plasma in blood.

  In simple plasma exchange therapy, plasma in a patient's blood is separated by a plasma separator 100 and drained through a separation circuit 13. On the other hand, fresh frozen plasma is injected into the blood from the fresh frozen plasma reservoir 101 through the replacement fluid circuit 80. At this time, the amount of light transmitted through the separation circuit 13 is monitored by the optical sensor 51, and the information is output to the control device 70. The control device 70, based on the information on the amount of transmitted light, plasma components in the liquid of the separation circuit 13 The presence or absence of is detected. When the plasma component that should be detected by the separation circuit 13 is not detected in the simple plasma exchange therapy, the control device 70 determines that the wrong type of blood purifier is attached, and gives an alarm. To emit.

  According to the present embodiment, since the presence or absence of the plasma component in the liquid of the separation circuit 13 can be detected by the optical sensor 51 and the control device 70, it is possible to detect a mistake in attaching the blood purifier. Therefore, treatment suitable for the purpose can be appropriately performed.

  In the blood purification apparatus 1 that performs double filtration plasma purification therapy, for example, as shown in FIG. 7, the secondary side of the plasma separator 100 and the primary side of the plasma component separator 110 are connected by a separation circuit 13. The plasma component separator 110 has a hollow fiber membrane 20 as a separation membrane that separates plasma components. The primary side of the plasma component separator 110 is connected to the waste liquid container 53 by the drain circuit 111. The drain circuit 111 is provided with a pump 112, and the separation circuit 13 is newly provided with a drip chamber 113 and a pressure sensor 114. The secondary side of the plasma component separator 110 is connected to the replacement fluid circuit 80. In double filtration plasma purification therapy, plasma in a patient's blood is separated by a plasma separator 100 during blood treatment, and the plasma is further separated into a high molecular component and a low molecular component by a plasma component separator 110. . The high molecular component is drained through the drain circuit 111, and the low molecular component is returned to the blood through the replacement fluid circuit 80. In addition, the replacement fluid is supplied to the blood from the replacement fluid reservoir 82 of the replacement fluid circuit 80 together with the low molecular component. In the blood purification apparatus 1 as well, when the plasma separator 100 is correctly attached, the liquid component of the separation circuit 13 always contains plasma components, and when the blood filter is mistakenly attached, Since the plasma component is not contained in the liquid of the separation circuit 13, it is possible to detect an erroneous attachment of the blood purifier by detecting the presence or absence of the plasma component in the liquid of the separation circuit 13 by the optical sensor 51 and the control device 70. .

  In the blood purification apparatus 1 that performs plasma adsorption therapy, for example, as shown in FIG. 8, the separation circuit 13 is connected to the plasma component adsorber 120, and the plasma component adsorber 120 is further connected to the drip chamber 40 by the plasma return circuit 121. Yes. In this plasma adsorption therapy, plasma in a patient's blood is separated by the plasma separator 100 during blood treatment, a predetermined component of the plasma is adsorbed by the plasma component adsorber 120, and the remaining plasma is returned to the blood. In the blood purification apparatus 1 as well, when the plasma separator 100 is correctly attached, the liquid component of the separation circuit 13 always contains plasma components, and when the blood filter is mistakenly attached, Since the plasma component is not contained in the liquid of the separation circuit 13, it is possible to detect an erroneous attachment of the blood purifier by detecting the presence or absence of the plasma component in the liquid of the separation circuit 13 by the optical sensor 51 and the control device 70. .

  The preferred embodiments of the present invention have been described above with reference to the accompanying drawings, but the present invention is not limited to such examples. It is obvious for those skilled in the art that various changes or modifications can be conceived within the scope of the idea described in the claims, and these naturally belong to the technical scope of the present invention. It is understood.

  For example, the blood purification apparatus 1 may perform a plurality of blood purification processes according to a plurality of blood purification therapies. In such a case, when performing blood purification processing such as simple plasma exchange therapy in which the plasma component is contained in the liquid of the separation circuit 13, double membrane filtration plasma exchange therapy, and plasma adsorption therapy, the control device 70 includes the separation circuit. An alarm is output when no plasma component is detected in the 13 liquids. In addition, ultrafiltration therapy, hemofiltration therapy, continuous hemofiltration therapy, hemodialysis therapy, continuous hemodialysis therapy, hemofiltration dialysis therapy, and continuous hemofiltration dialysis therapy in which plasma components are not contained in the liquid of the separation circuit 13 When blood purification processing such as the above is performed, the control device 70 outputs an alarm when a plasma component is detected in the liquid of the separation circuit 13.

The configuration of the blood purification apparatus 1 described in the above embodiment is not limited thereto. The predetermined plasma component that is detected by the plasma component detection unit is not particularly limited as long as it constitutes plasma. For example, the predetermined plasma component may be protein, carbohydrate, lipid, other inorganic ions, and the like.
is.

  The present invention is useful in providing a blood purification apparatus capable of detecting a mistake in attaching a blood purification device.

DESCRIPTION OF SYMBOLS 1 Blood purification apparatus 10 Blood filter 11 Blood removal circuit 12 Blood return circuit 13 Separation circuit 20 Hollow fiber membrane 31 Drip chamber 32 Syringe pump 33 Inlet pressure sensor 40 Drip chamber 41 Bubble detector 42 Clamp valve 43 Vein pressure sensor 50 Filtration pressure Sensor 51 Optical sensor 52 Pump 53 Waste liquid container 60 Light emitting part 61 Light receiving part 62 Support member 63 Sensor control part 70 Control device 71 Determination part 72 Alarm output part 80 Fluid replacement circuit 81 Fluid replacement pump 82 Fluid replacement storage container 90 Dialysate circuit 91 Dialysate pump 91 92 Dialysate storage container 100 Plasma separator 101 Fresh frozen plasma storage part 110 Plasma component separator 111 Drain circuit 112 Pump 113 Drip chamber 114 Pressure sensor 120 Plasma component adsorber 121 Plasma return circuit

Claims (6)

A blood purifier for separating predetermined components from blood;
A separation circuit through which a liquid of a predetermined component separated by the blood purifier flows;
A sensor for detecting the amount of light transmitted through the separation circuit;
A plasma component detector that detects the presence or absence of a predetermined plasma component in the liquid of the separation circuit based on the amount of transmitted light detected by the sensor ;
The blood purification apparatus performs blood purification processing in which the plasma component is contained in the liquid of the separation circuit,
A blood purification apparatus that issues an alarm when the plasma component detection unit does not detect the plasma component during the blood purification process . A blood purifier for separating predetermined components from blood;
A separation circuit through which a liquid of a predetermined component separated by the blood purifier flows;
A sensor for detecting the amount of light transmitted through the separation circuit;
A plasma component detector that detects the presence or absence of a predetermined plasma component in the liquid of the separation circuit based on the amount of transmitted light detected by the sensor ;
The blood purification apparatus performs blood purification processing in which the plasma component is not contained in the liquid of the separation circuit,
A blood purification apparatus that issues an alarm when the plasma detection unit detects the plasma component during the blood purification process . A blood purifier for separating predetermined components from blood;
A separation circuit through which a liquid of a predetermined component separated by the blood purifier flows;
A sensor for detecting the amount of light transmitted through the separation circuit;
A plasma component detector that detects the presence or absence of a predetermined plasma component in the liquid of the separation circuit based on the amount of transmitted light detected by the sensor ;
The blood purification device performs a plurality of blood purification processes according to a plurality of blood purification therapies,
When performing blood purification processing in which the plasma component is contained in the liquid of the separation circuit, an alarm is issued when the plasma component is not detected by the plasma component detection unit,
A blood purification apparatus that issues an alarm when the plasma component is detected by the plasma component detection unit when blood purification processing in which the plasma component is not contained in the liquid of the separation circuit is performed . The blood purification apparatus according to any one of claims 1 to 3 , wherein the sensor is a sensor that detects transmitted light having a wavelength of 200 nm to 550 nm. The blood purification treatment in which the plasma component is not contained in the liquid of the separation circuit includes ultrafiltration therapy, hemofiltration therapy, hemodialysis therapy, hemofiltration dialysis therapy, continuous hemodialysis therapy, continuous hemofiltration therapy and continuous The blood purification apparatus according to claim 2 or 3 , wherein the blood purification apparatus is one of hemofiltration dialysis therapy. The blood purification apparatus according to claim 1 or 3 , wherein the blood purification process in which the plasma component is contained in the liquid of the separation circuit is one of simple plasma exchange therapy, double membrane filtration plasma exchange therapy, and plasma adsorption therapy. .