JP6572059B2 - Extracorporeal circulation management device, extracorporeal circulation device, and control method for extracorporeal circulation management device - Google Patents

Description

  The present invention relates to an extracorporeal circulation management apparatus that manages an extracorporeal circulation apparatus that performs extracorporeal circulation of blood of a patient or the like, an extracorporeal circulation apparatus, and a control method for the extracorporeal circulation management apparatus.

Conventionally, for example, an extracorporeal circulation device having an artificial heart-lung machine or the like has been used to circulate the patient's blood outside the body when blood supply to the patient is necessary during surgery or the like. Such an extracorporeal circulation device has a flow rate sensor, a pressure sensor, a rotational speed detection unit of a drive motor, and the like, and thus manages the values of the patient and the state of the device itself. It has a configuration that can.
Moreover, when there is a sudden change in the circulating blood of the patient, a proposal has been made to compare this rapid change with the vital sign of the patient (for example, Patent Document 1).

Japanese Patent Laid-Open No. 2007-238

  However, when an abnormality occurs in the values output from the individual flow rate sensors, pressure sensors, drive motor rotation speed detection units, etc., it is difficult to understand what caused this abnormality. However, there is a problem that the burden on the person in charge such as a clinical engineer who manages these numerical values is heavy.

  Therefore, the present invention can provide information for grasping the cause and the like from various output information output by a detection unit such as a flow rate sensor, a pressure sensor, or a rotation number detection unit of a drive motor of the extracorporeal circulation device. An object is to provide an extracorporeal circulation management device, an extracorporeal circulation device, and a control method for the extracorporeal circulation management device.

In the present invention, the present invention has a display unit that introduces a patient's blood into an oxygenator, manages an extracorporeal circulation device that provides the patient with blood from the oxygenator, and displays various information. a extracorporeal circulation management apparatus, the flow sensor information obtained from each part of the extracorporeal circulation apparatus, a pressure sensor information, at the same time the display unit drive motor rotation information as time continuous state information is time continuous information And the target information of the flow rate sensor information and the pressure sensor information over time continuous state information are simultaneously displayed on the display unit, and the flow rate sensor information and the pressure sensor information over time of the continuous state information. It is determined whether or not information remains in the target information, and the trend information of the temporal continuous state information of the flow sensor information and the pressure sensor information is low for a short time. , Short rise, long-term decline, as well as determined be the one of long-term increases, stores combination information of these determination results, based on the combination information of the determination result, and generates the warning information, together said display This is achieved by an extracorporeal circulation management device characterized by displaying on a part .

According to the above configuration, a plurality of different types of state information (for example, flow sensor information, pressure sensor information, drive motor rotation) acquired from, for example, a flow sensor, a pressure sensor, a drive motor, and the like disposed in each part of the extracorporeal circulation device Number information, etc.) is displayed on the display unit as time-sequential continuous state information (sequential data in time series, for example, trend data such as flow rate time-series transition data).
Therefore, the clinical engineer who is the person in charge who visually recognizes the continuous state information such as the trend data output to the display unit, for example, the state of the extracorporeal circulation device or the patient from the trend data of the time-series flow sensor, etc. Can be easily grasped.

Moreover, according to the said structure, it is the structure which produces | generates warning information based on tendency information, such as the inclination of several continuous time state information, and displays together.
Therefore, warning information is automatically generated based on the trend information such as the inclination of the continuous state information of the flow rate sensor and the pressure sensor, and is notified to the person in charge.

  According to the said structure, since it becomes a structure which combines with a continuous time state information, for example, the trend data of a flow sensor, etc., and its target information (for example, flow target value etc.), it outputs to a display part. The person in charge who visually recognizes the display can easily determine whether or not the state of the continuous state information with time is normal.

  Preferably, unit time information of the temporal continuous state information output to the display unit can be selected based on a use condition of the extracorporeal circulation device.

According to the above configuration, the unit time information (for example, 30 seconds unit, one week unit, etc.) of the continuous time state information output to the display unit is used as the usage condition (for example, during surgery or ICU treatment). Based on (secondary).
Thus, for example, during urgent surgery, it is possible to provide detailed time-series information (trend data, etc.) in units of 30 seconds, while ICU (Intensive Care Unit) treatment after surgery. When the continuous state information (trend data or the like) for a long period is preferable, such as moderate, the continuous state information for one week is displayed, for example.
Thus, in the said structure, since the preferable unit time according to the use condition of the extracorporeal circulation apparatus at that time can be selected, it is an apparatus which is easy to use.

  Preferably, the unit time information includes long-term unit time information and short-term unit time information, the temporal continuous state information is output to the display unit with the long-term unit time information, and the highly urgent When the warning information is generated, the temporal continuous state information is output to the display unit together with the short-term unit time information.

According to the above configuration, when continuous state information over time is output as long-term unit time information to the display unit and warning information with high urgency is generated, the continuous state information over time is combined with short-term unit time information. Is output to the display.
Therefore, for example, during ICU treatment after surgery, for example, continuous time state information (flow rate trend data, etc.) was displayed with long-term unit time information of about one week, but there was a sudden change in the condition, etc. When a highly urgent warning is generated, short-term unit time information such as 30 seconds is also displayed to make it easier for the person in charge to grasp the situation.

  Preferably, the apparatus includes an oxygenator that introduces blood from a patient, and a conduit that supplies the patient with blood from the oxygenator, and includes the extracorporeal circulation management device.

According to the present invention, the above object is to introduce flow rate sensor information, pressure sensor information, and drive motor obtained from each part of an extracorporeal circulation device that introduces blood from a patient into an oxygenator and provides blood to the patient from the oxygenator. together simultaneously displayed on the display unit rotation information as time continuous state information is time continuous information, even together target information of the time continuous state information of the flow rate sensor information and the pressure sensor information At the same time, it is displayed on the display unit, and it is determined whether or not the temporal continuous state information of the flow sensor information and the pressure sensor information remains within the target information, and the flow sensor information and the pressure sensor information It is determined whether the trend information of the continuous state information over time is any one of short-term decline, short-term rise, long-term decline, and long-term rise, and a combination of these judgment results Storing information, based on the combination information of the determination result, and generates the warning information is achieved by the control method of the extracorporeal circulation management apparatus and displaying on the display unit together.

  As described above, according to the present invention, information for grasping the cause and the like from various output information output by the detection unit such as the flow rate sensor, pressure sensor, and drive motor rotation number detection unit of the extracorporeal circulation device. It is possible to provide an extracorporeal circulation management device, an extracorporeal circulation management device, and a control method for the extracorporeal circulation management device.

It is the schematic which shows the main structures of the extracorporeal circulation apparatus of this invention. It is a schematic block diagram which shows the main structures of the controller shown in FIG. It is a schematic block diagram which shows the main structures of a 1st various information storage part. It is a schematic block diagram which shows the main structures of a 2nd various information storage part. It is a schematic block diagram which shows the main structures of a 3rd various information storage part. It is a schematic block diagram which shows the main structures of a 4th various information storage part. It is a schematic block diagram which shows the main structures of the 5th various information storage part. It is a schematic block diagram which shows the main structures of the 6th various information storage part. It is a schematic block diagram which shows the main structures of the 7th various information storage part. It is a schematic flowchart in case an extracorporeal circulation apparatus is used during an operation etc. It is another schematic flowchart when an extracorporeal circulation apparatus is used during an operation. It is another schematic flowchart when an extracorporeal circulation apparatus is used during an operation. It is another schematic flowchart when an extracorporeal circulation apparatus is used during an operation. It is another schematic flowchart when an extracorporeal circulation apparatus is used during an operation. It is a general | schematic flowchart in the case of using an extracorporeal circulation apparatus during a treatment with an ICU after a surgery stably. It is another schematic flowchart in the case of using the extracorporeal circulation apparatus during the treatment with the ICU after the operation is stable. It is another schematic flowchart in the case of using the extracorporeal circulation apparatus during the treatment with the ICU after the operation is stable. It is another schematic flowchart in the case of using the extracorporeal circulation apparatus during the treatment with the ICU after the operation is stable. It is another schematic flowchart in the case of using the extracorporeal circulation apparatus during the treatment with the ICU after the operation is stable. It is a schematic explanatory drawing which shows the example of a screen displayed on the touch panel by ST5. It is a schematic explanatory drawing which shows the example which displays warning content etc. on a touchscreen. It is a schematic explanatory drawing which shows the state by which the data of the long-term use mode of ST44 were displayed. It is a schematic explanatory drawing which shows the example of a screen of "short-term use" displayed with long-term use. It is a schematic explanatory drawing which shows the example of a screen displayed by ST72.

DESCRIPTION OF EMBODIMENTS Hereinafter, preferred embodiments of the present invention will be described in detail with reference to the accompanying drawings.
The embodiments described below are preferred specific examples of the present invention, and thus various technically preferable limitations are given. However, the scope of the present invention is particularly limited in the following description. Unless otherwise stated, the present invention is not limited to these embodiments.

FIG. 1 is a schematic diagram showing the main configuration of the extracorporeal circulation apparatus 1 of the present invention.
The extracorporeal circulation device 1 shown in FIG. 1 is a device that performs extracorporeal circulation of the blood of the patient P shown in FIG. The patient P when using the extracorporeal circulation device 1 may be a case where the heart does not operate normally or a case where the heart operates normally but the lung does not operate normally.

  By the way, the extracorporeal circulation apparatus 1 shown in FIG. 1 according to the present embodiment is used, for example, when performing cardiac surgery on the patient P, or for subsequent treatment in the ICU.

  Specifically, the “centrifugal pump 3” of the extracorporeal circulation device 1 is operated, blood is removed from the vein (vena cava) of the patient P, and the gas in the blood is exchanged by the artificial lung 2, for example, the artificial lung 2. After performing blood oxygenation, “artificial lung extracorporeal blood circulation” is performed to return the blood to the artery (aorta) of the patient P again. That is, the extracorporeal circulation device 1 is a device that performs substitution of the heart and lungs.

  The extracorporeal circulation apparatus 1 has the following configuration. That is, as shown in FIG. 1, the extracorporeal circulation device 1 has a “circulation circuit 1R” for circulating blood, and the circulation circuit 1R includes “artificial lung 2”, “centrifugal pump 3”, and “drive motor 4”. , “Venous side cannula (blood removal side cannula) 5”, “arterial side cannula (blood supply side cannula) 6”, and an extracorporeal circulation management device, for example, a controller 10. The centrifugal pump 3 is also called a blood pump, and pumps other than the centrifugal type can be used.

1 is inserted through the femoral vein, and the distal end of the venous cannula 5 is placed in the right atrium. An artery side cannula (blood supply side cannula) 6 is inserted from the femoral artery via the connector 9 of FIG. The venous cannula 5 is connected to the centrifugal pump 3 through a connector 8 using a blood removal tube 11. A blood removal tube (also referred to as a “blood removal line”) 11 is an example of a conduit for sending blood.
When the drive motor 4 operates the centrifugal pump 3 according to the command SG of the controller 10, the centrifugal pump 3 removes blood from the blood removal tube 11 and passed through the oxygenator 2 into the blood supply tube 12 (“liquid supply line”). It is also configured to return to the patient P via “.
The blood removal tube 11 and the blood supply tube 12 are examples of a conveyance path.

The artificial lung 2 is disposed between the centrifugal pump 3 and the blood supply tube 12. The oxygenator 2 performs a gas exchange operation (oxygen addition and / or carbon dioxide removal) on the blood. The oxygenator 2 is, for example, a membrane oxygenator, and a hollow fiber membrane oxygenator is particularly preferably used. The blood supply tube 12 is a conduit connecting the artificial lung 2 and the artery side cannula 6.
For the blood removal tube 11 and the blood supply tube 12, for example, a synthetic resin conduit having high transparency such as vinyl chloride resin or silicone rubber can be used.
In the blood removal tube 11, blood flows in the V direction, and in the blood supply tube 12, blood flows in the W direction.

Further, the extracorporeal circulation apparatus 1 has a “blood flow sensor 14” in the blood removal tube 11. This blood flow sensor 14 is configured to detect the value of the flow rate of blood flowing from the patient P through the blood removal tube 11.
Further, a “pressure sensor 15” is disposed on the patient P side of the blood supply tube 12.
This “pressure sensor 15” is configured to detect the pressure value of the blood in the blood supply tube 12. That is, the pressure sensor 15 is a sensor for measuring the pressure of blood passing through the pipe line, and is a sensor for detecting an abnormal blood pressure.

  Unlike the present embodiment, another pressure sensor is disposed in the vicinity of the oxygenator 2 of the blood supply tube 12, and the differential pressure between the other pressure sensor and the pressure sensor 15 is measured, so that the oxygenator 2 is clogged. It does not matter even if it is the composition which detects. For example, another pressure sensor may be arranged upstream of the oxygenator 2.

The blood flow sensor 14 is a sensor for measuring a flow value of blood passing through the pipeline, and is a sensor for detecting an abnormality in the flow value.
For example, an ultrasonic flow sensor or the like is used as the blood flow sensor 14.

As shown in FIG. 1, for example, a “touch panel 13” that is a display unit that inputs and displays various types of information is formed in the controller 10.
The touch panel 13 is a “display device with a position input device”, and is an electronic component that combines a display device such as a liquid crystal panel and a position input device such as a touch pad. Therefore, various information can be input by pressing the display on the screen, and various information can be displayed.

  The controller 10 or the like of the extracorporeal circulation apparatus 1 shown in FIG. 1 includes a computer, and the computer includes a CPU (Central Processing Unit), a RAM (Random Access Memory), a ROM (Read Only Memory), and the like (not shown). Are connected via a bus.

FIG. 2 is a schematic block diagram showing the main configuration of the controller 10 shown in FIG.
As shown in FIG. 2, the controller 10 has a “control unit 16”, and the control unit 16 communicates with the “communication device 17” for the controller 10 to communicate with the drive motor 4, the pressure sensor 15, the blood flow sensor 14, and the like. ”, The touch panel 13,“ input device 18 ”and“ timing device 19 ”for inputting various information are controlled.
Further, the control unit 16 performs the “first various information storage unit 20”, the “second various information storage unit 30”, the “third various information storage unit 40”, and the “fourth various information” illustrated in FIG. The “storage unit 50”, “fifth various information storage unit 60”, “sixth various information storage unit 70”, and “seventh various information storage unit 80” are also controlled.

  3 and FIG. 9 respectively show “first various information storage unit 20”, “second various information storage unit 30”, “third various information storage unit 40”, and “fourth various information storage unit 50”. ”,“ Fifth Various Information Storage Unit 60 ”,“ Sixth Various Information Storage Unit 70 ”, and“ Seventh Various Information Storage Unit 80 ”. Specific contents thereof will be described later.

  FIGS. 10 to 19 are schematic flowcharts showing main operation examples and the like of the extracorporeal circulation apparatus 1 according to the present embodiment. Of these, FIGS. 10 to 14 show the extracorporeal circulation apparatus 1 used during surgery and the like. It is a schematic flowchart in the case. FIGS. 15 to 19 are schematic flowcharts in the case where the extracorporeal circulation apparatus 1 is used during treatment with the ICU after the operation in a stable state.

On the touch panel 13 of the controller 10 of the extracorporeal circulation apparatus 1 according to the present embodiment, for example, each data of the drive motor 4, the pressure sensor 15 and the blood flow sensor 14 which are each part of the operating extracorporeal circulation apparatus 1 is displayed on the touch panel 13. It becomes the composition which is done.
First, the case where the extracorporeal circulation apparatus 1 is used during surgery etc. is demonstrated using FIG. 10 thru | or FIG.

In step (hereinafter referred to as “ST”) 1 in FIG. 10, a selection screen of “short-term use mode (such as during surgery)” and “long-term use mode (such as ICU treatment)” is displayed on the touch panel 13 of the controller 10.
In the short-term use mode, trend data (flow time-series transition data, etc., which is an example of continuous state information over time) that is a transition of each data of the drive motor 4, the pressure sensor 15 and the blood flow sensor 14 with time is comparatively used. This is a case where it is shown on the touch panel 13 in a short time, for example, in units of 30 seconds (an example of unit time information).

  In the present embodiment, an example in which various types of information are displayed on the touch panel 13 has been described. However, the present invention is not limited to this, and the information displayed on the touch panel 13 may be an external monitor other than the controller 10 or a tablet PC. Etc. are also included.

On the other hand, the long-term use mode is a mode in which trend data and the like (flow time series transition data and the like) of the drive motor 4, the pressure sensor 15 and the blood flow sensor 14 are displayed on the touch panel 13 for a relatively long time, for example, in units of 7 days. is there. For example, during ICU treatment.
Therefore, during operation, ICU treatment, and the like are examples of conditions for using the extracorporeal circulation device 1.

In the example of FIG. 10, trend data of the drive motor 4, the pressure sensor 15, and the blood flow sensor 14 during the operation are acquired. In this case, since data in a short time is required, the “short-term use mode” is selected.
Therefore, in ST2 of FIG. 10, the mode selected by the operator, for example, the “short-term use mode” is stored in the “selection mode storage unit 21” of FIG.

  Next, the process proceeds to ST3. In ST3, the “trend data generation processing unit (program) 22” of FIG. 3 operates, the transition data of the detection data of “blood flow sensor 14” and “pressure sensor 15”, and the transition of rotation data of “drive motor 4”. For example, “flow rate target value data (upper limit value and lower limit value)”, “pressure”, which is data, time data of the “timer 19” corresponding thereto, and target information of the “target value data storage unit 23” in FIG. Based on the “target value data (upper limit value and lower limit value)”, time-series transition data of the flow rate, pressure, and rotation speed are created and stored in the “time-series transition data storage unit 24” in FIG. Hereinafter, the “blood flow rate” is also referred to as “flow rate”.

Next, the process proceeds to ST4. In ST4, the “display mode adjustment processing unit (program) 25” in FIG. 3 operates and refers to the “selection mode storage unit 21” and the “time-series transition data storage unit 24”.
In this example, since the “short-term use mode” is selected, the “revolution time series transition data”, “flow time series transition data”, “pressure” stored in the “time series transition data storage unit 24” in FIG. Adjust time-series transition data, flow rate target value (upper and lower limit) data, and pressure target value (upper and lower limit) data as “short-term use mode” as “data for 30 seconds per screen”. 3. Store in the “display screen data storage unit 26”.

Next, the process proceeds to ST5. In ST5, the data stored in the “display screen data storage unit 26” in FIG.
FIG. 20 is a schematic explanatory diagram illustrating an example of a screen displayed on the touch panel 13 in ST5.
As shown in FIG. 20, the entire screen is displayed as transition data (trend data) for 30 seconds. Specifically, “rotational speed time-series transition data (trend Data) ”,“ flow time series transition data (trend data) ”which is the flow value of the blood flow sensor 14, and“ pressure time series transition data (trend data) ”which is the pressure value of the pressure sensor 15.

“Flow target value (upper and lower limit) data” for the flow value and “Pressure target value (upper and lower limit) data” for the pressure value are also “Short-term use mode”. It is displayed as adjusted.
Therefore, a person in charge such as a clinical engineer who looks at the screen of FIG. 20 can easily grasp the transition and change of the flow rate value and the pressure value in a short time (30 seconds or the like). Further, since the flow rate value and the pressure value are displayed according to the target value, it is possible to easily grasp whether or not these are within the target value.

Next, the process proceeds to ST6. In ST6 and below, the controller 10 automatically analyzes trend information such as a gradient such as “flow rate time-series transition data” (flow rate value) displayed on the display screen.
In ST6, the “outflow target value determination processing unit (program) 31” in FIG. 4 operates, and the “display screen data” in the “display screen data storage unit 26” in FIG. The “time series transition data” is compared with the “flow rate target value (upper and lower limit) data” within the same time.
For example, within the time between the arrow A (start point) and the arrow B (end point) in FIG.
Then, it is determined whether any part of the “flow time series transition data” (flow rate value) within the time exceeds the upper limit or lower limit of the “flow target value (upper limit and lower limit) data”. If it is, the “out of flow rate target value flag” is stored in the “out of flow rate target value flag storage unit 32” in FIG.

  That is, it is possible to automatically grasp whether or not “flow time series transition data” (flow rate value) exceeds the upper limit or lower limit of “flow rate target value (upper and lower limit) data” within the time.

  Next, the process proceeds to ST7. In ST7, the “flow rate short-term rise determination processing unit (program) 33” in FIG. 4 operates and “within a predetermined time” determined by the “outflow target value determination processing unit (program) 31”, for example, the arrow in FIG. The coordinate points of the start point A (t1, y1) with the earlier time in A and the arrow B and the end point B (t2, y2) with the later time are obtained. (At this time, the coordinate y is the flow rate and t is the time.) Then, the inclination α of the coordinates of the start point (t1, y1) and the end point (t2, y2) is obtained. For example, it is obtained by an equation of α = y2−y1 / t2−t1, and it is determined whether or not the value is larger than “10”, for example.

  If “α” is larger than “10” in ST8, the process proceeds to ST9. In ST9, the “short-term flow rate increase determination processing unit (program) 33” operates to determine that the slope α is “short-term increase”.

Next, the process proceeds to ST10. In ST10, it is determined whether or not the “outflow target value flag” is stored for the data.
If the “outflow target value flag” is not stored in ST10, the process proceeds to ST11. In ST11, the “flow rate short-term rise determination processing unit (program) 33” operates, and the gradient α of the flow rate transition data within the predetermined time is “short-term rise data within the flow rate target” as “short-term rise data within the flow rate target” in FIG. Storage unit 34 "is stored.

  On the other hand, if the “outflow target value flag” is stored in ST10, the process proceeds to ST12. In ST12, the slope α of the flow rate transition data within the predetermined time is stored in the “flow rate non-target short-term rise data storage unit 35” in FIG. 4 as “flow rate non-target short-term rise data”.

  In this way, when the slope of the “flow time series transition data” of the flow rate value rises rapidly in the short term, there is a high possibility that something has changed, so that the change is within the range of the “flow rate target value”. The thing of the thing and the thing outside the range are divided and memorized.

If “α” is not equal to or greater than “10” in ST8, since it has not increased rapidly in a short period, it is determined whether or not it has rapidly decreased in ST13 or less.
In ST13, the “short-term flow rate lowering determination processing unit (program) 41” of FIG. 5 operates and “within a predetermined time (for example, the arrow A in FIG. The coordinate point of the start point A (t1, y1) with the earlier time in “time between the arrows B)” and the end point B (t2, y2) with the later time is obtained.
Then, the inclination α of the coordinates of the start point A (t1, y1) and the end point B (t2, y2) is obtained. For example, it is obtained by an equation of α = y2−y1 / t2−t1, and it is determined whether or not the value is smaller than “−10” (whether or not it has rapidly decreased).

  When it is determined in ST14 that “α” is smaller than “−10”, the process proceeds to ST15. In ST15, the “short-term flow rate decrease determination processing unit (program) 41” of FIG. 5 operates to determine that the slope “α” is “short-term decrease (rapid decrease)”.

Next, the process proceeds to ST16. In ST16, the “short-term flow rate decrease determination processing unit (program) 41” in FIG. 5 operates, and it is determined whether or not the “outflow target flag” is stored in ST6 for the target data. If not, the process proceeds to ST17.
In ST17, the slope α of the flow rate transition data within the predetermined time (between the arrows A and B in FIG. 20) is set as “short-term drop data in target flow” as “short-term drop data in target flow data storage unit 42” in FIG. Is stored. That is, the flow rate value is stored as data that rapidly decreases within the flow rate target.

  On the other hand, if the “outflow target value flag” is stored in ST16, the process proceeds to ST18. In ST18, the “flow rate short-term drop determination processing unit (program) 41” operates, and the slope α of the flow rate transition data within the predetermined time is set as “flow rate non-target short-term drop data”. It is stored in the storage unit 43 ”. That is, the flow rate value is stored as data that suddenly falls outside the flow rate target.

On the other hand, if “α” is not equal to or less than “−10” in ST14, “α” is not equal to or greater than “10”. Then, the process proceeds to ST19, and the “outflow target value flag” is stored in the data. Judge whether there is.
In ST19, when the “out of flow target value flag” is not stored, there is no problem data. However, when the flag is stored, the flow value is out of range, so there is some problem. There is a possibility that there is a possibility that there is a short-term rise or short-term decline.

  In ST20, the “flow rate long-term rise determination processing unit (program) 44” of FIG. 5 operates, and the time within “predetermined time” determined by the “outflow rate target value determination processing unit (program) 31” is an early start point A ( The coordinate point of the end point B (t2, y2) whose time is later than t1, y1) is obtained. Then, the inclination α of the coordinates of the start point A (t1, y1) and the end point B (t2, y2) is obtained. For example, it is obtained by the equation α = y2−y1 / t2−t1, and it is determined whether or not the value is larger than “0.5”, for example.

When “α” is larger than “0.5” in ST21, the “flow rate long-term increase determination processing unit (program) 44” operates to determine that the slope α is “long-term increase” and The slope α of the flow rate transition data within the time is stored in the “flow rate non-target long-term rise data storage unit 45” in FIG. 5 as “flow rate non-target long-term rise data”.
That is, it is memorized that a gradual rise, although not sudden, occurs outside the flow rate target.

  On the other hand, when “α” is larger than “0.5” in ST21, the process proceeds to ST23. In ST23, the “flow rate long-term decrease determination processing unit (program) 51” of FIG. 6 operates and “within a predetermined time (arrow A and arrow in FIG. 20) determined by the“ outflow target value determination processing unit (program) 31 ”. B)), the coordinate point of the start point A (t1, y1) whose time is early and the end point B (t2, y2) whose time is late is obtained. Then, the inclination α of the coordinates of the start point A (t1, y1) and the end point B (t2, y2) is obtained. For example, it is obtained by an equation of α = y2-y1 / t2-t1, and it is determined whether or not the value is smaller than “−0.5”, for example.

  Next, in “ST24”, when “α” is smaller than “−0.5”, the “flow rate long-term decrease determination processing unit (program) 51” operates to determine that the slope α is “long-term decrease”. The slope α of the flow rate transition data within the predetermined time is stored in the “flow rate non-target long-term drop data storage unit 52” as “flow rate non-target long-term drop data”.

This completes the analysis regarding the flow rate value (flow rate time series transition data).
With these configurations, it is possible to analyze the transition (change in slope) of the flow rate value (flow time-series transition data) in the short-term use mode from both the long-term and short-term time axes. It can be done accurately.
For example, when analyzing the transition (slope) of a flow rate value (flow time series transition data) on a short-term time axis, this analysis is used to analyze the case where the slope is normal but the flow rate exceeds the target flow rate. The configuration is valid.

In this case, in addition to the analysis result of the short-term time axis, the trend data transition (slope) is analyzed together with the analysis result such as long-term rise or long-term decrease obtained from the long-term time axis analysis. . Therefore, it is possible to obtain information on a gradual and steady change in the flow rate value that may be overlooked only by short-term time axis analysis.
Therefore, the person in charge can easily analyze the flow rate value (flow rate time-series transition data), compare with the warning content, and perform verification work.

In ST26, the pressure value (pressure time series transition data) is analyzed.
The analysis method is performed in the same manner as the above-described flow rate value, and the result is obtained as “a pressure target short-term rise data storage unit 53”, “pressure target short-term rise data storage unit 54”, “pressure target short-term rise data storage unit 55”, “ The data is stored in the non-pressure target short-term decrease data storage unit 56 ”,“ pressure target non-long-term increase data storage unit 57 ”, and“ pressure non-target long-term decrease data storage unit 58 ”.

  Next, the process proceeds to ST27. In ST27, the “motor rotational speed transition change determination processing unit (program) 59” of FIG. 6 operates to determine whether or not the rotational speed of the drive motor 4 is abnormal within a predetermined time similar to the flow rate, and the result (for example, , No abnormality) is stored in the “revolution data storage unit 59a” in FIG.

Thus, the analysis on the flow rate value, the pressure value, and the rotational speed of the drive motor 4 is completed, and each result is stored in each storage unit. Therefore, a comprehensive analysis using these results is performed below. .
In ST28, the “warning determination processing unit (program) 61” of FIG. 7 operates, and “the flow rate target short-term rise data storage unit 34” “flow rate target short-term rise data storage unit 35” “flow rate target short-term drop data storage”. Unit 42 ”“ flow rate non-target short-term decrease data storage unit 43 ”“ flow rate non-target long-term increase data storage unit 45 ”and“ flow rate non-target long-term decrease data storage unit 52 ”“ pressure target short-term increase data storage unit 53 ”“ pressure ” Non-target short-term rise data storage unit 54, “pressure target short-term drop data storage unit 55”, “pressure non-target short-term drop data storage unit 56”, “pressure non-target long-term rise data storage unit 57” and “pressure non-target long-term drop data” It is determined whether or not the combination of data stored in the “storage unit 57” matches the combination of “flow rate” and “pressure” in the “warning information storage unit 62”.

  The “warning information storage unit 62” stores, for example, “warning content” data, which is warning information that can be assumed by a combination of the above results of flow rate and pressure, and the degree of warning, that is, “priority” information. Are indicated as “high”, “low”, and the like.

Then, in ST29, it is determined whether or not there is an item that matches the combination of the flow rate and pressure in the “warning information storage unit 62”.
In the present embodiment, for example, the following results can be considered from the example of FIG.
For example, the flow rate value corresponds to “short-term decrease outside target value”, and the pressure value corresponds to “short-term increase within target value”. In this case, according to the “warning information storage unit 62”, the flow rate “short-term decrease” and the pressure “short-term rise” are combined, and therefore “warning content” becomes “circuit kink”.

In ST 30, the corresponding “warning content” is displayed on the touch panel 13.
In the above example, the touch panel 13 is displayed as shown in FIG. 21, and FIG. 21 is a schematic explanatory diagram showing an example of displaying the warning content and the like on the touch panel 13.
That is, as shown in FIG. 21, “flow rate: drop (outside target value), pressure: slightly up (inside target value)” is displayed, and “rotational speed transition data storage unit 59a” is referred to. Number: No change "is displayed.
In addition, information corresponding to “warning content” such as “a circuit kink is assumed. Check the cause” is also displayed.

  Therefore, when an abnormality or the like occurs in the extracorporeal circulation apparatus 1, information on the abnormality or the cause and the cause thereof can be automatically provided to a clinical engineer who is a person in charge. Can be reduced.

FIG. 20 is a schematic flowchart in the case where the extracorporeal circulation apparatus 1 is used during treatment with the ICU after the operation using the ICU by using FIGS. 15 to 19.
In ST41 of FIG. 15, a selection screen of “short-term use mode (such as during surgery)” and “long-term use mode (such as ICU treatment)” is displayed on the touch panel 13 as in the case of use during surgery (short-term use) in FIG. The

In this time, since the operation is completed and the patient and the patient are stable, the data displayed on the touch panel 13 does not need to be “30 seconds”. For example, “one week” is preferable. Select Mode.
Then, the “display mode adjustment processing unit (program) 25” in FIG. 3 operates and refers to the “selection mode storage unit 21” and the “time series transition data storage unit 24”. “Flow rate time series transition data” and “flow rate target value (upper and lower limit) data” are adjusted as data for 7 days on the screen and stored in the “display screen data storage unit 26” of FIG.

Next, the data of the “display screen data storage unit 26” is displayed on the touch panel 13 in ST44.
FIG. 22 is a schematic explanatory diagram showing a state in which data for the long-term use mode of ST44 is displayed.
As shown in FIG. 22, in the long-term use mode, for example, only data related to the flow rate value is displayed.

Next, in “ST45”, “display screen data” in “display screen data storage unit 26” is referred to, “flow time series transition data” within a predetermined time, and “flow target value (upper and lower limit) data” within the same time, , And determine whether any part of the “flow time series transition data” within the time exceeds the upper limit or lower limit of the “flow target value (upper and lower limit) data”. Stores the “outside flow rate target value flag” in the “outside flow rate target value flag storage unit 32”.
This is the same as ST described above.

  Next, the process proceeds to ST46. In ST46, the "second flow rate long-term rise determination processing unit (program) 63" in FIG. 7 operates, and the time within "predetermined time" determined by the "outflow target value determination processing unit (program) 31" is early. The coordinate points of the start point (t1, y1) and the end point (t2, y2) with a late time are obtained. Then, the inclination β of the coordinates of the start point (t1, y1) and the end point (t2, y2) is obtained. For example, it is obtained by the equation β = y2−y1 / t2−t1, and it is determined whether or not the value is larger than “0.5”, for example.

That is, since the data displayed on the touch panel 13 is “long-term use mode” data, it is determined whether or not “slope β” is “long-term rise” unlike the above-mentioned “short-term use mode”.
If “β” is greater than “0.5” in ST47, it is determined in ST48 that “long-term rise” is detected. If “outflow target value flag” is not stored in ST49, ST50 is determined. It is stored in the “flow rate target long-term rise data storage unit 71” in FIG.
On the other hand, when the “outside flow rate target value flag” is stored, it is stored in the “second out-of-flow rate target long-term rise data storage unit 72”.

  If “β” is not equal to or greater than “0.5” in ST47, the “second flow rate long-term decrease determination processing unit (program) 73” in FIG. The coordinate point of the start point (t1, y1) whose time is early and the end point (t2, y2) which is late in “predetermined time” determined in (Program) 31 is obtained. Then, the inclination β of the coordinates of the start point (t1, y1) and the end point (t2, y2) is obtained. For example, it calculates | requires by the type | formula of (beta) = y2-y1 / t2-t1, and it is judged whether the value is smaller than "-0.5", for example.

That is, it is determined whether or not there is a “long-term decrease” tendency.
If “β” is smaller than “−0.5” in ST53, it is determined in ST54 that the slope β is “long-term drop”, and “out-of-flow target value flag” is not stored in ST55. Is stored in the “flow rate target lowering data storage unit 74” of FIG.

  If it is determined in ST55 that the “out of flow rate target value flag” is stored, it is stored in the “second out of flow rate target long-term decrease data storage unit 75” in FIG. 8 in ST57.

If “β” is not smaller than “−0.5” in ST53, if “outflow target value flag” is stored for the slope β in ST58, then whether or not there is a short-term increase and a short-term decrease is determined. to decide.
Specifically, in ST59, the “second flow rate short-term decrease determination processing unit (program) 76” of FIG. 8 operates and the “within a predetermined time” determined by the “flow rate target value determination processing unit (program) 31”. The coordinate points of the start point (t1, y1) with the earlier time and the end point (t2, y2) with the later time are obtained.
Then, the inclination β of the coordinates of the start point (t1, y1) and the end point (t2, y2) is obtained. For example, it is obtained by the equation β = y2−y1 / t2−t1, and it is determined whether or not the value is larger than “10”, for example.

If “β” is larger than “10” in ST60, it is stored in “second flow rate non-target short-term rise data storage unit 77” in ST61.
If “β” is not larger than “10” in ST60, the process proceeds to ST62. In ST62, the "second flow rate short-term decrease determination processing unit (program) 81" of FIG. 9 operates, and the time within "predetermined time" determined by the "outflow target value determination processing unit (program) 31" is early. The coordinate points of the start point (t1, y1) and the end point (t2, y2) with a late time are obtained. Then, the inclination β of the coordinates of the start point (t1, y1) and the end point (t2, y2) is obtained. For example, it is obtained by the equation β = y2−y1 / t2−t1, and it is determined whether or not the value is smaller than “−10”, for example.

If “β” is smaller than “−10” in ST63, it is stored in the “second flow rate non-target short-term drop data storage unit 82” in FIG. 8 in ST64.
With these configurations, as in the short-term use mode, it is possible to analyze the transition (change in slope) of the flow rate value (flow time-series transition data) in the long-term use mode from both the long-term and short-term time axes. The flow rate value (flow time series transition data) can be analyzed accurately.
For example, when analyzing the transition (slope) of the flow value (flow time series transition data) on the long-term time axis, the slope is normal, while the flow value (flow time series transition data) exceeds the target value. This configuration is effective for the analysis of cases.

In this case, in addition to the long-term time-axis analysis result, the short-term rise or fall analysis result obtained from the short-term time-axis analysis for the transition (slope) of the flow value (flow time-series transition data) Analyzing together. For this reason, it is possible to obtain information on a rapid change in the flow rate value (flow rate time-series transition data) that may be overlooked only by long-term time axis analysis.
Therefore, the person in charge can facilitate the analysis of the flow value (flow time series transition data), the comparison with the warning content, and the verification work.

  Next, in ST65, the pressure value is similarly processed, and the result is stored in the “pressure target long-term rise data storage unit” or the like.

  Next, in ST66, the data of the drive motor 4 is stored in the rotational speed data storage unit 59a. In ST67, the “warning determination processing unit (program) 61” operates to operate the “long flow rate target long-term rise data storage unit”, “ It is determined whether or not the combination of data stored in the “pressure target long-term rise data storage unit” or the like matches the combination of “flow rate” and “pressure” in the “warning information storage unit 62”.

In ST68, it is determined whether or not there is a combination that matches the flow rate and pressure combination in the “warning information storage unit 62”.
When there is a matching combination, the “screen display processing unit by combination priority (program) 83” of FIG. 9 operates and “warning information that matches the combination of data such as“ long flow rate target long-term rise data storage unit ”. It is determined whether or not the “priority” of the combination of the “storage unit 62” is “high”.

When the priority of the matched flow rate and pressure combination is “high” in ST70, a “short-term use” screen corresponding to the long-term use is displayed on the touch panel 13 in ST71, and the corresponding “warning content” is displayed. “Circuit kink is assumed. Check the cause” is displayed.
FIG. 23 is a schematic explanatory diagram illustrating an example of a “short-term use” screen displayed together with long-term use.
In the case of high urgency, for example, the person in charge or the like can more easily grasp the situation by displaying the display of the flow rate, pressure, and rotation speed in units of 30 seconds.

For example, in the case of high urgency, since it is possible to compare together with those in trend data and short-term use mode of the flow rate or the like in long-term use mode, tracking the source of a warning from the trend data of each mode, It can be verified.

If the “priority” is not “high” in ST70, the process proceeds to ST72, and “warning content” corresponding to the “long-term use” screen of the touch panel 13 is displayed.
FIG. 24 is a schematic explanatory diagram illustrating an example of a screen displayed in ST72.
As shown in FIG. 24, a warning is displayed on the long-term use screen.

In the present invention, the above-mentioned “short-term use mode” and “long-term use mode” can be freely changed by the operator even during operation.
For example, when the “short-term use mode” is selected during the operation, the mode can be changed to the “long-term use mode” halfway.
Further, in the present embodiment, “warning content” is determined by inclination data of “flow rate” and “pressure”, but the present invention is not limited to this, and the flow rate may be determined with priority.

  DESCRIPTION OF SYMBOLS 1 ... Extracorporeal circulation apparatus, 2 ... Artificial lung, 3 ... Centrifugal pump, 4 ... Drive motor, 5 ... Vein side cannula (blood removal side cannula), 6 ... Arterial side cannula (Blood supply side cannula), 8, 9 ... connector, 10 ... controller, 11 ... blood removal tube, 12 ... blood supply tube, 13 ... touch panel, blood flow sensor, 15 ... -Pressure sensor, 16 ... control unit, 17 ... communication device, 18 ... input device, 19 ... timing device, 20 ... first various information storage unit, 21 ... selection mode Storage unit 22 ... Trend data generation processing unit (program) 23 ... Target value data storage unit 24 ... Time series transition data storage unit 25 ... Display mode adjustment processing unit (program) 26... Display screen data storage unit, 30 .. Second various information storage units, 31... Non-flow rate target value determination processing unit (program), 32... Non-flow rate target value flag storage unit, 33. 34 ... Short-term rise data storage unit within the flow rate target, 35 ... Short-term rise data storage unit outside the flow target, 40 ... Third various information storage units, 41 ... Short-term flow rate drop determination processing unit ( Program), 42 ... Short-term drop data storage unit within flow target, 43 ... Short-term drop data storage unit outside flow target, 44 ... Long-term flow increase determination processing unit (program), 45 ... Out of flow target Long-term increase data storage unit, 50... Fourth various information storage unit, 51... Flow rate long-term decrease determination processing unit (program), 52. Intra-target short-term rise data storage unit, 54 ..Pressure non-target short-term increase data storage unit, 55... Pressure target short-term decrease data storage unit, 56. 58. ... non-pressure target long-term decrease data storage unit, 59 ... motor rotation speed transition change determination processing unit (program), 59a ... rotation speed transition data storage unit, 60 ... fifth various information storage unit , 61... Warning determination processing unit (program), 62... Warning information storage unit, 63... Second flow rate long-term rise determination processing unit (program), 70. 71 ... Long-term rise data storage unit within the flow rate target, 72 ... Second long-term rise data storage unit outside the target flow rate, 73 ... Second long-term flow fall determination processing unit (program), 74, ...・ Flow rate target decrease data storage unit, 75... Second flow rate non-target long-term decrease data storage unit, 76... Second flow rate short-term decrease determination processing unit (program), 77. Non-target short-term rise data storage unit, 80... Information storage unit, 81... Second flow rate short-term decrease determination processing unit (program), 82... Second flow rate target short-term decrease data storage unit, 83. Program) 1R ... circulation circuit, P ... patient

Claims (5)

Introducing a patient's blood into an oxygenator, managing an extracorporeal circulation device that provides blood to the patient from the oxygenator, and an extracorporeal circulation management device having a display for displaying various information,
Flow sensor information obtained from each part of the extracorporeal circulation apparatus, a pressure sensor information, together with the simultaneously displayed on the display unit as a time continuous state information is time continuous information drive motor rotation information,
The target information of the temporal continuous state information of the flow sensor information and the pressure sensor information is also displayed on the display unit at the same time,
It is determined whether the temporal continuous state information of the flow sensor information and the pressure sensor information remains in the target information, and the trend of the temporal continuous state information of the flow sensor information and the pressure sensor information Judge whether the information is short-term decline, short-term rise, long-term decline, or long-term rise, and memorize the combination information of these judgment results,
An extracorporeal circulation management device characterized in that warning information is generated based on the combination information of the determination result and is also displayed on the display unit. The extracorporeal circulation management device according to claim 1 , wherein unit time information of the temporal continuous state information output to the display unit is selectable based on a use condition of the extracorporeal circulation device. . The unit time information has long-term unit time information and short-term unit time information, and outputs the continuous state information with time as the long-term unit time information to the display unit. when generated, extracorporeal circulation management apparatus according to claim 2, characterized in Rukoto is output to the display unit in the unit time information of the short said temporal continuity state information together. An oxygenator that introduces the patient's blood;
An extracorporeal circulation device comprising the extracorporeal circulation management device according to any one of claims 1 to 3, and a conduit for providing blood to the patient from the oxygenator . The flow rate sensor information, pressure sensor information, and drive motor rotation information acquired from each part of the extracorporeal circulation device that introduces the patient's blood into the oxygenator and provides blood to the patient from the oxygenator is information that is continuous over time. While displaying on the display unit at the same time as a certain continuous state information over time,
The target information of the temporal continuous state information of the flow sensor information and the pressure sensor information is also displayed on the display unit at the same time,
It is determined whether the temporal continuous state information of the flow sensor information and the pressure sensor information remains in the target information, and the trend of the temporal continuous state information of the flow sensor information and the pressure sensor information Judge whether the information is short-term decline, short-term rise, long-term decline, or long-term rise, and memorize the combination information of these judgment results,
A control method for an extracorporeal circulation management device, characterized in that warning information is generated based on the combination information of the determination result and is displayed on the display unit.

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