JP6900756B2 - Method and device for determining the connection status of the replenisher line to the blood circuit in the hemodialysis machine - Google Patents

Description

The present invention relates to a method and a determination device for determining a state of connection of a replenisher line to a blood circuit in a hemodialysis apparatus.

Conventionally, a hemodialyzer has a blood dialyzer such as a dialyzer or a hemodiafilter that purifies the patient's blood, a blood circuit connected to the hemodialyzer to circulate the patient's blood, and a dialysate in the hemodialyzer. It is mainly composed of a dialysate circuit for introducing and deriving, and a replacement fluid line for sending a replacement fluid in an amount corresponding to the amount of water removed by the hemodialyzer to the blood circuit.
Hemodiafiltration using a hemodialysis apparatus is known to be an offline method using physiological saline as a replenisher and an online method using a dialysate as a replenisher (see Patent Document 1). In addition, the method of sending the replacement fluid to the blood circuit is divided into two methods: a pre-dilution method in which the replacement fluid is injected into the blood circuit on the upstream side of the hemodialyzer and a post-dilution method on the downstream side. Be done.

In the case of the pre-dilution method, the blood is diluted with a replacement solution, enters the hemodialyzer, and is filtered. Therefore, while blood concentration is unlikely to occur in the hemodialyzer, the blood concentration becomes low, and when the amount of the replacement solution is the same, the removal efficiency of the uremic substance is lower than that of the post-dilution method. In order to increase the removal efficiency, a large amount of replenisher is required as compared with the case of the post-dilution method, and the amount of replenisher per treatment is generally 24 to 96 liters.
On the other hand, in the case of the post-dilution method, blood enters the hemodialyzer without being diluted, is filtered, and then diluted with a replenisher according to the amount of water removed. Since water is removed in the hemodialyzer to the extent that blood concentration does not occur, the amount of replenisher solution is smaller than that of the pre-dilution method, and the amount of replenisher solution per treatment is about 20 liters.

Japanese Unexamined Patent Publication No. 2015-80595

In this way, since the amount of replenisher fluid differs depending on the replenishment method, a misconnection of the replenisher fluid line to the blood circuit can lead to a serious danger. Therefore, when assembling the circuit of the hemodialysis apparatus, it is necessary to confirm whether the connection state of the replenisher line to the blood circuit corresponds to the liquid feeding method.
However, the assembled blood circuit and dialysate circuit are intricately attached to the hemodialysis machine, and it is possible to instantly visually determine whether or not the replacement fluid line is connected to the correct position with respect to the blood circuit. It's difficult to do.

Therefore, an object of the present invention is to provide a determination method and a determination device that can easily determine the connection state to the blood circuit of the replenisher line.

In the present invention, a blood dialyzer, an arterial line where one end is connected to the subject's artery and the other end is connected to the blood dialyzer, and one end is connected to the blood dialyzer and the other end is the subject's vein. A blood circuit having a venous side line connected to the arterial side line, a blood pump arranged in the arterial side line, a dialysate introduction line for introducing dialysate into the blood dialyzer, and a dialysate derived from the blood dialyzer. A dialysate circuit having a dialysate lead-out line, a replacement fluid line connected to the arterial side line or the venous side line to send a replacement fluid to the blood circuit, and a replacement fluid pump arranged in the replacement fluid line. A method for determining the connection state of the replenisher line to the blood circuit in a hemodialysis apparatus including a bubble detector arranged on the arterial side line or the venous side line to detect air bubbles. In the blood circuit in which one end side of the side line and one end side of the vein side line are connected and are not filled with liquid, a pump operation step of operating the blood pump and the replenishment pump, and the blood pump and Depending on the bubble detection step of detecting bubbles by the bubble detector in a state where a preset first time has elapsed after operating the replenishment pump, and whether or not bubbles are detected by the bubble detector. The present invention relates to a determination method including a determination step of determining whether the replacement fluid line is connected to the arterial side line or the venous side line.

Further, the bubble detector is arranged on one end side of the connection point of the replenishment liquid line in the arterial side line, and in the pump operation step, the replenisher liquid is directed toward one end side of the arterial side line. In the determination step, if no air bubbles are detected, it is determined that the replacement fluid line is connected to the arterial side line, and if bubbles are detected, the replacement fluid line is It is preferable to determine that it is connected to the venous line.

Further, the present invention includes a blood dialyzer, an arterial line in which one end is connected to the artery of the subject and the other end is connected to the blood dialyzer, and one end is connected to the blood dialyzer and the other end is the subject. A blood circuit having a venous side line connected to the vein, a blood pump arranged in the arterial side line, a dialysate introduction line for introducing dialysate into the blood dialyzer, and dialysate from the blood dialyzer. A dialysate circuit having a dialysate lead-out line, a replacement fluid line connected to the arterial side line or the venous side line to send a replacement fluid to the blood circuit, and a replacement fluid line arranged in the replacement fluid line. A device for determining the connection state of the replenisher line to the blood circuit in a blood dialysis device including a pump and a bubble detector arranged on the arterial side line or the vein side line to detect bubbles. In the blood circuit in which one end side of the arterial side line and one end side of the venous side line are connected and are not filled with liquid, a pump operating unit that operates the blood pump and the replenishment pump, and the pump. After the blood pump and the replenisher pump are operated by the operating unit, a bubble detection unit that detects bubbles by the bubble detector and bubbles are generated by the bubble detector in a state where a preset first time has elapsed. The present invention relates to a determination device including a determination unit for determining whether the replacement fluid line is connected to the arterial side line or the venous side line depending on whether or not it is detected.

Further, the bubble detector is arranged on the arterial side line, the pump operating unit operates the blood pump so as to flow a replenishing liquid toward one end side of the arterial side line, and the determining unit: When no air bubbles are detected, it is determined that the replacement fluid line is connected to the arterial side line, and when bubbles are detected, it is determined that the replacement fluid line is connected to the venous side line. Is preferable.

Further, in the present invention, the arterial side line in which one end side is connected to the artery of the subject and the other end side is connected to the blood dialyzer, and one end side is connected to the blood dialyzer and the other end side is the subject. A blood circuit having a venous side line connected to the vein, a blood pump arranged in the arterial side line, a dialysate introduction line for introducing dialysate into the blood dialyzer, and dialysate from the blood dialyzer. A dialysate circuit having a dialysate lead-out line, a replacement fluid line connected to the arterial side line or the venous side line to send a replacement fluid to the blood circuit, and a replacement fluid line arranged in the replacement fluid line. The blood circuit in a hemodialysis apparatus comprising a pump, an arterial bubble detector arranged on the arterial line to detect air bubbles, and a venous air bubble detector arranged on the venous line to detect air bubbles. A method for determining the connection state of the replenisher line to the replenisher, in which the blood circuit is filled with liquid and the replenisher line is filled with gas, and the dialysate circuit dialializes the blood dialyzer. After operating the replenishment pump and the pump operation step of operating the replenishment pump while back-filtering and injecting the liquid, detection of air bubbles by the arterial air bubble detector and the vein side air bubble detector is started. When one of the arterial air bubble detector or the vein side air bubble detector detects an air bubble before the other, the replenisher line is the arterial side line or the vein. The present invention relates to a determination method including a determination step of determining that the device is connected to any of the side lines.

Further, in the pump operation step, in a state where the blood circuit is filled with a liquid and the replenisher line is filled with a gas, the dialysate is back-filtered and injected into the blood dialyzer from the dialysate circuit. At the same time, the blood pump is operated so that the liquid flows to one end side of the arterial side line at a flow rate smaller than the injection amount of the dialysate, and the supplementary liquid pump is operated. When the bubble is detected first, it is determined that the replenisher line is connected to the arterial side line, and when the bubble is detected first by the venous bubble detector, the replenisher line is said. It is preferable to determine that it is connected to the venous line.

Further, in the present invention, the arterial side line in which one end side is connected to the artery of the subject and the other end side is connected to the blood dialyzer, and one end side is connected to the blood dialyzer and the other end side is the subject. A blood circuit having a venous side line connected to the vein, a blood pump arranged in the arterial side line, a dialysate introduction line for introducing dialysate into the blood dialyzer, and dialysate from the blood dialyzer. A dialysate circuit having a dialysate lead-out line, a replacement fluid line connected to the arterial side line or the venous side line to send a replacement fluid to the blood circuit, and a replacement fluid line arranged in the replacement fluid line. The blood circuit in a hemodialysis apparatus comprising a pump, an arterial bubble detector arranged on the arterial line to detect air bubbles, and a venous air bubble detector arranged on the venous line to detect air bubbles. A device for determining the connection state of the replenisher line to the replenisher, and in a state where the blood circuit is filled with liquid and the replenisher line is filled with gas, the dialysate circuit dialializes the blood dialyzer. After the blood pump and the replenisher pump are operated by the pump operating unit that operates the replenishment pump and the pump operating unit while injecting the liquid by back filtration, the arterial bubble detector and the venous bubble. The replenisher when one of the arterial bubble detector or the venous bubble detector detects bubbles before the other, the bubble detector that starts the detection of bubbles by the detector and detects the bubbles. The present invention relates to a determination device including a determination unit for determining that the line is connected to either the arterial side line or the venous side line.

Further, the pump operating unit causes the blood dialyzer to reverse-filter and inject the dialysate from the dialysate circuit in a state where the blood circuit is filled with a liquid and the replenisher liquid line is filled with a gas. At the same time, the blood pump is operated so that the liquid flows to one end side of the arterial side line at a flow rate smaller than the injection amount of the dialysate, and the supplementary liquid pump is operated. If a bubble is detected first by the arterial bubble detector, it is determined that the replenisher line is connected to the arterial line, and the venous bubble detector first detects the replacement fluid line. It is preferable to determine that the replenisher line is connected to the venous line when air bubbles are detected in.

Further, it is preferable that the liquid feed amount of the replenishment pump is smaller than the liquid feed amount of the blood pump and smaller than the amount obtained by subtracting the liquid feed amount of the blood pump from the injection amount of the dialysate.

Further, when the setting unit for setting the method of supplying the replenishing liquid to the blood circuit, the liquid feeding method set in the setting unit, and the connection state determined by the determination unit do not correspond to each other, notification is performed. It is preferable to further include a notification unit.

According to the present invention, the presence or absence of bubbles can be detected by a bubble detector arranged in the blood circuit, and the connection state of the replenisher line to the blood circuit can be easily determined based on the detection result.

It is a figure which shows the schematic structure of the hemodialysis apparatus in 1st Embodiment. It is a block diagram which shows the structure of the hemodialysis apparatus which comprises the determination apparatus which concerns on 1st Embodiment. It is a figure which shows the flowchart of the determination method which concerns on 1st Embodiment of this invention. In the first embodiment, the connection state of the circuit in the pre-dilution method is shown. In the first embodiment, the connection state of the circuit in the post-dilution method is shown. The priming of the blood circuit in the first embodiment is shown. It is a figure which shows the flowchart of the determination method which concerns on the modification of this invention. It is a figure which shows the schematic structure of the hemodialysis apparatus in 2nd Embodiment. It is a block diagram which shows the structure of the hemodialysis apparatus which comprises the determination apparatus which concerns on 2nd Embodiment. It is a figure which shows the flowchart of the determination method which concerns on 2nd Embodiment of this invention. The priming of the blood circuit in the second embodiment is shown. In the second embodiment, the connection state of the circuit in the case of pre-dilution is shown. In the second embodiment, the connection state of the circuit in the case of post-dilution is shown.

Hereinafter, preferred embodiments of the determination method of the present invention and a hemodialysis apparatus including the determination device will be described with reference to the drawings. The hemodialysis apparatus of the present invention purifies the blood of a renal failure patient or a drug addict patient, removes excess water in the blood, and replenishes (replenishes) the blood with water as needed.

Further, the hemodialysis apparatus of the present embodiment automatically performs each step such as a priming step, a blood removal step, a replenishment step, and a blood return step continuously and automatically by controlling the flow of the dialysate in the blood circuit. It is an automatic hemodialysis machine. By applying the determination method of the present invention to the hemodialysis apparatus in the priming step, it is possible to determine the connection state of the replenisher line to the blood circuit by using the priming step.

<First Embodiment>
The overall configuration of the hemodialysis apparatus 100A of the first embodiment will be described with reference to FIGS. 1 and 2. FIG. 1 is a diagram showing a schematic configuration of a hemodialysis apparatus 100A according to the first embodiment of the present invention, and FIG. 2 is a block diagram showing a configuration of a hemodialysis apparatus 100A.

As shown in FIGS. 1 and 2, the hemodialysis apparatus 100A includes a blood circuit 110A for flowing blood, a blood pump 111a, an arterial bubble detector 111b, a venous bubble detector 112b, and a hemodialyzer. It includes 120, a dialysate circuit 130, a dialysate feeding unit 133, a replenisher line 140, a replacement fluid pump 140a, and a control device 150 as a determination device.

The blood circuit 110A has an arterial side line 111, a venous side line 112, and a drainage line 113. The arterial side line 111, the venous side line 112, and the drainage line 113 are all mainly composed of a flexible and soft tube through which a liquid can flow.

One end of the arterial line 111 is connected to the blood inlet 122a of the hemodialyzer 120, which will be described later. A blood pump 111a, an arterial bubble detector 111b, an arterial clamp 111c, and an arterial connection 111d are arranged on the arterial line 111.
The blood pump 111a delivers a liquid such as blood or priming fluid inside the arterial line 111 by squeezing the tube constituting the arterial line 111 with a roller.
The arterial bubble detector 111b may be arranged at one end side of the connection point with the replacement fluid line 140 described later in the arterial side line 111, and in the present embodiment, it is more than the blood pump 111a in the arterial side line 111. It is located on the upstream side and detects the presence or absence of air bubbles in the tube.

The arterial side clamp 111c is arranged on the upstream side of the arterial side bubble detector 111b. The arterial side clamp 111c is controlled according to the result of detecting air bubbles by the arterial side air bubble detector 111b, and opens and closes the flow path of the arterial side line 111.
The arterial side connecting portion 111d is arranged on the other end side of the arterial side line 111. A needle punctured into a patient's blood vessel is connected to the arterial connection portion 111d.

One end of the venous line 112 is connected to the blood outlet 122b of the hemodialyzer 120, which will be described later. A drip chamber 112a, a venous bubble detector 112b, a venous clamp 112c, and a venous connection 112d are arranged on the venous line 112.
The drip chamber 112a stores a certain amount of blood in order to remove air bubbles, coagulated blood, and the like mixed in the vein side line 112.
The venous side bubble detector 112b is arranged on the downstream side of the drip chamber 112a and detects the presence or absence of air bubbles in the tube.

The venous side clamp 112c is arranged on the downstream side of the venous side bubble detector 112b. The venous side clamp 112c is controlled according to the result of detecting air bubbles by the venous side air bubble detector 112b, and opens and closes the flow path of the venous side line 112.
The venous side connection portion 112d is arranged on the other end side of the venous side line. A needle that punctures the patient's blood vessel is connected to the venous side connection portion 112d.

The drainage line 113 is connected to the drip chamber 112a. A drainage line clamp 113a is arranged on the drainage line 113. The drainage line 113 is a line for draining the priming liquid in the priming step described later.

The hemodialyzer 120 includes a container body 121 formed in a tubular shape and a dialysis membrane (not shown) housed inside the container body 121. As the hemodialyzer 120, a dialyzer or a hemodiafilter is used. The inside of the container body 121 is divided into a blood flow path and a dialysate side flow path by a dialysate (neither is shown). The container body 121 is formed with a blood inlet 122a and a blood outlet 122b communicating with the blood circuit 110A, and a dialysate inlet 123a and a dialysate outlet 123b communicating with the dialysate circuit 130.

According to the blood circuit 110A and the hemodialyzer 120 described above, the blood taken out from the artery of the subject (dialysis patient) flows through the arterial line 111 by the blood pump 111a and flows through the blood side of the hemodialyzer 120. Introduced in. The blood introduced into the hemodialyzer 120 is purified by the dialysate flowing through the dialysate circuit 130 described later via the dialysate membrane. The blood purified in the hemodialyzer 120 passes through the venous side line 112 and is returned to the subject's vein.

In the present embodiment, the dialysate circuit 130 is composed of a so-called closed capacity control type dialysate circuit 130. The dialysate circuit 130 includes a dialysate supply line 131a, a dialysate drainage line 131b, a dialysate introduction line 132a, a dialysate lead-out line 132b, and a dialysate delivery unit 133.

The dialysate delivery unit 133 includes a dialysate chamber 1331, a bypass line 1332, and a water removal / reverse filtration pump 1333.
The dialysate chamber 1331 is composed of a hard container capable of accommodating a constant volume (for example, 300 ml to 500 ml) of dialysate, and the inside of the container is provided with a soft diaphragm (diaphragm) to accommodate the liquid feed accommodating portion 1331a and drainage. It is divided into parts 1331b.
The bypass line 1332 connects the dialysate lead-out line 132b and the dialysate drainage line 131b.

The water removal / backfiltration pump 1333 is located at bypass line 1332. The water removal / reverse filtration pump 1333 has a direction in which the dialysate inside the bypass line 1332 is circulated to the dialysate drainage line 131b side (water removal direction) and a direction in which the dialysate is circulated to the dialysate discharge line 132b side (back filtration direction). It consists of a pump that is driven so that the liquid can be sent to the dialysis machine.

The dialysate supply line 131a is connected to the dialysate supply device (not shown) at the proximal end side and to the dialysate chamber 1331 at the distal end side. The dialysate supply line 131a supplies the dialysate to the fluid delivery accommodating portion 1331a of the dialysate chamber 1331.

The dialysate introduction line 132a connects the dialysate chamber 1331 and the dialysate introduction port 123a of the hemodialyzer 120, and dialysates the dialysate contained in the liquid delivery accommodating portion 1331a of the dialysate chamber 1331 to the hemodialyzer 120. Introduce into the liquid side flow path.

The dialysate lead-out line 132b connects the dialysate outlet 123b of the hemodialyzer 120 and the dialysate chamber 1331, and leads the dialysate discharged from the hemodialyzer 120 to the drainage accommodating portion 1331b of the dialysate chamber 1331. To do.

The base end side of the dialysate drainage line 131b is connected to the dialysate chamber 1331, and drainage of the dialysate contained in the drainage storage portion 1331b is discharged.

According to the above dialysate circuit 130, by partitioning the inside of the hard container constituting the dialysate chamber 1331 with a soft diaphragm (diaphragm), the amount of dialysate derived from the dialysate chamber 1331 (liquid feeding accommodation). The amount of dialysate supplied to section 1331a) and the amount of drainage collected in the dialysate chamber 1331 (drainage accommodating section 1331b) can be made equal.
As a result, when the water removal / reverse filtration pump 1333 is stopped, the flow rate of the dialysate introduced into the hemodialyzer 120 and the amount of dialysate (drainage) drawn out from the hemodialyzer 120 are the same. Can be done.

Further, when the water removal / back filtration pump 1333 is driven so as to send the liquid in the back filtration direction, a part of the drainage discharged from the dialysate chamber 1331 causes the bypass line 1332 and the dialysate lead-out line 132b. It passes through and is collected again in the dialysate chamber 1331. Therefore, the amount of dialysate derived from the hemodialyzer 120 is the amount of dialysate collected in the dialysate chamber 1331 (that is, the amount of dialysate flowing through the dialysate introduction line 132a), and the amount of dialysate flowing through the bypass line 1332. The amount is obtained by subtracting the amount of liquid. As a result, the amount of dialysate led out from the hemodialyzer 120 is distributed through the dialysate introduction line 132a by the amount of dialysate (drainage) collected again in the dialysate chamber 1331 through the bypass line 1332. It will be less than the flow rate of dialysate. That is, when the water removal / back filtration pump 1333 is driven so as to send the liquid in the back filtration direction, a predetermined amount of dialysate is injected (back filtration) into the blood circuit 110A in the hemodialyzer 120.

On the other hand, when the water removal / reverse filtration pump 1333 is driven to send the liquid in the water removal direction, the amount of dialysate flowing through the dialysate lead-out line 132b is the dialysate collected in the dialysate chamber 1331. (That is, the amount of dialysate flowing through the dialysate introduction line 132a) plus the amount of dialysate flowing through the bypass line 1332. As a result, the amount of dialysate flowing through the dialysate lead-out line 132b is the same as the amount of dialysate (drainage) discharged to the dialysate drainage line 131b through the bypass line 1332. It will be larger than the amount of dialysate in circulation. That is, when the water removal / reverse filtration pump 1333 is driven so as to send the liquid in the water removal direction, the hemodialyzer 120 removes a predetermined amount of water from the blood.

The replacement fluid line 140 is a line for directly supplying the dialysate to the blood circuit 110A. As shown in FIG. 1, the upstream side of the replenisher line 140 is connected between the dialysate chamber 1331 and the dialysate introduction port 123a in the dialysate introduction line 132a of the dialysate circuit 130. As shown by the solid line in FIG. 1, when the downstream side of the replenisher line 140 is connected between the blood pump 111a and the hemodialysis machine 120 in the arterial side line 111, the pre-dilution type hemodiafiltration is performed ( See FIG. 4A). Further, as shown by the broken line in FIG. 1, when the downstream side of the replenisher line 140 is connected to the drip chamber 112a in the venous side line 112, post-dilution type hemofiltration dialysis is performed (see FIG. 4B).

The control device 150 as a determination device is composed of an information processing device (computer), and includes a pump operation unit 151, a bubble detection unit 152, a clamp operation unit 153, a determination unit 154, a setting unit 155, and a notification. A unit 156 and a unit are provided.

The pump operation unit 151 controls the operation of various pumps arranged in the blood circuit 110A, the dialysate circuit 130, and the replenisher line 140.
The bubble detection unit 152 operates the arterial side bubble detector 111b and the vein side bubble detector 112b as necessary to detect bubbles and acquire the detection result.

The clamp operation unit 153 operates (opens and closes) various clamps arranged in the blood circuit 110A, the dialysate circuit 130, and the replenisher line 140 according to the operation of various pumps and the detection result of air bubbles by the bubble detection unit 152. Control.

The determination unit 154 is connected to the arterial side line 111 or the vein side line 112 based on the bubble detection result by the bubble detection unit 152 in the determination method described in detail later. Judge whether or not.

The setting unit 155 sets the method of sending the replenishing liquid to the blood circuit 110A. Specifically, it is set whether the hemodialysis treatment given to the patient is a pre-dilution method or a post-dilution method.

The notification unit 156 notifies when the liquid feeding method set in the setting unit 155 and the connection state of the replenishment liquid line 140 determined by the determination unit 154 to the blood circuit 110A do not correspond to each other.

The control device 150 described above controls and operates the operation of the hemodialysis device 100A by executing the control program of each step described below.
Each step includes a priming step, which is a preparatory step for cleaning and cleaning the blood circuit 110A and the blood dialyzer 120, a blood removal step in which the blood circuit 110A is filled with the patient's blood after puncture and circulated extracorporeally, and a blood removal step. Subsequently, a dialysis step of dialyzing and purifying blood, a rapid replenishment step performed when blood pressure drops during dialysis treatment, a blood return step of returning blood in the blood circuit 110A to the patient's body, and the like.

In the present invention, in the priming step performed after connecting each circuit and each line to assemble the circuit, it is determined whether or not the replenisher line 140 connected to the blood circuit 110A is in a connected state corresponding to the liquid feeding method. I do. If the connection state does not correspond to the liquid feeding method, reconnect the circuit and complete the priming process with the correct connection state. Then, after a blood removal step, in the dialysis step, hemofiltration dialysis is performed while feeding a replacement solution to the blood circuit 110A by a pre-dilution or post-dilution method.

Next, the determination method according to the first embodiment will be described with reference to FIGS. 3 and 4. FIG. 3 is a diagram showing a flowchart of the determination method according to the first embodiment, FIG. 4A shows the connection state of the circuit in the pre-dilution method, and FIG. 4B shows the connection state of the circuit in the post-dilution method.

As shown in FIGS. 4A and 4B, the determination method according to the present embodiment is suitable for priming by connecting the arterial side connecting portion 111d and the venous side connecting portion 112d. In this case, the priming liquid is discharged from the drain line 113.
Before starting the priming process, the liquid feeding method is set in the setting unit 155 in advance. As shown in FIGS. 4A and 4B, the arterial side connecting portion 111d and the venous side connecting portion 112d are connected, and the drainage line clamp 113a, the arterial side clamp 111c, the venous side clamp 112c, and the replenishment liquid line clamp 140b Is in the open state. Since it is before the start of the priming process, the blood circuit 110A is not filled with the priming liquid and is filled with air. In this state, the determination by the determination method shown in FIG. 3 is started and the priming step is performed.

The step S10A after the start of the determination is a pump operation step in which the water removal / back filtration pump 1333, the replacement fluid pump 140a, and the blood pump 111a are operated by the pump operation unit 151. By operating the pump in step S10A, the replenisher liquid (dialysate) is sent from the replenisher liquid line 140 to the blood circuit 110A as a priming liquid at a predetermined liquid supply amount (for example, 50 mL / min), and the replenisher liquid line 140 Do the priming.
In the present embodiment, as an example, the blood pump 111a is operated so as to send the liquid to the arterial side connection portion 111d side in the arterial side line 111 (see FIGS. 4A and 4B).

Step S20A is a bubble detection step of detecting the presence or absence of bubbles by operating the bubble detector by the bubble detection unit 152 when the first time has elapsed from the start of operation of the various pumps.
Here, the first time is the time for the priming liquid sent from the replenisher line 140 to the blood circuit 110A to reach the bubble detector without passing through the hemodialyzer 120, and the priming liquid via the hemodialyzer 120. It may be set to the time between the time when the bubble detector is reached. That is, when the first time elapses, the first time may be appropriately set so that the result of detecting bubbles by the bubble detector differs depending on the connection state of the circuit. In this embodiment, the first time is 10 seconds.

Further, since the priming liquid is sent from the hemodialyzer 120 side to the arterial side connection portion 111d side in the arterial side line 111, it reaches the arterial side bubble detector 111b before the venous side bubble detector 112b. Therefore, in this case, it is preferable to use the arterial bubble detector 111b, which can set the first time short, as the bubble detector. When the blood pump 111a is operated in the opposite direction, the vein side bubble detector 112b can set the first time shorter, so it is preferable to use the vein side bubble detector 112b as the bubble detector.

Step S30A is a determination step in which the determination unit 154 determines the connection state of the replenisher line 140 to the blood circuit 110A based on the detection result of air bubbles.
In the present embodiment, the blood pump 111a operates so as to send the liquid to the arterial side connection portion 111d side in the arterial side line 111. Therefore, in the bubble detector, the replacement liquid line 140 is the arterial side line 111 as shown in FIG. 4A. When connected to, the priming fluid has already reached the arterial bubble detector 111b after the lapse of the first hour, and no bubbles are detected. On the other hand, as shown in FIG. 4B, when the replacement liquid line 140 is connected to the venous side line 112, the priming liquid has not reached the arterial side bubble detector 111b after the lapse of the first time, so that bubbles Is detected. Therefore, when air bubbles are detected, it is determined that the replenisher line 140 is connected to the venous side line 112, and when no air bubbles are detected, the replenisher liquid line 140 is connected to the arterial side line 111. It is judged.

In step S40, the control device 150 determines whether or not the liquid feeding method set by the setting unit 155 and the connection state determined by the determination unit 154 correspond to each other. If it corresponds (Yes), the determination is ended, and if it does not correspond (No), a notification is given in step S50 and the determination ends.
Table 1 shows the conditions under which notification is performed by the notification unit 156 in the present embodiment.

After the determination is completed, if the connection state is correct, the priming of the replenisher line 140 is completed. If the connection state is incorrect, the operations of the various pumps are stopped, the replenisher line 140 is correctly connected to the blood circuit 110A, and then the replenisher line 140 is primed again. After the priming of the replenisher line 140 is completed, various pumps are operated as shown in FIG. 5, the blood circuit 110A is primed, and the priming process is completed in the correct connection state corresponding to the liquid feeding method.

According to the determination method described above, the connection state of the replenisher line 140 to the blood circuit 110A can be determined by priming the replenisher line 140 before priming the blood circuit 110A in the priming step. it can.

According to the hemodialysis apparatus 100A provided with the determination method and the determination device (control device 150) according to the first embodiment described above, the following effects are obtained.

(1) In the blood circuit 110A in which one end side of the arterial side line 111 (arterial side connection portion 111d) and one end side of the venous side line 112 (venous side connection portion 112d) are connected and are not filled with liquid. The pump operating unit 151 performs a pump operating step of operating the blood pump 111a and the replenishing liquid pump 140a to allow the replenishing liquid to flow from the replenishing liquid line 140 into the blood circuit 110A, and the bubble detection unit 152 is in a state where the first time has elapsed. In, a bubble detection step of detecting bubbles by the bubble detector 111b or 112b is performed, and the determination unit 154 performs a determination step of determining the connection state of the replenisher line 140 to the blood circuit 110A depending on whether or not the bubbles are detected. I decided to do it. This makes it possible to easily determine the connection state of the replenisher line 140 to the blood circuit 110A by using the priming step in the hemodialysis apparatus 100A.

(2) The bubble detector 111b is arranged on one end side of the connection point of the replenisher line 140 in the arterial side line 111, and the pump operating unit 151 sets the blood pump 111a at one end of the arterial side line 111 in the pump operating process. The replenisher is operated so as to flow toward the side, and in the determination step, the determination unit 154 determines that the replenisher line 140 is connected to the vein side line 112 when no air bubbles are detected, and the air bubbles are detected. If this is the case, it is determined that the replenisher line 140 is connected to the venous line 112. As a result, the replacement fluid is flowed toward one end side of the arterial side line 111, so that the first time in the bubble detection step can be set shorter than when the bubble detector is arranged on the vein side line 112. it can. Therefore, the connection state can be determined in a shorter time.

(3) The determination device (control device 150) was determined by the setting unit 155 that sets the method of supplying the replenishing liquid to the blood circuit 110A, the liquid supply method set in the setting unit 155, and the determination unit 154. A notification unit 156 that notifies when the connection state does not correspond is further provided. As a result, when the connection state of the replacement liquid line 140 to the blood circuit 110A is incorrect, the medical staff can be promptly notified.

<Modification example>
Next, a modified example of the first embodiment will be described with reference to FIG.
The determination method according to the modification is to determine the connection state based on whether or not the priming liquid has reached the bubble detector by the time the first time elapses. Since the configuration of the hemodialysis apparatus 100A is the same except that the time point at which the detection of air bubbles is started is different from that of the first embodiment, the description thereof will be omitted.

Similar to the first embodiment, the liquid feeding method is set in the setting unit 155 in advance before the start of the priming process. As shown in FIGS. 4A and 4B, the arterial side connection portion 111d and the venous side connection portion 112d are connected, and the drainage line clamp 113a, the arterial side clamp 111c, the venous side clamp 112c, and the replenishment liquid line clamp 140b are connected. Is in the open state. Since it is before the start of the priming process, the priming liquid is not filled in the blood circuit 110A and the replenishing liquid line 140, and is filled with air. In this state, the determination by the determination method shown in FIG. 6 is started and the priming step is performed.

The step S10A after the start of the determination is a pump operation step in which the water removal / back filtration pump 1333, the replacement fluid pump 140a, and the blood pump 111a are operated by the pump operation unit 151. The replenisher line 140 is primed by sending a replenisher (dialysate) as a priming liquid from the replenisher line 140 to the blood circuit 110A at a predetermined amount (for example, 50 mL / min).

Step S20A'is a bubble detection step of detecting the presence or absence of bubbles by operating the bubble detector by the bubble detection unit 152 after the operation of various pumps is started. The result of detecting bubbles is that there are bubbles until the priming liquid reaches the bubble detector, and there are no bubbles when the priming liquid reaches.

In step S30A', the replenishment liquid line is determined by whether or not the priming liquid has reached the bubble detector by the first time from the start of the pump operation by the determination unit 154, that is, whether or not the bubbles are no longer detected. This is a determination step for determining the connection state of the 140 to the blood circuit 110A. Here, the first time can be set in the same manner as in the case of the first embodiment.
In the modified example, the blood pump 111a operates to send the liquid to the arterial side connection portion 111d side in the arterial side line 111, so that the replacement liquid line 140 is connected to the arterial side line 111 in the bubble detector as shown in FIG. 4A. If connected, the priming fluid has already reached the arterial bubble detector 111b after the first hour, and no bubbles are detected. On the other hand, as shown in FIG. 4B, when the replacement liquid line 140 is connected to the venous side line 112, the priming liquid has not reached the arterial side bubble detector 111b after the lapse of the first time, so that bubbles Is detected. Therefore, if the priming fluid arrives and bubbles are no longer detected by the time the first time elapses, it is determined that the replacement fluid line 140 is connected to the arterial side line 111, and the first time elapses. If bubbles are detected without the priming solution reaching, it is determined that the replenisher line 140 is connected to the venous line 112.

In step S40, the control device 150 determines whether or not the liquid feeding method set by the setting unit 155 and the connection state determined by the determination unit 154 correspond to each other. If it corresponds (Yes), the determination is ended, and if it does not correspond (NO), the notification unit 156 gives a notification in step S50 and ends the determination.
Table 2 shows the conditions under which notification is performed by the notification unit 156 in the modified example.

After the determination is completed, if the connection state is incorrect, the operations of the various pumps are stopped, the replenisher line 140 is correctly connected to the blood circuit 110A, and then the replenisher line 140 is primed again. After the priming of the replenisher line 140 is completed, the blood circuit 110A is primed. Specifically, as shown in FIG. 5, the arterial side clamp 111c, the venous side clamp 112c, and the drainage line clamp 113a are opened, and the replacement liquid line clamp 140b is closed. As shown in FIG. 5, the pump operating unit 151 operates various pumps to inject the dialysate into the hemodialyzer 120 by back filtration to perform priming of the blood circuit 110A.
In this way, various pumps are operated to perform priming of the blood circuit 110A, and the priming process is completed in a correct connection state corresponding to the liquid feeding method.

According to the determination method described above, the replenisher solution line 140 is primed before the blood circuit 110A is primed in the priming step, and the presence or absence of air bubbles detected after the lapse of the first time is confirmed. The connection state of the line 140 to the blood circuit 110A can be determined.

According to the hemodialysis apparatus 100A provided with the determination method and the determination device (control device 150) according to the modification described above, the same effects as those of the above effects (1) to (3) are obtained.

<Second Embodiment>
Next, the second embodiment will be described with reference to FIGS. 7 to 11.
The overall configuration of the hemodialysis apparatus 100B of the second embodiment will be described with reference to FIGS. 7 and 8. FIG. 7 is a diagram showing a schematic configuration of the hemodialysis apparatus 100B according to the second embodiment of the present invention, and FIG. 8 is a block diagram showing the hemodialysis apparatus 100B.
In the second embodiment, the blood circuit 110B in the hemodialysis apparatus 100B does not have a drainage line but includes a ventilation line 114, and the hemodialysis apparatus 100B includes a liquid level adjusting pump 114b. It differs from the hemodialysis apparatus 100A of the first embodiment in that. Other configurations are designated by the same reference numerals and the description thereof will be omitted.

As shown in FIGS. 7 and 8, the blood dialysis apparatus 100B includes a blood circuit 110B for flowing blood, a blood pump 111a, an arterial bubble detector 111b, a venous bubble detector 112b, and a blood dialyzer. The dialysate circuit 130, the dialysate feeding unit 133, the replenisher line 140, the replenisher pump 140a, the control device 150 as a determination device, and the liquid level adjusting pump 114b are provided.

The blood circuit 110B has an arterial side line 111, a venous side line 112, and a ventilation line 114.
One end of the venous line 112 is connected to the blood outlet 122b of the hemodialyzer 120. A drip chamber 112a, a venous bubble detector 112b, a venous clamp 112c, and a venous connection 112d are arranged on the venous line 112.
The drip chamber 112a stores a certain amount of blood in order to remove air bubbles, coagulated blood, and the like mixed in the vein side line 112.
The venous side bubble detector 112b is arranged on the downstream side of the drip chamber 112a and detects the presence or absence of air bubbles in the tube.
The venous side clamp 112c is arranged on the downstream side of the venous side bubble detector 112b. The venous side clamp 112c is controlled according to the result of detecting air bubbles by the venous side air bubble detector 112b, and opens and closes the flow path of the venous side line 112.
The venous side connection portion 112d is arranged on the other end side of the venous side line. A needle that punctures the patient's blood vessel is connected to the venous side connection portion 112d.

The ventilation line 114 is a tube provided for allowing air in the drip chamber 112a to flow in and out, and one end side thereof is connected to the upper part of the drip chamber 112a. A ventilation line clamp 114a, which is composed of a solenoid valve and opens and closes the flow path of the ventilation line 114, is arranged in the ventilation line 114. Further, on the other end side of the ventilation line 114, a liquid level adjusting pump 114b for allowing air to flow in and out of the drip chamber 112a to adjust the liquid level height of the liquid is arranged.

According to the blood circuit 110B and the hemodialyzer 120 described above, the blood taken out from the artery of the subject (dialysis patient) flows through the arterial line 111 by the blood pump 111a and flows through the blood side of the hemodialyzer 120. Introduced in. The blood introduced into the hemodialyzer 120 is purified by the dialysate flowing through the dialysate circuit 130 described later via the dialysate membrane. The blood purified in the hemodialyzer 120 passes through the venous side line 112 and is returned to the subject's vein.

Next, the determination method according to the second embodiment will be described with reference to FIGS. 9 to 11. FIG. 9 is a diagram showing a flowchart of the determination method according to the second embodiment, and FIG. 10 is an explanatory diagram when priming the blood circuit 110B in the priming step. FIG. 11A shows the connection state of the circuit in the pre-dilution method, and FIG. 11B shows the connection state of the circuit in the post-dilution method.

As shown in FIGS. 10 and 11, the determination method according to the present embodiment is suitable for priming without connecting the arterial side connecting portion 111d and the venous side connecting portion 112d. In this case, the priming fluid is discharged from the arterial side connecting portion 111d and the venous side connecting portion 112d, respectively.
Further, in the determination method according to the present embodiment, the blood circuit 110B is primed in advance before the start of determination, the blood circuit 110B is filled with the priming solution (reverse filtration dialysate), and the replenishment solution line 140 is filled with the priming solution (priming solution). The connection state is determined in a state where the dialysate as a replenisher solution) is not filled (filled with gas).

As shown in FIG. 10, the arterial side clamp 111c, the venous side clamp 112c, and the ventilation line clamp 114a are opened, and the replacement fluid line clamp 140b is closed. As shown in FIG. 10, the pump operating unit 151 operates various pumps to inject dialysate from the dialysate circuit 130 into the hemodialyzer 120 by back filtration to prime the blood circuit 110B. The replenisher line 140 is not primed, and the connection state described below is determined with the replenisher line 140 filled with air. Further, the liquid level of the drip chamber 112a is adjusted to a predetermined liquid level by the liquid level adjusting pump 114b during the priming of the blood circuit 110B. After that, the liquid level is maintained by operating the ventilation line clamp 114a by the clamp operating portion 153 to close the state.

Before the start of determination, the liquid feeding method is set in the setting unit 155 in advance.
As shown in FIG. 9, in step S10B after the start of determination, the pump operating unit is in a state where the arterial side clamp 111c, the venous side clamp 112c and the replenisher line clamp 140b are opened and the ventilation line clamp 114a is closed. This is a pump operation step of operating the water removal / reverse filtration pump 1333, the replenishment pump 140a, and the blood pump 111a according to 151. Various pumps are operated by the pump operating unit 151 as shown in FIGS. 11A and 11B, and dialysate is injected into the blood dialyzer 120 at a flow rate of 350 mL / min by back filtration, and the replacement fluid (dialysis) is injected from the replacement fluid line 140. The liquid) is pumped to the blood circuit 110B at a flow rate of 50 mL / min. Further, the blood pump 111a is operated so as to send the liquid to the arterial side connection portion 111d side at a flow rate of 200 mL / min. Therefore, the priming solution (reverse filtration dialysate, replacement solution) is discharged from the arterial side connection portion 111d at a flow rate of 200 mL / min and from the venous side connection portion 112d at a flow rate of 200 mL / min.

When the replenisher line 140 is connected to the arterial side line 111, a part of the air filled in the replenisher line 140 reaches the arterial bubble detector 111b first. , The other part may be set to reach the venous bubble detector 112b later through the blood dialyzer 120, and if the replenisher line 140 is connected to the venous line 112, air. A part of the vein side bubble detector 112b may be set to reach the vein side bubble detector 112b first, and the other part may be set to reach the arterial side bubble detector 111b later through the blood dialyzer 120.
In the present embodiment, the liquid feed amount of the replenisher pump 140a is smaller than the liquid feed amount of the blood pump 111a, and the feed amount of the dialysate injected into the blood dialyzer 120 by back filtration is used to feed the blood pump 111a. It was set to be less than the amount obtained by subtracting the amount of liquid. As a result, the air sent from the replenisher line 140 to the blood circuit 110B is sent to either the arterial bubble detector 111b or the venous bubble detector 112b without passing through the hemodialyzer 120.

In step S20B, after the operation of various pumps by the pump operation unit 151 is started by the bubble detection unit 152, the arterial side bubble detector 111b and the vein side bubble detector 112b are operated to start the detection of bubbles and detect the bubbles. This is a bubble detection process.
As shown in FIG. 11A, when the replenisher line 140 is connected to the arterial side line 111, the air filled in the replenisher line 140 reaches the arterial bubble detector 111b and is detected. Further, as shown in FIG. 11B, when the replenishing liquid line 140 is connected to the venous side line 112, the air filled in the replenishing liquid line 140 reaches the venous side bubble detector 112b and is detected. To.

Step S30B is a determination step in which the determination unit 154 determines the connection state of the replenisher line 140 to the blood circuit 110B based on the detection result of air bubbles.
The determination unit 154 states that the replenisher line 140 is connected to the arterial side line 111 when the air bubble detection unit 152 starts detecting air bubbles and then the arterial air bubble detector 111b detects air bubbles first. It is determined that the replenisher line 140 is connected to the vein side line 112 when the bubble is detected first by the vein side bubble detector 112b.

In step S40, the control device 150 determines whether or not the liquid feeding method set by the setting unit 155 and the connection state determined by the determination unit 154 correspond to each other. If it corresponds (Yes), the determination is ended, and if it does not correspond (No), a notification is given in step S50 and the determination ends.
Table 3 shows the conditions under which notification is performed by the notification unit 156 in the present embodiment.

After the determination is completed, if the connection state is correct, priming is continued, air is removed from the blood circuit 110B and the replenisher line 140, and the priming step is completed. If the connection status is incorrect, the operations of various pumps are stopped, the replenisher line 140 is correctly connected to the blood circuit 110B, and then the replenisher line 140 and the blood circuit 110B are primed again to supply the liquid. Complete the priming process with the correct connection for the method.

According to the determination method described above, in the priming step, the blood circuit 110B is primed and the replenisher line 140 filled with air is primed in a state of being filled with the priming solution, and the arterial side line 111 and the vein are performed. By detecting air bubbles on the side line 112, it is possible to determine the connection state of the replenisher line 140 to the blood circuit 110B.

According to the hemodialysis apparatus 100B provided with the determination method and the determination device (control device 150) according to the second embodiment described above, the following effects are obtained.

(4) In a state where the blood circuit 110B is filled with the liquid and the replenisher line 140 is filled with the gas, the pump operating unit 151 back-filters and injects the dialysate from the dialysate circuit 130 into the blood dialyzer 120. While operating the blood pump 111a so that the liquid flows to one end side of the arterial side line 111 at a flow rate smaller than the injection amount of the dialysate, the pump operating step of operating the replacement fluid pump 140a is performed, and the pump operating unit 151 is performed. After operating the blood pump 111a and the replacement liquid pump 140a, the bubble detection unit 152 starts the detection of bubbles by the arterial side bubble detector 111b and the vein side bubble detector 112b to perform a bubble detection step of detecting the bubbles. When the arterial bubble detector 111b detects the bubble first, the determination unit 154 determines that the replenisher line 140 is connected to the arterial line 111, and the venous bubble detector 112b first detects the bubble. When is detected, a determination step of determining that the replenisher line 140 is connected to the venous line 112 is performed. This makes it possible to easily determine the connection state of the replenisher line 140 to the blood circuit 110B by using the priming step in the hemodialysis apparatus 100B.

(5) The fluid replacement volume of the replacement fluid pump 140a is set to be smaller than the fluid feed volume of the blood pump 111a and smaller than the volume of dialysate injected minus the fluid feed volume of the blood pump 111a. As a result, the air sent from the replenisher line 140 to the blood circuit 110B is sent to either the arterial bubble detector 111b or the venous bubble detector 112b without passing through the hemodialyzer 120.

(6) The determination device (control device 150) was determined by the setting unit 155 that sets the method of supplying the replenisher to the blood circuit 110B, the liquid supply method set in the setting unit 155, and the determination unit 154. It is further provided with a notification unit 156 that notifies when the connection state does not correspond to each other. As a result, when the connection state of the replacement liquid line 140 to the blood circuit 110B is incorrect, the medical staff can be promptly notified.

Although the preferred embodiments and modifications of the connection state determination supplement method and the determination device of the present invention have been described above, the present invention is not limited to the above-described embodiments and modifications, and may be appropriately modified. It is possible.
For example, in the first embodiment and the modified example, as an example, a blood pump is operated so as to send liquid from the hemodialyzer side to the arterial side connection portion side in the arterial side line, and in a state where the first time has passed, the artery The presence or absence of bubbles (whether or not the priming liquid has arrived) was detected by the side bubble detector, but the present invention is not limited to this. The blood pump may be operated so as to send the liquid from the arterial side connection side to the hemodialyzer side in the arterial side line, and the presence or absence of bubbles (whether or not the priming liquid has arrived) is detected by the venous side bubble detector. You may.

Further, in the second embodiment, in the pump operation step, the dialysate is back-filtered and injected into the blood dialyzer 120 from the dialysate circuit 130, and the liquid is injected into the arterial side line 111 at a flow rate smaller than the injection amount of the dialysate. The blood pump 111a was operated and the replenisher pump 140a was operated so as to flow to one end side of the dialysis pump, but the present invention is not limited to this. That is, the pump operation step may be carried out without operating the blood pump.

100A, 100B Hemodialysis device 110A, 110B Blood circuit 111 Arterial side line 111a Blood pump 111b Arterial side bubble detector 111d Arterial side connection
112 Venous side line 112b Venous side bubble detector 112d Venous side connection part 120 Hemodialyzer 130 Dialysate circuit 131a Dialysate supply line 131b Dialysate drainage line 132a Dialysate introduction line 132b Dialysate outlet line 133 1331 Dialysate chamber 1332 Bypass line 1333 Water removal / back filtration pump 140 Replenisher solution line 140a Supplementary solution pump 150A, 150B Control device (judgment device)
151 Pump operation unit 152 Bubble detection unit 153 Clamp operation unit 154 Judgment unit 155 Setting unit 156 Notification unit

Claims (12)

Hemodialyzer and
One end has an arterial line connected to the subject's artery and the other end connected to the hemodialyzer, and one end has a venous line connected to the hemodialyzer and the other end connected to the subject's vein. Blood circuit and
A blood pump located on the arterial line and
A dialysate circuit having a dialysate introduction line for introducing dialysate into the hemodialyzer and a dialysate lead-out line for leading out dialysate from the hemodialyzer.
A replacement fluid line connected to the arterial side line or the venous side line to supply the replacement fluid to the blood circuit, and a replacement fluid line.
The replacement fluid pump arranged in the replacement fluid line and
A bubble detector located on the arterial side line or the vein side line to detect bubbles, and
A method for determining the connection state of the replenisher line to the blood circuit in a hemodialysis apparatus comprising the above.
Which is connected with the arterial one end and the other end side of the vein side line of the line, in the blood circuit in a state where the liquid is not satisfied, and the pumping step of operating the blood pump and the replacement fluid pump,
A bubble detection step of detecting bubbles by the bubble detector in a state where a preset first time has elapsed after operating the blood pump and the replacement fluid pump.
A determination method comprising a determination step of determining whether the replenisher line is connected to the arterial side line or the venous side line depending on whether or not bubbles are detected by the bubble detector. The bubble detector is arranged on one end side of the connection point of the replenisher line in the arterial side line.
In the pump operation step, the blood pump is operated so as to flow the replenisher toward one end side of the arterial side line.
In the determination step, if no bubbles are detected, it is determined that the replenisher line is connected to the arterial side line, and if bubbles are detected, the replenisher line is connected to the vein side line. The determination method according to claim 1, wherein the determination method is performed. Hemodialyzer and
One end has an arterial line connected to the subject's artery and the other end connected to the hemodialyzer, and one end has a venous line connected to the hemodialyzer and the other end connected to the subject's vein. Blood circuit and
A blood pump located on the arterial line and
A dialysate circuit having a dialysate introduction line for introducing dialysate into the hemodialyzer and a dialysate lead-out line for leading out dialysate from the hemodialyzer.
A replacement fluid line connected to the arterial side line or the venous side line to supply the replacement fluid to the blood circuit, and a replacement fluid line.
The replacement fluid pump arranged in the replacement fluid line and
A bubble detector located on the arterial side line or the vein side line to detect bubbles, and
A device for determining the connection state of the replenisher line to the blood circuit in a hemodialysis device comprising the above.
Wherein one end side of the artery side line and the other end side of the vein side line are connected, in the blood circuit in a state where the liquid is not met, a pumping unit for operating the blood pump and the replacement fluid pump,
A bubble detection unit that detects bubbles by the bubble detector in a state in which a preset first time has elapsed after the blood pump and the replacement fluid pump are operated by the pump operating unit.
A determination device including a determination unit for determining whether the replenisher line is connected to the arterial side line or the vein side line depending on whether or not bubbles are detected by the bubble detector. The bubble detector is placed on the arterial side line and
The pump operating unit operates the blood pump so as to flow the replenisher toward one end side of the arterial side line.
The determination unit determines that the replenisher line is connected to the arterial line when no air bubbles are detected, and connects the replenisher line to the vein side line when air bubbles are detected. The determination device according to claim 3, wherein the determination device is determined to be. A setting unit that sets the method of sending the replenisher to the blood circuit, and
The determination device according to claim 3 or 4, further comprising a notification unit that notifies when the liquid feeding method set in the setting unit and the connection state determined by the determination unit do not correspond to each other. Hemodialyzer and
One end has an arterial line connected to the subject's artery and the other end connected to the hemodialyzer, and one end has a venous line connected to the hemodialyzer and the other end connected to the subject's vein. Blood circuit and
A blood pump located on the arterial line and
A dialysate circuit having a dialysate introduction line for introducing dialysate into the hemodialyzer and a dialysate lead-out line for leading out dialysate from the hemodialyzer.
A replacement fluid line connected to the arterial side line or the venous side line to supply the replacement fluid to the blood circuit, and a replacement fluid line.
The replacement fluid pump arranged in the replacement fluid line and
An arterial bubble detector that is placed on the arterial line and detects bubbles,
A vein-side bubble detector that is placed on the vein-side line and detects bubbles,
A method for determining the connection state of the replenisher line to the blood circuit in a hemodialysis apparatus comprising the above.
In a state where the blood circuit is filled with a liquid and the replenisher line is filled with a gas, the replenisher pump is operated while back-filtering and injecting the dialysate from the dialysate circuit into the blood dialyzer. Pump operation process and
After operating the replenishment pump, a bubble detection step of detecting bubbles by starting detection of bubbles by the arterial bubble detector and the vein bubble detector, and a bubble detection step.
When one of the arterial bubble detector or the venous bubble detector detects a bubble before the other, the replenisher line is connected to either the arterial line or the venous line. A determination method comprising a determination step of determining In the pump operation step, while the blood circuit is filled with a liquid and the replenisher line is filled with a gas, the dialysate is back-filtered and injected into the blood dialyzer from the dialysate circuit. The blood pump was operated so that the liquid flowed to one end side of the arterial side line at a flow rate smaller than the injection amount of the dialysate, and the replacement fluid pump was operated.
In the determination step, when bubbles are detected first by the arterial bubble detector, it is determined that the replenisher line is connected to the arterial line, and the bubbles are first detected by the vein side bubble detector. The determination method according to claim 6, wherein when it is detected, it is determined that the replenisher line is connected to the vein side line. The amount of liquid supplied by the replenishment pump is smaller than the amount of liquid supplied by the blood pump and less than the amount of injection of the dialysate minus the amount of liquid supplied by the blood pump according to claim 6 or 7. Judgment method. Hemodialyzer and
One end has an arterial line connected to the subject's artery and the other end connected to the hemodialyzer, and one end has a venous line connected to the hemodialyzer and the other end connected to the subject's vein. Blood circuit and
A blood pump located on the arterial line and
A dialysate circuit having a dialysate introduction line for introducing dialysate into the hemodialyzer and a dialysate lead-out line for leading out dialysate from the hemodialyzer.
A replacement fluid line connected to the arterial side line or the venous side line to supply the replacement fluid to the blood circuit, and a replacement fluid line.
The replacement fluid pump arranged in the replacement fluid line and
An arterial bubble detector that is placed on the arterial line and detects bubbles,
A vein-side bubble detector that is placed on the vein-side line and detects bubbles,
A device for determining the connection state of the replenisher line to the blood circuit in a hemodialysis device comprising the above.
In a state where the blood circuit is filled with a liquid and the replenisher line is filled with a gas, the replenisher pump is operated while the dialysate is back-filtered and injected into the blood dialyzer from the dialysate circuit. Pump operation part and
After the blood pump and the replenisher pump are operated by the pump operating unit, the bubble detecting unit that detects bubbles by starting the detection of bubbles by the arterial bubble detector and the venous bubble detector,
When one of the arterial bubble detector or the venous bubble detector detects a bubble before the other, the replenisher line is connected to either the arterial line or the venous line. A determination device including a determination unit for determining The pump operating unit is in a state where the blood circuit is filled with a liquid and the replenisher line is filled with a gas, and the dialysate is back-filtered and injected into the blood dialyzer from the dialysate circuit. The blood pump was operated so that the liquid flowed to one end side of the arterial side line at a flow rate smaller than the injection amount of the dialysate, and the replacement fluid pump was operated.
The determination unit determines that the replenisher line is connected to the arterial side line when the air bubble detection unit starts detecting air bubbles and then the arterial air bubble detector detects air bubbles first. The determination device according to claim 9, wherein the determination device determines that the replenisher line is connected to the vein side line when the bubble is detected first by the vein side bubble detector. The liquid supply amount of the supplementary liquid pump is smaller than the liquid feed amount of the blood pump and smaller than the amount of the dialysate injection minus the liquid feed amount of the blood pump according to claim 9 or 10. Judgment device. A setting unit that sets the method of sending the replenisher to the blood circuit, and
The determination device according to any one of claims 9 to 11, further comprising a notification unit that notifies when the liquid feeding method set in the setting unit and the connection state determined by the determination unit do not correspond to each other. ..

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