JP7276155B2 - 細胞外液量算出装置及び細胞外液量算出方法 - Google Patents
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
- A61M1/1601—Control or regulation
- A61M1/1603—Regulation parameters
- A61M1/1605—Physical characteristics of the dialysate fluid
- A61M1/1609—Physical characteristics of the dialysate fluid after use, i.e. downstream of dialyser
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
- A61M1/1601—Control or regulation
- A61M1/1603—Regulation parameters
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
- A61M1/1621—Constructional aspects thereof
- A61M1/1647—Constructional aspects thereof with flow rate measurement of the dialysis fluid, upstream and downstream of the dialyser
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/33—Controlling, regulating or measuring
- A61M2205/3331—Pressure; Flow
- A61M2205/3334—Measuring or controlling the flow rate
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/50—General characteristics of the apparatus with microprocessors or computers
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/50—General characteristics of the apparatus with microprocessors or computers
- A61M2205/52—General characteristics of the apparatus with microprocessors or computers with memories providing a history of measured variating parameters of apparatus or patient
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2230/00—Measuring parameters of the user
- A61M2230/20—Blood composition characteristics
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2230/00—Measuring parameters of the user
- A61M2230/20—Blood composition characteristics
- A61M2230/207—Blood composition characteristics hematocrit
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Description
なお、本発明者らが行なった臨床実験により、上記の細胞外液量算出装置10で採用している細胞外液量算出方法により算出された透析後の標準化細胞外液量を用いれば、患者の細胞外液量が適正であるか否かを評価することが可能であることが確認されている。
また、本発明者らが行なった実験では、細胞内液量を算出することによって、透析患者の筋肉量を評価可能であることが確認されている。上述したように、細胞内液量は、筋肉量の増減を反映して増減する。そこで、透析患者の体重が変化していない場合であっても、細胞内液量が減少している場合には、透析患者の筋肉量が減少していると推定することができる。すなわち、細胞内液量を算出することによって、透析患者がサルコペニア(葛谷雅文:超高齢社会におけるサルコペニアとフレイル. 日内会誌 104: 2602-2607, 2015)であることを早期に発見することができる。
Claims (6)
- 透析前の血漿尿酸濃度と、透析後の血漿尿酸濃度と、透析による尿酸除去量と、透析による除水量と、を取得可能に構成される第一の取得部と、
該第一の取得部で取得した該透析前の血漿尿酸濃度と該透析後の血漿尿酸濃度と該尿酸除去量と該除水量とに基づいて特定される、尿酸の透析前後の収支に基づいて、細胞外液量を算出する第一の演算部と、を備える、細胞外液量算出装置。 - ダイアライザの尿酸総括物質移動-面積係数と、ダイアライザの血液流通速度と、ダイアライザの透析液流通速度と、ヘマトクリット値と、を取得可能に構成される第二の取得部と、
該第二の取得部で取得した該尿酸総括物質移動-面積係数と、該血液流通速度と、該透析液流通速度と、該ヘマトクリット値に基づいて、尿酸クリアランスを算出する第二の演算部と、
前記第二の演算部により算出された前記尿酸クリアランスと、前記第一の取得部で取得した前記透析前の血漿尿酸濃度と前記透析後の血漿尿酸濃度に基づいて、前記尿酸除去量を算出する第三の演算部と、を備える、請求項1に記載の細胞外液量算出装置。 - 透析前の血漿尿素濃度と、透析後の血漿尿素濃度と、透析による尿素除去量と、を取得可能に構成される第三の取得部と、
該第三の取得部で取得した該透析前の血漿尿素濃度と、該透析後の血漿尿素濃度と、該尿素除去量と、前記第一の取得部で取得した前記透析による除水量とに基づいて、体内総体液量を算出する第四の演算部と、を備える、請求項1又は2に記載の細胞外液量算出装置。 - 前記第四の演算部において算出された体内総体液量から、前記第一の演算部において算出された細胞外液量を差し引いて、細胞内液量を算出する第五の演算部と、を備える、請求項3に記載の細胞外液量算出装置。
- 前記第五の演算部により算出された細胞内液量を用いて細胞外液量を補正する第六の演算部と、を備える、請求項4に記載の細胞外液量算出装置。
- 細胞膜を通過不能であると共に毛細血管膜を通過可能な物質の透析前の血漿中の濃度である透析前物質濃度と、前記物質の透析後の血漿中の濃度である透析後物質濃度と、透析によって除去された前記物質の量である物質除去量と、透析による除水量と、を取得可能に構成される第一の取得部と、
該第一の取得部で取得した該透析前物質濃度と該透析後物質濃度と該物質除去量と該除水量とに基づいて特定される、前記物質の透析前後の収支に基づいて、細胞外液量を算出する第一の演算部と、を備える、細胞外液量算出装置。
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US (1) | US20200345916A1 (ja) |
EP (1) | EP3738624B1 (ja) |
JP (1) | JP7276155B2 (ja) |
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US20210187178A1 (en) * | 2018-08-23 | 2021-06-24 | Nipro Corporation | Extracellular fluid volume calculator and method for calculating extracellular fluid volume |
WO2022172926A1 (ja) * | 2021-02-12 | 2022-08-18 | ニプロ株式会社 | 筋肉量算出装置及び筋肉量算出方法 |
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JPS57183855A (en) * | 1981-05-01 | 1982-11-12 | Asahi Medical Co | Apparatus for measuring body liquid amount of inside and outside of cell and osmotic pressure in blood |
SE513034C2 (sv) * | 1997-06-02 | 2000-06-19 | Gambro Lundia Ab | Metod och anordning för beräkning av dialyseffektivitet |
US6615077B1 (en) * | 2000-08-14 | 2003-09-02 | Renal Research Institute, Llc | Device and method for monitoring and controlling physiologic parameters of a dialysis patient using segmental bioimpedence |
DE60000544T2 (de) * | 2000-11-06 | 2003-02-27 | Fresenius Medical Care De Gmbh | Verfahren und Gerät zur Bestimmung des Trockengewichts eines Patienten mit Nierenversagen |
JP4123230B2 (ja) * | 2002-07-12 | 2008-07-23 | セイコーエプソン株式会社 | 血液中水分量検出装置及び血液透析時期判定装置 |
JP4726045B2 (ja) * | 2005-04-08 | 2011-07-20 | 日機装株式会社 | 血液透析装置 |
JP4822258B2 (ja) * | 2005-11-11 | 2011-11-24 | 日機装株式会社 | 血液透析装置 |
JP2008264217A (ja) * | 2007-04-20 | 2008-11-06 | Sekisui Chem Co Ltd | 血液透析評価方法及び血液透析評価装置 |
WO2010127136A2 (en) * | 2009-04-30 | 2010-11-04 | Pharmacophotonics, Inc. | Measurement of body fluid volumes |
EP2514449A4 (en) * | 2009-12-17 | 2015-06-24 | Nipro Corp | hemodialyzer |
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WO2012051261A2 (en) * | 2010-10-15 | 2012-04-19 | Fresenius Medical Care Holdings, Inc. | Dry weight predictor |
US9061099B2 (en) * | 2011-04-29 | 2015-06-23 | Medtronic, Inc. | Cardiovascular monitoring for fluid removal processes |
JP5815981B2 (ja) * | 2011-05-10 | 2015-11-17 | ニプロ株式会社 | 透析装置 |
WO2013040082A2 (en) * | 2011-09-12 | 2013-03-21 | Medtronic, Inc. | Polystyrene sulfonate resin for use with a hemodialysis system having a controlled compliance dialysis circuit |
CN103998072B (zh) * | 2011-09-19 | 2018-02-06 | 弗雷森纽斯医疗护理控股有限公司 | 透析患者的干重量估计 |
CN102697522B (zh) * | 2012-06-01 | 2013-11-20 | 贝恩医疗设备(广州)有限公司 | 一种在线相对血容量检测装置及其检测方法 |
JP5641459B1 (ja) * | 2013-09-10 | 2014-12-17 | 学校法人加計学園 | 透析排液から患者の体液内の初期溶質量を決定する装置 |
DE102014104768A1 (de) * | 2014-04-03 | 2015-10-29 | B. Braun Avitum Ag | Vorrichtung und Verfahren zum Bestimmen eines Verteilungsvolumens bei einem Dialysepatienten |
CN204654896U (zh) * | 2015-05-21 | 2015-09-23 | 中国人民解放军第三军医大学第三附属医院 | 一种血容量变化比率计算尺 |
EP3302605B1 (en) * | 2015-05-25 | 2019-12-25 | Gambro Lundia AB | Apparatus for extracorporeal blood treatment i |
US10434236B2 (en) * | 2015-05-25 | 2019-10-08 | Gambro Lundia Ab | Extracorporeal blood treatment apparatus having dialysis fluid parameter data entry |
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