JP7372335B2 - 注入カニューレ、ecmoシステム - Google Patents
注入カニューレ、ecmoシステム Download PDFInfo
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- JP7372335B2 JP7372335B2 JP2021543424A JP2021543424A JP7372335B2 JP 7372335 B2 JP7372335 B2 JP 7372335B2 JP 2021543424 A JP2021543424 A JP 2021543424A JP 2021543424 A JP2021543424 A JP 2021543424A JP 7372335 B2 JP7372335 B2 JP 7372335B2
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- cannula
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- 238000001802 infusion Methods 0.000 title claims description 77
- 238000002618 extracorporeal membrane oxygenation Methods 0.000 title description 27
- 230000010410 reperfusion Effects 0.000 claims description 74
- 239000012530 fluid Substances 0.000 claims description 36
- MYMOFIZGZYHOMD-UHFFFAOYSA-N Dioxygen Chemical compound O=O MYMOFIZGZYHOMD-UHFFFAOYSA-N 0.000 claims description 14
- 241001465754 Metazoa Species 0.000 claims description 9
- 239000011248 coating agent Substances 0.000 claims description 8
- 238000000576 coating method Methods 0.000 claims description 8
- 239000003146 anticoagulant agent Substances 0.000 claims description 7
- QVGXLLKOCUKJST-UHFFFAOYSA-N atomic oxygen Chemical compound [O] QVGXLLKOCUKJST-UHFFFAOYSA-N 0.000 claims description 6
- 229910052760 oxygen Inorganic materials 0.000 claims description 6
- 239000001301 oxygen Substances 0.000 claims description 6
- 238000005086 pumping Methods 0.000 claims description 5
- 230000001028 anti-proliverative effect Effects 0.000 claims description 3
- 230000002785 anti-thrombosis Effects 0.000 claims description 3
- 229910001000 nickel titanium Inorganic materials 0.000 claims description 3
- 230000001706 oxygenating effect Effects 0.000 claims description 3
- 239000012781 shape memory material Substances 0.000 claims description 3
- 238000007599 discharging Methods 0.000 claims description 2
- 238000002601 radiography Methods 0.000 claims 1
- 238000002604 ultrasonography Methods 0.000 claims 1
- 210000001367 artery Anatomy 0.000 description 58
- 230000017531 blood circulation Effects 0.000 description 32
- 239000008280 blood Substances 0.000 description 25
- 210000004369 blood Anatomy 0.000 description 25
- CURLTUGMZLYLDI-UHFFFAOYSA-N Carbon dioxide Chemical compound O=C=O CURLTUGMZLYLDI-UHFFFAOYSA-N 0.000 description 14
- 229920000306 polymethylpentene Polymers 0.000 description 12
- 239000011116 polymethylpentene Substances 0.000 description 12
- 238000002347 injection Methods 0.000 description 10
- 239000007924 injection Substances 0.000 description 10
- 238000011144 upstream manufacturing Methods 0.000 description 10
- 241001631457 Cannula Species 0.000 description 7
- 229910002092 carbon dioxide Inorganic materials 0.000 description 7
- 239000001569 carbon dioxide Substances 0.000 description 7
- 239000012528 membrane Substances 0.000 description 7
- 210000000056 organ Anatomy 0.000 description 6
- 208000007536 Thrombosis Diseases 0.000 description 5
- 238000000034 method Methods 0.000 description 5
- 230000002093 peripheral effect Effects 0.000 description 4
- 210000003462 vein Anatomy 0.000 description 4
- 230000002950 deficient Effects 0.000 description 3
- 230000006870 function Effects 0.000 description 3
- 238000003780 insertion Methods 0.000 description 3
- 230000037431 insertion Effects 0.000 description 3
- 230000000702 anti-platelet effect Effects 0.000 description 2
- 229940127219 anticoagulant drug Drugs 0.000 description 2
- 210000004204 blood vessel Anatomy 0.000 description 2
- 238000004891 communication Methods 0.000 description 2
- 238000006114 decarboxylation reaction Methods 0.000 description 2
- 201000002818 limb ischemia Diseases 0.000 description 2
- 210000001365 lymphatic vessel Anatomy 0.000 description 2
- 239000000463 material Substances 0.000 description 2
- 238000006213 oxygenation reaction Methods 0.000 description 2
- 239000000243 solution Substances 0.000 description 2
- 208000010110 spontaneous platelet aggregation Diseases 0.000 description 2
- 239000010409 thin film Substances 0.000 description 2
- 238000009564 veno-arterial ECMO Methods 0.000 description 2
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 2
- 208000031104 Arterial Occlusive disease Diseases 0.000 description 1
- 206010053567 Coagulopathies Diseases 0.000 description 1
- 208000005189 Embolism Diseases 0.000 description 1
- 208000004248 Familial Primary Pulmonary Hypertension Diseases 0.000 description 1
- 206010018910 Haemolysis Diseases 0.000 description 1
- 208000010496 Heart Arrest Diseases 0.000 description 1
- HTTJABKRGRZYRN-UHFFFAOYSA-N Heparin Chemical compound OC1C(NC(=O)C)C(O)OC(COS(O)(=O)=O)C1OC1C(OS(O)(=O)=O)C(O)C(OC2C(C(OS(O)(=O)=O)C(OC3C(C(O)C(O)C(O3)C(O)=O)OS(O)(=O)=O)C(CO)O2)NS(O)(=O)=O)C(C(O)=O)O1 HTTJABKRGRZYRN-UHFFFAOYSA-N 0.000 description 1
- 206010064911 Pulmonary arterial hypertension Diseases 0.000 description 1
- 230000002776 aggregation Effects 0.000 description 1
- 238000004220 aggregation Methods 0.000 description 1
- 208000021328 arterial occlusion Diseases 0.000 description 1
- 210000004191 axillary artery Anatomy 0.000 description 1
- 230000015572 biosynthetic process Effects 0.000 description 1
- 230000000747 cardiac effect Effects 0.000 description 1
- 230000035602 clotting Effects 0.000 description 1
- 230000000295 complement effect Effects 0.000 description 1
- 238000012937 correction Methods 0.000 description 1
- 230000000911 decarboxylating effect Effects 0.000 description 1
- 229910003460 diamond Inorganic materials 0.000 description 1
- 239000010432 diamond Substances 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 238000002224 dissection Methods 0.000 description 1
- 230000002526 effect on cardiovascular system Effects 0.000 description 1
- 210000001105 femoral artery Anatomy 0.000 description 1
- 239000000835 fiber Substances 0.000 description 1
- 239000007789 gas Substances 0.000 description 1
- 230000000004 hemodynamic effect Effects 0.000 description 1
- 230000008588 hemolysis Effects 0.000 description 1
- 229960002897 heparin Drugs 0.000 description 1
- 229920000669 heparin Polymers 0.000 description 1
- 239000012510 hollow fiber Substances 0.000 description 1
- 210000004072 lung Anatomy 0.000 description 1
- 230000001926 lymphatic effect Effects 0.000 description 1
- 230000010412 perfusion Effects 0.000 description 1
- 230000002572 peristaltic effect Effects 0.000 description 1
- 230000035479 physiological effects, processes and functions Effects 0.000 description 1
- 229920001296 polysiloxane Polymers 0.000 description 1
- 229920002635 polyurethane Polymers 0.000 description 1
- 239000004814 polyurethane Substances 0.000 description 1
- 201000008312 primary pulmonary hypertension Diseases 0.000 description 1
- 210000001147 pulmonary artery Anatomy 0.000 description 1
- 230000002685 pulmonary effect Effects 0.000 description 1
- 230000001105 regulatory effect Effects 0.000 description 1
- 230000000241 respiratory effect Effects 0.000 description 1
- 230000000717 retained effect Effects 0.000 description 1
- 208000037812 secondary pulmonary hypertension Diseases 0.000 description 1
- 230000035939 shock Effects 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 210000000115 thoracic cavity Anatomy 0.000 description 1
- 230000002792 vascular Effects 0.000 description 1
Images
Classifications
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- 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
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- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
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- A61L33/00—Antithrombogenic treatment of surgical articles, e.g. sutures, catheters, prostheses, or of articles for the manipulation or conditioning of blood; Materials for such treatment
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- 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
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- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
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- A61M25/00—Catheters; Hollow probes
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- A61M25/00—Catheters; Hollow probes
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- A61M25/00—Catheters; Hollow probes
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- A61L2300/00—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
- A61L2300/40—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices characterised by a specific therapeutic activity or mode of action
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- A61M25/00—Catheters; Hollow probes
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- A61M2025/0031—Multi-lumen catheters with stationary elements characterized by features relating to least one lumen located at the distal part of the catheter, e.g. filters, plugs or valves characterized by lumina for withdrawing or delivering, i.e. used for extracorporeal circuit treatment
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- A61M25/00—Catheters; Hollow probes
- A61M25/0043—Catheters; Hollow probes characterised by structural features
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- A61M2205/00—General characteristics of the apparatus
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- 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
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- A—HUMAN NECESSITIES
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- 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
- A61M25/00—Catheters; Hollow probes
- A61M25/0021—Catheters; Hollow probes characterised by the form of the tubing
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- A61M25/0029—Multi-lumen catheters with stationary elements characterized by features relating to least one lumen located at the middle part of the catheter, e.g. slots, flaps, valves, cuffs, apertures, notches, grooves or rapid exchange ports
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- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
- A61M25/0108—Steering means as part of the catheter or advancing means; Markers for positioning using radio-opaque or ultrasound markers
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Engineering & Computer Science (AREA)
- Hematology (AREA)
- Anesthesiology (AREA)
- Biomedical Technology (AREA)
- Vascular Medicine (AREA)
- Biophysics (AREA)
- Pulmonology (AREA)
- Emergency Medicine (AREA)
- Urology & Nephrology (AREA)
- Cardiology (AREA)
- Epidemiology (AREA)
- Chemical & Material Sciences (AREA)
- Materials Engineering (AREA)
- Surgery (AREA)
- Infusion, Injection, And Reservoir Apparatuses (AREA)
- External Artificial Organs (AREA)
Description
- 動脈の後方壁または前方壁を圧迫するおそれがあり、それは、有効な再灌流を妨げ、壁に対して注入された血流の力により動脈の壁を損傷させるおそれがある(動脈解離、血栓症、遠位の塞栓症)、
- 動脈の外側に配置されて効果がない、または皮下に大きな血種を作るおそれもある。
- 流体が第1の方向に流れるように、カニューレの第1の空間を画定する主管腔と、
- カニューレの第2の空間を画定する付属の再灌流管腔であって、
○第1の方向に流れる流体の一部を収集するための入口、
○付属の再灌流管腔により収集された流体の流れ方向を変えるための角度付き部分、および
○収集された流体を第2の方向に、空洞部内へと放出するための出口、
を備える、付属の再灌流管腔と、
を備える。
- 付属の再灌流管腔の出口と、補助管腔の出口の間の所定の距離は、0.1mmから500mmの間にある、
- 移動手段は、カニューレ内に設けられた長手方向溝部内を移動できる押しボタンを備え、長手方向溝部内の押しボタンを移動させることは、停止部を、前記停止部に接続された接続要素を介して補助管腔に沿って移動させる、
- 配置された停止部は、カニューレが空洞部の内側にあるとき、引き抜かれないように設計された形状および寸法を有する、
- 停止部は、形状記憶材料から作られる、
- 停止部は、ニッケル-チタン合金ワイヤから作られる、
- 配置された停止部は、ダイヤモンド形状をしている、
- 停止部は、抗血栓性の、かつ/または抗増殖性のコーティングを有する、
- 停止部および/または補助管腔の出口は、前記停止部および/または補助管腔の出口が放射線写真法または超音波検査法により識別され得るように設計された放射線不透過性の、または超音波不透過性のマーキングを有する、また
- ブリード弁が、付属の再灌流管腔に接続される。
- 所定の流体を受け入れるための取込みカニューレと、
- 取込みカニューレから来る所定の流体を圧送するためのポンプと、
- ポンプの出口から来る所定の流体を酸素化するための酸素供給器と、
- 酸素化された流体を空洞部の中に注入するための、本発明の第1の態様による注入カニューレと、
を備える。
2 取込みカニューレ
3 注入カニューレ1の入口
3´ 注入カニューレ1の出口
4 静脈
5 動脈
6 長手方向溝部
10 主管腔の入口
10´ 主管腔の出口
20 再灌流管腔LAの入口
20´ 再灌流管腔LAの出口
21 角度付き部分
23 側方開口部
24 ブリード弁
30 補助管腔LXの入口
30´ 補助管腔LXの出口
41 停止部
42 押しボタン
43 接続要素、接続手段
241 ブリード弁の出口
431 接続手段の一端
d 距離
ECH 熱交換器
F0 二酸化炭素の多い血液
F1 脱炭酸された血液
LA 付属の再灌流管腔
LA1 LAの部分
LA2 LAの部分
LP 主管腔
LX 補助管腔
OXY 酸素供給器
PMP ポンプ
S 生理学的方向
T1 管
T2 管
T3 管
T4 管
Claims (11)
- 人または動物の体の空洞部(5)内に流体(F1)を注入するためのカニューレ(1)であって、
前記流体(F1)が第1の方向に流れるように、前記カニューレ(1)の第1の空間を画定する主管腔(LP)と、
前記カニューレ(1)の第2の空間を画定する付属の再灌流管腔(LA)であって、
前記第1の方向に流れる前記流体(F1)の一部を収集するための入口(20)、
前記付属の再灌流管腔(LA)により収集された前記流体(F1)の流れ方向を変えるための角度付き部分(21)、および
前記収集された流体(F1)を第2の方向に、前記空洞部(5)内へと放出するための出口(20´)、
を備える、付属の再灌流管腔(LA)と、
を備え、
前記カニューレ(1)は、前記カニューレ(1)を前記空洞部(5)内に位置決めするためのデバイスを備え、前記位置決めデバイスは、停止部(41)と、前記停止部(41)を補助管腔(LX)に沿って移動するように構成された移動手段と、を備え、前記補助管腔(LX)は、前記カニューレ(1)の第3の空間を画定し、かつ前記空洞部(5)内に開口する出口(30´)を備え、
前記移動手段は、前記カニューレ(1)が前記空洞部(5)内の適切な位置に確実にロックされるように、前記補助管腔(LX)の前記出口(30´)を介して、前記停止部(41)を前記空洞部(5)内に配置できるようにし、
前記補助管腔(LX)の前記出口(30´)は、前記付属の再灌流管腔(LA)の前記出口(20´)から所定の距離(d)に配置され、したがって、前記停止部(41)が前記カニューレ(1)を、前記空洞部(5)内の適切な位置にロックしたとき、前記付属の再灌流管腔(LA)の前記出口(20´)は、前記収集された流体(F1)が前記第2の方向に放出されるように、前記空洞部(5)内で方向付けられる、
ことを特徴とするカニューレ(1)。 - 前記補助管腔(LX)の前記出口(30´)と前記付属の再灌流管腔(LA)の前記出口(20´)との間の前記所定の距離(d)は、0.1mmから500mmの間である、ことを特徴とする請求項1に記載の注入カニューレ(1)。
- 前記移動手段は、前記カニューレ(1)に設けられた長手方向溝部(6)内を移動できる押しボタン(42)を備え、前記長手方向溝部(6)において前記押しボタン(42)を移動させることにより、前記停止部(41)を、前記停止部(41)に接続された接続要素(43)を介して、前記補助管腔(LX)に沿って移動させる、ことを特徴とする請求項1または2に記載のカニューレ(1)。
- 配置された前記停止部(41)は、前記カニューレが前記空洞部(5)の内側に挿入されたとき、前記カニューレ(1)が引き抜かれることを防止するように設計された形状および寸法を有する、ことを特徴とする請求項1から3のいずれか一項に記載の注入カニューレ(1)。
- 前記停止部(41)は、形状記憶材料から作られる、ことを特徴とする請求項1から4のいずれか一項に記載の注入カニューレ(1)。
- 前記停止部(41)は、ニッケル-チタン合金ワイヤから作られる、ことを特徴とする請求項1から5のいずれか一項に記載の注入カニューレ(1)。
- 配置された前記停止部(41)は、ダイヤモンド形状をしている、ことを特徴とする請求項1から6のいずれか一項に記載の注入カニューレ(1)。
- 前記停止部(41)は、抗血栓性および/または抗増殖性のコーティングを有する、ことを特徴とする請求項1から7のいずれか一項に記載の注入カニューレ(1)。
- 前記停止部(41)および/または前記補助管腔(LX)の前記出口(30´)は、前記停止部(41)および/または前記補助管腔(LX)の前記出口(30´)が、放射線写真法または超音波検査法により識別可能なように設計された放射線不透過性の、または超音波不透過性のマーキングを有する、ことを特徴とする請求項1から8のいずれか一項に記載の注入カニューレ(1)。
- 前記付属の再灌流管腔(LA)に接続されたブリード弁(24)を備える、ことを特徴とする請求項1から9のいずれか一項に記載の注入カニューレ(1)。
- 人または動物の体の空洞部(5)内に流体(F1)を注入するためのシステムであって、
所定の流体(F0)を受け入れるための取込みカニューレ(2)と、
前記取込みカニューレ(2)から来る前記所定の流体(F0)を圧送するためのポンプ(PMP)と、
前記ポンプ(PMP)の出口から来る前記所定の流体(F0)を酸素化するための酸素供給器(OXY)と、
酸素化された前記流体(F1)を前記空洞部(5)内に注入するための、請求項1から10のいずれか一項に記載の注入カニューレ(1)と、
を備える、ことを特徴とするシステム。
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FR1900752 | 2019-01-28 | ||
FR1900752A FR3092000B1 (fr) | 2019-01-28 | 2019-01-28 | Canule d’injection, système d’injection d’un fluide |
PCT/EP2020/051350 WO2020156874A1 (fr) | 2019-01-28 | 2020-01-21 | Canule d'injection, système ecmo |
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SG11202107511VA (en) | 2021-08-30 |
US20220062523A1 (en) | 2022-03-03 |
BR112021014770A2 (pt) | 2021-10-05 |
FR3092000A1 (fr) | 2020-07-31 |
CA3126210A1 (fr) | 2020-08-06 |
ES2949645T3 (es) | 2023-10-02 |
CN113631213A (zh) | 2021-11-09 |
ZA202104955B (en) | 2022-05-25 |
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WO2020156874A1 (fr) | 2020-08-06 |
KR20210121139A (ko) | 2021-10-07 |
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