JPH03215270A - Blood treatment apparatus - Google Patents

Abstract

PURPOSE:To achieve the security of safety and the enhancement of operability by certainly taking the balance of the amount of a replenishing fluid and a fluid discharge amount by measuring the total wt. of a replenishing fluid container and a fluid discharge container and comparing the same with the total wt. thereof at the start time of blood treatment to forwardly and reversely rotate a correction pump. CONSTITUTION:The blood taken out of a patient by a blood pump 15 is circulated to a blood dilayser 2 and a human body. In the blood dialyser 2, a dialysing fluid is supplied to the blood dialyser from a dialysing fluid supply apparatus through a dialysing fluid introducing flow path 3 and the waste dialysing fluid is discharged from a dialysing fluid lead-out flow path 4 and a part thereof is discharged to a discharge container 6 from a discharge flow path 7. A replenishing fluid is injected in a blood external circulation flow path 1 from a replenishing fluid container 8 through a replenishing fluid flow path 10 in the amount equal to that of the fluid discharged to the fluid discharge container 6. The total wt. of the replenishing fluid container 8 and the fluid discharge container 6 is measured by a wt. measuring means 13 and, on the basis of the signal of the wt. measuring means 13, a rotation control circuit 14 compares the wt. measured value at the start time of blood treatment with the measured value to forwardly and reversely rotate a correction pump 12 and the pump 12 is stopped when the measured value becomes equal to an initial value. Therefore, the amount of the replenishing fluid and a fluid discharge amount can always be made well- balanced.

Description

Detailed Description of the Invention (Industrial Field of Application) The present invention relates to a blood processing device that performs large-volume fluid replacement, and particularly to a blood processing device that can perform blood flow dialysis (HDF), continuous blood furnace filtration (CHF), etc. It relates to a processing device.

(Prior art) Hemodialysis has traditionally been applied to remove toxic substances present in the blood of patients suffering from kidney failure, liver failure, etc. However, some patients may not be treated adequately with hemodialysis. There is. In recent years, dialysis and furnace filtration have been combined for such patients, and the separated furnace fluid (a part of the dialysis waste fluid) is discarded and replacement fluids such as artificial body fluids are mixed with the blood. Substance-containing body fluids, such as large amounts of water containing medium-molecular-weight substances, or plasma containing waste products, are continuously separated in a furnace, and the separated liquid is discarded to produce fresh, healthy plasma components or artificially produced plasma components. A continuous blood perfusion method is used in which a replacement fluid such as an artificial body fluid is mixed with blood again.

In such treatment methods, it is absolutely necessary to maintain a balance between the fluid (or part of the dialysate) that is discarded and the replacement fluid that is mixed with the blood in order to prevent side effects such as hypotensive shock. For this reason, a method is usually adopted in which two pumps, a drainage pump and a replacement fluid pump, are used to set the flow rates of both pumps to be the same, or a method is adopted in which a double tubing pump is used to set the drainage fluid flow rate and the replacement fluid flow rate to the same value.

(Problem to be solved by the invention) However, when the amount of fluid replacement (drained fluid amount) is large, especially when it reaches 2012 as seen in recent treatment cases, blood processing takes a long time and the conventional two pumps or In the method using a double tubing pump, pressure fluctuations before and after the pump cause upstream flow l changes, making it extremely difficult to maintain a balance between the amount of replacement fluid and the amount of drained fluid.

Therefore, an object of the present invention is to provide a blood processing apparatus that can reliably maintain the balance between the amount of fluid replacement and the amount of drained fluid even during long-term blood processing.

(Means for Solving the Problems) The present invention provides a hemodialyzer or a blood filter provided in an extracorporeal blood circulation flow path, and a dialysate outlet flow path or a blood filter provided in the hemodialyzer. A liquid outlet channel provided in the
The dialysate lead-out flow path is connected to the fluid lead-out flow path via a drainage bomb, and a drainage flow path that discharges a portion of the dialysate or dialysis fluid from the flow path into a drainage container; , a fluid replacement flow path that is connected to the extracorporeal blood circulation flow path via a fluid replacement pump and injects the replacement fluid in the fluid replacement container into the flow path; a flow path that bypasses the fluid replacement bomb or the drainage pump; and the bypass flow. a correction pump that is provided in a path and can be rotated in forward and reverse directions; a weight measuring means for measuring the total weight of the liquid container and the replacement liquid container; and a measured value of the total weight of the two containers measured by the weight measuring means; This blood processing apparatus is equipped with a rotation control circuit that rotates the correction pump in the forward and reverse directions while comparing the initial measured value measured at the start of blood processing until the deviation value between the two becomes zero.

(Example) Next, an example of the blood processing apparatus of the present invention will be described with reference to the drawings. FIG. 1 is an example of a device in which blood is applied to hyperdialysis method, in which a dialysate inlet of a hemodialyzer 2 provided in an extracorporeal blood circulation flow path 1 and a dialysate introduction flow path 3 connected to an outlet are shown in FIG. a dialysate outlet channel 4; a drain channel 7 connected to the dialysate outlet channel 4 to discharge a portion of the dialysate into a drain container 6 by a drain pump 5; and a blood extracorporeal circulation channel 1. is connected to the replenishing fluid container 8.
A fluid replacement channel 10 for injecting the fluid contained in the tank into the extracorporeal blood circulation channel 1 by a fluid replacement pump 9, a correction pump 12 which is provided in a channel 11 that bypasses the fluid replacement bomb 9 and is reversible in the forward and reverse directions, and a drainage container 6. It is comprised of a weight measuring means 13 that measures the total weight of the replacement fluid container 8, and a rotation control circuit 14 that rotates the collection bomb forward and backward to balance the amount of drained fluid and the amount of replacement fluid.

The extracorporeal blood circulation channel 1 is a channel for taking blood from a patient and returning purified blood to the patient.The blood is taken out by a blood pump 15. Further, a fluid replacement flow path 10 is connected between the blood pump 15 and the hemodialyzer 2 in the flow path.

The hemodialyzer 2 houses hollow fibers or notebook-like membranes of cuproammonium cellulose, polyacrylonitrile, polyvinyl alcohol, etc. in the housing, and uses the membrane to separate the inside of the housing into a blood side and a dialysate side. It is variously called a type artificial kidney or a Kiel type artificial kidney.

The dialysate introduction flow path 3 is a flow path that connects the dialysate inlet of the hemodialyzer and a dialysate supply device (not shown), and a flow meter, a heater, etc. are attached to this flow path.

The dialysate outlet flow path 4 is connected to a dialysate outlet of the hemodialyzer and is a flow path for discharging dialysis fluid. A negative pressure pump 16 is attached to this channel for introducing dialysate into the hemodialyzer.

Further, a drainage channel 7 is connected to the upstream side of the negative pressure bomb in the dialysate outlet channel 4 .

A replacement fluid bomb 9 provided in the replacement fluid flow path 10 and a drain fluid flow path 7
The drain pumps 5 provided in the drain pumps 5 may be independent mouth-to-lab bombs or may be double tubing type bombs. A double tubing type pump is usually used.

The correction pump 12, which is provided in the flow path 1l that bypasses the replacement fluid bomb 9 and is rotatable in forward and reverse directions, normally has a flow rate of 2 times the flow rate of the replacement fluid bomb.
It has a flow rate of 0% or less, and the rotation control circuit 1 described later
It receives the signal from 4 and rotates forward and backward to maintain the balance between the amount of replacement fluid and the amount of drained fluid.

The weight measuring means 13 measures the total weight of the drain fluid container 6 and the replacement fluid container 8, and is a known measuring means, usually a load cell.

The rotation control circuit 14 receives the information from the weight measuring means 13,
When the initial value <measured value, a signal to rotate the correction pump in the forward direction is sent to the drive circuit 22 to drive the correction pump and increase the amount of replacement fluid injected. On the other hand, when the initial value>measured value, a signal to reversely rotate the correction pump is sent to the drive circuit 22,
Drive the correction pump to reduce the amount of replacement fluid injected. The correction pump is driven until the deviation value between the measured value and the initial value becomes zero, and when the deviation value between both becomes zero, a signal to stop the correction pump is sent to the drive circuit 22 to stop the correction pump.

Next, the operation of the above configuration will be explained. blood pump 15
Once the blood is removed from the patient within the range of 100-200+a&/min by the rotation of the dialyzer 2, the blood is circulated to the hemodialyzer 2 and the human body. In the above hemodialyzer, the dialysate supply device (
A dialysate is supplied to the hemodialyzer 2 from a dialysate (not shown) through a dialysate introduction channel 3, and a dialysis fluid containing unnecessary substances and water that has passed through the membrane is discharged from a dialysate outlet channel 4. A portion of the dialysis fluid is discharged into the drainage container 6 from the drainage channel 7 provided in the dialysate outlet channel 4 . On the other hand, blood extracorporeal circulation flow path 1
A replacement fluid is injected from the replacement fluid container 8 in an amount equal to the drainage fluid discharged into the drainage fluid container through the liquid flow path.

The total weight of the replacement fluid container 8 and the drain fluid container 6 is always measured by the weight measuring means 13, and its signal is sent to the rotation control circuit 14. In the rotation control circuit 14, the weight measurement value at the start of blood processing is compared with the measured value, and when the initial value is less than the measured value, the correction bomb 12 is rotated forward to increase the amount of fluid replacement, and when the initial value is greater than the measured value, the correction bomb 12 is rotated forward. The compensation pump rotates in the opposite direction, reducing the amount of replacement fluid. When the measured value becomes equal to the initial value, the correction pump stops rotating. Therefore, the amount of fluid to be replaced and the amount of drained fluid can always be balanced.

Incidentally, the amount of drained fluid and the amount of replacement fluid are set to be the same, but in reality, there are problems such as eccentricity of the shafts of the drainage pump 5 and replacement fluid pump 9, dimensional errors in the tube diameters, and furthermore, the pump 5.
9, there are differences in suction and discharge pressures, etc., and the effective volume of the tube internal volume changes, which inevitably causes a flow rate error.

When the above-mentioned flow rate error occurs, the amount of circulating blood in the patient changes, which increases the burden on the patient's circulatory system, resulting in a very alarming situation.

However, in the above configuration, the amount of fluid to be drained and the amount of fluid to be replaced are adjusted by rotating the correction pump in forward and reverse directions so that the total weight of the fluid replacement container and the drainage fluid container is always equal to the total weight at the start of blood treatment. It is possible to significantly reduce the error in the amount, thus further promoting the above-mentioned safety.

In the above embodiment, the explanation was given using a case where hemodialysis is performed, but for example, as shown in FIG.
Even in the case where a filter 30 is provided and blood is continuously supplied, the above is provided in the liquid flow path 31, but by connecting the drain flow path 7 upstream of the pump 32, the amount of liquid and replacement fluid can be increased. It is possible to maintain a balance in quantity, and the same parts will be given the same numbers and their explanation will be omitted.

Further, in the above description, an example has been described in which the bypass flow path is provided on the replacement fluid bomb side, but the bypass flow path may be provided on the drainage pump side. In that case, the forward and reverse operations of the correction bomb are reversed.

(Effects of the Invention) As described above, the present invention measures the total weight of the fluid replacement container and the drain fluid container, compares it with the total weight at the start of blood processing, and rotates the correction pump in the forward and reverse directions. It is possible to provide a blood processing device that can reliably balance the volume and drainage volume, contribute to ensuring safety, and has excellent operability.

[Brief explanation of drawings]

FIG. 1 is a block diagram showing an example of a blood processing apparatus according to the present invention, and FIG. 2 is a block diagram showing another embodiment. Blood extracorporeal circulation flow path Hemodialyzer Dialysate outlet flow path Drain pump Drain container Drain flow path Fluid replacement container Fluid replacement pump Fluid replacement flow path Bypass flow path Correction pump Weight measuring means Rotation control circuit

Claims (1)

[Claims] A hemodialyzer or a hemofilter provided in an extracorporeal blood circulation channel, a dialysate outlet channel provided in the hemodialyzer or a filtrate outlet channel provided in the hemofilter, and a dialysate outlet A drainage channel that is connected to the channel or the filtrate outlet channel via a drainage pump and discharges a portion of the dialysate or filtrate from the channel into the drainage container, and the blood extracorporeal circulation channel. A replacement fluid flow path that is connected to the fluid replacement pump via a replacement fluid pump and injects the replacement fluid in the replacement fluid container into the flow path, a flow path that bypasses the replacement fluid pump or the drainage pump, and a forward and reverse rotation provided in the bypass flow path. a possible compensation pump, a weight measuring means for measuring the total weight of the filtrate container and the replacement fluid container, a measured value of the total weight of the two containers measured by the weight measuring means and an initial value measured at the start of the blood treatment. A blood processing device comprising a rotation control circuit that rotates a correction pump in the forward and reverse directions while comparing the measured values with each other until the deviation value between the two becomes zero.