JPH0380028B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION Field of the Invention The present invention relates to automatic peritoneal perfusion devices. In particular, the present invention relates to devices for performing continuous cycling peritoneal dialysis (CCPD) and intermittent peritoneal dialysis (IPD). The device of the invention can also be used to perform peritoneal perfusion during patient conditioning to perform continuous ambulatory peritoneal dialysis (CAPD);
It can also be used to cleanse the peritoneal cavity with antibiotic-containing irrigation fluid to treat patients who develop peritonitis during CAPD treatment.

BACKGROUND OF THE INVENTION The currently most widely used therapy for end-stage renal failure is hemodialysis using an artificial kidney. In hemodialysis, a patient's blood is purified by passing it through an artificial kidney. Peritoneal dialysis is one type of dialysis therapy, although it has not yet become as widespread as hemodialysis. In peritoneal dialysis, dialysate (also called perfusate) is injected into the patient's peritoneal cavity, and metabolites diffuse from the patient's blood through the peritoneum into the dialysate and are removed along with the dialysate. Water is also removed due to the osmotic effect of the dialysate.

Among the techniques of peritoneal dialysis, standard intermittent peritoneal dialysis (IPD) and continuous cycling peritoneal dialysis (CCPD) are relevant to the present invention.

Medical treatment for patients starting peritoneal dialysis is
an injection phase in which a catheter is surgically implanted into the abdominal cavity and dialysate is introduced into the abdominal cavity through the catheter; a storage phase in which the injected dialysate is stored in the abdominal cavity for a predetermined period of time; and a drainage phase for removal.

IPD is performed in one treatment by repeating the above-mentioned cycles many times, eg, 10 times, over a period of 4 to 5 hours, typically 3 times a week intermittently.

CCPD is typically performed daily during sleep hours. In this case, the retention time is long, for example, ordinary dialysate is used for up to 3 cycles, and the last injected dialysate is stored in the peritoneal cavity for 16 hours until the next treatment, and the fluid is drained at the end for the next treatment. be done.

To reduce the risk of bacterial infection, once the dialysis source and tube set are attached, instead of connecting and disconnecting the dialysate source to the peritoneal catheter with a tube after each cycle, the system automatically repeats the operating cycle for a predetermined number of times. Repeated automatic dialysate cycling devices have been developed. By using this device,
It does not require the constant presence of a nurse and can be performed by the patient himself if he is skilled.

It is desirable to keep the circuit closed except for the tip of the drainage tube. Even in IPD mode, the device
It is desirable to be able to perform peritoneal dialysis even in CCPD mode. It is also desirable to be able to arbitrarily select the amount of dialysate to be injected, the storage time, and the number of cycles.Furthermore, from the second cycle, preparation for the next dialysate to be injected during the storage and drainage steps is completed. It would be desirable to reduce the overall turnaround time by beginning the infusion of new dialysate as soon as the spent dialysate drains.

It is desirable that the device be of relatively simple construction, easy to prepare, such as installing tube sets, and capable of easy and reliable operation.

SUMMARY OF THE INVENTION The apparatus of the present invention includes a perfusion fluid source, a perfusion fluid warming container, and injection and perfusion fluid removal means connectable to a patient's peritoneal catheter. The irrigant source is a irrigant storage plastic bag, preferably normally closed and containing an outlet port that can be opened by pricking with a spike. The irrigant heating container is a plastic bag of similar construction. A first conduit, preferably a polyvinyl chloride tube, is provided connecting the bags.
Separating from the first conduit, a second conduit, preferably a polyvinyl chloride tube, couples the irrigant warming bag to the patient's peritoneal catheter. The irrigant removal means includes a third conduit, preferably a polyvinyl chloride tube, branching off from said second conduit and leading to a drain.

The irrigation fluid flow path from the irrigation fluid storage plastic bag to the third conduit is connected to a closed system to prevent infection.

A first roller pump is provided within which a first conduit, a plastic tube, can be removably mounted for delivering a predetermined amount of irrigation fluid from the storage bag to the warming bag. The warming bag is housed in a heater supported on the top of an adjustable height stand and gravity feeds the heated perfusate through the second conduit and the patient's peritoneal catheter during the infusion phase. Provides the necessary head pressure for

According to the invention, first sensing means are provided for sensing the flow of perfusion fluid from the warming container through the second conduit and the patient's peritoneal catheter into the peritoneal cavity.

Also, after the retention period, a third
A second sensing means is provided for monitoring the flow of spent perfusate drained through the conduit.

First valve means are provided for selectively controlling the flow of fluid from the warming container through the second conduit and the patient's catheter into the peritoneal cavity.

A second valve means is also provided for selectively controlling the flow of spent perfusion fluid drained from the peritoneal cavity through the patient's catheter and the third conduit after the retention period.

The device of the invention includes automatic control means for automatically operating the device according to a predetermined operating sequence.

The control means controls each component of the device according to the following sequence in IPD mode.

(a) After confirming that the perfusate flow paths are all primed and the device is ready for peritoneal dialysis, the first valve means is closed and the dialysate is routed from the dialysate storage bag through the first conduit. The first roller pump is activated to deliver a predetermined amount of dialysate to the heating bag, and after the predetermined amount of dialysate has been delivered into the heating bag, the heater is activated to bring the dialysate near body temperature. Warm up to. (b) After confirming that the second valve means is closed, the first valve means is opened and the warmed dialysate is gravity fed through the second conduit and the patient's catheter into the peritoneal cavity. allow. (c) after the first sensing means senses that the feed of the warmed dialysate has been completed, the first valve means is closed; and (d) from that point on, the dialysate is stored in the patient's peritoneal cavity. Activates a timer that measures a predetermined length of time.

Meanwhile, step (a) above is started in parallel. (e) after a predetermined retention time, opening the second valve means and draining the spent dialysate from the peritoneal cavity through the patient's catheter and the third conduit;
(f) When the second sensing means no longer senses flow through the third conduit, the second valve means is closed and the first valve means is opened to begin step (b) above. do.

The control means also controls the dialysate to be terminated after the steps (a) to (f) are repeated a predetermined number of cycles.

The system of the invention can be used in CCPD mode. A first dialysate bag having a first composition and a second dialysate bag having a second composition are provided for use in the CCPD mode.

The outlet ports of the first and second dialysate bags are connected to the first conduit by fourth and fifth conduits, respectively. third and fourth valves for selectively controlling the flow of fluid from the first and second dialysis bags through the fourth and fifth conduits and into the first conduit and thus into the warming bag; Means will be provided.

The operation of the device in CCPD mode is similar to IPD mode, except for some differences.

If CCPD mode is selected, the cycle begins with the drain step, step (e) above. In CCPD mode, only the first dialysate is used during the first cycle except for the last cycle. Therefore, in step (a), which is started in parallel with the draining step, the first liquid source and the first
A third valve means is opened to control flow through a fourth conduit connecting the second liquid source and the first conduit. The fourth valve means is closed.

After the drainage step, i.e. steps (e) and (f) above, and after the first dialysate in the heating bag has reached near body temperature, the infusion step (b)
is started, followed by steps (c) and (d), and then returns to step (e). After this cycle has been repeated several times, in the last cycle the third valve means is closed and the fourth valve means is opened and the second dialysate is supplied to the dialysis fluid in steps (a) and (b). After the steps, the operation ends at step (c). The patient's peritoneal cavity therefore remains infused with the second dialysate and is not drained until the next CCPD procedure.

The device of the present invention can be used in either IPD or CCPD mode; once the device is ready for operation and started, it will automatically repeat the determined cycle a predetermined number of times to complete the peritoneal dialysis treatment. . Therefore, no human labor is required except for the preparation process and the cleanup process after completion, and there is no need for a nurse to be present during the process.

Furthermore, except for the first cycle, the generally time-consuming heating of the dialysate is performed concurrently with and completed during the retention period, thereby significantly shortening the total peritoneal dialysis time.

Other features and advantages of the invention emerge from the claims and the description of preferred embodiments with reference to the accompanying drawings.

DESCRIPTION OF THE DRAWINGS FIG. 1 is a front view of the automatic peritoneal perfusion device of the present invention with the fluid circuit removed. 2 is a right side view of the apparatus of FIG. 1; FIG. 3 is a left side view of the apparatus of FIG. 1; FIG. Figure 4 shows the first stage in IPD mode.
1 is a schematic perspective view of the dialysate bag and fluid circuit of the illustrated device; FIG. FIG. 5 is a schematic diagram of the fluid circuit in CCPD mode. FIG. 6 is an enlarged view of the control panel of the apparatus of FIG. FIG. 7 is a perspective view of a specific example of a heater box that accommodates a heating bag. FIG. 8 is a perspective view of one embodiment of a dialysate bag storage station and concentration cleanser.

FIG. 9 is a partial perspective view of the dialysate bag clamped with the outlet port inserted into the clamp.
DESCRIPTION OF A PREFERRED EMBODIMENT A preferred embodiment of an automatic peritoneal perfusion device according to the present invention is illustrated in FIGS. 1-3. The apparatus 10 shown therein is used in combination with the fluid circuit set 40 and dialysate bag 30 shown in FIG.

The apparatus 10 includes a platform 12 with casters 14 extending vertically from the platform 12 and a housing 16 and dialysate bag support posts 18. Housing 16 has a horizontally extending extension having a control panel 20 and generally has an inverted L-shape. Inside the housing 16, drive motors for the roller pumps 22 and 23 and various control circuits are housed.
Upright from the top of the housing 16 is a column 24 supporting a dialysate heater box 25, which column can be raised and lowered to adjust its height.

The dialysate bag support post 18 has a hanger 28 at its upper end that has a plurality of hooks 29 from which a plurality of dialysate bags 30 can be suspended with the outlet port down. The support post 18 also has a disk-shaped concentrator 27 that can temporarily occlude the dialysate bag outlet port or the tube connected thereto.

A pinch valve 34 is provided on the side wall of the housing 16 to control the flow of dialysate to be injected into the patient, which will be described later.
A pinch valve 35 is attached to control the flow of dialysate drained from the patient. Also attached to the same side wall is a sensor 31 that detects the flow of dialysate sent to the patient from a heating bag housed in the heater box 25; It's a techter.

Below the front wall of the housing 16 is a level detector 36 which cooperates with a bubble trap in a fluid circuit set 40 to be described below to sense the flow of fluid drained from the patient.

The opposite side wall of the housing 16 to which the pinch valves 34, 35 are attached has third and fourth pinch valves 38, 39 and a negative pressure monitor 37. The roles of these valves and monitors will be explained in detail later.

FIG. 4 shows the apparatus 1 shown in FIGS. 1 to 3.
A set 40 is shown for use in conjunction with 0. The set essentially consists of a flexible plastic tube, such as polyvinyl chloride, and the apparatus 10 includes a number of guides 42 for attaching the set to the apparatus.

The set shown in Figure 4 is configured to perform intermittent peritoneal dialysis (IPD). Set 40 has a first conduit 44 connected at one end to a plurality of dialysate bags 30 and at the other end to a normally empty warming hat 45 to be housed within heater box 25. The conduit 44 has a tapered portion in the middle that is attached to the roller pump 22 and passes through a negative pressure monitor 37 upstream of the pump 22 .

A second conduit 46 branches off from the first conduit 44 downstream of the pump 22 . Second conduit 46
passes through a first pinch valve 34, the free end of which terminates in a connector 53 for connection to a patient's peritoneal catheter (not shown).

A third conduit 48 branches off from conduit 46 downstream of first pinch valve 34, passes through second pinch valve 35, and extends to a drain. including a foam trap 50 downstream of the pinch valve 35;
The liquid level in the trap is sensed by sensor 36. Trap 50 is vent tube 5
1, and its tip is equipped with a filter 52 that allows gas to pass through but prevents bacteria from entering. The conduit 48 has a tapered portion downstream of the trap 50 for attachment to the second roller pump 23.

When the set 40 is connected to the dialysate bag 30 suspended from the hanger 28 and the connector 53 is connected to the patient's catheter (not shown), it is a closed system fluid flow path that does not come into contact with the outside air except for the opening to the drain. can be formed. The set is supplied as pre-sterilized disposable parts and is discarded after one use. Therefore, the risk of bacterial infection that may cause peritonitis can be avoided.
If desired, any part of the three conduits 48 can be irradiated with, for example, an ultraviolet lamp to sterilize the dialysate inside, thereby preventing infection even if bacteria enter through the drain opening. .

FIG. 5 schematically illustrates a set 40A prepared for performing continuous cycling peritoneal dialysis.

Set 40A of FIG. 5 has the same arrangement as set 40 of FIG. 4, with some differences. That is, the fourth
Instead of the plurality of dialysate bags 30 shown in the figure, there are a plurality of first bags 30a containing dialysate having a first composition and second bags 30b containing dialysate having a second composition. It is available for selective use. Therefore, one end of the first conduit branches into a fourth conduit 60 and a fifth conduit 62, which are connected to the outlet ports of the first bag 30a and the second bag 30b, respectively. The fourth and fifth conduits 60, 62 are arranged to pass through the third pinch valve 38 and the fourth pinch valve 39, respectively, so that closing valve 39 and opening valve 38 will close the first bag. Dialysate from bag 30a is delivered by pump 22, and conversely, closing valve 38 and opening valve 39 delivers dialysate from second bag 30b.

The operation of the apparatus of the present invention is automatically controlled by an electrical control circuit (not shown) containing a microprocessor.

The operation begins with the device 1 shown in Figures 1 to 3.
0, attach set 40 of FIG. 4 or set 40A of FIG.
It starts with priming.

After priming the fluid circuit, in IPD mode (using set 40), the dialysate is heated to near body temperature, and the heated dialysate is injected into the patient's peritoneal cavity.
The operation cycle of draining the liquid after the storage period is repeated a predetermined number of times and then terminated.

In CCPD mode (using set 40A), the procedure begins with draining the patient's peritoneal cavity of the dialysate last injected in the previous dialysis treatment. Next, the cycle of heating, injection, and drainage is repeated a predetermined number of times using the first dialysate, and the process ends with the step of injecting the second dialysate. This last injected dialysate is not drained until the next dialysis machine, and is retained in the patient's peritoneal cavity during that time.

The operation of the apparatus of the present invention can be easily understood with reference to FIG. 6, which is an enlarged view of control panel 20.

The control panel includes various push button switches, digital set buttons, digital display, indicators, warning lights and alarm buzzer shut off switches.

Priming is started by pressing the mini-timing switch 70. A portion of dialysate, for example 500 ml, is thereby conveyed from the fluid source 30 or 30a by the pump 22 through the first conduit 44 to the warming bag 45. Next, when the priming switch 70 is pressed again, the first valve 34 is
opens and dialysate flows into the second conduit 46, and after a while the second pinch valve 35 also opens and the third
The liquid also flows into the conduit 48, cleaning and priming the inside of the circuit. When the liquid sent to the heating bag 45 for priming has finished flowing, the detector 31 (FIGS. 3 and 5) detects this and closes the valves 35 and 36. Next, in the IPD mode, pressing the switch 72 will begin introducing the dialysate into the heating bag 45 for the first cycle. The liquid passes from bag 30 through first conduit 44 to pump 2.
2 to the heating bag 45. The amount of liquid at this time is the amount set in advance using the set button 80. When a predetermined amount, for example 2, of dialysate is delivered into the warming bag 45, the pump 22 is stopped and the heater 25 warms the dialysate in the bag 45 to near body temperature. At this time, the heater heats the bag 45 at a temperature at least 10 degrees Celsius higher than the surface temperature of the bag 45 until the surface temperature reaches around body temperature, and after the surface temperature of the bag 45 reaches around body temperature, it heats the bag 45 at the final desired temperature. It is designed to heat in two stages. As a result, in subsequent cycles, heating of the dialysate to near the body temperature is completed within the storage time of the dialysate, and it is possible to eliminate loss of waiting time for warming the dialysate.

When the heater finishes heating the dialysate, warning light 1
The fluid temperature warning lamp, indicated by the illumination of one of
and into the patient's peritoneal cavity via the second conduit 46 and the patient's catheter. At this time, the first pinch valve 34 is open and the second pinch valve 35 is closed.

When the heated dialysate runs out and the flow through a portion of conduit 44 is interrupted, air detector 31 (FIGS. 3 and 5) detects the presence of air within conduit 44 and Close the valve 34. At this time, the timer is activated and starts counting the storage time set by the set button 82, for example, 20 minutes. At the same time, the pump 22 is activated and the set button 80 transfers dialysate for use in the next cycle from the fluid source 30 through the first conduit 44 to the heating bag 45.
The dialysate is pumped in the set amount, and the heater 25 is activated to warm the dialysate to near body temperature.

During the storage period, the remaining time until the end of the storage time set by the storage time set button 82 is displayed on the display 86. When the remaining time on the display reaches zero, the second pinch valve 35 opens to initiate a drain step. Drainage is conducted from the patient's catheter to a second conduit 46.
and the third conduit 48 into the trap 50. If the liquid level in the trap 50 exceeds a certain height _L1 , the sensor 36 (Fig. 1)
detects this and starts the second pump 23. The pump 23 rotates intermittently, for example, about 2/3 rotations,
The liquid level in the trap 50 is set to the above-mentioned constant height.
The sensor 36 detects that the level is below a certain height L ₁ and stops _the pump 23 . The amount of liquid to be drained is displayed on the drain amount display 100,
At the same time, the difference from the injection amount set by the liquid injection amount set button 80 is displayed on the display 102. When the pump 23 has repeatedly started and stopped and almost all the liquid has been drained, trap 5
Fluctuation of the liquid level within 0 becomes slow. If the liquid level does not fluctuate up and down the height L ₁ within a certain period of time,
The controller assumes drainage is complete and closes the second pinch valve 35, ending the first cycle.

By the end of the first cycle, the set amount of dialysate used for the second cycle has been sent into the heating bag 45 and heated to near body temperature, so the first pinch valve 34 is opened and the The injection step of the second cycle can be started immediately. The timer starts counting the retention time set by the set dial again, the remaining time is displayed on the display 86, and at the same time the pump 22 warms the set amount of dialysate to be used for the third cycle. It is sent to the heating bag 45 for heating. After the storage time has elapsed, the display 86 shows zero, the second pinch valve 36 opens, the pump 23 operates intermittently to drain the liquid, and the sensor 3
6 detects the end of draining and ends the second cycle.

This operating cycle is repeated a number of times set by the cycle setting button 84, and the number of cycles currently in progress is displayed on the cycle number display 88.

When the set number of cycles is completed, a lamp 96 indicating completion is lit, indicating that the treatment has been completed.

Indicating lamps 90, 92, and 94 are provided to indicate which step the device is currently in during operation. These lamps are provided for each step of injection, storage, and drainage, and the injection and drainage lamps each indicate which step the treatment has started from.In other words, in IPD mode, it has started from injection. In CCPD mode, the operation starts from the drain step, so the small lamps 91 and 95 attached to the drain lamp are activated, and when either the push button switch 72 or 74 is pressed, either of the small lamps 91 and 95 are activated. The small lamp is now lit.

The difference between the injected volume and the drained volume displayed on the display 102 is integrated and displayed for each cycle. The integrated difference at the end therefore represents the amount of water removed by ultrafiltration from the patient's blood into the dialysate due to the osmotic effects of the dialysate.

In this embodiment, the injection volume is measured by the effective length of the increased diameter first conduit installed into the pump 22, the cross-sectional area of the bore, and the rotational speed of the pump 22. The drainage volume is likewise determined by the effective length and the cross-sectional area of the bore of the second conduit associated with the pump 23 and the rotational speed of the second pump 23 .
It will be obvious that other means may be used to integrate the difference between the injected volume and the drained volume, such as a flow meter.

To implement CCPD, set up the circuit as shown in FIG. That is, a plurality of bags 30a containing a first dialysate (standard dialysate), for example, three bags 30a and one high osmotic dialysate bag 30b, are hung on the hanger 28, and the first bag 30a is
The outlet port of the second bag 30b connects to a fourth conduit 60, and the outlet port of the second bag 30b connects to a fifth conduit 62, which meet at one end of the first conduit 44. Fourth conduit 60 passes through third pinch valve 38 and fifth conduit 62 passes through fourth pinch valve 39.

After priming the circuit, CCPD mode begins with a drain step. Therefore, the control panel 20
The upper pushbutton switch 74 is pressed. With this operation, the above-mentioned draining step is started, and the small lamp 95 is turned on.

During the drain step, pinch valve 39 is closed, pinch valve 38 is opened, and pump 22 is pumped from bag 30a through fourth conduit 60 and first conduit 44 into warming bag 45 via set button 80.
The amount of dialysate set by the controller is sent, and the heater 25 starts heating the fluid. After the drain step is completed and the second pinch valve 35 is closed and the dialysate in the warming bag 45 has been warmed to near body temperature, the first valve 34 is opened and the conduits 44,46
Warmed dialysate is then injected into the peritoneal cavity via the patient's catheter. When the injection is completed, the valve 34 is closed and a timer is started to measure the retention time set by the set button 82.
The remaining time is displayed on the display 86. After the storage time ends, the process returns to the draining step. In CCPD mode, the drain-fill-reserve cycle of operation is typically repeated four times, during the last cycle of which the third valve 38 is closed and the fourth valve 39 is opened to pump hyperosmotic dialysate. The treatment is then completed, and the end indication lamp 96 is turned on.

Furthermore, the storage time is set longer than in the IPD mode, and the number of cycles is set to be smaller than in the IPD mode.

Also, since the cycle begins with a drain step, the amount of hyperosmolar dialysate injected in the last cycle of the previous CCPD procedure is the same as that currently in progress.
If it differs from the injection amount setting value for CCPD treatment, an error will occur in the cumulative water removal amount indicated on the display 102, so care must be taken.

Other than these differences, each step in CCPD mode is performed the same as in IPD mode.

Referring again to FIG. 6, control panel 20 includes push button switches 76,78. The switch 76 is a switch for switching to the next step during a certain step, and the temporary stop switch 7
By pressing this switch after pressing 8, the draining step can be started, for example, in the middle of the set retention time.

Switch 78 is for temporarily stopping the operation of the device in case of emergency. If this switch is pressed again after stopping, the operation of the device will be resumed from the step where it was stopped.

The control panel includes various warning lights 104 and an alarm buzzer stop switch 106. The warning light warns of malfunctions due to equipment failure, etc., and sounds the buzzer. Its functions include the ability to indicate injection failure, inappropriate fluid temperature, heater failure, water removal failure, excessive heating bag, low liquid level in the trap, and empty dialysate storage. For example, if an amount of dialysate corresponding to the product of the infusion volume set by button 80 and the number of cycles set by button 84 is not stored in bag 30, etc., and bag 30 is activated. When empty, a negative pressure is generated in the first conduit 44 upstream of the pump 22. This is negative pressure monitor 37
is detected, the corresponding warning etc. 104 lights up, the buzzer sounds, and the pump 22 is stopped. As described above, the device of the present invention has a phenol safe function that prevents malfunction of the device due to various causes.

The buzzer stop switch 106 is configured so that even if it is used to stop the buzzer once a certain warning condition occurs, it will not stop the buzzer if a warning condition due to another cause occurs next.

An alternative embodiment of heater box 125 is illustrated in FIG. The box 125 has a stationary upper part 129 and a lower part 126 that opens downward.
As a result, a heating bag 45 is housed inside. Upper part 129 and lower part 12
6 is hinged and can be stopped by a latch 128. The inner surface of the lower part 126 has a bug 4
5 and has a thermistor 126. Thermistor 126 is used to rapidly heat the dialysate especially in IPD mode with short storage time
The temperature of the object in contact with the body is slightly lower than body temperature,
For example, until reaching 35°C, the heating surface temperature of the heater is at least 10°C above that temperature, e.g. 50-100°C, preferably around 60°C, and then the heater surface temperature is reduced to about 39°C and the object to be heated is heated. The system continues to heat the food until it reaches close to body temperature. In order to generate the head pressure necessary for injection, the heater box is kept at a height of, for example, approximately 100 cm from the patient and approximately 180 cm from the floor. Conveniently, the two-stage heating of the heater allows rapid heating of the dialysate even when the retention time is set short, eliminating unnecessary waiting time.

FIG. 8 shows another embodiment of the central clamp and hanger. The hanger 228 is fixed to the tip of the column 218 and has a plurality of hooks 229 for hanging the bag 30 upside down. The concentrated clamp 227 has a disk shape, and clamp members 230 arranged radially are fixed thereon. The clamping member 230 has a vertical groove 236 that tapers at the bottom, as shown in FIG. 9, into which the outlet port 232 of the bag 30 is pushed. This clamp is useful when using a bag in which the outlet port 232 is closed by a diaphragm that can be ruptured with a spike. Outlet port 232 is inserted into groove 236 of clamping member 230.
By pushing the outlet port 232 into place, the outlet port 232 is fixed and the spike is inserted into the foreign object, e.g.
4, the diaphragm in the outlet port can be ruptured and the outlet port can continue to be occluded thereafter.

As can be seen from the above description, the device according to the invention maintains a closed fluid circuit, greatly reducing the risk of bacterial contamination, and utilizes gravity to inject and drain fluid into the patient. Therefore, there is no risk of burden on the patient, and each step is automatically performed, so there is no need for a nurse to be present at all times.
In addition, since the heating of the set amount of new dialysate to be used in the next cycle is completed in parallel with the storage and drainage steps, wasted waiting time is eliminated and the total processing time is shortened. Furthermore, since it is fully equipped with a safety device and an alarm device, it is easy and safe to handle, and since the entire structure is compact, it does not require excessive space.

Also, after a simple adjustment, even in IPD mode,
Peritoneal dialysis can also be performed in CCPD mode.

[Brief explanation of drawings]

1 is a front view of the automatic peritoneal perfusion device of the present invention with the fluid circuit removed, FIG. 2 is a right side view of the device in FIG. 1, FIG. 3 is a left side view of the device in FIG. 1, and FIG.
Figure 5 is a perspective view of the dialysate bag and fluid circuit for use in IPD mode, Figure 5 is a schematic diagram of the dialysate bag and fluid circuit for use in CCPD mode, and Figure 6 is a diagram of the device of Figure 1. FIG. 7 is an enlarged view of a control panel, FIG. 7 is a perspective view of a specific example of a heater box, FIG. 8 is a perspective view of a specific example of a hanger and a central cleaning device, and FIG. 9 is a partially enlarged view of FIG. 8. 12 is a stand, 16 is a housing, 18 is a dialysate bag support post, 20 is a control panel, 22, 23
is a roller pump, 44, 46, 48 are conduits, 5
0 is a trap, 45 is a heating bag, 30 is a dialysate storage bag, 34 and 35 are pinch valves, 36 is a level detector, and 31 is an air detector.

Claims (1)

[Scope of Claims] 1. A perfusate supply source, a perfusate warming container and a heater, means for injecting the heated perfusate into the abdominal cavity of a patient, and removing the injected perfusate from the patient's abdominal cavity. a first conduit connecting the perfusate supply source and the heating means, a second conduit connecting the perfusate heating container and the perfusate injection means, and the perfusion liquid removing means. In a peritoneal perfusion device having a third conduit connecting to a drain, perfusion from the perfusion source to the first conduit, the perfusate warming container, the second conduit, the injection means, the removal means and the third conduit. The fluid flow path is connected in a closed system, and includes a first roller pump for transporting the perfusion fluid from its source to a heated container through the first conduit, and a first roller pump for delivering the perfusion fluid from its source to a heated container through the first conduit. means for supporting the heated container at a height that provides sufficient head pressure to inject perfusion fluid into the patient's peritoneal cavity via the second conduit and injection means; a first sensing means for monitoring the flow of perfusate flowing from the warming container through the second conduit toward the patient; and heated perfusion fluid flowing from the warming container through the second conduit to the injection means. The first to control the flow of liquid
a second valve means for controlling the flow of perfusate flowing from said removal means through a third conduit to a drain; and a second valve means for controlling the flow of perfusate flowing from said removal means through a third conduit to a drain. a second sensing means for monitoring the flow of said first
means for automatically controlling the operation of the pump, the heater, the first valve means, and the second valve means according to a predetermined sequence, the control means including: (a) the first valve means; and controlling said first pump to deliver a predetermined amount of fresh perfusion fluid from its source through a first conduit to said warming container while the valve means is closed, said first pump being stored in said warming container. (b) then opening the first valve means while the second valve means is closed so that the heated irrigation fluid is heated to a predetermined temperature; (c) controlling the first valve means to permit injection from the warming container through the second conduit and the injection means;
(d) controlling the first valve means to close when the first sensing means no longer senses the flow of warmed irrigation fluid injected through the second conduit;
while the first valve means is closed, the first and second valve means are kept closed until a predetermined time has elapsed from the time when the first valve means is closed, and at the same time, the step (a) is started. (e) closing said first valve means to allow perfusate to drain from the patient through said removal means and a third conduit to a drain after said predetermined period of time; (f) when said second sensing means no longer senses the flow of irrigating fluid through the third conduit; Control is performed to close the second valve means and open the first valve means to start the step (b), and the steps (a) to (f)
An automatic peritoneal perfusion device, characterized in that the automatic peritoneal perfusion device is adapted to control the steps of the above steps to be repeated a predetermined number of cycles. 2. the irrigation fluid source comprises a first irrigation fluid source having a first composition and a second irrigation fluid source having a second composition, each connected to the first conduit; fourth and fifth conduits for connecting a first perfusate source and a second perfusate source, respectively, to the first conduit;
The automatic peritoneal perfusion device of claim 1 further comprising third and fourth valve means for selectively controlling the flow of perfusion fluid having the first and second compositions through the conduits. 3 a second flow sensing means downstream of the second flow sensing means of the third conduit for discharging perfusate through the third conduit to a drain in response to the second flow sensing means; An automatic peritoneal perfusion device according to claim 1 or 2, comprising a roller pump. 4. means for measuring the amount of irrigant discharged by said second roller pump, from which said volume was sent to said warming container by said first roller pump immediately before in the cycle; 4. The automatic peritoneal perfusion device of claim 3, further comprising means for subtracting and displaying said predetermined amount of fresh perfusion fluid. 5. The heater heats the heating container at least 10 degrees below the predetermined temperature until the heating container reaches the predetermined temperature.
3. The peritoneal perfusion device according to claim 1 or 2, wherein the perfusion fluid is heated at a temperature higher than 0.degree. C. and then heated at the predetermined temperature. 6. said irrigation fluid source comprises a plurality of flexible plastic bags containing irrigation fluid therein;
a post with a hanger for hanging the bag with the outlet port facing down;
3. An automatic as claimed in claim 1 or 2, comprising a central clamp supported on the post below the hanger for temporarily closing and fixing the port with respect to the post during connection to a conduit. Peritoneal perfusion device. 7 The third roller pump downstream of the second roller pump
4. The automatic peritoneal perfusion device of claim 3, further comprising means for sterilizing the interior of the conduit.