JPH04297272A - Blood circulator - Google Patents

Abstract

PURPOSE:To facilitate the adjusting of circulation of blood by connecting a base end of a blood removing/transmitting line having a catheter adapted to remove and transmit blood concurrently to a blood circulation circuit having a blood storage tank, an artificial lung and a pump to reduce the number of catheter mounting locations to one. CONSTITUTION:A blood circulator 1 is made up of a blood removing/ transmitting line 10 adapted for removing and transmitting blood and a circulation circuit 20 to circulate removed blood. Here, in the blood removing/ transmitting line 10, a catheter 11 adapted to remove and transmit blood concurrently is connected to a tube 12 for transmitting blood with a connector 13 while a pump 14 is set in the course of the tube 12. A lumen as blood passage is formed within the catheter 11 while the tip of the catheter 1 is inserted into a vein of a patient 30 percuteneously. Moreover, a base end of the tube 12 is connected to a blood storage tank 21. In the circulation circuit 20, the blood storage tank 21, an artificial lung 22 and a pump 23 are arranged clockwise in the order and connected with a tube 24 for transmitting blood.

Description

[Detailed description of the invention]

0001

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a blood circulation device used for extracorporeal blood circulation in an artificial lung, and particularly to a blood circulation device applied to a venous-venous bypass system.

0002

[Prior Art] In recent years, as a respiratory aid during respiratory failure,
ECMO
raneOxygeneration) system has been developed. This ECMO system is broadly classified into veno-venous bypass (VVB), veno-arterial bypass (VAB), and arterial-venous bypass (AVB).
There is. Among these, for example, in VVB, blood removal line,
It has a circuit consisting of a pump, a blood storage tank, an artificial lung, and a blood supply line, and when the pump operates, blood is removed from the patient's veins through the blood removal line catheter and transferred to the blood storage tank. The blood is temporarily stored, then oxygenated and decarboxylated in an oxygenator, and then returned to the patient's vein via the blood supply line catheter.

However, such conventional ECMO
In the system, it is necessary to secure the patient's blood vessels in each catheter of the blood removal line and the blood supply line.In other words, the catheter must be inserted and placed in at least two places, which places a heavy burden on the patient. There is a drawback.

In particular, during extracorporeal blood circulation, antithrombotic agents such as heparin are administered to prevent blood clots from forming in the bypass circuit, which tends to cause bleeding.
If there are two or more catheter insertion sites, the tendency for bleeding increases, and it takes time and effort to stop the bleeding.

Furthermore, in conventional ECMO systems, blood removal, circulation, and blood delivery are performed continuously, so poor blood removal tends to occur due to fluctuations in the amount of circulating blood, making it difficult to adjust the amount of blood circulating appropriately. Have difficulty.

[0006]

SUMMARY OF THE INVENTION An object of the present invention is to provide a blood circulation device that reduces the burden on a patient and allows easy adjustment of the amount of blood circulating.

[0007]

[Means for Solving the Problems] Such objects are achieved by the present invention as described in (1) to (4) below.

(1) A blood removal/blood supply line having a catheter that performs both blood removal and blood supply, and a blood circulation circuit including a blood storage tank, an artificial lung, and a pump, and the blood removal/blood supply line A blood circulation device characterized in that a proximal end of the blood circulation device is connected to the circulation circuit.

(2) The blood circulation device according to the above (1), wherein the blood removal/blood supply line includes a pump.

(3) The blood circulation device according to (1) above, further comprising a closing member capable of closing and opening the blood flow path of the blood removal/transmission line and the blood flow path of the circulation circuit, respectively.

(4) The blood circulation device according to any one of (1) to (3) above, wherein the blood reservoir is a flexible closed blood reservoir.

0012

[Function] According to the present invention, blood removal and blood feeding are both performed using one catheter. This allows the catheter to be inserted into the patient's blood vessel and placed in one place.
This reduces the burden on the patient, reduces bleeding from the catheter insertion site, and facilitates hemostasis operations.

[0013] Furthermore, the blood that has been removed is circulated in a circulation circuit that includes an artificial lung, and oxygenated and decarbonated. Even if blood removal, circulation, and blood feeding are performed intermittently in a batch manner, a sufficient respiratory support effect can be obtained.

Furthermore, since the blood removal/transfer line and the circulation circuit can be operated independently, the amount of blood removed, the amount of blood fed, and the amount of circulation can be set appropriately and separately.

[0015]

DESCRIPTION OF THE PREFERRED EMBODIMENTS The blood circulation apparatus of the present invention will be described in detail below based on preferred embodiments shown in the accompanying drawings.

FIGS. 1 to 4 are circuit configuration diagrams each schematically showing an example of the configuration when the blood circulation device of the present invention is applied to a lung auxiliary device. Hereinafter, the blood circulation apparatus shown in these figures will be sequentially explained.

The blood circulation system 1 shown in FIG. 1 includes a blood removal/transfer line 10 for removing and sending blood, and a circulation circuit 20 for circulating the removed blood.

The blood removal/blood supply line 10 includes a catheter 11 for both blood removal and blood supply, and a blood supply tube 1.
2 is connected with the connector 13, and the tube 1
A pump 14 is installed in the middle of 2.

A lumen, which is a blood flow path, is formed inside the catheter 11, and the distal end of the catheter 11 is inserted and left in the vein of the patient 30, preferably percutaneously. Here, "percutaneously" means that it is carried out through the skin without making an incision; for example, a blood vessel is secured by the Seldinger method, and the catheter 11 is inserted and left in the target site. In this way, by percutaneously inserting and indwelling the catheter 11, the burden on the patient is reduced.

The proximal end of the tube 12 is connected to a blood reservoir 2, which will be described later.
Connected to 1.

Note that when the pump 14 is a roller pump, the tube 12 includes a pump tube.

[0022] Examples of the constituent materials of the catheter 11 and the tube 12 include polyvinyl chloride, polyurethane, polypropylene, polyethylene, polyamide, silicone resin, polyester elastomer, ethylene-vinyl acetate copolymer (EVA), and urethane-silicon copolymer. Flexible materials such as vinyl chloride-vinyl acetate copolymers are preferably used.

[0023] Also, the catheter 11 and the tube 12
are made of various antithrombotic materials, or such antithrombotic materials are used on the inner and outer surfaces of the catheter 11 and on the tube 1.
It is also possible to coat the inner surface of 2. Examples of the antithrombotic material include antithrombotic polymers having a microphase separation structure such as segmented polyurethane and segmented polyamide, and polymers containing various antithrombotic drugs.

Although the dimensions of the catheter 11 are not particularly limited, it is preferable that the outer diameter is about 3 to 12 mm and the inner diameter is about 2 to 10 mm.

The pump 14 is capable of switching the direction of blood discharge between forward and reverse directions, and is preferably a roller pump, centrifugal pump, or the like.

The circulation circuit 20 includes a blood storage tank 21 and an artificial lung 22.
and a pump 23 are arranged in this order clockwise in the figure, and these are connected by a blood feeding tube 24 similar to that described above to form a ring-shaped circuit.

[0027] The blood tank (reservoir) 21 is flexible and has a variable internal volume, and is preferably of a closed type that substantially prevents air circulation. An example of such a blood reservoir is one in which resin sheet materials are stacked and their peripheral portions are fused or adhered to form a bag shape. In this case, the constituent materials of the sheet material include polyvinyl chloride, polypropylene, polyethylene, polyamide,
Examples include EVA, polyurethane, and silicone resin.

It goes without saying that in the present invention, the blood reservoir 21 may be constructed of a hard housing.

In addition, a sensor (not shown) for detecting the amount of blood stored is provided in the blood storage tank 21, and the pump 14
and/or a control means (not shown) for controlling the operation of the pumps 14 and 23 may be provided to control the operation of the pumps 14 and 23 based on information such as the detected blood storage amount. Furthermore, the pumps 14 and 23 may be activated and stopped by timer control, or by a combination of timer control and control based on the information.

The artificial lung 22 performs gas exchange, that is, adds oxygen to the blood and removes carbon dioxide. The type, format, etc. of this artificial lung 22 are not particularly limited, and for example,
Examples include membrane type, film type, and bubble type oxygenators, but in the present invention, hollow fiber oxygenators or flat membrane oxygenators are preferred, and hollow fiber oxygenators are particularly preferred. In this case, the artificial lung 22 may be either an external perfusion type or an internal perfusion type.

The effective membrane area of the oxygenator 22 is 0.05 to 2
It is preferable that it is about 0 m2.

The pump 23 is capable of circulating blood counterclockwise (or clockwise) in the drawing in the circulation circuit 20, and for example, a roller pump, a centrifugal pump, or the like is preferably used.

[0033] In the blood circulation device 1, a mixed injection port (for injecting an anticoagulant such as heparin or other drugs) is provided at a predetermined location of the blood removal/transmission line 10 and the circulation circuit 20.
(not shown) can also be installed. Further, a sampling manifold, a bubble trap, a defoaming member, a deaeration port, a temperature measurement unit, various connectors, etc. may be installed at predetermined locations on the blood removal/blood supply line 10 and the circulation circuit 20.

The operation of the blood circulation device 1 will be explained below.

[0035] The inside of the removal/blood supply line 10 and the circulation circuit 20 are primed with physiological saline or the like, and in this state,
The catheter 11 is inserted and left in the vein of the patient 30 by, for example, the Seldinger method.

Next, the pump 14 is operated to remove blood. The removed blood is transferred to the catheter 11 and tube 1.
2, the blood flows into the blood storage tank 21 and is stored therein.

Next, during or after such blood removal, the pump 23 is operated to circulate the blood in the blood reservoir 21 in the circulation circuit 20 counterclockwise (or clockwise) in the figure.
circulates. The blood flowing out from the blood storage tank 21 is transferred to the artificial lung 2.
When passing through step 2, oxygenation and decarboxylation are performed, so
The oxygen partial pressure in the blood increases, the carbon dioxide partial pressure decreases, and this blood is returned to the blood reservoir 21 again. At this time, the oxygen partial pressure of the blood circulating in the circulation circuit 20 is 300 to 700 mm.
It is preferable to circulate until the concentration reaches about Hg.

Next, during or after the blood circulation in the circulation circuit 20, the pump 14 is operated in the opposite rotation to the above, and the blood in the blood reservoir 21 is pumped through the tube 12 and the catheter 11 to the patient. Send blood (return blood) to 30 veins.

The above-described blood removal, circulation, and blood supply (one batch) are repeated until the respiratory function of the patient 30 is recovered.

[0040] In such a blood circulation device 1, blood can be circulated in the circulation circuit 20 even during blood removal or blood feeding, so that there is an advantage that the time required for one batch is shortened. The blood circulation device 1 also has the advantage that there is no need to install the closing members 5 and 6, which will be described later, and there is no need to operate the closing members 5 and 6.

[0041] Furthermore, by adjusting the blood circulation volume and circulation time to perform excessive oxygen addition and decarbonation to the returning blood, a sufficient respiratory support effect can be obtained even with such a batch system. .

The blood circulation devices 2, 3, and 4 shown in FIGS. 2, 3, and 4 each have one pump, and each blood flow path is connected to the blood removal/transmission line 10 and the circulation circuit 20. This is a configuration example in which a closing member that can be closed and opened is provided. These will be explained in order below. Note that descriptions of the same items as in the blood circulation device 1 will be omitted.

The blood circulation device 2 shown in FIG. 2 has a blood removal/blood supply line 10 and a circulation circuit 20.
is the same as the blood circulation device 1 described above except that the pump 14 is not installed in the middle of the tube 12. The circulation circuit 20 also includes an artificial lung 22, a blood reservoir 21, and a pump 2.
6 are arranged in this order clockwise in the figure, and these are connected by a tube 24 to form a ring-shaped circuit.

[0044] The pump 26 is capable of switching the direction of blood discharge in the circulation circuit 20 between forward and reverse directions, and for example, a roller pump, a centrifugal pump, or the like is preferably used.

A branch connector 25 is installed on the tube 24 between the oxygenator 22 and the pump 26, and the tube 12
The proximal end of the tube 2 is connected to the tube 2 through this branch connector 25.
4 is connected.

Further, in the middle of the tube 12 and between the oxygenator 22 and the branch connector 25 of the tube 24, there are closing members 5 that can close and open the flow path in the tube.
and 6 have been installed.

As the closing members 5 and 6, for example, clamps, roller clamps, Kochers, pinch valves, cocks, etc. can be used.

In addition, a three-way stopcock (not shown) is installed in place of the branch connector 25 to have the same function as the closing members 5 and 6, and the flow path is switched by this three-way stopcock. Good too.

[0049] Such opening/closing of the closing members 5 and 6 and switching of the flow path of the three-way stopcock may be performed manually, but may be performed manually based on information on the amount of blood stored in the blood reservoir 21 detected by the blood amount detection sensor. Alternatively, the closing members 5 and 6 may be automatically opened and closed under timer control.

The operation of the blood circulation device 2 will be explained below.

After priming and insertion and placement of the catheter 11 in the same manner as described above, blood is removed. This blood removal is performed by opening the occlusion member 5 and closing the occlusion member 6,
This is done by activating the pump 26 and suctioning.

The blood thus removed flows into the blood reservoir 21 via the catheter 11, tube 12, branch connector 25 and tube 24, and is stored therein.

Next, after such blood removal is completed, the closing member 5 is closed and the closing member 6 is opened, and the pump 26 is operated in the reverse rotation to circulate the blood in the blood reservoir 21. The circuit 20 circulates clockwise in the figure. The blood flowing out from the blood storage tank 21 is oxygenated and decarbonated when passing through the oxygenator 22, so the oxygen partial pressure in the blood increases.
The partial pressure of carbon dioxide gas decreases, and this blood is returned to the blood reservoir 21 again.

Next, after the blood circulation in the circulation circuit 20 is completed, the closing member 5 is opened again, and the closing member 6 is opened again.
is closed, the pump 26 continues to operate, and the blood storage tank 2 is closed.
The blood in the patient 30 is sent (returned) to the vein of the patient 30 via the tube 24, the branch connector 25, the tube 12, and the catheter 11.

The above-described blood removal, circulation, and blood supply (one batch) are repeated until the respiratory function of the patient 30 is recovered.

In the blood circulation device 2 having such a configuration, when blood is returned, the blood from the blood storage tank 21 does not pass through the oxygenator 22, so there is little pressure loss. Because the inside of the flow path does not become under reduced pressure,
Hemolysis due to passage through the artificial lung 22 under reduced pressure is prevented.

The blood circulation device 3 shown in FIG.
0, a blood storage tank 21, an oxygenator 22 and a pump 27.
in this order clockwise in the figure, and connect them to tube 2.
It is the same as the blood circulation device 2 except that it is connected at 4 to form a ring-shaped circuit.

Note that the pump 27 in the blood circulation device 3
Depending on the blood removal method described later, in the circulation circuit 20, the blood discharge direction can be switched between the forward and reverse directions, or the blood can be circulated clockwise in the figure.

The operation of the blood circulation device 3 will be explained below.

After priming and insertion and placement of the catheter 11 in the same manner as described above, blood is removed. This blood removal can be done in one of two ways:

First, both of the closing members 5 and 6 are opened, the blood circulation device 3 is placed lower than the patient 30, and blood is introduced into the blood reservoir 21 by the height difference. In this case, blood removed from the patient 30 flows into the blood reservoir 21 through the catheter 11, the tube 12, the branch connector 25, and the tube 24 on the side where the closing member 6 is located, and is stored therein.

Second, the closing member 5 is in the open state, and the closing member 6 is in the open state.
is closed, and blood is introduced into the blood reservoir 21 by operating the pump 27 and suctioning it. In this case, patient 30
Blood removed from the catheter 11 and tube 12
The blood then flows into the tube 24 via the branch connector 25, flows into the blood reservoir 21 via the pump 27 and the oxygenator 22, and is stored therein.

Next, after such blood removal is completed, the closing member 5 is closed and the closing member 6 is opened, and the pump 27 is operated to pump the blood in the blood reservoir 21 into the circulation circuit 20 as shown in the figure. Cycle clockwise (or counterclockwise).

Next, after the blood circulation in the circulation circuit 20 is completed, the closing member 5 is opened and the closing member 6 is closed, and the pump 27 continues to operate to drain the blood in the blood reservoir 21. Tube 24, oxygenator 22, branch connector 25
, patient 30 via tube 12 and catheter 11
send blood (return blood) to the veins of

The above-described blood removal, circulation, and blood supply (one batch) are repeated until the respiratory function of the patient 30 is recovered.

The blood circulation device 4 shown in FIG.
0 is the same as the blood circulation device 3 described above except that the arrangement of the artificial lung 22 and the pump 27 is reversed.

The operation of the blood circulation device 4 will be explained below.

After priming and insertion and placement of the catheter 11 in the same manner as described above, blood is removed. This blood removal can be performed by either of the two methods described above.

Next, after the blood removal is completed, the closing member 5 is closed,
The closing member 6 is opened, the pump 27 is operated, and the blood in the blood storage tank 21 is circulated clockwise in the figure (
or counterclockwise).

Next, after the blood circulation in the circulation circuit 20 is completed, the closing member 5 is opened and the closing member 6 is closed, and the pump 27 continues to operate to drain the blood in the blood reservoir 21. Tube 24, oxygenator 22, branch connector 25
, patient 30 via tube 12 and catheter 11
send blood (return blood) to the veins of

The above-described blood removal, circulation, and blood supply (one batch) are repeated until the respiratory function of the patient 30 is recovered.

In the blood circulation device 4 having such a configuration, when blood is returned, blood from the blood storage tank 21 passes through the oxygenator 22, but the oxygenator 22 is connected to the downstream side (discharge side) of the pump 27. Since the blood flow path is installed in the oxygenator 22, the pressure inside the oxygenator 22 is not reduced, and hemolysis when passing through the oxygenator 22 is prevented, which is an advantage.

Although various configuration examples of the blood circulation apparatus of the present invention have been described above, the present invention is not limited to these.

[0074]

[Experimental Examples] Specific examples of the blood circulation apparatus of the present invention will be described below.

(Example 1) A blood circulation device having the circuit configuration shown in FIG. 1 was manufactured. The conditions for each part are as follows.

<Evacuation/blood supply line> Catheter material: Polyester elastomer Catheter outer diameter: 6.0 mm Catheter inner diameter: 5.2 mm Catheter total length: 500 mm Tube material: Polyvinyl chloride Tube inner diameter: 10 mm Tube total length: 500 mm Attachments: Tube Pump type: Roller pump Pump discharge rate: 1000-6000ml/min

00
77] <Circulation circuit> Blood storage tank type: Sealed bag-like bag made of polyvinyl chloride sheet Blood storage tank capacity: 700ml Oxygenator type: Hollow fiber oxygenator (external perfusion type) Effective membrane area of oxygenator: 1 .6m2 Pump type: Roller pump Pump discharge rate: 1000-6000ml/min Tube material: PVC Tube inner diameter: 10mm Tube total length: 1000mm Attachments: Sampling manifold installed in the middle of the tube Total priming volume: 800ml

[0078] Using such a blood circulation device, the weight of 50
Experimental animals (sheep) weighing 1 kg were subjected to extracorporeal blood circulation through an artificial lung using a venous-venous bypass method under the following conditions.

[0079] The experimental animals were anesthetized and connected to a ventilator. The ventilation volume and respiratory rate were gradually reduced to bring the patient into a state of respiratory failure.

With the blood circulation device primed with physiological saline, the catheter was inserted into the jugular vein until the tip of the catheter reached the vicinity of the right atrium and left indwelling.

[0081] The state of the blood (arterial blood) immediately before blood circulation was as shown in Table 1 below.

First, the pump for the removal and blood supply line is set to a discharge rate of 3.
000ml/min for 10 seconds to remove blood,
500 ml of blood was stored in the blood reservoir. During blood removal, 1.5 ml of 1000 units/ml heparin sodium solution was injected from the mixed injection port.

[0083] Next, the pump in the circulation circuit is adjusted to a discharge rate of 3000
ml/min, the blood is circulated counterclockwise in Figure 1 in the circulation circuit, and the blood oxygen partial pressure is 50.
Circulation was continued until the temperature reached 0 mmHg.

1 after stopping the pump of the removal/blood supply line
After 0 seconds had elapsed, the same pump was operated in the opposite direction for 10 seconds at a discharge rate of 3000 ml/min to return the blood in the blood reservoir to the experimental animal.

[0085] Thereafter, while the pump in the circulation circuit continued to operate, the above blood removal (10 seconds) and blood return (10 seconds) were repeated at 10 second intervals, and such respiratory function support was continued for 20 hours. .

[0086] Approximately 30 minutes have passed since the start of respiratory function support.
After a few minutes had elapsed, the returned blood was collected from the sampling manifold and its condition was examined, as shown in Table 1 below.

[0087]

[Table 1]

(Example 2) A blood circulation device having the circuit configuration shown in FIG. 2 was manufactured. The conditions for each part are as follows.

<Evacuation/blood supply line> Catheter material: Polyester elastomer Catheter outer diameter: 6.0 mm Catheter inner diameter: 5.2 mm Catheter total length: 500 mm Tube material: Polyvinyl chloride Tube inner diameter: 10 mm Tube total length: 500 mm Attachments: Tube A mixed injection port is installed in the middle of the blockage member:

<Circulation circuit> Blood reservoir type: Sealed bag-like bag made of polyvinyl chloride sheet Blood reservoir capacity: 700 ml Oxygenator type: Hollow fiber oxygenator (external perfusion type) Effective membrane area of oxygenator: 1.6m2 Pump type: Roller pump Pump discharge rate: 1000-6000ml/min Tube material: PVC Tube inner diameter: 10mm Tube total length: 1000mm Closure member: Clamp Attachment: Sampling manifold installed in the middle of the tube Total priming amount: 800ml

[0091] Using such a blood circulation device, a weight of 50
Experimental animals (sheep) weighing 1 kg were subjected to extracorporeal blood circulation through an artificial lung using a venous-venous bypass method under the following conditions.

[0092] A catheter was similarly inserted into the jugular vein of an experimental animal brought into respiratory failure in the same manner as in Example 1 and left in place.

[0093] The state of the blood (arterial blood) immediately before blood circulation was as shown in Table 2 below.

[0094] First, with the tube of the circulation circuit occluded with cleanser, the pump was operated for 10 seconds at a discharge rate of 3000 ml/min to remove blood, and 500 ml of blood was stored in the blood reservoir.

Next, the pump is temporarily stopped, the tube of the circulation circuit is unblocked, and the tube of the blood removal/blood supply line is occluded with a cleanser. The blood was circulated clockwise in FIG. 2 in the circulation circuit, and the circulation was continued until the blood oxygen partial pressure reached 500 mmHg.

Next, the tube of the removal and blood supply line is unblocked, and the tube of the circulation circuit is occluded with a cleanser, and in this state, the pump is operated at a discharge rate of 3000 ml/min.
It was activated for 10 seconds to return the blood in the blood reservoir to the experimental animal.

[0097] After that, the above blood removal (10 seconds) and circulation (10 seconds) were carried out.
(for 10 seconds) and blood return (for 10 seconds) were repeated, and such respiratory function support was continued for 24 hours.

[0098] Approximately 30 minutes have passed since the start of respiratory function support.
After a few minutes had elapsed, the returned blood was collected from the sampling manifold and its condition was as shown in Table 2 below.

0099

[Table 2]

[0100]

Effects of the Invention As described above, according to the blood circulation device of the present invention, the catheter only needs to be inserted and indwelled in one place, so the burden on the patient is reduced, and blood removal, circulation, and blood supply are improved. Since they are independent, conditions such as the amount of blood removed, the amount of blood sent, and the amount of circulation can be set appropriately and separately, and therefore, excellent respiratory function auxiliary effects can be obtained.

[Brief explanation of drawings]

FIG. 1 is a circuit configuration diagram schematically showing a configuration example of a blood circulation device of the present invention.

FIG. 2 is a circuit configuration diagram schematically showing a configuration example of a blood circulation device of the present invention.

FIG. 3 is a circuit configuration diagram schematically showing a configuration example of a blood circulation device of the present invention.

FIG. 4 is a circuit configuration diagram schematically showing a configuration example of a blood circulation device of the present invention.

[Explanation of symbols]

1, 2, 3, 4 Blood circulation device 5, 6 Closure member 10 Removal/blood supply line 11
Catheter 12 Tube 13 Connector 14 Pump 20 Circulation circuit 21 Blood reservoir 22 Artificial lung 23 Pump 24 Tube 25 Branch connectors 26, 27
pump 30 patient

Claims (4)

[Claims] 1. A blood removal/transfer line having a catheter that performs both blood removal and blood feeding, and a blood circulation circuit including a blood storage tank, an artificial lung, and a pump, the blood removal/transfer line having a A blood circulation device characterized in that a proximal end thereof is connected to the circulation circuit. 2. The blood circulation device according to claim 1, further comprising a pump in the blood removal/blood supply line. 3. The blood circulation apparatus according to claim 1, further comprising a closing member capable of closing and opening the blood flow path of the blood removal/transmission line and the blood flow path of the circulation circuit, respectively. 4. The blood circulation apparatus according to claim 1, wherein the blood reservoir is a flexible closed blood reservoir.