JPH0451803Y2 - - Google Patents

Description

[Detailed description of the invention] [Field of industrial application] The present invention is designed to physiologically maintain the blood circulation circuit in advance when introducing blood from the human body into the blood circulation circuit of a dialyzer equipped with an arteriovenous circuit. The present invention relates to a blood circuit priming device that is filled with saline (hereinafter referred to as "saline").

[Conventional technology]

The blood circuit system in artificial dialysis consists of a dialyzer that permeates and diffuses blood and dialysate through a permeable membrane, and an arteriovenous blood circuit that introduces blood from the patient's body into the dialyzer and returns it to the patient's body. It consists of

The material used for the permeable membrane used in a dialysis machine is determined by its dialysis efficiency and molecular weight, but in the hollow fiber type dialyzer that is currently most commonly used, a large number of ultra-fine tubes with an inner diameter of about 200 μm are bundled together, and the inside of the tube is Blood is passed through the tube, and dialysate is made to flow outside the tube to perform percolation and diffusion around the wall of the tube, that is, through the membrane.

Such dialyzers are classified into dry types, which can be stored in the air due to their permeable membrane properties, and wet types, which can be stored by soaking both the blood passage side and the dialysis passage side in sterilized water. Wet type is often used to improve functionality.

To construct a blood circuit for dialysis treatment, the sterilely packaged arterial circuit, dialyzer, and venous circuit are opened and simultaneously connected and fitted together in a sterile manner. Before hemodialysis treatment, the blood circuit is cleaned and filled with saline, but priming must be completed immediately before the start of dialysis treatment to avoid giving time for bacteria to multiply within the circuit. Therefore, they were forced to work one to two hours before the start of dialysis treatment.

However, when priming a blood circuit connected to a wet type dialyzer, when saline is introduced from the open end of the arterial circuit, as the water filled in the microtube of the dialyzer is pushed out into the venous circuit, The disadvantage is that air in the arterial circuit is pumped into the microtube of the dialyzer. The air introduced into this fine tube closes the inner diameter of the tube, or forms small bubbles inside the tube and adheres to the tube wall, blocking the permeable membrane surface, restricting the flow of dialysate, and restricting the flow of blood. , resulting in a decrease in dialysis efficiency. In particular, if air bubbles are mixed into the permeable membrane in a wet type dialyzer, it is extremely difficult to remove them, and a desired dialysis effect cannot be achieved, resulting in an alarming situation.

Therefore, during priming, the operator must guide saline to the dialyzer connection port of the arterial circuit for each dialysis machine, remove the dialyzer connection port cap after the air in the arterial circuit has been discharged, and connect the dialyzer to the arterial circuit. It is necessary to connect the circuit, then connect the intravenous circuit in the same way, and discharge saline to clean the inside of the circuit.

In addition, once air bubbles enter the circuit or dialyzer, they become small bubbles and adhere to the wall surface, so to remove them, the tip of the filled water is gently moved and the hydrophilicity due to the surface tension of the interface is used to remove the bubbles. While looking directly at the small bubbles remaining on the inner wall of the circuit from the outside, strike the tube or dialyzer to separate it from the wall surface, remove it with a water flow, and guide the filling water. They were forced to do the very tedious work of doing this, and the time and effort required to do this required a great deal of effort, especially since the work was done early in the morning.

However, before dialysis treatment, priming work and other preparations must be done in parallel, and workers are forced to arrive at work several hours in advance in preparation for early morning treatment. The reality is that a large amount of personnel and time is spent on safety management of the dialysis machine, leaving less room for auxiliary operations such as priming.

The present invention was developed in light of these circumstances, and by automating priming, the time and effort spent on priming can be reduced, and workers can be given sufficient consideration to the dialysis treatment. Therefore, it is an object of the present invention to provide a device that can automate priming without introducing air bubbles into the dialyzer, targeting wet type dialyzers that are currently in particular use.

[Means to solve the problem]

The blood circuit priming device of the present invention, which solves the above problems, will be explained with reference to FIG.
In the blood circuit in which the replacement fluid line AL is connected to the arterial circuit 3 side of the dialyzer DL, suction pumps P1 and P2 are connected to the arteriovenous chambers AT and VT provided on the arterial and venous sides of the dialyzer DL, respectively. Motorized valves V are installed in the outer circuits of the venous chambers AT and VT, respectively.
1, V2 is provided, and by closing the electric valves V1 and V2 and evacuating each of the suction pumps P1 and P2, the blood passage side in the dialyzer DL is made negative pressure, and the dialysate side in the dialyzer DL is filled. After sucking out the liquid to the blood passage side through the permeable membrane, when this filling liquid reaches a level L2 near the lower end of the arterial chamber AT, the arterial side suction pump P1 and the venous side suction pump P2 are stopped. The liquid level of AT rises due to the residual negative pressure between both chambers AT and VT and reaches the inner bottom of the arterial chamber AT.
Next, by opening the electric valve V1 and evacuating the arterial side suction pump P1, the fluid replacement line is opened.
This system is characterized in that the arterial chamber AT is filled with fluid replacement from the AL up to a predetermined chamber level L1.

[Effect]

Hereinafter, the operation of the blood circuit priming device of the present invention will be explained in comparison with a conventional device.

In the conventional priming device shown in FIG. 3, an arterial chamber 32 is disposed in a fluid replacement bag 31 containing normal saline as a fluid, and then a venous chamber 34 is connected thereto via a dialyzer 33 as a dialyzer. and put each vessel in tube 35,3
6, 37, and 38 are connected to form a circuit.

However, in such a conventional priming device, since air exists in each circuit tube, when the replacement fluid flows out from the replacement fluid bag 31 due to the differential pressure, the air in the tube 35 is separated into air and liquid by the arterial chamber 32. However, the air in the tube 36 between the arterial chamber 32 and the dialyzer 33 is pushed by the replacement fluid flowing out from the arterial chamber 32 and flows into the blood passage in the dialyzer 33, forming a blood passage in the dialyzer 33. They close the permeable membrane surface or adhere in the form of small bubbles, restricting the flow of dialysate or obstructing the flow of blood as described above, and significantly reducing dialysis efficiency.

Therefore, in order to deal with such a situation, conventionally, an operator guides the replacement fluid to the tip of the tube 36, and when the air in the tube is exhausted, removes the cap of the artery side connection port of the dialyzer 33 and connects the artery side connection port 33a. By connecting the tube 36 to the dialyzer 33, the air inside the tube 36 is
This was done to prevent the blood from flowing into the blood passages.

By the way, the air in the tubes of the venous circuits 37 and 38 is separated into gas and liquid in the venous chamber 34 due to the differential pressure and is discharged, or is discharged from the outlet (venous side patient puncture needle connection port) 39 of the tube 38. Therefore, air within the venous circuit does not enter the blood passageway of the dialyzer 33.

Therefore, the main technical challenge for achieving automation of priming was to realize a means for removing the air within the tube 36 between the arterial chamber 32 and the dialyzer 33 without manual intervention.

The priming configuration of the present invention has achieved these problems. That is, in the configuration of the present invention, suction pumps P1 and P2 are connected to an arterial chamber AT provided on the arterial side of the dialyzer DL and a venous chamber VT provided on the venous side of the dialyzer DL, respectively. Then, by closing the outer circuits of the arteriovenous chambers AT and VT with electric valves V1 and V2, respectively, the blood passage including the dialyzer DL is made a closed circuit,
Therefore, by evacuating each suction pump P1, P2, the blood passage side in the dialyzer DL is made negative pressure.
Due to this ultrafiltration pressure, the dialysate passage side filling liquid in the dialyzer DL is sucked out to the blood passage side and flows toward the arterial chamber AT and the venous chamber VT.
Thereafter, even after the pump P1 is stopped when the pump P1 is stopped when the pump P1 is stopped when the pump P1 reaches the level L2 near the lower end of the arterial chamber AT due to the negative pressure on the blood passage side of the dialyzer DL. Negative pressure remains, and this residual pressure sucks out the filling fluid and raises the liquid level in the arterial chamber AT, causing air bubbles in the circuit tube 3a between the dialyzer DL and the arterial chamber AT to flow into the arterial chamber AT. It is extruded and separated into gas and liquid within the chamber.

Next, the air in the circuit is removed by opening the electric valve V1 and evacuating the arterial side suction pump P1, and the replacement fluid from the replacement fluid line AL is filled up to a predetermined chamber level L1 of the arterial chamber AT. Bubbles separated into gas and liquid inside are discharged to the outside.

On the other hand, the filling liquid that has flowed in the venous chamber VT direction flows out in the venous chamber VT direction, so that the air bubbles in the circuit tube 4a between the dialyzer DL and the venous chamber VT are pushed out into the venous chamber VT. Gas and liquid are separated in the venous chamber and discharged to the outside by the venous suction pump P2. Thus, the air bubbles in the circuit tube 3a between the dialyzer DL and the arterial chamber AT and the air bubbles in the circuit tube 4a between the dialyzer DL and the venous chamber VT are completely removed.

After that, the normal priming operation is performed, and the replacement fluid is caused to flow through the replacement fluid line AL into the arteriovenous circuit for a certain period of time using the differential pressure, and then is discharged to the arteriovenous puncture needle connection ports 10a and 10b, thereby cleaning the inside of the dialysis circuit.・Priming is performed.

〔Example〕

Embodiments of the present invention will be described below with reference to the drawings.

FIG. 1 is a schematic configuration diagram of a blood circuit priming device according to the present invention, and FIGS. 2a and 2b are side views from different directions of a dialysis device embodying the circuit shown in FIG. 1, respectively.

When priming with the device of this invention, a wet type dialyzer DL is connected as a dialyzer to the normally used dialysis blood circuit.
Arterial chamber from the arterial side of dialyzer DL
An arterial circuit 3 is configured by a line leading to the patient puncture needle connection port 10a via AT, and a dialyzer
A venous circuit 4 is constituted by a line from the venous side of the DL to the patient puncture needle connection port 10b via the venous chamber VT, and a fluid replacement bag 5 is provided in the middle of the arterial circuit 3.
Configure the replacement fluid line AL using the line leading to .

For such a blood circuit, the arterial chamber
Suction pumps P1 and P2 are connected to AT and venous chamber VT, respectively, and arteriovenous chamber AT,
In the outer circuit of VT, that is, both chambers AT including the dialyzer DL, motor-operated valves V1 and VT are respectively located surrounding the VT.
V2 is provided, and by closing these valves, a closed circuit is formed between the two valves.

The replacement fluid line AL includes an air bubble detector BD and a level chamber that detect the presence or absence of saline in the replacement fluid bag 5 by detecting the passage of air bubbles from the outside of the tube from the side of the replacement fluid bag 5 filled with saline as washing water. 7. Install the roller clamp 8 in this order, and connect the fluid replacement line.
The configuration is such that it is connected to the arterial circuit 3 at the AL connection site 3b. Note that the air bubble detector BD may be configured to detect that the saline in the replacement fluid bag 5 has become empty, and based on the signal, the electric valve is closed and the notification is made by sound, light, or the like.

The arterial circuit 3 sequentially starts from the artery side of the dialyzer DL.
Arterial chamber AT, motorized valve V1, heparin line connection socket 9a and blood pump segment 6
A motor-operated valve V3, which is pressurized and closed from the outside of the tube, is provided through the tube and reaches the patient puncture needle connection port 10a on the artery side, and a replacement fluid line AL is connected between the blood pump segment 6 and the motor-operated valve V3. The arterial chamber AT is
A level sensor LS1 detects a predetermined arterial chamber level L1 from the outside of the chamber, and a level sensor LS1 is provided near the lower end of the arterial chamber AT.
Equipped with a level sensor LS2 that detects

At the top of the arterial chamber AT, there is a level line tube 13a connected to the arterial suction pump P1.
is connected to the level line tube 13a, and a bacteria-removing air filter 12a and a pressure sensor S for limiting the operating pressure of the pump P1 are provided in the middle of the level line tube 13a, and the power reduction of the suction pump P1 is controlled at a specified pressure.

Note that the heparin line 9 connected to the heparin line connection socket 9a will be injected with a syringe filled with heparin solution before the start of clinical treatment, so until then it should be closed with a sealed cap 9b and closed with external pressure using forceps, etc. and wait.

The venous circuit 4 sequentially starts from the venous side of the dialyzer DL.
A venous chamber VT and an electric valve V2 are arranged to reach the venous side patient puncture needle connection port 10b.

At the top of the venous chamber VT, as in the arterial chamber AT, there is a venous suction pump P2.
A level line tube 13b is connected to the air filter 12b via a bacteria-removing air filter 12b. However, the pressure sensor S is not required in the venous pump P2. Further, a pressure line 14 separately provided at the top is connected to a venous pressure indicator (not shown) of the dialysis machine, but during the priming operation, the pressure line 14 is closed off with external pressure using forceps or the like and is on standby.

The venous chamber VT includes a level sensor LS3 that detects a predetermined venous chamber level L3 from outside the chamber.

In addition, the patient puncture needle connection port 10a on the arteriovenous side,
10b is a holder 15 provided on the upper layer of the drain tank 11 with the contact prevention cap 10 attached.
Hold it in place.

The blood circuit is assembled into the main body 20 of the apparatus as shown in FIG.
It can be fixed and configured as a single device.
At this time, the saline replenisher bag 5 is placed in a trap 2 at the uppermost position of the device body 20 to generate a head pressure difference.
2 to hang it, and move it to the top of the device body 20.
By arranging the venous level sensors LS1 and LS2 in parallel, and attaching the arteriovenous chambers AT and VT to them respectively, and removably attaching the dialyzer DL below them using the holder 21, the fluid replacement bag 5 and the arteriovenous level sensor are installed. LS1, LS2, and dialyzer DL are configured to generate a head pressure difference in this order, and a drain rank 11 is installed on the floor below the device body 20.

In addition, electric valves V1 to V3, etc. are arranged at appropriate positions according to the configuration shown in Fig. 1, and suction pumps P1,
By incorporating P2 into the main body of the device, the entire body can be constructed into a slim body as shown in FIG.

In treatment facilities, it is also possible to improve the utilization rate of the treatment room by setting up a priming room, filling it with replacement fluid at a fixed location, and replacing the circuit configuration with the dialysis machine. Further, in addition to configuring it as a single unit as described above, it is also possible to integrate it into a dialysis apparatus. In this case, a dialysis blood pump is connected to the pump segment 6, and the arterial side suction pump P1 is replaced by specifying the forward and reverse flow rates of the pump and operating the pump.
Additionally, if the increase in air in the arteriovenous chambers AT and VT significantly exceeds the chamber capacity, there is a risk that air will be sent into the circuit, and if the blood level flows into the level lines 13a, 13b and pressure line 14, the original Since the operation becomes impossible, suction pumps P1 and P are activated from the level detectors LS1 and LS3 to ensure the blood level even during dialysis treatment.
It is also possible to send signals for forward and reverse rotation to the pumps P1 and P2, and to stop the suction pumps P1 and P2 if the blood level deviates from a predetermined blood level, thereby providing a safe measure for dialysis treatment management.

Although the priming device of the present invention is applied to a wet type dialysis machine, it can be applied to a dry type dialysis machine by using an operation plan in which the suction operation of the arteriovenous suction pumps P1 and P2 is stopped during the priming operation. It can also be used as a device, and by selecting a switch, it can be selected according to the patient in the same treatment room.

Furthermore, this priming circuit
It is connected to the schedule timer in 0, and opens and closes the electric valves V1 to 3 and the suction pump P based on the detection signals of the bubble detector BD and level sensors LS1 to LS3.
1. It is configured to control the discharge operation of P2, and perform automatic priming operation.

The priming operation by the above-mentioned priming device will be explained below.

First, in preparation for starting priming, dialyzer DL
Hold the dialysate in an upright position, and with the dialysate inlet DL2 closed, remove the closing cap 16 of the dialysate outlet connection port DL1, or insert the injection needle 17 with an air filter (usually an air needle) into the closing cap 16. Puncture to reach the exit. On the other hand, the fluid line
After adjusting the water level in the AL level chamber 7 to a certain level of the fluid replacement line, the roller clamp 8 is closed to stop the flow of saline. Next, specify the scheduled time to start the priming operation on the timer, turn on the power switch, and turn on the electric valves V1, V2, and V.
After closing each circuit in step 3, connect the fluid replacement line.
Release the AL roller clamp 8.

This completes the priming preparation by the operator.

When the scheduled time specified by the timer arrives and the priming operation starts, first the suction pumps P1,
P2 performs the exhaust operation, and negative pressure is created on the blood passage side of the dialyzer DL between the electric valves V1 and V2, and the dialyzer
The filling liquid filled in the dialyzer is sucked into the blood passage side through the permeable membrane that forms the blood passage of DL, and gradually fills the blood circuits 3a and 4a leading to the arteriovenous chambers AT and VT while maintaining an interface. . When the filling fluid from this blood passage reaches a level position L2 near the lower end of the arterial chamber AT, the level sensor LS2 senses it and stops the suction pump P1, but even after that, the residual pressure in the blood passage in the dialyzer DL remains. The filling fluid in the dialyzer DL is introduced into the arterial chamber AT via the blood passage.

On the other hand, saline flows down from the replacement fluid bag 5 due to the differential pressure, and flows in the direction of the patient puncture needle connection in the arterial side circuit 3. Therefore, for a specified period of time, the electric valve V3
When opened, the air in the arterial circuit 3 from the fluid replacement line AL to the artery-side patient puncture needle connection port 10a is pushed out, is appropriately restricted by the narrowed part of the contact prevention cap 10 of the artery puncture needle connection port 10a, and is released. After that, electric valve V3 is closed.

Also, the suction pump P2 is on the VT side of the arterial chamber.
Due to the discharging operation, the filling water of the dialyzer DL fills the venous circuit, and when the suction pump P1 stops operating, the suction pump P2 also stops.

Next, when the electric valve V1 is opened and the suction pump P1 is operated for evacuation, the replacement fluid flows from the replacement fluid line AL through the arterial circuit 3 including the pump segment 6, reaches the arterial chamber AT, and drips into the chamber. to raise the liquid level. When the liquid level in this chamber reaches the position of the level detector L1, the level sensor LS1 senses this and the suction pump P1
will be stopped. Subsequently, due to the evacuation operation of the suction pump P2, the liquid level in the venous chamber VT rises, and when the liquid level reaches the level L3, the level sensor LS3 senses it and the suction pump P2 is stopped.

Next, when the electric valve V2 is opened, the replacement fluid bag 5
The saline inside goes through the fluid replacement line AL to the arterial circuit 3,
It passes through the dialyzer DL and the venous circuit 4, but since the air bubbles in these circuits have been completely removed, the dialyzer
The DL is appropriately restricted and released at the constricted portion of the contact prevention cap 10 of the venipuncture needle connection port 10b without any air bubbles being mixed into the DL.

The flow rate used for the cleaning is adjusted by the height (head) of the replacement fluid bag and the roller clamp 8, and is fixed depending on the type of blood circuit, the properties of the dialyzer, etc.

Further, the priming operation is ended by a timer and the electric valves V1 and V2 provided in the circuit are closed.

[Effect of idea]

According to the blood circuit priming device of the present invention,
When automating priming, the most important issue of not allowing air in the arterial circuit tube to flow into the dialyzer has been made possible through automatic operation, so we will specify the operation time and perform planned automatic priming before dialysis treatment. In addition, it is possible to save labor in priming work, reduce time and labor burden, and enable a small number of workers to perform the work.

Furthermore, the priming device of the present invention provides a highly practical priming device because (1) either a wet type or a dry type dialyzer can be used, and switching can be specified by selecting a switch. be able to.

(2) Integrating the priming circuit into the dialyzer,
It can also be an independent standalone device.

(3) The gas-liquid separation function of the arterial and venous chambers can be maintained at its best and air bubbles can be prevented to the maximum extent possible.

(4) Even during dialysis treatment, the arteriovenous chamber level can be constantly adjusted to safely perform normal treatment.

(5) If a bubble detector is installed in the replacement fluid line that connects to the replacement fluid bag, it will be possible to detect when the replacement fluid is empty, and the system will use this signal to close the motorized valve and notify you with sound, light, etc. This will further improve safety.

It has the following effects.

[Brief explanation of the drawing]

Fig. 1 is a schematic configuration diagram of a blood circuit priming device according to the present invention, Fig. 2 a and b are side views from different directions of a dialysis machine embodying the circuit shown in Fig. 1, and Fig. 3 is a conventional priming device. FIG. 2 is a schematic diagram of the configuration. DL...Dializer, AT...Arterial chamber, VT...Venous chamber, V1~
3...Electric valve, P1...Arterial side suction pump, P2
...Venous suction pump, LS1-3...Level sensor, S...Pressure sensor, BD...Bubble detector,
3... Arterial circuit, 4... Venous circuit, 5... Replacement fluid bag, 7... Level chamber, 13a, 13b
...Level line, 14...Pressure display line.

Claims (1)

[Claims for Utility Model Registration] (1) In a blood circuit in which a fluid replacement line AL is connected to the arterial circuit 3 side of a dialyzer DL equipped with arteriovenous circuits 3 and 4, the arteriovenous side of the dialyzer DL. Suction pumps P1 and P2 are connected to the arteriovenous chambers AT and VT provided in the chambers, respectively, and electric valves V1 and V2 are provided in the outer circuits of the arteriovenous chambers AT and VT, respectively, and the electric valves V1 and V2 are closed. At the same time, by evacuating each of the suction pumps P1 and P2, the blood passage side in the dialyzer DL is made negative pressure, and the filling liquid on the dialysate passage side in the dialyzer DL is transferred to the blood passage side through the permeable membrane. After suctioning, when this filling liquid reaches a level L2 near the lower end of the arterial chamber AT, the arterial side suction pump P1 and the venous side suction pump P2 are stopped.
The fluid level in arterial chamber AT is equal to both chambers AT,
It rises due to the residual negative pressure between VT and reaches the inner bottom of the arterial chamber AT, and then the motor-operated valve V
A blood circuit priming device characterized in that an arterial chamber AT is filled with a replacement fluid from a replacement fluid line AL to a predetermined chamber level L1 by opening the arterial side suction pump P1 and evacuating the arterial side suction pump P1. (2) The blood circuit priming device according to claim 1, characterized in that the arterial side suction pump P1 is equipped with a pressure sensor that limits its working pressure. (3) After activating the arterial and venous suction pumps P1 and P2 to secure the replacement fluid from the replacement fluid line AL connection port to the specified arterial chamber level L1 and venous chamber level L2, open the electric valves V1 and V2. and then discharge the replacement fluid from the venous puncture needle connection port 10b, and then open the electric valve V3 provided between the arterial puncture needle connection port 10a and discharge the replacement fluid to the arterial puncture needle connection port 10a for a specified time. The blood circuit priming device according to claim 1.