JPH06233813A - Hemocatharsis system - Google Patents

Abstract

PURPOSE:To provide a small-sized system easy to handle for performing the gradual body fluid regulation therapy by changing the revolving speed of a filtering pump to adjust the filtrate quantity so that the filtrate quantification unit weight is practically made equal to the set weight. CONSTITUTION:A replenishing fluid container 7, a dialyzing fluid container 8, and a filtrate container 9 are mounted on a filtrate quantification unit 10, the total weight is measured, and it is used for the control index of the revolving speed of a filtering pump 2 as the set value. The venous blood is mixed with an anticoagulant, and the mixture is guided into a homocatharisis device 6 by a pump 5 via a connecting tube 13. The feed of the dialyzing fluid in the dialyzing fluid container 8 is started by a pump 3. The blood guided into the homocatharisis device 6 is dialyzed and filtered by the pump 2, and it is guided into a communicating tube 14 and stored in the filtrate container 9 on the filtrate quantification unit 10. The revolving speed of the pump is controlled by the signal from the filtrate quantification unit 10, and the balance among the replenishing fluid quantity, dialyzing fluid quantity, and filtrate quantity is maintained.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a blood purifying apparatus which introduces blood removed from a vein into a blood purifier and filters and separates water, metabolites, electrolytes and the like to substitute for the renal function of a living body.

[0002]

2. Description of the Related Art Conventionally, as blood purification methods, whole blood exchange, plasma exchange, blood adsorption, hemodialysis, hemofiltration, hemodiafiltration, peritoneal dialysis and the like have been widely applied clinically. However, it may be difficult to apply the above-mentioned blood purification method to a patient who has developed acute renal failure, decreased renal function associated with heart disease, or the like because of deterioration of the circulatory condition.
Therefore, as a blood purification method that acts as a substitute for the filtration function of the kidney of the living body, a slow body fluid adjustment treatment method has been newly proposed. Since this slow body fluid adjustment treatment method is a method applied to the above-mentioned severely ill patients, it is mainly used for treatment in ICU, CCU and the like.

[0003]

However, ICU, C
As many patients who enter the CU etc. have complications as described above, it is not possible to treat them with a single means, and many treatment devices are installed at the bedside of the patient. For this reason, therapeutic instruments used in ICU, CCU, etc. are required to have not only excellent performance but also be as small as possible and easy to handle.

However, in the conventional practice of the slow body fluid adjustment therapy in ICU, CCU, etc., a blood pump,
Since the filtrate pump, the drug infusion pump, etc. were used alone, most of the bedside space was occupied by these devices, and doctors etc. could not act freely for treatment.

Further, in the slow body fluid adjusting treatment method, it is necessary to perform replacement fluid (infusion) according to the amount of filtrate filtered by the blood purifier, and when the amount of filtrate fluctuates, the amount of replacement fluid is adjusted in conjunction with it. Even if it is not done, it will impose a further burden on those involved in a busy treatment site. In addition, a roller pump that is generally used in this type of treatment device has a pump tube that has a constant pump rotation speed, but if the pressure exceeds a set value due to fluctuations in the pressure on the filtrate side, the pump tube There is a phenomenon that the amount of filtrate increases due to swelling than usual, and it is difficult to detect this fluctuation in the amount of filtrate, so the balance between the amount of filtrate and the replacement fluid becomes unbalanced, which may cause a serious therapeutic problem. There is a nature.

[0006]

The blood purification device of the present invention comprises:
It is a small-sized and easy-to-use device for performing a slow body fluid adjustment treatment method. That is, the present invention collects blood from a vein and returns to the vein in the blood-venous circulation system, at least a blood sampling pump, a blood purifier, a filtration pump and a filtrate quantifier, and a replacement fluid container and a dialysate by the filtrate quantifier. Measuring and setting the weight of the container and the filtrate container, supplying the replacement fluid and the dialysate at the set flow rate, and changing the rotation speed of the filtration pump so that the weight of the filtrate meter is substantially the same as the set weight. The present invention relates to a blood purification device characterized in that the amount of filtrate is adjusted.

The meaning of adjusting the amount of filtrate is to increase or decrease the amount of filtrate as the weight of the filtrate meter increases or decreases from the set value. It means the amount of filtrate to be equilibrated.

[0008]

The blood purification apparatus of the present invention is extremely small in size because it is integrally equipped with various pumps and multiple safety mechanisms for carrying out the slow body fluid adjustment treatment method.
Even if it is installed in a narrow space at the bedside, it does not particularly interfere with medical activities.

In the blood purification apparatus of the present invention, the amount of filtrate is controlled by adjusting the rotation speed of the filtration pump according to the preset weight setting value of the filtrate quantifier and the signal sent from the filtrate quantifier. . In the present invention, since the rotation speed of the filtration pump is controlled by the weight balance between the supplied replacement fluid and dialysate and the increased filtrate quantity, the filtrate quantity may vary even if the rotation speed is constant. It is not affected by the defects of the roller pump, and there is no fear of causing a dangerous situation in which the balance between the filtrate amount and the replacement liquid amount is lost. Further, instead of measuring the amount of filtrate in a batch manner as in the conventional method, the number of revolutions of the pump is controlled in a timely manner by the signal sent continuously, and an accurate amount of filtrate can be obtained. The complicated operation for carrying out the adjusted treatment method is reduced, the safety is improved, and other treatment means can be easily carried out.

An embodiment of the present invention will be described below in detail with reference to the drawings.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS FIG. 1 schematically shows the flow of blood in a blood purification apparatus according to the present invention. Prior to extracorporeal blood circulation, first, a replacement fluid container 7 and a dialysate container 8 are placed on the filtrate quantification device 10 (the containers are initially filled with the replacement fluid and the dialysate).
And the filtrate container 9 is placed, the total weight thereof is measured, and the weight is set as a set value to be a control index of the rotation speed of the filtration pump 2,
Start the following operations. The venous blood is removed by the puncture needle at the tip of the connecting tube 11 by the pump 1, mixed with the anticoagulant introduced through the connecting tube 12 by the pump 5, and introduced into the blood purifier 6 through the connecting tube 13. It At the same time, the supply of the replacement fluid in the replacement fluid container 7 is started by the pump 4,
The pump 3 starts the supply of dialysate in the dialysate container 8.

Any anticoagulant may be used as long as it can be used for extracorporeal circulation. For example, citric acid (AC
D, CPD, etc.), heparin, prostaglandin, gabexate mesylate and the like are used. These may be administered by a continuous administration device or a drip from a puncture portion or a branch portion provided in the blood line on the downstream side.

The blood introduced into the blood purifier 6 is dialyzed and filtered by the pump 2, water containing low molecular weight substances in the blood is introduced into the connecting pipe 14, and the water is introduced into the filtrate container 9 on the filtrate meter 10. Be accommodated. The filtrate quantification device 10 may be any device that can measure the weight, and a strain gauge type balance or the like that can take out an electric signal can be used. The sensitivity and accuracy may not be so high. For example, a strain gauge having a sensitivity of about 1 g can be used sufficiently. On the other hand, the concentrated blood in the blood purifier 6 is connected to the connecting pipe 15
The blood is returned to the vein.

As a blood purifier, a hollow fiber membrane module using a hollow fiber membrane as a filtering material is suitable. An ultrafiltration membrane is preferable as the hollow fiber membrane used in the hollow fiber membrane module. The ultrafiltration membrane may be perforated or non-perforated as long as it has little or no leakage of plasma proteins and can remove water. The material forming the hollow fiber membrane is not particularly limited, and examples thereof include cellulose-based, polysulfone-based, polyamide-based, polyacrylonitrile-based, poly (ethylene-vinyl alcohol) -based, polymethylmethacrylate-based, and polycarbonate-based materials. In addition to the above-mentioned materials, polyolefin [polyethylene, polypropylene, poly (4-methyl-pentene-1), etc.], glass, ceramics, carbon, etc. may be used as long as it is a porous film having ultrafiltration performance. Inorganic materials can also be used. The outer diameter of the hollow fiber membrane is not particularly limited,
Generally, those having a size of about 10 to 1000 μm are preferable.

In the extracorporeal circulatory system, the apparatus of the present invention is designed so that each pump, in particular, the number of revolutions of the pump 2, the pressure of the blood collecting line and the filtration side of the blood purifier, and the deviation from the set weight from the filtrate metering device. Signal, and information such as the presence / absence of bubbles in the bubble detector are detected by electric signals, and the AC / DC converter converts the AC / DC converted signals into a computer to monitor each state. It is like this.

The pumps 3 and 4 rotate at the initially set number of revolutions, but when the weight of the filtrate quantitative meter 10 is less than the preset weight, the weight of the filtrate quantitative meter 10 is previously indicated on the display. It is displayed that the weight is lower than the set weight, and the rotation speed of the pump 2 increases. In this way, the number of revolutions of the pump is controlled by the signal from the filtrate quantifier 10, and the amount of the replacement fluid and the dialysate and the amount of the filtrate are balanced. Pump 2, pump 3 and pump 4 are normally operated at the set rotational speed,
The total volume of dialysate and blood remains approximately constant. But,
When the above-mentioned equilibrium is lost and the weight of the filtrate quantifier 10 decreases, the rotation speed of the pump 2 is gradually increased to maintain the weight at the initial set value, and the negative pressure on the filtration side of the blood purifier 6 is reduced. Gradually increase. This negative pressure also increases as the performance of the hollow fiber membrane deteriorates. However, in the device of the present invention, when the negative pressure reaches 200 mmHg in consideration of safety, an alarm to that effect is displayed. It In that case, some trouble may occur in the device, or there may be a limit in use due to performance degradation or deterioration of the hollow fiber membrane module, so that the device must be inspected or parts replaced.

[0016]

According to the blood purification apparatus of the present invention, the amount of blood collected is constant, the replacement fluid container, the dialysate container and the filtrate container are placed on the same filtrate meter, and the replacement fluid and the dialysate are supplied at the set flow rate. By maintaining the initial weight of the filtrate quantitative meter, the balance between the filtrate amount and the replacement fluid and dialysate fluid is always maintained, and there is no fear of causing a serious problem in treatment.

Next, the concrete results of implementation using the blood purifier of the present invention will be described. Example 1 Bovine blood having a hematocrit value of 37% was placed in a cylindrical glass container having a volume of 10 liters, and a perforating needle portion was immersed therein,
Blood was circulated by the blood circuit shown in FIG. First, a replacement fluid container, a dialysate container (each of which is filled with a prescribed amount of liquid) and a filtrate container were allowed to stand on the filtrate quantifier, and the total weight thereof was measured to be 5.54 kg, which was set. Weight and weight. Then, blood was flown by the pump 1 at a rate of 100 ml / min, a replacement fluid was supplied by the pump 4 at a rate of 500 ml / hour, and a dialysate was supplied by a pump 3 at a rate of 1000 ml / hour. The pump 2 continued operation for 2 days while filtering water and the like from the blood passing through the blood purifier at a rate of 1500 ml / hour (during which the replacement fluid container and the dialysate fluid container were replaced 24 times, and at the same time in the filtrate fluid container). The filtrate was discarded, and the weight of the filtrate meter was measured, but it was almost the same.) During this period, the weight of the filtrate meter was 5.50 to 5.57.
It was almost constant in the kg range. The pressure on the inlet side of the blood purifier is 50 to 58 mmHg one day after the start of operation and two after two days.
It became 00 mmHg and an alarm was issued. Therefore, the entire device was inspected, but there was no particular problem, so the hollow fiber membrane module of the blood purifier was replaced, and operation was restarted under the same conditions as at the beginning. As described above, according to the blood purification device of the present invention, since the amount of filtrate is kept at a preset constant amount, a balance with the amount of replacement fluid is kept, and a serious problem in treatment is not caused.

[0018]

[Brief description of drawings]

FIG. 1 is a circuit diagram of a blood purification device of the present invention.

[Explanation of symbols]

 1 Blood Removal Pump 2 Filtration Pump 3 Dialysis Fluid Pump 4 Replacement Fluid Pump 5 Anticoagulant Injection Pump 6 Blood Purifier 7 Replacement Fluid Container 8 Dialysis Fluid Container 9 Filtrate Container 10 Filtrate Quantitator 11 First Connection Pipe 12 Second Connection Pipe 13 Third Connection Pipe 14 Fourth Connection Pipe 15 Fifth Connection Pipe

Claims (1)

[Claims] 1. A blood intervenous circulation system for collecting blood from a vein and returning the blood to the vein, which is provided with at least a blood collection pump, a blood purifier, a filtration pump and a filtrate quantifier, and a filtrate quantifier for a replacement fluid container and a dialysate container. By measuring and setting the weight of the filtrate container and supplying the replacement fluid and the dialysate at the set flow rate, by changing the rotation speed of the filtration pump so that the weight of the filtrate quantitative meter becomes substantially the same as the set weight. A blood purification device characterized by adjusting the amount of filtrate.