JPS5819265A - Membrane type artificial lang apparatus by blood dialyzing system - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

[Detailed description of the invention] The present invention relates to a hemodialysis type artificial lung.

For more details, please refer to BCMO (Extracorporea
The present invention relates to a membrane oxygenator for use in membrane oxygenators (Membrane Oxygenatlon), and in particular to small auxiliary lungs with excellent CO removal ability for patients with respiratory failure.

Generally, an artificial lung is a device whose purpose is to add oxygen (02) to blood and simultaneously remove carbon dioxide (Co2) from the blood. Until now, artificial lungs have been a ``technique of interest''.
That is, it has been clinically used as an artificial lung device that takes over the functions of the heart and lungs when the heart is opened and the heart is stopped for surgery. In addition to this, clinical cases have recently been reported in which artificial lungs are used to support lung function in patients with respiratory failure. Since oxygenators used for the latter purpose are used for relatively long periods of time, sometimes for several days in a row, they must be modified oxygenators that cause less damage to the blood. It is said that ICMO involves the use of the lungs.

In patients with respiratory failure, the partial pressure of oxygen in the blood (PO,) decreases, and at the same time, the partial pressure of oxygen gas (PCO,) in the blood shows a high value, and this is due to an increase in PCO2 rather than a decrease in PO2. This is said to be a clinically difficult problem. Increasing PO in the blood can be done relatively easily by, for example, using oxygen □ inhalation or a positive pressure ventilator. However, it is impossible to lower PCO2 in the blood with oxygen inhalation, and with artificial respiration, it is impossible to lower PCO2 in the blood.
However, it is often insufficient. Also, in some cases, PC
If a patient inhales a high concentration of 02 without lowering the 0, the P in the blood will decrease.
CO2 levels can rise rapidly and even lead to death. As a treatment for such patients with respiratory failure, blood is extracorporeally circulated at a small flow rate and C
If there were a method to remove O□, it would be a very effective means clinically.

An artificial lung was used, but with this method, the number of excess d
Therefore, using a hemodialyzer for artificial kidneys, which is currently widely used, blood is passed through one side of the J membrane and dialysate is passed through the other side, and dissolved CO in the blood is removed.

And if K HCO,- ions are transferred to the dialysate,
CO2 can be removed much more easily than in conventional modified oxygenators, which bring blood and gas into contact through a membrane. The present invention relates to a hemodialyzer for the purpose of removing CO from the blood, that is, an apparatus (system) using a hemodialysis converting oxygenator.

Of course, such a device can be used in a single-pass method, in which new dialysate is supplied to a hemodialysis converting oxygenator, and dialysate containing CO, HCO, and ions from the oxygenator is discarded. However, since the treatment generally requires a long period of time to run, this method requires hundreds of liters of dialysate, and the preparation of this dialysate requires a large amount of time, such as in the case of a rolled artificial kidney. This requires large equipment such as water purification equipment and dialysate supply equipment.The treatment location is fixed, and there is also a problem with the treatment of large amounts of wastewater.Furthermore, in this case, effective ion However, it is not possible to use simple compositions such as O-?- saline or isotonic loose gastric fluid as the dialysate. However, this solution contains sodium acetate and sodium lactate, and these organic acid salts are decomposed after entering the patient's body to produce HCO and '-ions. Even if CO2 and HCO; ions are removed by a device, these organic acids are transferred into the body instead, and P
This is not practical as it will increase CO.

As a result of various studies in view of the above points, the inventor has found that C.
They succeeded in obtaining a small and simple convertible oxygenator that regenerates and circulates dialysate containing O, HCO, ``-ions.In other words, the present invention regenerates and circulates dialysate containing O, HCO, ``-ions. A dialysis-type cavity-type oxygenator is used, in which blood and dialysate are brought into contact with each other through a membrane, and carbon dioxide and bicarbonate ions in the blood are transferred into the dialysate.

The dialysate is brought into contact with an inert gas such as air, nitrogen, oxygen, or a mixture thereof outside the dialysis type oxygenator system while suppressing the rise of the circle, and the dialysate is transferred from the blood into the dialysate. Carbon dioxide transferred from the blood to the dialysate 1. The carbon dioxide produced by the dehydration reaction of bicarbonate ions is diffused into the inert gas. The dialysis waves are regenerated, the dialysate is returned to the dialysis cavity oxygenator, and the dialysate is circulated. **This is a dialysis-type membrane cap artificial lung device featuring the following features:

Next, we will explain the details of the actual Qo-Example based on the drawings.
! I will clarify. In FIG. 1, reference numeral 1 indicates a dialysis type artificial lung), which may be replaced with a commercially available hemodialyzer for artificial kidneys.

! A bubble column, a packed column, a tray column, etc. can be used (see the blanks below). 3 is a bubble removal section], a micro bubble exchanger in the dialysate,
7 is a flow needle. Although the heat exchanger 6 is inserted into the liquid feeding line in FIG. 11, the complete liquid contacting device R24,L< can also be built into the bubble removal section 3.

Reference numeral 4 denotes a voice electrode, which measures the voice of the dialysate which changes due to the dissipation of C02. Reference numeral 41 denotes a voice regulating device, which injects acid or alkaline aqueous solution as necessary to adjust the pH.

8 is blood inlet, 9 is blood outlet, IO is dialysate inlet, 11
indicates the dialysate outlet, and C indicates the voice conditioning fluid tank.

Blood of a patient with a high PCO is circulated extracorporeally and is sent to a hemodialysis model artificial lung 1 through a blood inlet 8. This blood Fico, and! 'fCO, - CO□ and l injected from the dialysate inlet 10 through an ion-permeable membrane
The ICOs'' are contacted with a dialysate having a low concentration of ions.

Following the concentration gradient, CO2 and mco5'' ions move from the blood to the dialysate. The blood with reduced concentration of Co and HCO,- ions is returned to the patient's blood vessel through the blood outlet 9. On the other hand, CO2 and 11ICo, The dialysate with increased ion concentration comes out from the dialysis outlet U and passes through the gas-liquid contact device 3.
An inert gas such as air, nitrogen, oxygen, or a mixture thereof is sent from below the complete liquid contact device 3, and the dialysate comes into contact with the inert gas, and the dialysate The CO dissolved therein and the CO generated by the dehydration reaction of bicarbonate are diffused into the gas. As a result, the concentration of CO, nco, and ``-ions in the dialysate decreases, and the dialysate is regenerated. is removed and sent to the hemodialysis oxygenator 1 again by the pump 5.When the gas-liquid contact device 3 dissipates 002, the top of the dialysate rises, so it is measured by the voice electrode 4 and the voice control is performed. It is necessary to adjust the gas 1 in the device 4f so that it does not exceed the physiological range.In addition, when dissipating CO in the gas-liquid contact device 3, in order to promote the dehydration reaction of carbonic acid, carbonic acid dehydration is necessary. Either the enzyme or reaction accelerator is dissolved in the dialysate, or
Alternatively, by immobilizing carbonic anhydrase or anticoagulant using a polymer compound, the rate of CO dissipation can be further increased. In addition, phosphoric acid, chloric acid, boric acid, etc. can be used as a reaction accelerator.

Since the present invention has the above configuration, the following effects are achieved.

First, since the dialysate is used in circulation, only a small amount of 2 to 3J is required, and the hemodialysis model oxygenator according to the present invention is small and simple. In addition, as a dialysate, a general dialysate for artificial kidneys (for example, Ha+152ml11g/j
, K”2・OmKf/j%C&++2・5m1CF/
Simple compositions such as 0.9 saline and isotonic weak gastric fluid, which cannot be used in the bath method, can also be used.

Next, an experimental example of the present invention will be shown.

Experimental Example 1 The experiment was conducted using the apparatus shown in Figure 1. 9! C5 & contact device has a diameter of 5.5-1, a height of 70aa, and a volume of 1.66J.
It was carried out in a bubble column format. Heparinized fresh bovine blood 21 was used as the blood, and a mixed gas of CO2 and N2 was blown into it to raise the PGO□ to obtain venous blood. Blood flow rate is 172M
The dialysate flow rate was 500 degrees Fahrenheit using VWiII.

As the dialysate, 2.54% of 0.9% MaC4 was used.

Steam-saturated air was blown into the gas-liquid contact device at a flow rate of 20 degrees. In order to suppress the rise in dialysate voice due to CO, dissipation, 1M hydrochloric acid can be automatically injected, and the voice is 7.0.
Adjusted to ~7.4. A regenerated cellulose hollow fiber type (membrane surface lines 1 and 2) was used as a dialysis type back type oxygenator. 1st
Dialysate Fi(1) as shown in the table.

It was played back at a dissipation rate of 52 meters.

Table 1 Experimental Example 2 Is the experiment conducted using the equipment shown in Figure 1? Ta. The gas-liquid contacting device was of a bubble column type with a diameter of 4 aa, a height of 501 mm, and a volume of 0.61 mm, and the air flow rate was 1Oj/IIn. The regenerated cellulose hollow fiber type (membrane area 1.2
Go) was used. As a dialysate, NaCjQ・61/1
, KCIj O・5f/1. CtsCl, -2H2
00.35F/j, with a composition of glucose 2.61/l, carbonic anhydrase (carbonate hydrol 4.2
．． 1.1) 2.51 books dissolved in 301111/l were used. As the blood, heparinized fresh bovine blood 21 is used 1
1.C02 and N.

Gas was injected to raise the PCO, which was used as venous blood. The blood flow rate was 17211t/-1 and the dialysate flow rate was 5ood/i.

As shown in Table 2, the results showed that dialysate could be regenerated at a CO emission rate of 55e6.

Table 2 Experimental example 1. Compared to the volume of the gas-liquid i device, the CO emission rate is 14.
It was 9-/i.

South 41-4-1 Book 9 Diagram True Easy 1*@ Ill shows an explanatory diagram of the actual IL() system Ill.

Figure 1: Dialysis-type back-type artificial lung! ... Gas-liquid contact device, 8... Blood inlet 9...
・Blood outlet-10... Dialysate population 11... Dialysate outlet Patent applicant (IT) *Gutoshu Scientific Research Institute Ya 1 Cause Co2 Procedural amendment (voluntary) Patent dated October 22, 1982 Director General Minoru 1, Case OII 11, 1966 Patent Original No. 11116148, Invention 04, Blood Cell Dialysis System, Artificial Lung Apparatus, 4th Amendment. WAJllo rll @ 01 [Review 111011 Contents of the amendment (1) On page 6 of the specification, line 9 of the rattan, there is “genus artificial lung” (
2) The following ajlp corrections will be made to the 0 rattan 1 table written in the 12th summer line 1 to j1g line 6 of the specification.

(S) Specification jlIB] [The following oab corrections have been made to Table 2 stated in lines 5 to 10.

that's all

Claims (1)

[Claims] Kawa: A dialysis-type converting oxygenator that circulates blood extracorporeally and brings the blood and dialysate into contact through a membrane to transfer carbon dioxide and bicarbonate ions from the blood into the dialysate. , the dialysate is brought into contact with an inert gas such as air, nitrogen, oxygen, or a mixture thereof outside the dialysis converting oxygenator system while suppressing a rise in pH, and the dialysate is removed from the blood into the dialysate. Regenerating the dialysate by dissipating the carbon dioxide generated during the dehydration reaction of the carbon dioxide and bicarbonate ions transferred from the blood into the dialysate into the inert gas, and regenerating the dialysate. A hemodialysis membrane type oxygenator, characterized in that the membrane oxygenator is returned to the dialysis type linear oxygenator, and the dialysate is circulated. (2) The hemodialysis converting artificial lung device according to claim 1, wherein the dialysate contains carbonic anhydrase. 13) The hemodialysis convertible artificial lung device according to claim 2, wherein carbonic anhydrase is immobilized on a polymer compound. (4) The hemodialysis converting artificial lung device according to claim 1, wherein the dialysate contains a reaction accelerator. (5) The hemodialysis artificial lung device according to claim 4, wherein the reaction accelerator is fixed to a polymer compound.