JPS60103965A - Blood reservoir - 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 19. Background of the Invention (Technical Field) The present invention relates to a blood reservoir (cardiosomal reservoir) used in an artificial heart-lung circuit during open heart surgery
It is related to.

(Prior art and its problems) In an artificial heart-lung circuit, as illustrated in FIG.
Blood from the surgical field passes through the suction line 2 and pump 3 through the blood reservoir 4 and line 5, enters the venous reservoir/7 housed in the volume regulating means 6, and is further transferred by the pump 8 to the artificial joint 9 with a heat exchanger. The blood that has been sent and has been contaminated here is configured to be returned to the patient's body via a blood supply line IO.

By the way, in addition to the function of defoaming and storing blood aspirated in the surgical field such as the thoracic cavity and cardiac cavity, the blood reservoir has the function of defoaming and storing blood that is aspirated in the surgical field, such as the thoracic cavity and heart cavity. Devices that incorporate a filter for filtering out foreign substances such as microaggregates and are configured to perform the three important functions of filtration, defoaming, and blood storage have become widely used. However, the blood storage tanks currently in use have the following types for the above three functions. It has been pointed out that there is a problem.

(1) Filtration Function 1 - Problem When blood containing many foreign substances such as tissues and microaggregates is passed through a filter, the filter tends to become clogged quickly before it is used effectively. Furthermore, in the case of a pleated filter, a lumen is created due to the cylindrical arrangement of the filter, and therefore blood pools in this lumen, making it difficult to accurately determine the amount of blood in the blood reservoir. Therefore, there is a difference between the scale mark marked on the housing of the blood reservoir and the actual amount of blood stored, resulting in the problem that the actual amount of blood cannot be read when necessary. In addition, filter performance and the ability to quickly separate blood and bubbles within the filter conflict, making it difficult to achieve this efficiency.

(2) Problems with defoaming function Blood that enters the blood storage tank is filtered and defoamed by a filter and an antifoaming agent, and then stored in the housing, but at that time, it flows out from the filtration and defoaming member. In a structure in which blood (or priming liquid) is once defoamed and dripped onto the blood surface, bubbles will occur again, which is undesirable. In such a case, blood containing microbubbles is also sent to the patient, and there is a risk of brain damage due to peripheral blood vessel occlusion.

There are some structures that avoid the above phenomenon by bringing the filtration and defoaming member into contact with the bottom of the housing, but in this type of structure,
An air block phenomenon in which the air in the blood discharge boat at the bottom of the housing and the tube connected thereto cannot be discharged and is left behind tends to occur. For a membrane lung using a closed venous reservoir, there is a great risk of air getting mixed into the venous reservoir, the oxygenator, and the lung. The air block phenomenon is when the tube connected to the blood outflow port is clamped at the blood surface, and when human blood accidentally flows in, air cannot be released.
cS, I can taste the phenomenon where some of it stays inside the tube.

In addition, in blood storage tanks with built-in filters, due to the resistance of the filters that have recently become more sophisticated, it is necessary to have a structure that defoams after filtration. In this case, positive pressure filtration is used. In positive pressure filtration, as the number of blood meteors increases, the processing capacity of the defoaming member is exceeded, and air spurts blood from the filter, creating bubbles in the blood, which makes subsequent defoaming disadvantageous. . In such a case, the pressure increase in the filter is also large, which tends to reduce filter performance. In order to avoid this, some products have adopted a SiGlon type air separation structure at the blood inlet, but this cannot be done when a large amount of air is mixed in, and this can easily lead to Mr. A.
This results in considerably poor defoaming performance.

(3) Problems with blood storage function There are also problems with the shape and structure of the housing in terms of blood storage function. The housing can be easily manufactured using a mold, or by manufacturing the flange halves and gluing them together in the middle. However, with such a structure, there is a possibility of blood leakage at the bonded portion, and at the same time, it is troublesome to display the liquid volume scale on the label, and the display of the stored blood volume at the flange part is likely to be inaccurate. Furthermore, depending on the case of open heart surgery, blood volume is often measured through the vent line in order to ascertain the status of circulatory abnormalities and valve insufficiency. In other words, the heart is in an ischemic state, but if there is abnormal pulmonary venous return, blood accumulates in the left ventricle, and the degree of abnormality can be understood from the amount. Also, if there is caval valve insufficiency,
This is also determined by how quickly blood accumulates in the left ventricle. That is, to measure these quantities through the vent line,
Fine scale display is required. Therefore, the shape of the housing bottom and the blood outflow port is required to be such that the blood volume can be easily read.

11. Purpose of Q: The present invention has been made in view of the above-mentioned current situation, and its l
The object of the present invention is to provide a blood storage tank configured so that blood within a filter and bubbles in the blood can be rapidly separated over a long period of time.

That is, the present invention provides a cylindrical hollow body capable of storing blood, which has a blood inlet at the top and a blood outlet at the bottom.
A filtration and defoaming section is provided in the hollow body, and the filtration and defoaming section is a cylindrical body that communicates with the blood inflow port and has an open end to limit the blood flow path of the introduced blood. A filtration and defoaming member is provided, which includes a cylindrical filter that defines a gap between the body and the air bubbles in the blood, and a defoaming member disposed on the outer periphery of the filter. The present invention provides a blood reservoir characterized in that the upper part of the filter is protected from wetting by blood by a cylindrical body.

The present invention also includes a cylindrical hollow body capable of storing blood, which has a blood inlet at the top and a blood outlet at the bottom, and a filtration and defoaming section is provided in the hollow body, and the filtration and defoaming section is a rod-shaped body that evenly distributes the blood introduced from the blood inflow port; a cylinder that communicates with the blood inflow port and is open at the lower end and limits a blood flow path for the blood introduced between the rod-shaped body and the blood inflow port; a cylindrical body, a cylindrical filter that defines a gap for separating and eliminating air bubbles in blood between the cylindrical body, and a filtration/defoaming member disposed coaxially around the outer periphery of the filter. The present invention also provides a blood reservoir characterized in that the upper part of the filter is protected from wetting by blood by the cylindrical body.

(1) Detailed Description of the Invention The blood reservoir of the present invention will be described in detail below with reference to preferred embodiments shown in the accompanying drawings.

FIG. 2 is a perspective view of the blood storage tank 20 of the present invention, and FIG. 3 is a longitudinal sectional view taken along the line ■-■ in FIG. It can be clearly seen that the portions 11 are arranged separately. The housing 21 is a hard transparent material made of polycarbonate, acrylic-styrene copolymer, polyester, polyamide, polyvinyl chloride,
It is made of a hard plastic material such as acrylic-butadiene-styrene copolymer, preferably integrally molded. It is preferable that the top of the housing 21 is rotatable by means of the first and second lids 22 and 21:a+' 23 so that it can be freely connected to the extracorporeal circulation circuit.
-1: ;ei 72.1- has sucker blood input port 2
4. A filter-type infusion, a transverse port 25, and a rapid infusion boat 26 are provided, and the second upper lid 23L is provided with an air vent port 27 and a filter-type infusion boat 28. The body of the housing 21 is approximately cylindrical and hollow. The bottom of the housing 21 forms a slope that slopes toward the eccentrically formed blood outflow II+ 29;
I5 in the center! A mid-height support portion 32 for supporting the excessive foam defoaming member 3o and the deflector 31 is formed.

It is better to construct the housing 21 in half in terms of mold production, but from the viewpoint of blood leakage, scale clearance, label clearance, etc.
It is preferable to mold it seamlessly as a single piece except for the top part. In particular, it is necessary to prevent blood from accumulating at the bottom, and it is better to have no adhesive parts. The blood outflow port 29 provided at the bottom of the housing 21 is preferably provided eccentrically near the outer periphery of the bottom of the housing 21, since if it is provided at the center of the bottom of the housing 21, visibility of the scale, serum, etc. will be poor. Furthermore, depending on the case of open heart surgery, it may be necessary to know the exact amount of blood even if it is small, so it is preferable that the shape of the blood outflow port 29 is funnel-shaped with a smooth curved surface. The scale can be easily read if it has a bulging shape such as a hemisphere.

In this way, when blood flows into the venous reservoir through the tube connected to the funnel-shaped blood outflow port having a smooth curved surface, the blood flows along the blood outflow port 29 and the wall surface of the tube. The air block phenomenon, which is the problem mentioned above, does not occur. This is due to the vertical movement of the blood reservoir during adjustment operations to optimize the body's blood volume, which is constantly monitored, or fluctuations in blood inflow from the surgical field. Similarly, the air block phenomenon is also prevented.

The filtration/defoaming member 30 disposed in the upper portion of the housing 21 is supported between the upper support member 33 extending from the second upper cover and the mid-height support portion 32 together with the deflector 31 below. The filtration and defoaming member 30 has various functional elements arranged outward from the center, and sequentially and selectively distributes the air-mixed blood introduced into the center evenly and divides the blood and bubbles. The blood is separated, filtered, and defoamed, and the defoamed blood is stored in the blood storage part 11 through the deflector 31 of the housing part without the generation of bubbles.

The filtration and defoaming member 30 has a filter 35 having a lumen 34 and a defoaming member 36 on its outer periphery, and the filter 35 has an adhesive 38 between the one support 33 and the lower support 37.
The defoaming member 36 is fitted onto the filter 35 and supported between the lower support 37 and the deflector 31.

A funnel-shaped deflector 31 is supported between the lower support body 37 and the mid-high support part 32. The upper support body 33 has a cylindrical body 40 that hangs downward by a length shorter than the length of the filter in the inner cavity 34 formed by the filter 35, and has an annular gap 41 between the filter 35 and the cylindrical body 40. limit. Since there is a cylindrical body in this gap, blood directly enters and filters out. Therefore, the part of the filter corresponding to the gap 41 does not get wet, and from this part, the bubble air separated from the blood flows to the filter 35 and the defoaming member 36. and is discharged through the vent port 27.

The lower support 37 has a lumen 3 formed by a filter 35.
4 has a hollow member 42 standing upwardly within the hollow member 4.
The lower part 44 of 2 is in close contact with the filter 35, but the upper part 43
is reduced in diameter and extends upward within the cylindrical body 40 almost to the position of the upper support member 33 .

It is preferable that the hollow member 42 and the cylindrical body 40 are arranged concentrically with the filtering and defoaming member 30.
A gap 45 between the two defines the blood flow path. hollow part moon 42
It is preferable that the head of the tip part 44 be rounded so that the blood can be evenly distributed.

Conventionally, this blood distribution hollow member 42 is not disposed inside the filter 35, but forms a lumen in which it! However, in the present invention, by arranging the blood distribution hollow member 42 to a considerable height in the lumen 34 of the filter 35, unnecessary lumen is removed. By uniformly distributing blood to the filter 35 and forming a separation gap 41 between the blood and bubbles between the cylindrical body 40 and the filter 35, the filtration surface can be used effectively, and channeling as in the conventional case can be avoided. Became.

The constituent materials of the blood distribution hollow member 42 include polycarbonate, acrylic-styrene copolymer, polyamide, polyester, polyvinyl chloride, acrylic-butadiene-styrene copolymer, and polycarbonate, which can define the diameter of the inner cavity 34 of the filter 35. Hard plastics such as propopylene are preferred.

A filter 35 disposed around the blood distribution hollow member 42
Although there are various types of filters, such as a screen type with a mesh having a pore diameter of about 20 mm and a depth type with an adsorption effect, pleated filters are preferred for compactness and weight reduction. It is preferable that the filter 35 is not limited to a pleated type, and that it contacts the blood distribution hollow member 42 at equal intervals, with a certain amount of space formed therebetween. This is because the evenly spaced contact between the filter 35 and the blood distribution hollow member 42 can increase the effective area of the filter. Furthermore, the space formed between the filter 35 and the blood distribution hollow member 42 is intended to provide a storage space for substances that impede effective use of the filter, such as clogging and channeling caused by foreign substances such as tissues and microaggregates. It's for a reason.

In a blood storage tank with a built-in filter, blood is filtered under positive pressure, but at that time, as the flow rate increases, the processing capacity decreases, and the blood is ejected from the filter due to positive pressure, creating bubbles that are later quenched. As mentioned above, there are conditions that put foam at a disadvantage. To prevent this, it is best to treat the filter with an antifoaming agent in advance. As an antifoaming agent,
In general, antifoaming silicone (compound type mixed with silica, oil type), etc., and filter constituent materials include nylon, polyester, and polypropylene.
Delicious. The filter is preferably made of mesh or nonwoven fabric. By attaching an antifoaming agent to the filter, when blood comes into contact with the filter, the bubbles are defoamed and separated into blood and air. Therefore, the pressure lJf on the filter is also suppressed, and at the same time, the filtration performance of the filter is improved. maintained.

The defoaming member 36 on the outer periphery of the filter 35 is for foaming the blood that has been filtered or defoamed by the filter 35 on the downstream side, and is made of foamed urethane, stainless steel ribbon, polypropylene mesh, etc. This material is coated with the antifoaming agent mentioned above.

Further, the blood storage tank of the present invention is preferably separated into a filtration and defoaming section I and a blood storage section II. As mentioned above, this is
This is to prevent the stored blood from being immersed in the filter 35 or the defoaming member 36 as in the conventional case, and to avoid contact with foreign matter as much as possible. This is due to complement activation by components that are currently attracting attention (complement, a type of protein found in animal serum that plays an important enzymatic role when antigen-antibody reactions occur in vivo, is activated). activation, causing damage to cell membranes, the body's defense mechanism against infection, and inflammatory responses. In addition, due to activation, complement is consumed, temporarily lowering the body's immune system and increasing the risk of infection, etc.) To suppress desorption of silicone, etc., to reduce dead polyum of blood in a filter 35 and an antifoaming member 36, and to provide a scale by which the amount of blood at the time of return to fn can be accurately grasped.

In order to achieve this function, in the present invention, a filtration and defoaming mechanism is provided so that the blood that has been filtered and defoamed by the filtration and defoaming part can be led back to the blood outlet 29 at the bottom of the housing 21 without generating bubbles. A funnel-shaped deflector 31 is provided at the bottom of the foam member 30.

The deflector 31 is converged so as to be supported by a medium-high support portion 321- in the center of the bottom of the housing 21, and as shown in FIG. 3, a trough-like channel 47 is formed by a large number of kite plates 46. This deflector 31 is preferably configured so as not to contact the body of the housing 21 and the bottom portion adjacent to the body to open the wave path. If the deflector 31 and the housing come into contact as described above, when the blood level is below the contact point, the operator may easily mistake the contact point for the blood level. Blood is constantly flowing through the body, so if the deflector is made of transparent Il, it will be difficult to read the blood level. The defoamed blood leaving the filtration and defoaming member 3o forms a gentle flow through the trough-like passage 47 of the deflector 31, so that the invasion to the blood is small and no bubbles are generated again.

Note that the hollow housing 211, the cylindrical body 4o, and the hollow member 42
Although it is cylindrical in the above-mentioned case, it may have any other suitable shape such as a polygonal prism or irregular cross-sectional shape, and the member 42 may be solid. The gist of the present invention is not to separate the filtration and defoaming section from the blood storage section, but to form an area in the upper part of the filter that does not get wet due to the void formed by the cylindrical body, thereby making it convenient to eliminate air bubbles. In addition, the hollow member 42 may be a rod-shaped body, and the air bubbles trapped in the blood before reaching the filter float to the surface of the blood, making it easier to separate the air bubbles.

In the present invention, the hollow member 42, the cylindrical body 40, the filter 35, and the defoaming member 36 are arranged concentrically, and a blood flow path is formed between the hollow member 42 and the cylindrical body 40, and a blood flow path is formed between the cylindrical body 40 and the filter 35. A gap 41 for separating blood and bubbles between
It was discovered as a result of examining various configuration examples based on the experiments described below that it is extremely effective to form the following.

A structure as shown in FIG. 4 was created. filter 35
They are all made of the same material, have the same shape, and have the same area, and are pleated made of nonwoven fabric or a mesh of nylon, polyester, polypropylene, or the like. Hollow member 4
2 and the cylindrical body 40 were all made of the hard plastic described above. If there is a foam-defoaming member around the outer periphery of the filter 35, the defoaming state will be inaccurately confirmed, so no foam-defoaming member is used. Half of these configurations (one day after blood collection) had a flow rate of 1000.
It was flowed at a rate of ml/win, and the performance and pressure loss depending on the foaming state were evaluated. As is clear from the table below showing the results, in the f:tSaa diagram, blood mixed with bubbles directly hits the lower adhesive 38, and the blood tends to push out the filter 35 before the bubbles are separated. In the case of Fig. 4b, the effective length of the filter 35 is shorter, so compared to the longer filter shown in Fig. 4d, the deflection of the filter 35 is l-7t, It was easy to decrease, and the result was similar to that of Section 4al) 4. In the case shown in FIG. 4C, the pressure IJI was smaller than that shown in FIGS. 4a and 4b, and good results were obtained. In the invention shown in Fig. 4d, Figs. 4a and 4b
Even better results were obtained than those shown in Fig. 4 and Fig. 4C. In the one shown in FIG. 4C, the existence of a gap 41 between the cylindrical body 40 and the filter 35 prevents the upper part of the filter from getting wet, so air can escape easily, and in the one shown in FIG. In addition to the above-mentioned function of the gap 41 between the filter 35 and the hollow member 42, air bubbles in the blood float to the surface during contact with the hollow member 42, thereby promoting the separation of air bubbles from the blood. It is thought that there will be.

IV. Filtration, defoaming, and blood storage functions when using the blood reservoir of the present invention for L-body f'F of the present invention will be explained.

The blood reservoir is constructed and used as shown in Figure 1. The bubble-like fluid sucked from the surgical field such as the cardiothoracic cavity by the open heart surgical mound passes through the blood inlet port 24 and flows into one of the hollow members 42.
Part of it falls to 43''-. of the hollow member 42, ysI1
44 and the cylindrical body 40, +M eyes fM
flows while avoiding direct contact with the filter 35,
The filter 35 is removed only at the lower part 43 of the hollow member 42.
come into contact with. Blood is medium', = rf1+ 1 of 4A42
Bubbles 1. B. Cutting of large liquid parts: By increasing the area, blood can be separated into bubbles. The separated bubbles pass through the filter 35 and the cylindrical body 40.
Since a gap 41 is provided between the blood and the blood, the blood collects in that area, is washed away by the blood, and does not pass through the filter.

As shown by the solid line showing the flow of Blood II★ and by the dotted line showing the flow of Blood II★, the 7-person pull is separated from the blood and collects towards the cavity 41, and is filtered with or without antifoaming agent. 35 and the defoaming rIB material 36, the air is discharged to the outside through the Ghent port 27, accumulates in the filter lumen 34, increases the internal pressure, and together with the h'' force due to positive pressure filtration. Bubbles are no longer ejected from the filter 35 together with blood.

In addition, the amount of blood conventionally stored in the filter lumen 34 is reduced due to the presence of the hollow member 42 and the rapid and effective separation of blood and bubbles as described in 1.
It is now possible to accurately grasp the blood particles in the blood storage tank.

The filter 35 disposed on the outer periphery of the hollow member 42 is evenly distributed in the hollow member 42 , and the filter 35 is arranged on the outer periphery of the hollow member 42 .
Due to the gap 41 between the bubbles and the blood, the bubbles effectively filter out foreign substances such as tissues and microaggregates contained in the separated blood or fluid.

In this way, the blood that has been filtered or defoamed by the filter 35 is completely defoamed while passing through the defoaming member 36 and oozes out from the defoaming member 36 . The blood that has oozed out slowly flows down the trough-like passage 47 of the deflector 31 and flows into the blood space 48 without generating bubbles again. The JII liquid in the blood storage space 48 forms a flow of hLIζ11 around the middle and high support part 32 at the inclined bottom of the housing 21, and *tm flows from the outlet 29 through the tube 5 to the venous reservoir/toe 7.

Also, 1"1 white fk outflow 1129 is j of housing 21
The bulge is formed in the center of the groin, and is formed near the outer periphery, and its shape is a smooth curved surface like a sphere.
It can be easily read by the 1" mark placed at the blood outflow port 29. In this way, the infiltrated blood can form a swirling flow, and the blood outflow can also flow smoothly. By configuring this to ensure that the blood flows along the bottom of the housing 21, the blood 1 residual flow 1129, and the wall of the tube connected thereto, the air block phenomenon is prevented. , and there is no risk of circulation within the patient's body via bubbles or venous reservoirs.

(1) Specific Effects of the Invention The blood reservoir of the present invention provides many advantages over conventional ones, as listed below.

(1) By providing a cylindrical body and a hollow member concentrically in the inner cavity of the filter, and in particular forming a gap between the cylindrical body and the filter, the separation of blood and/or Hebrew is promoted and the separated bubbles are The part of the filter that is protected from getting wet by the cylindrical body allows air to escape.
Unlike in the past, the bubbles increase the internal pressure and are no longer forced out of the filter together with the blood along with the pressure of positive pressure filtration.

[Brief explanation of drawings]

FIG. 1 is a diagrammatic perspective view of an example of an artificial heart-lung circuit, FIG. 2 is a perspective view of a preferred embodiment of the blood reservoir of the present invention, and FIG. 3 is a longitudinal cross-sectional view taken along line m-m in FIG. , and FIG. 4 are diagrammatic partial cross-sectional views of various configuration examples used in experiments to confirm the effectiveness of the configuration of the blood reservoir of the present invention. Explanation of the numbers ■...Blood removal line, 2...Soccer line, 3, 8
...Pump, 4.Blood reservoir, 5.Line, 6.
...Capacity regulating means, 7. Venous reservoir, 9. Oxygenator with heat exchanger, 10. Blood supply line, 20. Blood storage tank of the present invention, 21. Housing, 22.・First
1 lid, 23...2-1-λ1.24...Spirit blood inflow port I, 25...filter-passing infusion, ring I
Ifl boat, 26... rapid infusion ho I..., 27...
・Air vent port, 28... Filter-impermeable infusion boat, 29... Blood outflow port, 30... Filtration defoaming member, 31... Deflector, 32... Mid-high support part,
33... L blade support, 34... Inner cavity, 35... Filter, 36... Defoaming member, 37... Lower support 11
1 body, 38... contact 1 agent, 40... cylindrical body, 41.
...Annular 1 No.:'J gap, 42...Hollow member, 43...
・''Second part, 44...lower part, 45...' void, 46・
...Kite plate, 47...Gutter-like channel, 48...Reservoir space 1 Figure 4 Figure 4 3838 838

Claims (2)

[Claims] (1) A cylindrical hollow body capable of storing blood having one blood inflow port at the nape and a blood outflow port at the bottom, an IPI defoaming section provided in the hollow body, and the filtration defoaming section The department is. communicates with the blood inflow +11 and opens at the lower end,
This t1 is a cylindrical body that limits the blood flow path of the introduced blood.
It has a cylindrical filter that defines a gap for separating and eliminating air bubbles in the blood between the filter and the body, and a retractable foam defoaming member arranged coaxially with the defoaming member disposed around the outer periphery of the filter,
The cylindrical body allows the filter 1. A blood storage tank characterized in that its sides are protected from getting wet with blood. (2) A cylindrical hollow body having blood 7 & inflow 11 at one mouth and blood outflow 11 at the bottom, capable of storing +In +if, and providing a filtration defoaming section in the hollow body; The bubble part is a forest that evenly distributes the blood introduced from the surface flow inlet, and communicates with the blood wave inlet and is open at the lower end, so that the blood introduced between the bubble part and the forest can be distributed evenly. A cylindrical body that limits a flow path, a cylindrical filter that defines a gap between the cylindrical body and the air bubbles in the blood to separate and eliminate them, and a defoaming member placed around the outer periphery of this filter are arranged coaxially. 1. A blood storage tank comprising a filtration and defoaming member, wherein the cylindrical body protects two sides of the filter from wetting by a 1 m liquid.