JPS60103968A - 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 (1) Background of the Invention (Technical Field) The present invention relates to a blood reservoir (cardiodynia reservoir) used in an artificial heart-lung circuit during extracorporeal circulation associated with open heart surgery.

(Prior art and its problems) In an artificial heart-lung circuit, as illustrated in FIG.
The blood from Minamino flows through suction line 2 and pump 3.
The blood passes through a blood storage tank 4 and a line 5, enters a venous reservoir/7 stored in a volume regulating means 6, and is further sent to a heat exchanger upper lung 9 by a pump 8, where the oxygenated blood is It is configured to be returned to the patient's body via the blood supply line 10.

By the way, in addition to defoaming and storing blood aspirated in the operative field such as the thoracic cavity and heart cavity, the blood reservoir has the function of defoaming and storing blood that accompanies the aspirated blood in the operative field or is present during blood collapse. An organization that
It incorporates a filter for filtering out foreign substances such as microaggregates, and is configured to perform the three important functions of IM filtration, defoaming, and blood storage, and has become widely used. However, it has been pointed out that the blood reservoirs currently in use have the following various problems in the three functions mentioned above.

(1) Skin hyperfunction 1; Problem If blood containing many foreign substances such as tissues and bucroaggregates passes through the filter, the filter may quickly become clogged without being used effectively. . In addition, in the case of a pleated filter, the fact that the filter is arranged in a cylindrical shape creates two lumens, which causes blood to accumulate in this lumen, making it difficult to accurately grasp the blood 5i in the blood reservoir. φ. Therefore, blood storage 4+'! There is a difference between the scale mark marked on the housing and the actual blood storage rate, resulting in the problem that the actual blood rI3 cannot be read when necessary. In addition, filter performance and the ability to quickly separate blood into the filter are in conflict with each other, and it is difficult to find a balance between them.

(2) Defoaming function 1゜Problem IH: Blood that enters the tank is defoamed 7y4 by a filter and an antifoaming agent, and then stored in the housing. Blood flowing out from the parts (
In a structure in which the priming liquid (or priming liquid) is dripped onto the blood surface that has been defoamed and stored, bubbles will occur again, which is not desirable. 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.

Some structures avoid this phenomenon by bringing the filtration and defoaming member into contact with the bottom of the housing, but in this type of structure, the air in the blood discharge port at the bottom of the housing and the tube connected to it An air block phenomenon in which air cannot be discharged and is left behind tends to occur. For a membrane lung using a closed venous reservoir, this poses a significant risk of air contamination into the venous reservoir, oxygenator, and patient. Air block phenomenon is when a tube connected to a blood outflow port is clamped at the liquid level inside the tube, and when a large amount of blood flows in, air cannot be expelled and some of the air remains inside the tube. It means the phenomenon of being put away.

In addition, in a blood storage tank with a built-in filter, due to the resistance of the filter, which has recently become more sophisticated, it is necessary to use a structure that defoams after filtration (function 1). When doing so, positive pressure causes hypersensitivity. In positive pressure filtration, as the blood flow increases, the processing capacity of the defoaming member is exceeded, and positive air jets out the blood from the filter, creating bubbles in the blood, which tends to impede subsequent defoaming. In such a case, the pressure at the filter 1. y1 is also large, which tends to reduce filter performance. In order to avoid this, some products adopt a cyclone type air separation structure for the blood inflow 11, but it is difficult to handle when a large amount of air is mixed in, which tends to cause pressure '-)1, and the antifoaming performance is quite poor. This results in the following.

(3) Problems with blood storage function There are also problems with the blood storage function 11 and the shape and structure of the housing. The housing is made by mold making 2, the flange is 1'
A simple method is to manufacture two parts and glue them together in the middle. However, in such a structure, the residual In leakage i + (potential and at the same time due to the label 107 : +1
-The Ll scale display is troublesome, and the display of the amount of stored blood at the flange tends to be inaccurate. Furthermore, depending on the case of open heart surgery, blood volume is often measured through the hentline 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 will accumulate in the left ventricle, and the degree of entry can be understood from J4. Also, if there is caval valve insufficiency, this is also determined by the amount of blood stored in the left ventricle. That is, in order 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.

Further, even if the area of the filter is the same, it greatly affects the aforementioned ability of the filter to separate blood from bubbles, and the longer the area, the better the separation function. For this reason,
Many of them use long filters that reach the bottom of the housing (near J).However, in these types of blood storage tanks, the contact time between the components and the blood is long, which is why they are currently attracting attention. Complement activation and silicone desorption are large and undesirable.A typical example of a filter in which the filter reaches close to the bottom of the housing is IJs.
P 4,184,4138.1i'114,209,1
There are 93 and so on.

II, light 1! II. Purpose of the invention The present invention was made in view of the current situation described in -1.The second feature is that the filtration and defoaming section and the storage section are separated so that blood flows through the filtration and defoaming section of the blood storage tank. The contact time with foreign matter is kept short, that is, only the passing time, and it is easy to check the amount of stored JnI at the surface, i.e., the amount of blood returned is accurate.
We are trying to provide R7 blood vessels.

That is, the present invention has a blood inflow port at the top and a hollow body for directing the liquid flow 11 at the bottom, and in the hollow body, there is a skin over-defoaming part of the upper mountain and a blood storage part of the lower mountain. Separately installed (), the blood storage section has a capacity such that the stored blood does not come into contact with the filtration and defoaming section at any time, and the blood is filtered and defoamed by the filtration and defoaming member of the filtration and defoaming section. The present invention provides a blood storage tank characterized by having a guide portion that guides the collected blood to the bottom of the hollow body without causing it to drip.

III. DETAILED DESCRIPTION OF THE INVENTION In the following, a blood reservoir of the present invention is shown in the accompanying drawings. A preferred embodiment will be described in detail.

FIG. 2 is a trunk view of the blood storage tank 2o of the present invention, and FIG. 3 is a vertical sectional view taken along the line lll-[ in FIG. It is clearly seen that the blood storage part II is arranged separately. The housing 21 is a rigid transparent body made of a hard plastic material such as polycarbonate, acrylic-styrene copolymer, polyester, polyamide, polyvinyl chloride, or Ac1 true butadiene-styrene copolymer, preferably integrally molded. Manufactured. The top of the housing 21 is preferably rotatable so that it can be freely connected to the extracorporeal circulation circuit by means of the first upper cover 22 and the second upper cover 23. Blood Human Lopo)24. Filter-passing infusion, loop Jm port 25, rapid infusion port 2
6 is provided, and an air vent port 2 is provided on the second upper lid 23.
7. A filter-type infusion port 28 is provided. The body of the housing 21 is approximately cylindrical and hollow.

The bottom of the housing 21 has a slope that slopes toward the eccentrically formed blood outflow port 29.
A mid-height support portion 32 for supporting the antifoaming material 3o and the deflector 31 is formed.

It is preferable that the housing 21 be formed in two halves, seamlessly, except for the top part, from the viewpoints of blood leakage, scale marking, labeling, etc. In particular, it is necessary to prevent blood from accumulating at the bottom, and it is better to have no adhesive parts. Blood 1 (?i 11r, roll 2) provided at the bottom of the housing 21
9 is preferably provided eccentrically near the outer periphery of the bottom 8B of the housing 2I, since the dowel 11 is provided at the center of the bottom of the housing 21, and visibility of the parts such as i11 is poor.

Furthermore, depending on the case of open heart surgery, it may be necessary to know an accurate 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. In particular, if the shape is convex, such as a hemisphere, the 11-size plate is easy to read.

In this way, when blood flows into the venous reservoir through the tube connected to the funnel-shaped blood outflow port made of a smooth curved surface, 1 mm flows along the blood outflow L129 and the wall surface of the tube. The air block phenomenon, which was a problem previously discussed, does not occur. This also applies if the blood level rises or falls at the blood outlet due to lower movement of the blood reservoir during adjustment operations to optimize the body's blood, which is constantly monitored, or fluctuations in blood inflow from the surgical field. , similarly, the near block phenomenon is prevented.

The filtration and defoaming member 30 disposed in the upper part of the double housing 21, together with the deflector 31 below it, has an upper support 33 extending from the second lid and a mid-high support part 32.
Supported between. The filtration/defoaming member 30 has various functional elements concentrically arranged outward from the center, and sequentially distributes the air-mixed blood introduced into the center evenly, separates blood from bubbles, and filters it. , defoaming is performed, and the defoamed blood is stored in the blood storage part II via the deflector 3 at the lower part of the housing without generating bubbles again.

The filtration/defoaming member 30 has a filter 35 having a lumen 34 and a defoaming member 36 around the filter 35 .

The filter 35 is fixed between the -L support 33 and the lower support 37 with an adhesive 38, and the defoaming member 36 is fitted onto the filter 35 and supported between the lower support 37 and the deflector 31. Ru.

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 does not directly enter the gap, and therefore, a part of the filter corresponding to the gap 41 is not removed, and from this part, the bubble air separated from the blood flows through the filter 35 and the defoaming member. 36 and Ben I. Bowe I. 27.

The lower support 37 has a lumen 3 formed by a filter 35.
4 has a hollow member 42 standing on one side, and the lower part 44 of the hollow member 42 is in close contact with the filter 35, while the diameter of the hollow member 43 is reduced and extends upward within the cylindrical body 40 to form an almost upper support member. 3
Extend to position 3.

The hollow member 42 and the cylindrical body 40 are preferably arranged concentrically with the filtering and defoaming member 30, and the gap 45 between the hollow member 42 and the cylindrical body 40 defines the blood flow path. The head of the upper portion 44 of the hollow member 42 is preferably rounded to provide even blood distribution.

Conventionally, this blood distribution hollow member 42 was not disposed inside the filter 35 to form a lumen, and there was a problem that blood accumulated in this lumen, making it impossible to measure the star.However, in the present invention, ,
The placement of the blood distribution hollow member 42 into the lumen 34 of the filter 35 to a considerably elevated position eliminates unnecessary lumens and improves the even distribution of blood into the filter 35 and the cylindrical body 4.
Blood and bubble separation gap 4 between 0 and filter 35
By forming No. 1, the filtering surface can be used effectively, and channeling as in the conventional case can no longer occur. Note that the constituent materials of the blood distribution hollow member 42 include polycarbonate, acrylic-styrene copolymer, polyamide, polyester, polyvinyl chloride, acrylic-butadiene-styrene copolymer μ, 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
There are various types of filters, but even if a screen type with a mesh with a pore diameter of about 20 pL, a depth type with an adsorption effect, etc. are used, a pleated filter is preferable in order to make Combaku i and light 11 tH. The filter 35 is not limited to the pleated type, and the blood distribution hollow member 4
2 at equal intervals, and it is preferable to form a certain amount of space between them. 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 between the filter 35 and the blood distribution hollow member 42 is formed by tissue, microaggregation 1,
This is to provide a storage space for substances that interfere with the effective use of the filter, such as clogging and channeling caused by foreign substances such as.

In a blood storage tank with a built-in filter, blood is filtered under positive pressure, but as the blood flow rate increases, the processing capacity decreases, and the blood is ejected from the filter due to positive pressure, generating bubbles, which are then defoamed. As mentioned above, it may be disadvantageous. To prevent this, it is best to treat the filter with an antifoaming agent in advance. The antifoaming agent is generally antifoaming silicone (compound type mixed with silica, oil type), etc., and the filter constituent material is preferably nylon, polyester, polypropylene, etc. The filter is preferably made of these mensch or nonwoven fabrics. By attaching an antifoaming agent to the filter, when blood comes into contact with the filter, bubbles are defoamed and blood and air are separated, which prevents the pressure increase due to the filter and maintains the filter's filtration performance. be done.

The defoaming member 36 on the outer periphery of the filter 35 is for defoaming the blood that has been filtered or defoamed by the filter 35 on the upstream side. ,” coated with a series of antifoaming agents.

Further, the blood storage tank of the present invention is divided into a filtration and defoaming section I and a blood storage section I+. As mentioned above, this is done by using the filter 35 or the defoaming part 3 as in the case of the stored blood.
This is to avoid contact with foreign matter as much as possible by not immersing the device in water. This is due to activation of the body by a member that is currently attracting attention (a type of complement protein containing 3Il, which is present in animal serum and plays an enzymatic role when antigen-antibody reactions occur in vivo). Activation ('l, cell membrane damage, the body's defense mechanism against infection, fire) 11 reactions are impaired.Also, activation +1
Complement is consumed by oxidation, which lowers the immune system of the living body, and there is also a risk of infection. Reduce and return blood puntoporium in month 36 +nt
I+! ]'s blood 111 provides 1] sheng that can be grasped to 11 rust.

In order to achieve this function, in the present invention, so that the blood that has been filtered and defoamed in the effusion section I can be guided again to the blood outflow 29 at the bottom of the housing 21 without generating bubbles. A leakage-shaped deflector 31 is provided at the lower part of the filtering and defoaming member 30 6 The deflector 31 is connected to the housing 21
As shown in FIG. 3, a trough-like flow path 47 is formed by a large number of F plates 46. This deflector 31 is
It is preferable to prevent the flow path from coming into contact with the body of the housing 21 and the bottom adjacent to the body. This is because if the deflector 31 and the housing come into contact as described above, when the blood level is at the contacting part, the contacting part can easily be seen as the blood level, so there is a risk of misidentification as the name of the surgery. In addition, since blood is constantly flowing through the deflector, if the deflector is made of a transparent material, the blood level tends to be difficult to read, so the deflector should be made of something that does not give the impression of blood color or is made of an opaque material. is preferred. Defoamed blood leaving the filtration and defoaming member 30 passes through the trough-like passage 47 of the deflector 31 and forms a gentle flow, so that the invasion of blood is small and +111m bubbles are not generated.

Now, this filtration 7+'l storage section II that does not come into contact with the foam section
The blood storage lit is always 300~300 in a closed system.
Since a blood pool of about 500n+1 is forced, at least 500ml1 is required as a lower limit, and as a myocardial protection method performed when the aorta is blocked, a cooling fluid is flowed, so at most 2000ml or more of cooling fluid is required. 2500m 1st place is required as 1st period.

The deflector 31 is for guiding the filtered and defoamed blood to the bottom of the hollow housing 2 without foaming again. Most conventional deflectors are configured so that blood flows to the -1- side of the housing part.
As mentioned above, it was easy to make mistakes.

In the present invention, the above-described example is shown as the deflector 31 that guides +r+100 fk filtered and defoamed from the filtration defoaming member 30 to the bottom of the hollow housing 21. It is not necessary to have a sloped bottom portion, and neither is it necessary to have a mid-height support portion 32. As diagrammatically shown in FIG. 4, the blood processed in the filtration and defoaming section 30 is guided as shown by the arrow by the deflector 31 that converges toward the blood outflow port 29 located in the center of the housing 21. You can also. At this time, it is preferable to form a plurality of openings 49 at the bottom of the deflector 31 so that excess blood flows through the openings 49 into the sea storage space 481. In this case as well, the blood flows down on the deflector 31, but the color of the blood is not visible unlike in the conventional case where it flows on the outside surface, so the blood level can be visually observed accurately and the amount of blood stored can be measured. It becomes easier. moreover,
It is even more effective if the deflector 31 is made of an opaque material.

Note that the hollow housing 21. Cylindrical body 40. Hollow member 42
has been described as having a cylindrical shape, but it can be formed into any other suitable shape such as a polygonal columnar shape or an irregular cross-sectional shape, and it goes without saying that the hollow member may be a solid body.

IV. Physical Functions of the Invention The filtration, defoaming, and blood storage functions of the blood storage tank of the present invention when used will be explained.

The blood reservoir is constructed and used as shown in FIG. Bubble-containing blood aspirated from a surgical field such as the cardiothoracic cavity during open-heart surgery or the like falls onto the lower part 43 of the hollow member 42 through the blood inlet port 24. Through the blood flow path between the 11th section 44 of the hollow member 42 and the cylindrical body 40, +Inil+ flows down while avoiding direct contact with the filter 35, and contacts the filter 35 for the first time at the lower part 44 of the hollow member 42. The blood passes through the portion from the part 43 to the lower part 44 of the hollow member 42, and by increasing the contact area of the member with the bubble-containing blood before contacting the filter 35, the bubbles and the blood are separated. Separated. <Pull is
Since a gap 41 is provided between the filter 35 and the cylindrical body 40, the blood collects in that area, is swept away by the blood, and does not pass through the filter.

As shown by the solid line showing the flow of blood and the dotted line showing the flow of bubbles, the bubbles are separated from the blood and gather toward the gap 41.
The air is defoamed through the filter 35, which may or may not be impregnated with an antifoaming agent, and the defoaming member 36, and the air is discharged to the outside through the vent port 27, accumulates in the filter lumen 34, and increases the internal pressure. This, together with the pressure caused by positive pressure filtration, prevents bubbles from being ejected from the filter 35 together with the 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 above, and the amount of blood in the blood reservoir can be accurately determined. I am now able to understand.

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 .
0, the bubbles effectively filter out foreign substances such as tissues and microaggregates contained in the separated blood or transfused blood from the blood.

In this manner, 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 oozing blood flows gently down the trough-like passage 47 of the deflector 31 and flows into the blood storage space 48 without generating bubbles again. The blood in the fII space 48 forms a swirling flow around the middle and high support part 32 at the inclined bottom part of the housing 21, and reaches the venous reservoir 7 through the blood outlet 29 and the tube 5. This also applies to the configuration example shown in FIG.

Furthermore, if the blood outflow 1129 is not formed at the center of the bottom of the housing 21 but near the outer periphery, and the blood outflow 1129 is formed by a bulge having a smooth curved surface such as a spherical shape, even if the blood outflow 1129 is Even if the blood of
! (2) It can be easily read by the scale attached to the liquid outlet 29. In this way, by forming a swirling flow in the immersion liquid 1 (11) and ensuring a smooth flow of blood outflow 29, the blood flows through the bottom of the housing 21, Since the air flows along the wall of the outlet 29 and the tube connected thereto, the air block phenomenon is prevented, and the bubbles flow along the wall of the tube 1 connected to the outlet 29.
There is no fear that it will circulate in the patient's body via the hazapa.

The blood storage capacity of the blood storage space 48 of the blood storage section TI is 500 to 250.
Since the filter 35 and the defoaming member 36 are not constantly immersed in the stored blood, there is little risk of complement activation or silicone elution, and the blood storage capacity is sufficient even in an emergency.

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

(1) Since the filtration and defoaming part and the blood storage part are completely separated, the blood collection does not soak in foreign substances such as the filtration member or the defoaming member during inspection, so complement activation and silicone There is very little risk of elution.

(2) By providing a cylindrical body and a hollow member concentrically in the filter lumen, and in particular by forming a gap between the cylindrical body and the filter, separation of blood and bubbles is promoted and the separation is stiffened. Since the hepple can be released as air through a part of the filter that is protected from wetting by the cylindrical body, the bubbles no longer increase the internal pressure and are forced out of the filter along with the pressure of positive pressure filtration, as was the case in the past. Ta.

[Brief explanation of the drawing]

FIG. 1 is a diagrammatic perspective view of an example of a heart-lung circuit for a person 1, FIG. 2 is a perspective view 1Δ of a preferred embodiment of the blood reservoir of the present invention, and FIG. 3 is a longitudinal section taken along the line ■-■ in FIG. The plan view and FIG. 4 are diagrammatic cross-sectional views of other configuration examples of the blood guiding portion of the blood reservoir of the present invention. Theory of famous T No. 1: ■...Blood removal line, 2...Lean car line, 3.
8...Pump, 4...Blood reservoir, 5...Line, 6
...capacity regulating means, 7...venous reservoir, 9...
Heat exchanger (SAJ oxygenator, 10... Blood supply line, 20...
... Blood storage tank of the present invention, 21 ... Housing, 22 ...
・First lid, 23...Second top lid, 24...Human blood infusion boat, 25...Filter JIfI fluid, blood transfusion port, 26...Rapid infusion boat, 27...・Air vent port, 28... Filter-impermeable infusion boat, 29... Blood outflow [1° 30... Filtration and defoaming member, 31... Deflector, 32... Mid-high support part, 33
...Upper support, 34...Inner cavity, 35...Filter, 36...Defoaming member, 37...Lower blade support, 3
8... Adhesive, 39... Lip, 40... Cylindrical body,
41... Annular void, 42... Hollow member, 43...
1° part, 44... F part, 45... void, 46...
Guide plate, 47... gutter-like channel, 48... blood storage space,
49...Open “I Patent Applicant Chill Seven Co., Ltd. Figure 1

Claims (1)

[Scope of Claims] (L) A hollow body having a blood inflow II at the top and a blood outflow port at the bottom; The blood storage section has a volume j, (so that the stored blood does not come into constant contact with the filtration and defoaming section, and the filtration and defoaming member of the filtration and defoaming section A blood storage tank characterized by having a guide 1゛°ζ8 that guides the collected blood without letting it reach the bottom of the hollow body. (2) The storage tank has a capacity of 500
-2500ml 4! f + t4, the blood reservoir according to claim 1.