JPS60259270A - Serum separation and replacement apparatus - 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] (Field of use of production! f) Tree 9. FIJ No. relates to an improvement in a device for separating blood cell components and plasma components using a sip device provided in a closed extracorporeal circulation circuit.

(Prior art and its problems) Plasma separation and exchange methods have recently been known as a treatment method for renal failure, 111 insufficiency, autoimmune diseases, and the like.

This method: - Generally, plasma components are continuously separated using an a-filter membrane in a closed extracorporeal circulation circuit, and blood cell components are returned to the body. In this case, the discarded plasma contains low molecular weight active ingredients in a state bound to high molecular weight toxins, and it is necessary to supplement the body with a predetermined amount of these ingredients.

Conventional methods for injecting replenishment fluid include measuring the replenishment fluid and scavenging fluid using a gI meter and balancing the sum of the two, but this method has disadvantages in terms of operability and accuracy. There's a problem.

Furthermore, as disclosed in Japanese Patent Application Laid-Open No. 100696/1984, a method is also known in which the amounts of fluid transferred by the drainage pump and the replacement fluid pump are controlled to be equal in accordance with pressure changes in the space in the body fluid storage section. . However, what was proposed in the same bulletin was the so-called 1ia dilution, in which the necessary replenishment fluid was injected in advance before swabbing with a mouthpiece, and the body fluid entering the mouthpiece was diluted. Because of this, there is a drawback that the oral fluid efficiency is poor even if the oral fluid is removed.

In addition, unlike human kidneys, the plasma exchange method requires the use of expensive blood products such as albumin plasmanate as a replenisher instead of the electrolyte solution contained therein. I'm not familiar with the method of using 11 people to plan on replenishing fluids for many years.

The present invention was proposed to solve these problems.

(L stage for solving problems) As shown in FIGS. 1 and 2 corresponding to the embodiment, the present invention includes a mouth strainer 5 in a closed extracorporeal circulation circuit, and this mouth strainer 5 In a plasma separation and exchange device for separating blood cell components and plasma components, a means P1 for detecting a differential pressure between the blood introduction side and the plasma output side of the mouth filter 5 is provided, and the plasma extraction circuit 8 is provided with the differential pressure detection stage r. A pump M2 is provided which can adjust the flow rate so that the pressure is at or below the set pressure by interlocking control with the blood cell deriving circuit 17, and a replacement fluid introducing circuit 18 is provided in the blood cell deriving circuit 17. A pump M whose flow rate is adjusted is provided, and the blood cell deriving circuit 17 is provided with a JIT-
A force meter P is provided.

(Function) The pump M2 of the plasma extraction circuit is driven to a set pressure or less than the set pressure based on information from the differential pressure detection means between the inlet side and the outlet side of the oral filter 2, and the membrane 2 of the oral filter At the same time, the pump of the replacement fluid introducing circuit 18 is driven according to the amount of plasma drawn out, and an appropriate amount of replacement fluid is supplied to the blood cell drawing circuit 17. Also,
The blood cell derivation circuit 17 is designed to prevent abnormal pressure from being applied to the perostomy membrane 2 due to problems with the shunt, etc. on the patient side.
This is monitored by a pressure gauge P3.

(Example) FIG. 1 shows an embodiment of the present invention.

To explain its configuration along with its function, first, blood is introduced from the patient through the blood introduction circuit 1 by the pump M1, and 4
1-Reserve blood in blood reservoir 4. The following mouth strainer 5 is partitioned by a mouth strainer membrane 2 such as a polyvinyl alcohol membrane,
The blood from the blood reservoir 4 is separated into blood cell components and plasma components via the oral membrane 2 by pressure protection.

The plasma components separated here are collected as drainage/heng, etc., but the pore size of the membrane 2 of the membrane 2 of the membrane 5 used in the plasma separation method is about 0.02 to 0.4, which is normal. Its pore size is larger than membranes used for hemodialysis. Therefore, if the pore size approaches the size of blood cells and, for example, abnormal pressure is applied to the membrane 2 by pump M2, the blood cells will forcefully try to pass through the membrane pores, leading to the risk of hemolysis. .

Therefore, in the present invention, a means for sensing the differential pressure between the blood inlet side and the plasma outlet side of the mouth strainer 5 is used to detect, for example, the differential pressure 1lP1 between the blood inlet side and the plasma outlet side as shown in FIG. By interlocking control with this differential pressure gauge P1, the rotation speed of the pump M2 provided in the plasma extraction circuit 8 is automatically changed, or the switch is automatically turned ON-OFF, so that the differential pressure ttP+ becomes the set pressure. Alternatively, the flow rate is adjusted so that the pressure is below the set pressure.

In the case of this embodiment, the differential pressure gauge P] is configured to measure the differential pressure between the blood reservoir 4 disposed in front of the sip device 5 and the plasma reservoir 7 disposed in front of the pump Mz. The auxiliary flow rate of the pump M is set to 15 to 20 mm so that the pressure is 1 OOm + nHg or less, preferably 60 mmHg or less.
It is controlled at 1/min.

Further, in FIG. 1, 17 is a blood cell derivation circuit for returning blood cells to the patient, and this blood cell derivation circuit 17 is provided with a blood reservoir 14, and a replacement fluid introduction circuit 18 is branched and provided upstream thereof. From the replacement fluid introduction circuit 18, a replacement fluid such as albumin or HES contained in the replacement fluid container 16 is sent to the blood reservoir 14 due to pump leakage.

In the present invention, when introducing this replacement fluid, leakage of the replacement fluid introduction pump is controlled according to the flow rate of the plasma derivation circuit 8. Specifically, the pump Mz may be controlled directly in conjunction with the pump Mz, or if the pump Mλ and another pump are controlled in conjunction with each other, the pump Ml may be controlled indirectly through the other pump.
It may be controlled in conjunction with.

In addition, in the present invention, a blood reservoir 14 is provided in the middle of the blood cell deriving circuit 17, and a pressure gauge P3 is provided in this blood reservoir 14 to monitor the patient's condition (anemia, etc.) and troubles with the shunt. At the same time, it also monitors and prevents abnormal pressure from occurring in the membrane 2 of the mouthpiece device 5 due to changes in the blood lead-out circuit 17 due to movements of the patient's arm, etc. There is.

FIG. 2 shows an embodiment in which the present invention is applied to a double-port plasma separation and exchange apparatus, in which a 20th filter 11 is incorporated in the embodiment '' of FIG. In this embodiment, the mouth strainer 5 in FIG. 1 becomes the tenth strainer, and the plasma components separated here are sent to the ff<20 strainer 11 through the plasma derivation circuit 8.

The inside of the 20th filtration device 11 is partitioned by a filtration membrane 10 such as an ethylene vinyl alcohol membrane 1, and the plasma introduced into the 20th filtration device 11 is connected to the pump FVjZ and a discharge circuit 12, which will be described later. Due to the positive pressure generated by the difference in flow rate between the pump M3 and the pump M3, the material is separated into a polymer-acid material and a low-molecular acid material. The separated high molecular weight substances are led out through a discharge circuit 12 and discharged into a storage container 13, in this case pump M2. If the flow rates of M3 and M3 become unbalanced, an abnormal pressure will be applied to the fJS20 filter 11, making it impossible to obtain stable filtration and separation effects. Therefore, in this embodiment, the flow rate ratio of the pumps M and M3 is controlled in conjunction with each other, and the 20th filter 1
1, the flow rate ratio between the amount of plasma introduced and the amount of polymeric acid substance discharged is adjusted to a predetermined value. For example, the pump M
If the flow rate of pump M3 is 15 mm1/min, the flow rate of pump M3 will be automatically controlled to be 1/3-1/4 of that, or 3-5 mm1/min.

In addition, in the figure, Pz is the pressure level provided in the plasma reservoir 9, and when high pressure is applied to the 20th pressure vessel 11, the temperature rises. J
! Since there is a risk of puncture of the 10th class, this W force 1i
Monitored by IPz.

On the other hand, the low molecular weight substances separated in the 20th filter 11 are sent to the blood reservoir 14 through the derivation circuit 15, and are combined with the blood cell components sent from the 10th filtration device 5 through the derivation circuit 17. After that, it will be returned to the patient's body.

In addition, in order to supplement the plasma removed in the 20th tube II, a replacement fluid such as albumin or HES is sent from the replacement fluid container 16 to the blood reservoir 14 through the introduction circuit 18.

In this embodiment, when introducing this replacement fluid, the pump M4 for introducing replacement fluid provided in the introduction circuit 18 and the pump M3 provided in the discharge circuit 12 for the polymer borrowed material are controlled in conjunction with each other, and indirectly. It is controlled in conjunction with the pump Mz. In this way, it is possible to adjust the amount of the polymer-heavy substance so that the amount of the replacement fluid is equal to the amount of the 11-person replacement fluid. For example, as mentioned above, the flow rate of pump M3 is 3 to 5.
In the case of mm1/min, the pump Mψ is adjusted so that the flow rate is the same as this, so that the blood is stored in just the right amount. Replacement fluid will be injected on the 14th.

According to the present invention, each of the pumps listed in I.

The interlocking control means of M32M4 may be electrical control, but two or three tubes constituting each circuit 8, 12, and 13 may be appropriately combined and squeezed at the same time.

As an example, as shown in FIG. 3, tube 8a of circuit 8 and circuit 12.
y) Change the inner diameter, for example, change the inner diameter of tube 8a to 8+
nm, tubes 12a, 18. If the inner diameter of tube a is set to 4 ml 11 and these tubes are simultaneously squeezed by the same drive roller 20, it becomes possible to adjust the flow acid according to the diameter of each tube.

What has been described above is an example of the present invention, and the 10th filter 5 and the 20th filter if may be of a hollow fiber type or other types, and other devices may also be modified according to the spirit of the present invention. It is possible.

(Effects) According to the present invention described below, when blood cell components and plasma components are separated by a mouthpiece provided in a closed extracorporeal circulation circuit, the blood inlet side and the plasma outlet side of the mouthpiece are separated. Since the flow rate of the pump on the plasma output side is adjusted by detecting the differential pressure between the membranes and the differential pressure detection means, the pressure applied to the oral membrane can be detected from the relative pressure on the inlet side and the outlet side. The plasma discharge pump allows for always balanced pressure control. Therefore, destruction of blood cells due to abnormal pressure reduction etc. can be prevented.

Further, according to the present invention, since the replacement fluid delivery pump is controlled according to the plasma delivery flow rate which is strictly controlled, it is possible to inject only the necessary amount of valuable blood products.

Furthermore, the safety of the plasma separation and exchange device has been improved by using a pressure gauge in the blood cell extraction circuit to prevent abnormal pressure from occurring in the membrane of the mouthpiece due to problems with the shunt or other factors. -I will do it.

[Brief explanation of the drawing]

1 and 2 are schematic diagrams showing embodiments of the present invention;
The figure is a schematic diagram showing another embodiment of the pump control means in the present invention. In the figure, l is the blood introduction circuit, 2 is the oral membrane, 5 is the oral passage device, and 8
17 is a plasma derivation circuit, 17 is an m bulb derivation circuit, 18 is a replacement fluid introduction circuit, P is a differential pressure gauge, P3 is a pressure gauge, M is a blood derivation pump, and M4 (f is a replacement fluid introduction pump. Patent applicant Namanabu Kawasumi Kogyo Co., Ltd. Kuraray Co., Ltd. Agent Patent Attorney Shigeru Nishino Figure 1

Claims (1)

[Claims] In a plasma separation and exchange device that includes a mouth strainer in a closed extracorporeal circulation circuit and separates blood cell components and plasma components with the mouth strainer, the differential pressure between the blood inlet side and the plasma outlet side of the mouth strainer is detected. providing a pump capable of adjusting the flow rate so that the pressure is at or below the set pressure by interlocking control with the differential pressure detection means in the plasma derivation circuit; and providing a replacement fluid introduction circuit in the blood cell derivation circuit; A plasma separation and exchange apparatus characterized in that the replacement fluid introduction circuit is provided with a pump whose flow rate is adjusted according to the plasma extraction section, and the blood cell extraction circuit is further provided with a pressure pump 1.