JPS6246192B2 - - Google Patents
Info
- Publication number
- JPS6246192B2 JPS6246192B2 JP55117719A JP11771980A JPS6246192B2 JP S6246192 B2 JPS6246192 B2 JP S6246192B2 JP 55117719 A JP55117719 A JP 55117719A JP 11771980 A JP11771980 A JP 11771980A JP S6246192 B2 JPS6246192 B2 JP S6246192B2
- Authority
- JP
- Japan
- Prior art keywords
- blood
- artificial lung
- circuit
- artificial
- water
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired
Links
- 210000004369 blood Anatomy 0.000 claims description 81
- 239000008280 blood Substances 0.000 claims description 81
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 claims description 27
- 229910001868 water Inorganic materials 0.000 claims description 27
- 210000004072 lung Anatomy 0.000 claims description 21
- 239000012528 membrane Substances 0.000 claims description 12
- 230000017531 blood circulation Effects 0.000 claims description 7
- CURLTUGMZLYLDI-UHFFFAOYSA-N Carbon dioxide Chemical compound O=C=O CURLTUGMZLYLDI-UHFFFAOYSA-N 0.000 claims description 6
- QVGXLLKOCUKJST-UHFFFAOYSA-N atomic oxygen Chemical compound [O] QVGXLLKOCUKJST-UHFFFAOYSA-N 0.000 claims description 6
- 229910052760 oxygen Inorganic materials 0.000 claims description 6
- 239000001301 oxygen Substances 0.000 claims description 6
- 239000000126 substance Substances 0.000 claims description 6
- 210000000056 organ Anatomy 0.000 claims description 4
- 229910002092 carbon dioxide Inorganic materials 0.000 claims description 3
- 239000001569 carbon dioxide Substances 0.000 claims description 3
- 238000001356 surgical procedure Methods 0.000 description 10
- ZLMJMSJWJFRBEC-UHFFFAOYSA-N Potassium Chemical compound [K] ZLMJMSJWJFRBEC-UHFFFAOYSA-N 0.000 description 9
- 229910052700 potassium Inorganic materials 0.000 description 9
- 239000011591 potassium Substances 0.000 description 9
- DGAQECJNVWCQMB-PUAWFVPOSA-M Ilexoside XXIX Chemical compound C[C@@H]1CC[C@@]2(CC[C@@]3(C(=CC[C@H]4[C@]3(CC[C@@H]5[C@@]4(CC[C@@H](C5(C)C)OS(=O)(=O)[O-])C)C)[C@@H]2[C@]1(C)O)C)C(=O)O[C@H]6[C@@H]([C@H]([C@@H]([C@H](O6)CO)O)O)O.[Na+] DGAQECJNVWCQMB-PUAWFVPOSA-M 0.000 description 5
- 229910052708 sodium Inorganic materials 0.000 description 5
- 239000011734 sodium Substances 0.000 description 5
- 210000000601 blood cell Anatomy 0.000 description 4
- 238000005534 hematocrit Methods 0.000 description 4
- 239000012510 hollow fiber Substances 0.000 description 4
- 229920002239 polyacrylonitrile Polymers 0.000 description 4
- 206010018910 Haemolysis Diseases 0.000 description 3
- 102000001554 Hemoglobins Human genes 0.000 description 3
- 108010054147 Hemoglobins Proteins 0.000 description 3
- 230000008588 hemolysis Effects 0.000 description 3
- 210000003734 kidney Anatomy 0.000 description 3
- 230000004087 circulation Effects 0.000 description 2
- 238000007872 degassing Methods 0.000 description 2
- 238000010790 dilution Methods 0.000 description 2
- 239000012895 dilution Substances 0.000 description 2
- 239000007789 gas Substances 0.000 description 2
- NOESYZHRGYRDHS-UHFFFAOYSA-N insulin Chemical compound N1C(=O)C(NC(=O)C(CCC(N)=O)NC(=O)C(CCC(O)=O)NC(=O)C(C(C)C)NC(=O)C(NC(=O)CN)C(C)CC)CSSCC(C(NC(CO)C(=O)NC(CC(C)C)C(=O)NC(CC=2C=CC(O)=CC=2)C(=O)NC(CCC(N)=O)C(=O)NC(CC(C)C)C(=O)NC(CCC(O)=O)C(=O)NC(CC(N)=O)C(=O)NC(CC=2C=CC(O)=CC=2)C(=O)NC(CSSCC(NC(=O)C(C(C)C)NC(=O)C(CC(C)C)NC(=O)C(CC=2C=CC(O)=CC=2)NC(=O)C(CC(C)C)NC(=O)C(C)NC(=O)C(CCC(O)=O)NC(=O)C(C(C)C)NC(=O)C(CC(C)C)NC(=O)C(CC=2NC=NC=2)NC(=O)C(CO)NC(=O)CNC2=O)C(=O)NCC(=O)NC(CCC(O)=O)C(=O)NC(CCCNC(N)=N)C(=O)NCC(=O)NC(CC=3C=CC=CC=3)C(=O)NC(CC=3C=CC=CC=3)C(=O)NC(CC=3C=CC(O)=CC=3)C(=O)NC(C(C)O)C(=O)N3C(CCC3)C(=O)NC(CCCCN)C(=O)NC(C)C(O)=O)C(=O)NC(CC(N)=O)C(O)=O)=O)NC(=O)C(C(C)CC)NC(=O)C(CO)NC(=O)C(C(C)O)NC(=O)C1CSSCC2NC(=O)C(CC(C)C)NC(=O)C(NC(=O)C(CCC(N)=O)NC(=O)C(CC(N)=O)NC(=O)C(NC(=O)C(N)CC=1C=CC=CC=1)C(C)C)CC1=CN=CN1 NOESYZHRGYRDHS-UHFFFAOYSA-N 0.000 description 2
- 230000004199 lung function Effects 0.000 description 2
- 238000002156 mixing Methods 0.000 description 2
- -1 polyethylene Polymers 0.000 description 2
- 239000000243 solution Substances 0.000 description 2
- 238000000108 ultra-filtration Methods 0.000 description 2
- WQZGKKKJIJFFOK-GASJEMHNSA-N Glucose Natural products OC[C@H]1OC(O)[C@H](O)[C@@H](O)[C@@H]1O WQZGKKKJIJFFOK-GASJEMHNSA-N 0.000 description 1
- 108090001061 Insulin Proteins 0.000 description 1
- 102000004877 Insulin Human genes 0.000 description 1
- 239000004698 Polyethylene Substances 0.000 description 1
- 239000004743 Polypropylene Substances 0.000 description 1
- 206010062237 Renal impairment Diseases 0.000 description 1
- 229920001893 acrylonitrile styrene Polymers 0.000 description 1
- 210000001367 artery Anatomy 0.000 description 1
- 239000012237 artificial material Substances 0.000 description 1
- WQZGKKKJIJFFOK-VFUOTHLCSA-N beta-D-glucose Chemical compound OC[C@H]1O[C@@H](O)[C@H](O)[C@@H](O)[C@@H]1O WQZGKKKJIJFFOK-VFUOTHLCSA-N 0.000 description 1
- 229920002678 cellulose Polymers 0.000 description 1
- 239000001913 cellulose Substances 0.000 description 1
- 239000000306 component Substances 0.000 description 1
- 239000000356 contaminant Substances 0.000 description 1
- 238000001816 cooling Methods 0.000 description 1
- 230000007423 decrease Effects 0.000 description 1
- 238000000502 dialysis Methods 0.000 description 1
- 239000002934 diuretic Substances 0.000 description 1
- 229940030606 diuretics Drugs 0.000 description 1
- 210000003743 erythrocyte Anatomy 0.000 description 1
- 230000006870 function Effects 0.000 description 1
- 239000008103 glucose Substances 0.000 description 1
- 108700003062 glucose-insulin-potassium cardioplegic solution Proteins 0.000 description 1
- 230000002949 hemolytic effect Effects 0.000 description 1
- 229940125396 insulin Drugs 0.000 description 1
- 239000007788 liquid Substances 0.000 description 1
- 210000004185 liver Anatomy 0.000 description 1
- 239000000463 material Substances 0.000 description 1
- 239000008155 medical solution Substances 0.000 description 1
- 238000000034 method Methods 0.000 description 1
- 230000027939 micturition Effects 0.000 description 1
- 210000004165 myocardium Anatomy 0.000 description 1
- 235000015097 nutrients Nutrition 0.000 description 1
- 239000002504 physiological saline solution Substances 0.000 description 1
- 229920003229 poly(methyl methacrylate) Polymers 0.000 description 1
- 229920000515 polycarbonate Polymers 0.000 description 1
- 239000004417 polycarbonate Substances 0.000 description 1
- 229920000573 polyethylene Polymers 0.000 description 1
- 239000004926 polymethyl methacrylate Substances 0.000 description 1
- 229920001155 polypropylene Polymers 0.000 description 1
- 229920005749 polyurethane resin Polymers 0.000 description 1
- 231100000857 poor renal function Toxicity 0.000 description 1
- 230000037452 priming Effects 0.000 description 1
- SCUZVMOVTVSBLE-UHFFFAOYSA-N prop-2-enenitrile;styrene Chemical compound C=CC#N.C=CC1=CC=CC=C1 SCUZVMOVTVSBLE-UHFFFAOYSA-N 0.000 description 1
- 102000004169 proteins and genes Human genes 0.000 description 1
- 108090000623 proteins and genes Proteins 0.000 description 1
- 238000011144 upstream manufacturing Methods 0.000 description 1
- 230000008320 venous blood flow Effects 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
- A61M1/3623—Means for actively controlling temperature of blood
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
- A61M1/3643—Priming, rinsing before or after use
Landscapes
- Health & Medical Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Biomedical Technology (AREA)
- Engineering & Computer Science (AREA)
- Anesthesiology (AREA)
- Cardiology (AREA)
- Hematology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- External Artificial Organs (AREA)
Description
【発明の詳細な説明】
本発明は、肺機能を代行する人工肺装置に関す
るものであり、さらに詳しくは血液回路中に血液
中の水分を除去する手段を設けて、手術中におけ
る血液濃度の低下を防止するようにした人工肺装
置に関するものである。DETAILED DESCRIPTION OF THE INVENTION The present invention relates to an artificial lung device that performs lung function, and more specifically, a means for removing water in the blood is provided in the blood circuit to reduce blood concentration during surgery. The present invention relates to an artificial lung device designed to prevent.
従来より、心臓切開手術等には人工肺装置が必
ず用いられている。周知の如く、この人工肺装置
としては、気泡型、フイルム型および膜型がある
が、これらの装置はいずれも血液を酸素と接触せ
しめて血液中の二酸化炭素と酸素を交換し、酸素
付加された血液を得るための人工肺本体と、それ
と人体を結合し血液の循環経路を構成する血液回
路とからなつている。 Conventionally, an artificial lung device has always been used in open heart surgery and the like. As is well known, there are bubble-type, film-type, and membrane-type artificial lung devices, and all of these devices bring blood into contact with oxygen to exchange carbon dioxide and oxygen in the blood, resulting in oxygenated oxygen. The artificial lung consists of an artificial lung, which is used to obtain blood, and a blood circuit, which connects the artificial lung to the human body and forms a blood circulation route.
この血液回路に流入される血液は、人体からの
静脈血液および切開創からの出血液であり、流出
する血液は人体へ返却する動脈血液である。 The blood flowing into this blood circuit is venous blood from the human body and blood from the incision, and the blood flowing out is arterial blood returning to the human body.
前記構成からなる人工肺装置を人体と結合して
心臓等の切開手術を行なう場合、切開創からの出
血液は、通常心筋冷却用砕氷溶解水と混ざつて稀
釈された状態で血液回路に流入してくる。そのた
め、時間の経過と共に患者に循環される血液の濃
度（ヘマトクリツト値）が低下し好ましくないの
で、この循環血液の一部を系外に除去し、代りに
保存血液を血液回路中に補給することが行われて
いるが、それでもなお血液の稀釈は避けられな
い。そこで、手術後24〜40時間かけて利尿剤を投
与し、排尿促進することが行われている。 When an artificial lung device having the above structure is connected to a human body to perform an open surgery on the heart, etc., blood from the incision usually flows into the blood circuit in a diluted state by mixing with water dissolved in crushed ice for cooling the myocardium. I'll come. As a result, the concentration (hematocrit value) of the blood circulating in the patient decreases over time, which is undesirable, so some of this circulating blood is removed from the system and stored blood is replenished into the blood circuit instead. However, blood dilution is still unavoidable. Therefore, diuretics are administered for 24 to 40 hours after surgery to promote urination.
しかし、上記方法は大量の保存血液を必要とす
る上に、保存血液中に存在する比較的高濃度のカ
リウムのために、循環血液中のカリウム濃度が増
加する傾向を示す欠点があり、従来よりこの改善
が望まれていた。 However, the above method requires a large amount of stored blood, and has the disadvantage that the potassium concentration in the circulating blood tends to increase due to the relatively high concentration of potassium present in the stored blood. This improvement was desired.
本発明の目的は、このような手術中における血
液濃度の低下を防止し、常に所定の血液濃度を保
ちながら人体の肺機能を代行できる改良された人
工肺装置を提供することにある。本発明によれ
ば、血液回路中に設けられた水分除去手段によつ
て血液中の水分が適宜系外に除去排出され、血液
濃度の低下を防止し、保存血液の補給を大巾に減
少させるか、もしくは実質上皆無とすることがで
きる。 An object of the present invention is to provide an improved artificial lung device that can prevent such a drop in blood concentration during surgery and perform the lung functions of the human body while always maintaining a predetermined blood concentration. According to the present invention, water in the blood is appropriately removed and discharged from the system by the water removing means provided in the blood circuit, thereby preventing a drop in blood concentration and greatly reducing the need for replenishment of stored blood. or virtually none at all.
本発明における血液中の水分を除去する手段と
しては、血液から水もしくは水と比較的低分子量
の成分を選択的に除去できるものであれば特に制
限はない。好ましく使用できるものとしては、従
来より知られている人工腎臓や人工肝臓等の人工
臓器を挙げることができる。これらのものは臨床
において多くの実績があり、信頼性の高い装置の
入手が容易である。このような人工臓器には透析
型および限外過型があり、半透膜の形状の違い
から、中空繊維型、コイル型、平膜積層型に分け
られる。 The means for removing water from blood in the present invention is not particularly limited as long as it can selectively remove water or water and components with relatively low molecular weights from blood. Examples of those that can be preferably used include conventionally known artificial organs such as artificial kidneys and artificial livers. These devices have a good track record in clinical practice, and highly reliable devices are easily available. Such artificial organs include dialysis type and ultra-extraordinary type, and are divided into hollow fiber type, coil type, and flat membrane laminated type based on the difference in the shape of the semipermeable membrane.
また、これら人工臓器の半透膜の素材は、セル
ロース、ポリアクリロニトリル、ポリカーボネー
ト、ポリメチルメタアクリレート、ポリエチレ
ン、ポリプロピレン等が用いられている。本発明
における水分除去手段としては、上記のあらゆる
タイプのものが使用可能である。しかし、限外
過型が処理能力の点から好ましく、また半透膜の
形状としては中空繊維型が好ましい。 Furthermore, the materials used for the semipermeable membranes of these artificial organs include cellulose, polyacrylonitrile, polycarbonate, polymethyl methacrylate, polyethylene, and polypropylene. Any of the above-mentioned types can be used as the moisture removing means in the present invention. However, the ultrafiltration type is preferable from the viewpoint of processing capacity, and the hollow fiber type is preferable as the shape of the semipermeable membrane.
血液中から水分および低分子量物質を選択的に
除去するには、例えば、血球成分、蛋白質等の高
分子量のものは除去されず、低分子もののみ除去
できる性質をもつ半透膜を使用すればよい。一般
的に多用されている人工腎臓の場合は、分子量
3000〜10000より低いものを選択的に過ないし
透析するようになつているが、これらは十分に水
やカリウム、ナトリウム等の血液中の低分子物質
を除去することができる。 In order to selectively remove water and low molecular weight substances from blood, for example, a semipermeable membrane can be used which has the property of only removing low molecular weight substances and not high molecular weight substances such as blood cell components and proteins. good. In the case of commonly used artificial kidneys, molecular weight
Although it is designed to selectively dialyze those with a concentration lower than 3,000 to 10,000, these can sufficiently remove low-molecular substances in the blood such as water, potassium, and sodium.
一方、心臓切開手術などにおいては、人工肺に
よる血球の損傷もかなり多く、特に赤血球の溶血
によるヘモグロビンの遊離化現象が問題となつて
いる。この遊離ヘモグロビンは、他の血液と一諸
に血液回路中を循環流通し、その分子量はおよそ
34000位である。したがつて、本発明における水
分除去手段の半透膜として、分子量40000位以下
を過するようなものを用いれば、水分と同時に
遊離ヘモグロビンも系外に除去されるので、非常
に好ましい。このような分子量のものを過でき
る半透膜としては、例えばポリアクリロニトリル
系のものが知られている。 On the other hand, in open heart surgery and the like, blood cells are often damaged by the artificial lung, and in particular, the phenomenon of hemoglobin release due to hemolysis of red blood cells is a problem. This free hemoglobin circulates in the blood circuit together with other blood, and its molecular weight is approximately
It is ranked 34,000th. Therefore, it is very preferable to use a semipermeable membrane for the water removal means of the present invention having a molecular weight of about 40,000 or less, since free hemoglobin is removed from the system at the same time as water. A polyacrylonitrile-based semipermeable membrane, for example, is known as a semipermeable membrane that can pass a membrane having such a molecular weight.
水分除去手段は、人工肺装置の血液回路中のい
ずれに設けてもよい。また、血液回路における循
環血液の一部をバイパスして水分除去手段に通す
こともできる。一般に人工的材料は多かれ少なか
れ血液を溶血する性質を有するので、それに接触
させる血液量はできるだけ少ない方が溶血量も減
少するので好ましい。本発明の好ましい実施態様
によれば、上記バイパス量は全循環血液量に対し
て５〜50％、好ましくは５〜20％であり、溶血量
はそれに比例して減少する。 The water removal means may be provided anywhere in the blood circuit of the artificial lung device. Also, a portion of the circulating blood in the blood circuit can be bypassed and passed through the water removal means. In general, artificial materials have the property of hemolyzing blood to a greater or lesser extent, so it is preferable that the amount of blood brought into contact with it be as small as possible, since this will also reduce the amount of hemolysis. According to a preferred embodiment of the invention, the bypass volume is between 5 and 50%, preferably between 5 and 20% of the total circulating blood volume, and the amount of hemolysis is proportionally reduced.
図面は本発明の人工肺装置の一実施例を説明す
るためのフローシートである。図面において、患
者１の静脈血流は、ライン２からリザーバタンク
３に流入し、ここで脱気された後、ポンプ４によ
つて熱交換器５を経由し、人工肺６に導かれる。
人工肺６において酸素O2と接触した血液は、含
有する二酸化炭素CO2をガス中に放出し、酸素を
付加されてリザーバタンク７中に導入され、ここ
で血液に混入されているガスが分離除去された
後、ポンプ８、フイルター９を通つて患者１の動
脈に戻される。切開手術中に切開創から流出する
血液は、ライン１０を通り、フイルター１１、ポ
ンプ１２を経てリザーバタンク３に流入させる。
１３は血液中の水分を除去する水分除去手段であ
り、ライン１４からバイパスしてポンプ１５を通
つて血液が導入される。水分除去手段１３にて除
去された水、もしくは水とカリウム、ナトリウム
などの低分子量成分は、ライン１６から系外に排
出され、一方、処理済の血液はライン１７を通つ
てリザーバタンク７に流入させ、ここで脱気する
とともに、人工肺６よりの血液流と合流され患者
に戻される。 The drawing is a flow sheet for explaining one embodiment of the artificial lung device of the present invention. In the figure, the venous blood flow of a patient 1 flows through a line 2 into a reservoir tank 3 where it is degassed and then guided by a pump 4 to an oxygenator 6 via a heat exchanger 5.
Blood that has come into contact with oxygen O 2 in the artificial lung 6 releases the carbon dioxide CO 2 it contains into gas, is oxygenated and introduced into the reservoir tank 7, where the gas mixed in the blood is separated. After being removed, it is returned to the patient's 1 artery through a pump 8 and a filter 9. Blood flowing out of an incision during an open surgery passes through a line 10, passes through a filter 11, a pump 12, and flows into a reservoir tank 3.
Reference numeral 13 denotes a water removal means for removing water from blood, and blood is introduced through a pump 15 bypassing a line 14. The water removed by the water removal means 13, or water and low molecular weight components such as potassium and sodium, is discharged from the system through a line 16, while the treated blood flows into the reservoir tank 7 through a line 17. Here, it is degassed, combined with the blood flow from the artificial lung 6, and returned to the patient.
フローシートにおいて、ライン２および１０か
らの血液がリザーバタンク３等を経由し、ライン
１８によつて患者１に戻される循環回路が血液回
路である。この血液回路を構成する各要素のう
ち、リザーバタンク３，７は血液の一時的貯滞と
脱気機能を持ち、フイルター９，１１は血液中へ
の混入物の除去、ポンプ４，８，１２，１５は加
圧、熱交換器５は血液の冷却または加温を行う。
リザーバタンク３の上部には、ライン１９によつ
て血液回路のプライミング用生理食塩水、保存血
液、種々の薬液、栄養液等を血液回路に導入する
のに用いることができる。 In the flow sheet, the blood circuit is a circulation circuit in which blood from lines 2 and 10 passes through reservoir tank 3 and the like and is returned to patient 1 via line 18. Among the elements constituting this blood circuit, reservoir tanks 3 and 7 have the function of temporarily storing blood and degassing, filters 9 and 11 remove contaminants from the blood, and pumps 4, 8, 12 , 15 pressurize the blood, and the heat exchanger 5 cools or warms the blood.
The upper part of the reservoir tank 3 can be used to introduce physiological saline for priming the blood circuit, stored blood, various medical solutions, nutrient solutions, etc. into the blood circuit through a line 19.
本発明における水分除去手段１３は、図面に示
す血液回路において、好ましくはリザーバタンク
３からリザーバタンク７の間のいずれかのライン
中、あるいはそのラインもしくはラインに設けら
れた各要素に対するバイパスライン中に設けられ
る。リザーバタンク７より上流側に設ける理由
は、できるだけ最終ラインに脱気手段を設けるこ
とが好ましいことによる。図面に示す例では、水
分除去手段よりの処理済血液はリザーバタンク７
に戻され、ここで他の血液と十分に混合すること
ができるようになされている。 In the blood circuit shown in the drawings, the water removal means 13 of the present invention is preferably located in any line between the reservoir tank 3 and the reservoir tank 7, or in a bypass line for that line or each element provided in the line. provided. The reason why it is provided upstream of the reservoir tank 7 is that it is preferable to provide the degassing means in the final line as much as possible. In the example shown in the drawings, the processed blood from the water removal means is stored in the reservoir tank 7.
The blood is returned to the blood cell, where it can be thoroughly mixed with other blood.
次に、本発明の人工肺装置を用いて心臓の切開
手術を行つた実施例を示す。 Next, an example will be shown in which open heart surgery was performed using the artificial lung device of the present invention.
実施例
図面のフローシートに示すものとほぼ同様の人
工肺装置を用いた。使用した人工肺は気泡型人工
肺（米国シヤイリー社Ｓ―100A型）であり、気
―液混合部とリザーバタンクが結合された最大許
容血液流量６／minの装置である。水分除去手
段は、ポリアクリロニトリル中空繊維束を使用し
た円筒形の限外過装置（旭メデイカル(株)製
PAN―15型）であり、アクリロニトリルスチレ
ン共重合体製の238mm×48mm中の円筒容器に納め
られた内径200μｍ、膜厚50μｍの11000本のポリ
アクリロニトリル中空繊維の束からなり、その両
端はポリウレタン樹脂で液密に接着された有効膜
面積が1.1m2のものである。EXAMPLE An artificial lung device substantially similar to that shown in the flow sheet of the drawings was used. The oxygenator used was a bubble-type oxygenator (S-100A model, manufactured by Chialy, USA), which is a device that combines an air-liquid mixing section and a reservoir tank and has a maximum allowable blood flow rate of 6/min. The water removal means was a cylindrical ultrafiltration device (manufactured by Asahi Medical Co., Ltd.) using polyacrylonitrile hollow fiber bundles.
It consists of a bundle of 11,000 polyacrylonitrile hollow fibers with an inner diameter of 200 μm and a film thickness of 50 μm housed in a 238 mm x 48 mm cylindrical container made of acrylonitrile styrene copolymer, with both ends covered with polyurethane resin. The effective membrane area is 1.1m2 and is bonded liquid-tightly.
人工肺装置に最初保存血1600ml、GIK液（グル
コース、インシユリン、カリウム液）1000ml、計
2600mlを充填した後、患者と結合した。手術時間
はおよそ100分間であり、その間の血液回路に循
環した血液流量は平均4700ml／minであつた。ラ
イン１４からポンプ１５によつてバイパスした水
分除去手段１３への血液流量は、この間190〜200
ml／minであり、除去された水分は2120mlで、こ
の中のカリウム量は7.0ミリ当量、ナトリウム量
は262.9ミリ当量であつた。一方、血液回路へは
手術中リザーバタンク３を経て、GIKおよびその
他必要な補助薬品類が2000ml補給された。血液回
路中のヘマトクリツト値は平均して30％、カリウ
ム値は3.3ミリ当量／、ナトリウム値は124ミリ
当量／であつた。そして、この間血液回路中の
血液の排出は必要とせず、新たな保存血液の補給
はほとんど必要としなかつた。 Initially, 1600 ml of blood and 1000 ml of GIK solution (glucose, insulin, potassium solution) were stored in the oxygenator.
After filling 2600ml, it was combined with the patient. The operation time was approximately 100 minutes, during which time the blood flow rate circulating in the blood circuit was 4700 ml/min on average. During this period, the blood flow rate from the line 14 to the water removal means 13 bypassed by the pump 15 was 190 to 200.
ml/min, and the water removed was 2120 ml, in which the amount of potassium was 7.0 milliequivalents and the amount of sodium was 262.9 milliequivalents. Meanwhile, 2000 ml of GIK and other necessary auxiliary chemicals were supplied to the blood circuit via reservoir tank 3 during the surgery. The average hematocrit value in the blood circuit was 30%, the potassium value was 3.3 meq/, and the sodium value was 124 meq/. During this period, the blood in the blood circuit did not need to be drained, and there was almost no need to replenish new stored blood.
もし、この人工肺装置に水分除去手段を入れな
いとすると、ヘマトクリツト値は大巾に低下し、
計算上23.5％となり、血液中の血球濃度は21.5％
も稀釈されることになる。また、人体も含めた循
環回路中のカリウム値は7.0ミリ当量増加し、同
様にナトリウムも262.9ミリ当量増加する。これ
らは手術中の患者の腎臓の負担を増大せしめ、腎
機能の障害の発生原因となり好ましくない。 If no water removal means were included in this oxygenator, the hematocrit value would drop significantly,
The calculation is 23.5%, and the blood cell concentration in the blood is 21.5%.
will also be diluted. In addition, the potassium value in the circulation circuit, including the human body, increases by 7.0 milliequivalents, and sodium also increases by 262.9 milliequivalents. These are undesirable because they increase the burden on the patient's kidneys during surgery and cause impaired renal function.
上記の血液の稀釈を防ぎ、本発明と同一のヘマ
トクリツト値を維持するためには、血液の一部を
回路から外部へ除去し、新たな保存血液を約4000
ml以上補給し、バランスを保たなければならな
い。しかし、そのようにした場合、カリウム値の
上昇は避けられない。 In order to prevent the blood dilution described above and maintain the same hematocrit value as in the present invention, a portion of the blood is removed from the circuit and new stored blood is added to the
Must be supplemented with more than ml to maintain balance. However, when doing so, an increase in potassium levels is unavoidable.
図面は本発明の人工肺装置の一実施例を説明す
るためのフローシートである。
３，７……リザーバタンク、４，８，１２，１
５……ポンプ、５……熱交換器、６……人工肺、
９，１１……フイルター、１３……水分除去手
段。
The drawing is a flow sheet for explaining one embodiment of the artificial lung device of the present invention. 3, 7...Reservoir tank, 4, 8, 12, 1
5... pump, 5... heat exchanger, 6... oxygenator,
9, 11...filter, 13...moisture removal means.
Claims (1)
素と酸素を交換し、酸素付加された血液を得るた
めの人工肺本体と、それと人体を結合し血液の循
環経路を構成する血液回路とからなる人工肺装置
において、血液回路中に血液中の水分を除去する
手段を設けたことを特徴とする人工肺装置。 ２ 血液中の水分を除去する手段として半透膜を
使用する人工臓器を設けた特許請求の範囲第１項
記載の人工肺装置。 ３ 半透膜が分子量40000以下の物質を過する
ものである特許請求の範囲第２項記載の人工肺装
置。 ４ 血液回路中にバイパスラインを形成し、該バ
イパスライン中に血液中の水分を除去する手段を
設けた特許請求の範囲第１項ないし第３項記載の
人工肺装置。[Scope of Claims] 1. An oxygenator main body for bringing blood into contact with oxygen to exchange carbon dioxide and oxygen in the blood to obtain oxygenated blood, and a blood circulation route that connects the main body with the human body. 1. An artificial lung device comprising a blood circuit and a blood circuit, characterized in that the blood circuit is provided with means for removing water in the blood. 2. The artificial lung device according to claim 1, which is provided with an artificial organ that uses a semipermeable membrane as a means for removing water from blood. 3. The artificial lung device according to claim 2, wherein the semipermeable membrane is permeable to a substance having a molecular weight of 40,000 or less. 4. The artificial lung device according to claims 1 to 3, wherein a bypass line is formed in the blood circuit, and means for removing water in the blood is provided in the bypass line.
Priority Applications (5)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP55117719A JPS5743748A (en) | 1980-08-28 | 1980-08-28 | Artificial lung device |
| DE19813133498 DE3133498A1 (en) | 1980-08-28 | 1981-08-25 | LIFE-SUPPORT-MACHINE |
| GB8126080A GB2082475A (en) | 1980-08-28 | 1981-08-26 | Artificial lung device |
| AU74754/81A AU7475481A (en) | 1980-08-28 | 1981-08-27 | Artificial lung device |
| FR8116382A FR2489144A1 (en) | 1980-08-28 | 1981-08-27 | ARTIFICIAL LUNG DEVICE |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP55117719A JPS5743748A (en) | 1980-08-28 | 1980-08-28 | Artificial lung device |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| JPS5743748A JPS5743748A (en) | 1982-03-11 |
| JPS6246192B2 true JPS6246192B2 (en) | 1987-10-01 |
Family
ID=14718593
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP55117719A Granted JPS5743748A (en) | 1980-08-28 | 1980-08-28 | Artificial lung device |
Country Status (5)
| Country | Link |
|---|---|
| JP (1) | JPS5743748A (en) |
| AU (1) | AU7475481A (en) |
| DE (1) | DE3133498A1 (en) |
| FR (1) | FR2489144A1 (en) |
| GB (1) | GB2082475A (en) |
Families Citing this family (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPS59155260A (en) * | 1983-02-22 | 1984-09-04 | 東レ株式会社 | Free hemoglobin separation membrane |
| BR8705585A (en) * | 1987-10-13 | 1989-05-09 | Adib Domingos Jatene | OXYGENER DEVICE |
| US5470531A (en) * | 1992-11-03 | 1995-11-28 | Cobe Laboratories, Inc. | Exchanger and method for manufacturing the same |
| DE4238884A1 (en) * | 1992-11-19 | 1994-05-26 | Jostra Medizintechnik | Device with blood@ oxygenator - is for use in cases of acute cardiac insufficiency and has attached hose system, being filled with infusion soln. |
| DE19702098B4 (en) * | 1997-01-22 | 2004-02-12 | HORUS medizinische Artikel und Geräte | Mobile heart-lung machine |
| US6723132B2 (en) | 2002-06-26 | 2004-04-20 | Karim Salehpoor | Artificial lung device |
| EP4438073A2 (en) * | 2018-06-27 | 2024-10-02 | The Geneva Foundation | Wearable modular extracorporeal life support device for mobile treatment of single and multiorgan failure |
Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPS5045498A (en) * | 1973-08-22 | 1975-04-23 | ||
| JPS5551409A (en) * | 1978-10-12 | 1980-04-15 | Toray Ind Inc | Filtering apparatus |
Family Cites Families (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| FR2447196A1 (en) * | 1979-01-23 | 1980-08-22 | Sodip Sa | MEDICAL EXCHANGER-SEPARATOR WITH MEMBRANES |
-
1980
- 1980-08-28 JP JP55117719A patent/JPS5743748A/en active Granted
-
1981
- 1981-08-25 DE DE19813133498 patent/DE3133498A1/en not_active Withdrawn
- 1981-08-26 GB GB8126080A patent/GB2082475A/en not_active Withdrawn
- 1981-08-27 AU AU74754/81A patent/AU7475481A/en not_active Abandoned
- 1981-08-27 FR FR8116382A patent/FR2489144A1/en active Pending
Patent Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPS5045498A (en) * | 1973-08-22 | 1975-04-23 | ||
| JPS5551409A (en) * | 1978-10-12 | 1980-04-15 | Toray Ind Inc | Filtering apparatus |
Also Published As
| Publication number | Publication date |
|---|---|
| GB2082475A (en) | 1982-03-10 |
| JPS5743748A (en) | 1982-03-11 |
| FR2489144A1 (en) | 1982-03-05 |
| AU7475481A (en) | 1982-03-04 |
| DE3133498A1 (en) | 1982-05-27 |
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