JPS63302861A - Extracorporeal blood circulation apparatus - Google Patents

Abstract

PURPOSE:To store blood in a blood storage tank only by head perfusion, by controlling the temp. of blood by a heat exchanger arranged in a horizontal state and subsequently performing the gas exchange of blood in an oxygenator to store said blood in the blood storage tank. CONSTITUTION:The main body part 30 of an extracorporeal circulation apparatus is integrally constituted by collecting a heat exchanger 32, and oxygenator 34 and an open type blood storage tank 36. The blood B flowing in the heat exchanger 32 from a blood supply port 46 is adjusted to desired temp. in a heat exchange chamber 45 and subsequently guided to the oxygenator 34 through the connection pipelines 48a, 48b of an upper side part. The blood B to which oxygen added in the oxygenator 34 is easily flooded only by the head perfusion from a patient to enter the blood storage tank 36 from blood inflow ports 72a, 72b through connection pipelines 68a, 68b. As a result, since the blood B flows in the blood storage tank 36 without injection, the mixing of air bubbles in the blood B is suitably suppressed and the blood B is stored in the blood storage tank 36.

Description

DETAILED DESCRIPTION OF THE INVENTION [Field of Industrial Application] The present invention relates to an extracorporeal blood circulation device. The present invention relates to an extracorporeal blood circulation device configured to exchange blood with an artificial lung, temporarily store it in a blood storage tank, and then supply it to the human body.

[Background of the Invention] For example, when performing thoracic surgery, an extracorporeal blood circulation circuit is constructed using an artificial lung, and carbon dioxide and oxygen are exchanged using the artificial lung. In this case, the blood is adjusted to a predetermined temperature by a heat exchanger, gas exchanged in an oxygenator, and then stored in a blood reservoir to remove air bubbles and deliver a certain amount of blood, and then pumped. It is delivered to the human body at a constant pulsation rate.

Here, the blood storage tank includes a closed type blood storage tank that stores blood in a bag-like soft member in an airtight state, and an open type blood storage tank that stores blood in a housing made of a hard member.

In this case, an open type blood reservoir is easy to prime and check the amount of blood stored, and it is also easy to configure it integrally with an oxygenator, so extracorporeal blood using such an open type blood reservoir can be used. Various circulation devices have been proposed.

Therefore, a schematic configuration of an extracorporeal blood circulation device shown for comparison is shown in FIG. 1. This extracorporeal blood circulation device is one in which a heat exchanger 2, an oxygenator 4, and a blood storage tank 6 are integrally constructed.
It is connected to the human body via a pump (not shown) that generates pulsations. Blood B discharged from the human body is introduced into the heat exchanger 2 from the blood inflow port 8, and after being adjusted to a predetermined temperature with hot or cold water supplied from the water port 10, it is passed through the connecting pipe 12 to the oxygenator 2. guided by. artificial lung 4
contains a large number of hollow fiber membranes (not shown) through which gas A containing oxygen supplied from the gas inflow port 14 flows, and blood B passing around the hollow fiber membranes is mixed into blood B. The carbon dioxide contained in the gas A is exchanged with the oxygen contained in the gas A, and the gas A flows into the blood storage tank 6 from the blood inlet 18 via the connecting pipe line 16. Note that the gas A after the gas exchange is discharged to the outside via the gas outflow port 20. On the other hand, the blood B that has flowed into the blood storage tank 6 from the blood inflow port 18 is temporarily stored in the blood storage tank 6 after air bubbles in the blood B are removed by the antifoaming material 22, and then flows through the blood outflow port 24. Supplied to the human body.

By the way, in such an extracorporeal blood circulation apparatus, as described above, the blood B is circulated between the human body and the human body by applying pressure to the blood stream using a pump. here,
When the heat exchanger 2 is arranged long in the vertical direction as shown in FIG. 1, blood B flows in through the blood inflow port 8 provided at the lower end of the heat exchanger 2 and rises inside the heat exchanger 2. After the temperature is adjusted during that time, the oxygen tube is led to the oxygenator 4 through the connection pipe 12 at its upper end. In this case, the position of the connection pipe 16 that connects the oxygenator 4 and the blood storage tank 6 will be located higher than the ground by the height difference between the blood inflow port 8 of the heat exchanger 2 and the connection pipe 12, and , the height difference from the patient to the connecting conduit 16 becomes shorter, so the potential energy of the blood B is lost. Therefore, even if an attempt is made to vertically perfuse the blood B using the heat exchanger 2 and the oxygenator 4 using only the height of the patient and the connecting pipe 16 without using a pump, insufficient pressure may occur. To avoid this, the position of the operating table must be raised accordingly. On the other hand, if this is possible, a pump is also required upstream of the heat exchanger 2.

[Object of the Invention] The present invention has been made in view of the above-mentioned problems. After adjusting the temperature of blood using a heat exchanger arranged in a substantially horizontal state, gas is exchanged in an oxygenator and the blood is transferred into a blood storage tank. It is an object of the present invention to provide a two-extracorporeal blood circulation device which has a simple configuration and can store blood in the blood reservoir using only head perfusion by having a configuration for storing blood.

[Means for Achieving the Object] In order to achieve the above object, the present invention has a blood inlet section on the lower side and a blood outlet section on the upper side, and a heat exchanger that is long in the horizontal direction and short in the vertical direction; an oxygenator having a blood inflow section and a blood outflow section above; the blood outlet section of the heat exchanger and the blood inflow section of the oxygenator are connected to form an integral structure; After the temperature of the introduced blood is adjusted, the blood is drawn out from the blood outlet part toward the oxygenator, and the blood that flows in from the blood inlet part of the oxygenator undergoes gas exchange in the oxygenator. It is characterized by being configured so that it flows out from the outflow part.

[Embodiments] Next, preferred embodiments of the extracorporeal blood circulation apparatus according to the present invention will be described in detail with reference to the accompanying drawings.

2 and 3, reference numeral 30 indicates the main body of the extracorporeal blood circulation apparatus, and this main body 30 is connected to the heat exchanger 3.
2, an artificial lung 34, and an open type blood storage tank 36 are integrated into one body.

The heat exchanger 32 includes a cylindrical housing 38 arranged so that its longitudinal direction is horizontal, and a large number of heat exchange tubes 40 housed in the housing 38. The hot water or cold water W is supplied from one water port 42 and the hot water or cold water W is discharged from the other water port 44 . Housing 38
A blood supply port 46 communicating with a heat exchange chamber 45 defined between the inner circumferential wall of the housing 38 and the outer circumferential wall of the heat exchange tube 40 is formed at the upper side circumference of the housing 38 . Further, two connecting pipes 48a and 48b communicating with the heat exchange chamber 45 are formed in the lower part of the side circumference of the housing 38 at a position substantially opposite to the blood supply port 46. In this case, blood B flowing into the heat exchanger 32 from the blood supply port 46 is heated or cooled to a predetermined temperature by passing around the heat exchange tube 40, and then flows through the connecting pipes 48a and 48b. The oxygen is supplied to the artificial lung 34 via the oxygen pump (see FIG. 3).

The artificial lung 34 removes carbon dioxide from the blood B and adds oxygen thereto, and has a large number of hollow fiber membranes 52 housed in a bundle in a generally cylindrical housing 50 with a narrowed center.

Partition walls 54a and 54b that hold both ends of the hollow fiber membrane 52 are attached to both upper and lower ends of the housing 50. In this case, the hollow fiber membrane 52 is housed, and the housing 50 and the partition wall 5
The lower end side of the space surrounded by 4a and 54b communicates with the heat exchanger 32 via connecting pipes 48a and 48b, and constitutes a gas exchange chamber 56 through which blood B flows. Further, lid members 58 are provided at both upper and lower ends of the housing 50.
a b and 58b are attached, and a gas supply chamber 60 and a gas exhaust chamber 62 are defined between the partition walls 54a, 54b and the lid members 58a, 58b, respectively. In addition, the hollow fiber membrane 5
2 is supplied with oxygen-containing gas A from a gas inlet port 64 through a gas supply chamber 60 .

Further, the gas A sent out from the hollow membrane 52 is discharged from the gas outlet port 66 via the gas exhaust chamber 62.

On the other hand, the upper end side of the gas exchange chamber 56 in the oxygenator 34 once extends horizontally, and then extends vertically upward for a predetermined length.
It communicates with the blood reservoir 36 via 8b. In this case, the bottom surface of the blood storage tank 36 is composed of first to third step portions 70a to 70c, and the blood inflow lower 2a of the connecting conduits 68a and 68b.

72b is opened on both sides of the first step 70a, which is the uppermost layer, through mechs 74a and 74b for rectification.

Here, the blood reservoir 36 is made of a transparent plastic body or the like, and the blood inflow port 36 is made of a transparent plastic body or the like. Above 2a and 72b, lower a and 76b for mixed drug injection are provided for co-injecting vasodilators, antithrombotic preparations, etc. into the blood B.

Blood B at the time of inflow into the first stage portion 70a of the blood storage tank 36
In order to prevent foaming, the blood inflow lowers 2a, 72b
A urethane antifoaming material 78 is disposed adjacent to. Further, in order to suppress resonance vibration of the blood surface, approximately the center of the second stage section 70b where blood B is stored is located at the second stage section 70b. A partition wall 82 is provided that substantially separates the blood storage area above Ob into a first blood storage section 80a and a second blood storage section 80b. Further, on the end side of the third stage portion 70c, which is the lowest layer, there is a blood outflow port 84 for sending out the blood B stored in the blood storage tank 36 to the human body side.
is provided. Note that this blood outflow port 84 communicates with the human body via a pump (not shown) that generates pulsation.

The extracorporeal blood circulation apparatus according to the present invention is basically constructed as described above, and its operation and effects will be explained next.

First, blood B flowing into the heat exchanger 32 from the blood supply port 46 is adjusted to a desired temperature in the heat exchange chamber 45. That is, a large number of heat exchange tubes 40 are horizontally arranged in the heat exchange chamber 45, and water W maintained at a predetermined temperature flows through these heat exchange tubes 40. ing. Therefore, the blood B flowing into the heat exchange chamber 45 is adjusted to a desired temperature by passing through the outer circumference of the heat exchange tube 40, and then is supplied to the oxygenator 34 via the connecting pipes 48a and 48b. be done.

Here, the heat exchanger 32 is incorporated into the main body 30 so that its longitudinal direction is in a horizontal state, and the blood B is fed through a blood inflow port formed in the lower part of the housing 38 constituting the heat exchanger 32. 46 flows into the heat exchange chamber 45, where the temperature is adjusted, and is led to the oxygenator 34 via connection pipes 48a and 48b on the upper side. In this case, blood supply port 46
The difference in height between the blood inlet port 8 and the connecting pipes 48a and 48b is set to be considerably smaller than the difference in height between the blood inflow port 8 and the connecting pipe 12 shown in FIG. Therefore, the blood B flowing in from the blood supply port 46 passes through the connecting pipe 48a148b to the oxygenator 3 without losing much of its potential energy.
4. As a result, there is no need to provide a pump upstream of the blood supply port 46 as in the conventional case, and blood B can be supplied to the artificial lung 34 and the blood reservoir 36 to be described later by only head perfusion from the patient.

The blood B flows from a blood supply port 46 communicating with the lower part of the heat exchange chamber 45, and is supplied to the oxygenator 34 via connecting pipes 48a and 48b communicating with the upper part of the heat exchange chamber 45. Therefore, the blood B flowing into the heat exchange chamber 45 undergoes heat exchange extremely efficiently. Furthermore, even if air bubbles are mixed into the blood B, the air bubbles will not remain in the heat exchange chamber 45 and will be discharged from the upper part of the blood storage tank 36 via the oxygenator 34. The problem of blood B coagulating during use of the blood circulation device is avoided.

Blood B flowing into the oxygenator 34 from the heat exchanger 32 via the connecting pipes 48a and 48b is oxygenated and carbon dioxide is removed in a gas exchange chamber 56 surrounded by the housing 50.

That is, a large number of bundled hollow fiber membranes 52 are housed in the housing 50, and a gas A containing oxygen is introduced into the hollow fiber membranes 52 from a gas inlet port 64 through a gas supply chamber 60. being sent.

Therefore, blood B exchanges oxygen and carbon dioxide via the hollow fiber membrane 52. Note that the gas A containing carbon dioxide is discharged to the outside from the gas outlet port 66 via the gas exhaust chamber 62.

In the oxygenator 34, the oxygenated blood B flows through the connecting pipes 53a and 68b to the blood inlet. 2a and 72b into the blood storage tank 36. In this case, as mentioned above,
Since the heat exchanger 32 is arranged in a substantially horizontal state, the blood inflow lower 2a is arranged in a substantially horizontal position.

72b can be positioned lower relative to the patient. Therefore, blood B is easily produced in the blood reservoir 36 only by head perfusion from the patient. Furthermore, the connecting pipes 68a and 68b are formed in a box shape such that they once extend horizontally from the upper end of the gas exchange chamber 56 constituting the oxygenator 34, and then extend upward for a predetermined length. has been done. Therefore, the blood B flowing out from the gas exchange chamber 56 based on the pressure generated by a pump (not shown) or by vertical perfusion from the human body rises in the L-shaped connecting pipe 68a168b, causing a decrease in the flow rate due to its own weight. . As a result, the blood B flows into the blood reservoir 36 without spouting out, so that the mixing of air bubbles into the blood B is suitably suppressed. By the way, is the blood B a blood inflow port? The blood B is rectified by the meshes L74a and 74b attached to the blood B, and the air bubbles contained in the blood B are reliably removed by the urethane antifoaming material 78, and then the blood B is stored in the blood storage tank 36.

On the other hand, the blood B stored in the blood storage tank 36 is intermittently delivered toward the human body under the action of a pump (not shown) that communicates with the blood outflow port 84. In this case, there is a concern that the liquid level 86 of the blood B stored in the blood storage tank 36 may resonate and vibrate due to the intermittent delivery of the blood B by the pump. However, such resonance vibrations are extremely effectively suppressed by the partition wall 82 provided at the second stage portion 70b of the blood reservoir 36. That is, by arranging the partition 82 at a predetermined location within the blood reservoir 36, the natural frequency of the system and the pulsation rate of the pump can be significantly different from each other, and resonance vibrations can be suppressed. As a result, the liquid level 86 of blood B becomes calm,
The risk of air bubbles being mixed into the blood B is significantly reduced. Further, since the amount of variation in the liquid level 86 due to pulsations is small, the height of the liquid level 86, that is, the amount of blood stored in the blood reservoir 36 can be easily and accurately confirmed from the outside. Furthermore, since the shaking of the blood B in the blood reservoir 36 is effectively suppressed, the occurrence of vibrations is extremely small, and there is no possibility that unnecessary vibrations will be caused in the entire device.

[Effects of the Invention] As described above, according to the present invention, in an extracorporeal blood circulation apparatus that integrally includes a heat exchanger, an oxygenator, and a blood storage tank, blood is introduced into the heat exchanger arranged in a substantially horizontal direction. After adjusting the temperature of the blood, gas exchange is performed using an oxygenator and the blood is stored in a blood storage tank. In this case, since the heat exchanger is arranged in a substantially horizontal position, the height difference between the inflowing blood and the outflowing blood is extremely small, and therefore the position of the blood outflow port relative to the blood reservoir of the oxygenator and the patient are The gap between can be lengthened. As a result, blood can be stored in the blood reservoir only by head perfusion from the patient.
An advantage is obtained that a blood pressurizing means such as a pump is not required before the heat exchanger.

Although the present invention has been described above with reference to preferred embodiments, the present invention is not limited to these embodiments.
Of course, various improvements and changes in design are possible without departing from the gist of the invention.

[Brief explanation of the drawing]

FIG. 1 is a schematic configuration diagram of an extracorporeal blood circulation device shown for comparison, FIG. 2 is a partial cross-sectional configuration diagram of an extracorporeal blood circulation device according to the present invention, and FIG. 3 is an extracorporeal blood circulation device shown in FIG. 2. FIG. 2 is a schematic perspective view of the configuration. 30... Main body part 32... Heat exchanger 34
...Artificial lung 36...Blood storage tank 38...
Housing 40... Heat exchange tube body 45...
Heat exchange chamber 46... blood supply port 68a,
68b... Connection pipe line 72a, 72b... Metsure 8... Urethane antifoaming material 84... Blood outflow port B... Blood

Claims (2)

[Claims] (1) A heat exchanger having a blood inlet section at the bottom and a blood outlet section at the top, which is long in the horizontal direction and short in the vertical direction, and an oxygenator having a blood inflow section at the bottom and a blood outflow section at the top; The blood outlet part of the heat exchanger and the blood inlet part of the artificial lung are connected to form an integral structure, and after the temperature of the blood introduced from the blood introduction part of the heat exchanger is adjusted, the blood is transferred from the blood outlet part to the artificial lung. After the blood directed toward the lungs and further inflowing from the blood inlet of the oxygenator undergoes gas exchange within the oxygenator,
An extracorporeal blood circulation device characterized in that the blood flows out from the blood outflow portion. (2) In the device according to claim 1, the heat exchanger is provided with a large number of heat exchange tubes in a substantially cylindrical casing, and the heat exchange tubes are arranged along the longitudinal direction of the casing. An extracorporeal blood circulation device consisting of tubes.