JPWO2014033782A1 - Extracorporeal circulation device, control device and control method thereof - Google Patents

Abstract

It is an object of the present invention to provide an extracorporeal circulation device that can appropriately secure the passage time necessary for avoiding that mixed air bubbles are sent to a subject. The present invention is an extracorporeal circulation device that circulates the blood of a subject outside the body using a circulation circuit, and includes a bubble sensor 114 that detects bubbles in the circulation circuit, and the circulation circuit into the subject's body. And a control unit 205 for controlling the display unit 203 to display a setting screen for setting the blood flow rate in the circulation circuit. The control unit 205 is controlled by the bubble sensor 114. Before the detected air bubble passes through the clamp 122, control is performed such that a condition for completing the blocking by the clamp 122 is displayed on the setting screen.

Description

  The present invention relates to an extracorporeal circulation device that circulates the blood of a subject extracorporeally, and in particular, an extracorporeal circulation device including a clamp that stops blood supply when air bubbles are detected in a circulation circuit, and the clamp is controlled. The present invention relates to a control device and a control method thereof.

  In an extracorporeal circulation device that circulates the subject's blood extracorporeally, when bubbles are mixed in the circulation circuit, a bubble sensor that detects the bubbles, and when bubbles are detected in the bubble sensor, A clamp for stopping the blood supply or a mechanism for guiding the air bubbles to another line is arranged to prevent the mixed air bubbles from being sent to the subject.

  In such an extracorporeal circulation device, the clamp (or a mechanism for guiding to another line) is arranged downstream of the bubble sensor in the circulation circuit, and the bubbles detected by the bubble sensor guide to the clamp (or another line). It is essential to complete the closing operation (guide operation) of the clamp before passing the mechanism).

  For this reason, in order to reliably prevent the mixed bubbles from being sent to the subject, the bubbles detected by the bubble sensor pass through a clamp (or a mechanism for guiding to another line). It is desirable to configure the extracorporeal circulation device so that the time required to pass (passing time) is as long as possible (note that this is the same when arranging a clamp or a mechanism for guiding to another line, so Then, the case of the clamp will be described).

  In general, in order to increase the passage time, the clamp should be arranged as far as possible from the bubble sensor, the length of the tube between the bubble sensor and the clamp should be increased, or the flow rate should be reduced, Etc. are considered.

JP 2008-220417 A

  However, if the clamp is arranged as far as possible from the bubble sensor, the distance between the clamp and the subject becomes close, and the clamp may come into contact with the subject when the clamp is closed. There is a problem.

  Also, if the length of the tube between the bubble sensor and the clamp is to be increased, the amount of blood of the subject to be exsanguinated outside the body increases, which is not desirable.

  Furthermore, since the blood flow volume per unit time during extracorporeal circulation (= flow velocity x tube inner diameter) is determined based on the body surface area of the subject, when the inner diameter of the tube is fixed, It is necessary for a person to maintain a certain flow rate.

  Therefore, it is desirable that the extracorporeal circulation device has a configuration that can achieve as short a transit time as possible while ensuring a transit time that can prevent the mixed bubbles from being sent to the subject. .

  The present invention has been made in view of the above problems, and provides an extracorporeal circulation device capable of appropriately ensuring the passage time necessary for avoiding mixed air bubbles being sent to a subject. The purpose is to provide.

In order to achieve the above object, the extracorporeal circulation apparatus according to the present invention has the following configuration. That is,
An extracorporeal circulation device that circulates the blood of a subject outside the body using a circulation circuit,
Detecting means for detecting bubbles in the circulation circuit;
Blocking means for blocking the path of the circulation circuit into the body of the subject;
Control means for controlling to display on the display means a setting screen for setting the blood flow rate in the circulation circuit,
The control means controls to display, on the setting screen, a condition for completing the blocking by the blocking means before the bubbles detected by the detecting means pass through the blocking means. .

  ADVANTAGE OF THE INVENTION According to this invention, it becomes possible to ensure appropriately the passage time required in order to avoid that the mixed bubble is sent to the subject.

  Other features and advantages of the present invention will become apparent from the following description with reference to the accompanying drawings. In the accompanying drawings, the same or similar components are denoted by the same reference numerals.

The accompanying drawings are included in the specification, constitute a part thereof, show an embodiment of the present invention, and are used to explain the principle of the present invention together with the description.
FIG. 1 is a diagram showing an overall configuration of an extracorporeal circulation device according to an embodiment of the present invention. FIG. 2 is a diagram illustrating an example of a functional configuration of the controller of the extracorporeal circulation apparatus. FIG. 3 is a diagram for explaining the positional relationship between the bubble sensor and the clamp. FIG. 4A is a flowchart showing the flow of flow rate setting monitoring processing in the controller. FIG. 4B is a flowchart showing the flow of flow rate setting monitoring processing in the controller. FIG. 5 is a flowchart showing the flow of the flow rate setting monitoring process in the controller. FIG. 6A is a flowchart showing the flow of flow rate setting monitoring processing in the controller. FIG. 6B is a flowchart showing the flow of flow rate setting monitoring processing in the controller. FIG. 7A is a flowchart showing a flow of clamp position monitoring processing in the controller. FIG. 7B is a flowchart showing a flow of clamp position monitoring processing in the controller. FIG. 8A is a flowchart showing a flow of flow rate setting and clamp position monitoring processing in the controller. FIG. 8B is a flowchart showing the flow of flow rate setting and clamp position monitoring processing in the controller.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the accompanying drawings. The embodiment described below is a preferred specific example of the present invention, and thus various technically preferable limitations are given. However, the scope of the present invention is particularly limited in the following description. Unless otherwise stated, the present invention is not limited to these embodiments.

[First Embodiment]
<1. Overall configuration of extracorporeal circulation device>
1A of FIG. 1 is a diagram illustrating an example of the overall configuration of the extracorporeal circulation device 100 according to the first embodiment of the present invention.

  The extracorporeal circulation device 100 is a device that performs cardiopulmonary assist operation (extracorporeal circulation operation such as PCPS (percutaneous cardiopulmonary support), priming operation). The extracorporeal circulation apparatus 100 has a blood extracorporeal circuit (hereinafter referred to as a circulation circuit) indicated by an arrow in the figure. In the extracorporeal circulation apparatus 100, after performing the priming operation, the blood of the subject 130 is circulated extracorporeally using this circulation circuit.

  Here, the priming operation refers to an operation of removing the bubbles in the circuit by circulating the priming solution in the circulation circuit in a state where the circulation circuit is sufficiently filled with the priming solution (for example, physiological saline).

  The extracorporeal circulation device 100 includes a controller 110 that functions as a control device, a drive motor 111, a centrifugal pump 112, an oxygenator 113, an oxygen supply source 117, a catheter (venous side) 119, and a catheter (arterial side) 120. A bubble sensor 114, a flow sensor 115, a blood filter 116, a branch line 118, and a clamp 122. These components are connected by a flexible tube or the like, and the lumen of the tube forms a flow path for blood or priming liquid.

  The catheter (arterial side) 120 sends blood toward the body of the subject 130, and the catheter (venous side) 119 performs blood removal from the body of the subject 130.

  The centrifugal pump 112 is also called a centrifugal artificial heart, drives a rotating body provided inside, applies pressure to the blood, and circulates the blood in the circulation circuit. The drive motor 111 gives a rotational driving force to the rotating body of the centrifugal pump 112.

  The artificial lung 113 performs blood circulation and blood gas exchange (oxygen addition, carbon dioxide removal, etc.). The oxygen supply source 117 is realized by, for example, an oxygen cylinder and supplies oxygen to be added to blood. The oxygen supplied from the oxygen supply source 117 is used at the time of gas exchange by the artificial lung 113.

  The bubble sensor 114 detects bubbles contained in the priming liquid (or blood) flowing in the circulation circuit during the priming operation (or during the extracorporeal circulation operation) by a predetermined detection method (ultrasonic wave, light, etc.). The blood filter 116 filters blood or removes bubbles in the blood. The flow sensor 115 includes, for example, a built-in ultrasonic transceiver, and detects the flow rate of the priming liquid (or blood) in the circulation circuit.

  The clamp 122 is a member for closing the tube so as to forcibly stop blood feeding toward the body of the subject 130 during the extracorporeal circulation operation. The clamp 122 performs the blocking operation when it is determined based on the output signal from the bubble sensor 114 that an abnormality that immediately stops blood supply has occurred.

  The branch line 118 switches the flow path of the circulation circuit. Specifically, when the blood of the subject 130 is circulated extracorporeally, a circulation circuit passing through the body of the subject 130 is constructed as shown in 1A of FIG. Circulate. During the priming operation, as shown in 1B of FIG. 1, the circuit of the circulation circuit to the inside of the body of the subject 130 is blocked by the branch line 118 (in other words, the circulation circuit that passes only outside the body of the subject 130 (in other words, the subject) A circulation circuit that does not pass through the body of the person 130 is constructed, and the circulation circuit is filled with the priming liquid (without passing through the body of the subject) to circulate the priming liquid. On the circulation circuit, one or a plurality of bubble discharge ports (not shown) for discharging bubbles are provided. By circulating a plurality of priming liquids in the circulation circuit, the bubbles in the circulation circuit are circulated. It will be discharged from the bubble discharge port.

  The controller 110 controls the extracorporeal circulation operation and the priming operation in the extracorporeal circulation device 100. In the controller 110, for example, the centrifugal motor 112 is driven by controlling the drive motor 111, or the gas exchange operation is performed by controlling the artificial lung 113. Further, the bubble sensor 114 is controlled to obtain an output signal from the bubble sensor 114. Further, when an abnormality that requires blood supply to be stopped is detected based on an output signal from the bubble sensor 114, the clamp 122 is controlled to perform a closing operation.

  Next, the flow of processing when performing cardiopulmonary assist operation (extracorporeal circulation operation, priming operation) using the extracorporeal circulation device 100 shown in FIGS. 1A and 1B will be briefly described.

  When the cardiopulmonary assist operation is started, the controller 110 controls the execution of the priming operation. During the priming operation, a circulation circuit that does not pass through the body of the subject 130 is constructed by the branch line 118 as shown in 1B of FIG. At this time, the priming liquid supply source 121 is connected to the branch line 118, and the priming liquid is supplied from the priming liquid supply source 121 into the circulation circuit. As a result, the circulation circuit is filled with the priming liquid.

  Then, the centrifugal pump 112 is driven under the control of the controller 110, and the priming liquid circulates a plurality of times in the circulation circuit. Bubbles in the circulation circuit are discharged from the bubble discharge port or the like with this circulation. At this time, bubbles in the circulation circuit are detected by the bubble sensor 114, and the controller 110 determines whether or not there are bubbles contained in the circulation circuit and the size of the bubbles based on the detection result of the bubble sensor 114. .

  Here, in the controller 110, when the result of the determination satisfies a predetermined criterion, the priming operation is terminated. At the end of this, the controller 110 notifies the user that the priming operation has ended using a display (not shown), a speaker (not shown), or the like. The user who receives the notification of the end of the priming operation switches the branch line 118 and constructs a circulation circuit that passes through the body of the subject 130 as shown in 1A of FIG. Thereby, the blood of the subject 130 is circulated extracorporeally.

  When the extracorporeal circulation operation starts, blood that has been removed from the catheter (vein side) 119 enters the oxygenator 113 via the centrifugal pump 112. In the artificial lung 113, as described above, gas exchange, that is, processing such as oxygen addition and carbon dioxide removal is performed. Thereafter, the filtered blood is sent from the catheter (arterial side) 120 into the body of the subject 130 through the blood filter 116 and the like. This process from blood removal to blood delivery is repeated, and the blood of the subject 130 is circulated extracorporeally.

  The above is the description of the overall configuration of the extracorporeal circulation device 100 according to the present embodiment and an example of the flow of the cardiopulmonary assist operation. Note that the configuration of the extracorporeal circulation device 100 shown in FIGS. 1A and 1B is merely an example, and the configuration may be changed as appropriate.

<2. Functional configuration of controller>
Next, the functional configuration of the controller 110 shown in FIG. 1 will be described with reference to FIG.

  The controller 110 includes a display unit 203, an operation unit 202, a storage unit 201, an I / F unit 206, a timer unit 204, and a control unit (computer) 205 as functional configurations.

  The display unit 203 is realized by a display such as a monitor, for example, and displays various types of information for the user. The operation unit 202 is realized by various buttons, for example, and inputs an instruction from a medical worker. Part or all of the display unit 203 and the operation unit 202 may be realized as a touch panel, for example.

  The storage unit 201 is realized by, for example, a hard disk and stores various types of information. It should be noted that various parameters and the like (to be described later, maximum flow rate value, distance L, diameter D, blood flow limit value, blood flow rate, etc.) referenced when executing processing in the user interface unit 210 described later are stored in the storage unit 201. Assume that it is stored.

  The I / F unit 206 exchanges various signals with an external device. The output signal from the bubble sensor 114 is taken into the controller 110 via the I / F unit 206. A control signal for the clamp 122 is output via the I / F unit 206. The timer unit 204 measures various times.

  The control unit 205 includes, for example, a CPU (Central Processing Unit), a ROM (Read Only Memory), a RAM (Random Access Memory), and the like, and the ROM stores a program for realizing the above-described cardiopulmonary assist operation. (Note that the description is omitted here).

  The program for realizing the cardiopulmonary assist operation includes a program that causes the CPU to function as the user interface unit 210 that forms the user interface with the medical staff. Furthermore, in the program that causes the CPU to function as the user interface unit 210, a program that causes the CPU to function as a flow rate setting monitoring unit that monitors a set value when the medical worker sets the blood flow during the extracorporeal circulation operation; And a program that functions as a lamp position monitoring unit that monitors the position of the clamp attached by the medical staff. The flow of the flow rate setting monitoring process by the flow rate setting monitoring unit and the clamp position monitoring process by the clamp position monitoring unit will be described later.

  The above is an example of the functional configuration of the controller 110. Note that the functional configuration shown in FIG. 2 is merely an example, and a new configuration may be added, or unnecessary configuration may be omitted as appropriate. For example, the storage unit 201 (such as a hard disk) is not necessarily provided and may be omitted.

<3. Explanation of clamp arrangement>
Next, the arrangement of the clamps 122 will be described with reference to FIG. FIG. 3 is a diagram for explaining the positional relationship between the bubble sensor 114 and the clamp 122. In FIG. 3, reference numeral 300 denotes a tube having an inner wall surface having a diameter (that is, an inner diameter) of D, and the lumen forms a flow path for blood or priming liquid.

  As shown in FIG. 3, a scale is attached to the outer peripheral surface of the tube 300 between the bubble sensor 114 and the clamp 122, and the medical staff can determine the position where the bubble sensor 114 is attached and the clamp 122. The distance L between the bubble sensor 114 and the clamp 122 can be recognized by reading the attached position. Then, the medical worker manually inputs the recognized value of the distance L to the user interface unit 210 when setting the blood flow during the extracorporeal circulation operation.

  In the present embodiment, the attachment positions of the bubble sensor 114 and the clamp 122 can be arbitrarily changed. However, the present invention is not limited to this. For example, the attachment position of the bubble sensor 114 is fixed. Also good. In this case, the scale shown in FIG. 3 may be attached with the attachment position of the bubble sensor 114 as “zero”. Thereby, the medical worker can easily recognize the value of the distance L.

  Further, in the present embodiment, a scale is attached to the tube 300, and a medical worker recognizes the distance L by reading the scale, and the recognized distance L is manually input to the user interface unit 210. However, the present invention is not limited to this. For example, a bar code indicating the scale of each position is attached to the tube 300, and a bar code reader is disposed on the bubble sensor 114 and the clamp 122. The bubble sensor 114 and the clamp 122 automatically identify the mounting position, and the user interface unit It is good also as a structure which transmits to 210. FIG. In this case, the user interface unit 210 automatically calculates the distance L based on each identified attachment position.

<4. Flow setting monitoring process flow>
Next, the flow of the flow rate setting monitoring process by the flow rate setting monitoring unit will be described. 4A and 4B are flowcharts showing the flow of the flow rate setting monitoring process by the flow rate setting monitoring unit.

  In the flow rate setting monitoring process shown in FIGS. 4A and 4B, the blood flow rate for setting the blood flow rate during extracorporeal circulation operation by the medical staff after the control unit 205 is turned on and the user interface unit 210 is activated. It starts when the setting screen 411 is called.

  When the flow rate setting monitoring process is started, it is determined in step S401 whether or not a distance L between the bubble sensor 114 and the clamp 122 has been newly input. The blood flow setting screen 411 includes an input field for inputting a distance L between the bubble sensor 114 and the clamp 122 in addition to a setting field for setting a blood flow during extracorporeal circulation operation. It is assumed that the previous value read from the storage unit 201 is displayed in advance in the setting field and the input field.

  If it is determined in step S401 that the distance L between the bubble sensor 114 and the clamp 122 has not been newly input, it is determined that there is no change in the attachment position of the bubble sensor 114 and the attachment position of the clamp 122, and The calculated maximum flow rate value is read from the storage unit 201.

  Note that the maximum flow rate value means that when the distance between the bubble sensor 114 and the clamp 122 is L, the closing operation of the clamp 122 is completed before the bubbles detected by the bubble sensor 114 pass through the clamp 122. It is a value indicating the maximum value of blood flow, which is a condition for causing

  Specifically, when the time from when the bubble sensor 114 detects the bubble until the closing operation of the clamp 122 is completed is T, the maximum flow rate value is calculated by diameter D × distance L / time T. Can do.

  On the other hand, if it is determined in step S401 that the distance L between the bubble sensor 114 and the clamp 122 has been newly input, the process proceeds to step S403, and the diameter D of the inner wall surface of the tube 300 is read from the storage unit 201. In step S404, the maximum flow rate value is calculated and displayed. Specifically, the extracorporeal circulation device from when the newly input distance L, the diameter D read out at step S403, and the bubble sensor 114 detects the bubble until the closing operation of the clamp 122 is completed. It is obtained by calculating D × L / T using the time T inherent to 100.

  In step S405, it is determined whether or not a blood flow value is input in the setting field for setting the blood flow on the blood flow setting screen 411. As described above, since the previous value is input in advance in the setting field for setting the blood flow, the process proceeds to step S406. In addition, also when a medical worker newly sets the blood flow rate, the process proceeds to step S406.

  In step S406, it is determined whether or not the blood flow rate input in the setting field for setting the blood flow rate is equal to or greater than the maximum flow rate value read in step S402 or the maximum flow rate value calculated in step S404. To do.

  If it is determined in step S406 that the blood flow rate input in the setting field is not equal to or greater than the maximum flow rate value, the process proceeds to step S409, and the blood flow rate input in the setting field is set as a setting value. .

  On the other hand, if it is determined in step S406 that the blood flow rate input in the setting field is equal to or greater than the maximum flow rate value, the process proceeds to step S407, and a message is output to the medical staff.

  Specifically, in the case of the blood flow rate currently input in the setting field, even if the bubble sensor 114 detects the bubble, the closing operation of the clamp 122 is completed before the bubble passes through the clamp 122. A message 412 indicating that it cannot be displayed is displayed.

  Further, in step S408, the medical worker is inquired whether or not to directly set the blood flow rate input in the setting field. As a result of the inquiry, the medical worker currently inputs the blood flow rate in the setting field. If there is a reply that it is desired to set the existing blood flow volume as it is ("OK" in 412), the process proceeds to step S409. In step S409, the blood flow rate input in the setting column is set as it is as a setting value.

  On the other hand, as a result of the inquiry in step S408, if a medical worker has responded that he / she wishes to change the blood flow rate input in the setting field (“return” in 412), the process returns to step S405. Return.

  In step S405, when a blood flow rate is newly input by the medical staff, the process proceeds to step S406, and it is determined whether or not the newly input blood flow rate is greater than or equal to the maximum flow rate value. Is done. Thereafter, the above process is repeated until a set value is set in step S409.

  As described above, in the extracorporeal circulation device 100 according to the present embodiment, the air bubbles detected by the air bubble sensor 114 based on the distance L between the air bubble sensor 114 and the clamp 122 are passed before the clamp 122. The maximum flow rate value, which is a condition for completing the closing operation, is calculated.

  Further, in the blood flow setting screen 411 for setting the blood flow during the extracorporeal circulation operation, when a blood flow exceeding the calculated maximum flow value is input, a message is displayed to the medical staff, A configuration that prompts the user to change the flow rate setting.

  As a result, it is possible to appropriately secure the passage time necessary to avoid the mixed bubbles from being sent to the subject.

[Second Embodiment]
In the first embodiment, the blood flow setting screen 411 is configured to display a message to the medical staff when a blood flow greater than or equal to the maximum flow value is input. However, the present invention is not limited to this. Not. For example, it is good also as a structure which restrict | limits an input so that the input of the blood flow rate beyond a maximum flow value cannot be performed. Details of this embodiment will be described below.

  FIG. 5 is a flowchart showing the flow of the flow rate setting monitoring process in the extracorporeal circulation device 100 according to the present embodiment. 4A and 4B, in the flow rate setting monitoring process shown in FIG. 5, after the power of the control unit 205 is turned on and the user interface unit 210 is activated, the blood flow during the extracorporeal circulation operation is calculated by the medical staff. This is started by calling a blood flow rate setting screen 511 for setting.

  When the flow rate setting monitoring process is started, it is determined in step S501 whether or not a distance L between the bubble sensor 114 and the clamp 122 has been newly input. The blood flow setting screen 511 is provided with an input field for inputting the distance L between the bubble sensor 114 and the clamp 122 in addition to a setting field for setting the blood flow during extracorporeal circulation. And

  If it is determined in step S501 that the distance L between the bubble sensor 114 and the clamp 122 has not been newly input, it is determined that there is no change in the attachment position of the bubble sensor 114 and the attachment position of the clamp 122, and has already been calculated. The blood flow limit value that has been set is read from the storage unit 201.

  It should be noted that the blood flow limit value means that when the distance between the bubble sensor 114 and the clamp 122 is L, the bubble 122 detected by the bubble sensor 114 is blocked before the clamp 122 is closed. This is a value indicating the maximum value of blood flow, which is a condition for completion, and is a soft limit value for the drive motor 111 (in order to prevent a value greater than a predetermined value from being output to the drive motor 111) Soft limit value). The blood flow limit value is also calculated by diameter D × distance L / time T, similarly to the maximum flow rate value.

  On the other hand, if it is determined in step S501 that the distance L between the bubble sensor 114 and the clamp 122 has been newly input, the process proceeds to step S503, and the diameter D of the inner wall surface of the tube 300 is read from the storage unit 201. In step S504, the blood flow limit value is calculated and displayed. Specifically, the extracorporeal circulation device from when the newly input distance L, the diameter D read out at step S503, and the bubble sensor 114 detects the bubble until the closing operation of the clamp 122 is completed. It is obtained by calculating D × L / T using the time T inherent to 100.

  In step S505, it is determined whether or not a blood flow value has been input in the setting field for setting the blood flow on the blood flow setting screen 511. As described above, since the previous value is input in advance in the setting field for setting the blood flow, the process proceeds to step S506. In addition, also when the medical worker newly sets the blood flow rate, the process proceeds to step S506.

  In step S506, it is determined whether or not the blood flow input in step S505 is equal to or greater than the blood flow limit value read in step S502 or the blood flow limit value calculated in step S504.

  If it is determined in step S506 that the blood flow volume input in the setting field is not equal to or greater than the blood flow limit value, the process proceeds to step S507, and the blood flow volume input in the setting field is set as a setting value.

  On the other hand, if it is determined in step S506 that the blood flow input in the setting field is equal to or greater than the blood flow limit value, the input blood flow is deleted, and the process returns to step S505.

  The medical worker determines that the blood flow volume limit value has been exceeded because the blood flow volume input in the setting field has not been accepted, and inputs a new blood flow volume in the setting field. These processes are continued until a value smaller than the blood flow limit value is input to the setting field by the medical staff.

  If it is determined in step S506 that the blood flow input in the setting field is not equal to or greater than the blood flow limit value, the process proceeds to step S507, and the blood flow input in the setting field is set as a setting value. To do.

  As is clear from the above description, in the extracorporeal circulation device 100 according to the present embodiment, the bubbles detected by the bubble sensor 114 pass through the clamp 122 based on the distance L between the bubble sensor 114 and the clamp 122. Before, it was set as the structure which calculates the blood flow rate limit value for completing the obstruction | occlusion operation | movement of the clamp 122. FIG.

  Further, the blood flow setting screen 511 for setting the blood flow during extracorporeal circulation is configured not to accept an input of blood flow equal to or greater than the calculated blood flow limit value.

  As a result, it is possible to appropriately secure the passage time necessary to prevent the mixed bubbles from being sent to the subject.

[Third Embodiment]
In the first and second embodiments, the case where the distance L between the bubble sensor 114 and the clamp 122 is manually input on the blood flow setting screens 411 and 511 has been described. However, the present invention is not limited to this. It may be configured to be automatically calculated and input. Details of this embodiment will be described below.

  6A and 6B are flowcharts showing the flow of the flow rate setting monitoring process in the extracorporeal circulation device 100 according to the present embodiment. Similar to FIGS. 4A, 4B, and 5, the flow rate setting monitoring process shown in FIGS. 6A and 6B is also performed by the medical staff after the power of the control unit 205 is turned on and the user interface unit 210 is activated. This is started by calling a blood flow setting screen 611 for setting a blood flow during operation.

  When the flow rate setting monitoring process is started, in step S601, in the user interface unit 210, the bubble sensor arranged so that the bubble sensor 114 and the clamp 122 read the barcode attached to the tube 300. An instruction is transmitted to 114 and the clamp 122. In the bubble sensor 114 and the clamp 122 to which the instruction is transmitted, information read by the barcode reader is acquired and transmitted to the user interface unit 210. The user interface unit 210 recognizes the positions of the bubble sensor 114 and the clamp 122 based on the information transmitted from the bubble sensor 114 and the clamp 122.

  In step S602, the distance L between the bubble sensor 114 and the clamp 122 is calculated based on the positions of the bubble sensor 114 and the clamp 122 recognized in step S601.

  In step S <b> 603, the diameter D of the inner wall surface of the tube 300 is read from the storage unit 201. In step S604, the maximum flow rate value is calculated.

  In step S605, it is determined whether or not a blood flow value is entered in the setting field for setting the blood flow on the blood flow setting screen 611. As described above, since the previous value is input in advance in the setting field for setting the blood flow, the process proceeds to step S606. In addition, also when a medical worker newly sets the blood flow volume, the process proceeds to step S606.

  In step S606, it is determined whether or not the blood flow rate input in the setting field for setting the blood flow rate is equal to or greater than the maximum flow rate value calculated in step S604.

  If it is determined in step S606 that the blood flow rate input in the setting field is not equal to or greater than the maximum flow rate value, the process proceeds to step S609, and the blood flow rate input in the setting field is set as a setting value. .

  On the other hand, if it is determined in step S606 that the blood flow rate input in the setting field is greater than or equal to the maximum flow rate value, the process proceeds to step S607 and a message is output to the medical staff.

  Specifically, in the case of the blood flow rate currently input in the setting field, even if the bubble sensor 114 detects the bubble, the closing operation of the clamp 122 is completed before the bubble passes through the clamp 122. A message 612 to the effect that it cannot be displayed is displayed.

  Further, in step S608, the medical worker is inquired whether to set the blood flow rate input in the setting field. As a result of the inquiry, the medical worker currently inputs the blood flow rate in the setting field. If there is a reply that it is desired to set the blood flow (“OK” in 612), the process proceeds to step S609. In step S609, the blood flow rate input in the setting field is set as a set value as it is.

  On the other hand, as a result of the inquiry in step S608, if a medical worker has responded that he / she wishes to change the blood flow rate input in the setting field (“return” in 612), the process returns to step S605. Return.

  In step S605, when a blood flow rate is newly input by the medical staff, the process proceeds to step S606, and it is determined whether the newly input blood flow rate is equal to or greater than the maximum flow rate value. Is done. Thereafter, the above process is repeated until a set value is set in step S609.

  As is clear from the above description, in the extracorporeal circulation device 100 according to the present embodiment, each time the blood flow setting screen 611 is called, information indicating the positions of the bubble sensor 114 and the clamp 122 is acquired, and the bubble sensor 114 is acquired. The distance L between the clamps 122 is automatically calculated.

  As a result, the medical staff changes the position of the bubble sensor 114 or the clamp 122, but forgets to update the distance L between the bubble sensor 114 and the clamp 122, and outputs a message based on the incorrect maximum flow rate value. It is possible to avoid such a situation.

  In the present embodiment, the case of applying to the calculation of the maximum flow rate value (in the case of applying to the first embodiment) has been described. However, the present invention is not limited to this, and the case of applying to the blood flow limit value. It goes without saying that the same applies to (when applied to the second embodiment).

[Fourth Embodiment]
In the first to third embodiments, the medical staff is encouraged to change the blood flow on the assumption that the distance L is calculated based on the positions of the bubble sensor 114 and the clamp 122. However, the present invention is not limited to this, and a configuration may be adopted in which the change of each position of the bubble sensor 114 and the clamp 122 is promoted on the premise of the blood flow rate.

  That is, instead of monitoring the blood flow based on the positions of the bubble sensor 114 and the clamp 122, the positions of the bubble sensor 114 and the clamp 122 may be monitored based on the blood flow. Details of this embodiment will be described below.

  7A and 7B are flowcharts showing a flow of clamp position monitoring processing in the extracorporeal circulation apparatus 100 according to the present embodiment. The clamp position monitoring process performed by the clamp position monitoring unit is the same as the flow rate setting monitoring process performed by the flow rate setting monitoring unit, after the control unit 205 is turned on and the user interface unit 210 is activated. This is started by calling a blood flow volume setting screen 611 for setting the blood flow volume.

  When the clamp position monitoring process is started, the processes of steps S601 to S606 are executed. In addition, since the process of step S601-S606 is the same as the process of step S601-S606 of FIG. 6A and 6B, description is abbreviate | omitted here.

  In step S701, the distance L 'required when blood is fed based on the blood flow (F) input in the setting field in step S605 is calculated. Specifically, when the time from when the bubble is detected by the bubble sensor 114 until the closing operation of the clamp 122 is completed is T and the diameter of the inner wall surface of the tube is D, the distance L ′ = F / D Obtained by calculating xT.

  In step S702, the difference between the distance L ′ calculated in step S701 and the current distance L calculated in step S602 is calculated. When the blood flow is F, the bubble sensor 114 detects the difference. A message 712 displays the moving direction and moving amount of the clamp 122, which are conditions for completing the closing operation of the clamp 122 before the bubble passes through the clamp 122.

  Specifically, when L′−L> 0, a message indicating that the clamp 122 should be moved by L′−L in a direction away from the bubble sensor 114 is displayed. On the other hand, if L′−L <0, a message is displayed to instruct the clamp 122 to move by L′−L in the direction to bring the clamp 122 closer to the bubble sensor 114.

  In step S703, the medical worker is inquired about whether or not to move the clamp 122. If the medical worker answers that the clamp 122 is moved ("move" in 712), step S703 is performed. Proceeding to S704, the medical worker waits for the movement of the clamp 122 to be completed.

  When the movement operation in step S704 is completed, the process returns to step S601 again, the position of the clamp 122 and the position of the bubble sensor 114 after movement are recognized, and the same processing is repeated.

  If it is determined that the blood flow rate input to the setting field in step S606 has become smaller than the maximum flow rate value because the maximum flow rate value has increased due to the movement of the clamp 122, the process proceeds to step S609. The blood flow is set as a set value. Alternatively, in step S703, when there is a reply that the clamp 122 is not moved ("set" in 712), the process proceeds to step S609, and the blood flow is set as it is as a set value.

  As is clear from the above description, in the extracorporeal circulation device 100 according to the present embodiment, each time the blood flow setting screen 611 is called, information indicating the positions of the bubble sensor 114 and the clamp 122 is acquired, and the bubble sensor 114 is acquired. The distance L between the clamps 122 is automatically calculated.

  Further, in the setting field of the blood flow setting screen 611, when a blood flow is input, a distance L ′ for appropriately completing the closing operation of the clamp 122 based on the input blood flow is calculated. The moving direction and moving amount of the clamp 122 are displayed.

  As a result, it is possible to appropriately secure the passage time necessary to avoid the mixed bubbles from being sent to the subject.

[Fifth Embodiment]
In the first to fourth embodiments, the user interface unit 210 is configured to operate either the flow rate setting monitoring unit or the clamp position monitoring unit. However, the present invention is not limited to this, and both are performed in parallel. It may be configured to operate. In other words, when the blood flow entered in the setting field on the blood flow setting screen is greater than or equal to the maximum flow value, both cases of reducing the blood flow and moving the clamp are displayed to the medical staff. It is good also as composition to do. Details of this embodiment will be described below.

  8A and 8B are flowcharts showing the flow of flow rate setting and clamp position monitoring processing in the extracorporeal circulation apparatus 100 according to the present embodiment. In addition, about the process same as FIG. 7A and FIG. 7B, suppose that the same reference number as FIG. 7A and FIG. 7B is attached | subjected, and description is abbreviate | omitted.

  If it is determined in step S606 that the blood flow input in the setting field of the blood flow setting screen 611 is greater than or equal to the maximum flow value, the processes in steps S701 and S801 are executed in parallel.

  In step S701, the distance L 'required when blood is fed based on the blood flow (F) input in the setting field in step S605 is calculated. Specifically, when the time from when the bubble is detected by the bubble sensor 114 until the closing operation of the clamp 122 is completed is T and the diameter of the inner wall surface of the tube is D, the distance L ′ = F / D Obtained by calculating xT.

  In step S702, the difference between the distance L ′ calculated in step S701 and the current distance L calculated in step S602 is calculated, and the moving direction and moving amount of the clamp 122 are displayed on the message 812.

  On the other hand, in step S801, the difference between the blood flow rate (F) input in the setting field in step S605 and the maximum flow rate value is calculated. In step S802, the difference value calculated in step S801 is displayed on the message 812 as the blood flow to be reduced.

  The medical worker refers to the movement direction and movement amount when moving the clamp 122 displayed in step S702 and the change amount displayed when reducing the blood flow displayed in step S802. select.

  If the blood flow rate is changed as a result of the selection (“change the blood flow rate” in 812), the process returns from step S803 to step S605 to wait for a change in the setting column input by the medical staff. If it is determined that the changed blood flow is smaller than the maximum flow value, the process proceeds to step S609, and the changed blood flow is set. On the other hand, if the changed blood flow is still greater than or equal to the maximum flow value, the above process is repeated until a set value is set in step S609.

  On the other hand, when the clamp 122 is moved as a result of selection (“move the clamp” in 812), the process proceeds from step S803 to step S704 and waits for the movement of the clamp 122 by the medical staff to be completed. When the moving operation in step S704 is completed, the process returns to step S601 again, recognizes the position of the clamp 122 and the position of the bubble sensor 114 after the movement, and repeats the same processing until the set value is set in step S609.

  On the other hand, as a result of selection, when the blood flow volume currently input in the setting field is set as it is (“Set as it is” in 812), the process proceeds to step S609, and the blood flow volume input in the setting field is set as it is. Set as a value.

  As is clear from the above description, in the extracorporeal circulation apparatus 100 according to the present embodiment, when the blood flow rate input in the setting field of the blood flow rate setting screen 611 is equal to or greater than the maximum flow rate value, the clamp position The moving direction and moving amount and the blood flow to be reduced are displayed in parallel.

  Accordingly, the medical staff appropriately selects the movement of the clamp and the change of the blood flow in appropriately securing the passage time necessary for preventing the mixed bubbles from being sent to the subject. It became possible.

[Other Embodiments]
The present invention is not limited to the above-described embodiment, and various changes and modifications can be made without departing from the spirit and scope of the present invention. Therefore, in order to make the scope of the present invention public, the following claims are attached.

Claims (8)

An extracorporeal circulation device that circulates the blood of a subject outside the body using a circulation circuit,
Detecting means for detecting bubbles in the circulation circuit;
Blocking means for blocking the path of the circulation circuit into the body of the subject;
Control means for controlling to display on the display means a setting screen for setting the blood flow rate in the circulation circuit,
The control means controls to display, on the setting screen, a condition for completing the blocking by the blocking means before the bubbles detected by the detecting means pass through the blocking means. Extracorporeal circulation device.   2. The extracorporeal circulation according to claim 1, wherein the condition is a flow rate calculated by a distance between the detection unit and the blocking unit in a path of the circulation circuit and an inner diameter of the path. apparatus.   The control means performs control so that a flow rate larger than a flow rate calculated by a distance between the detection unit and the blocking unit in the path of the circulation circuit and an inner diameter of the path cannot be set on the setting screen. The extracorporeal circulation apparatus according to claim 2, wherein the extracorporeal circulation apparatus is provided.   The condition is that the flow rate calculated by the distance between the detection unit and the blocking unit in the path of the circulation circuit and the inner diameter of the path is larger than the flow rate input on the setting screen. The extracorporeal circulation device according to any one of claims 1 to 3, wherein the amount of movement of the blocking means is for the purpose. An acquisition means for acquiring information indicating the position of the detection means and information indicating the position of the blocking means;
The distance between the detection means and the blocking means in the path of the circulation circuit is calculated based on the information acquired by the acquisition means. The extracorporeal circulation device described. In an extracorporeal circulation device that circulates the blood of a subject outside the body using a circulation circuit, a control device that controls to display a setting screen for setting the blood flow rate in the circulation circuit on a display means,
In order to complete the blocking by the blocking means before the bubbles detected by the detecting means for detecting bubbles in the circulating circuit pass through the blocking means for blocking the path of the circulating circuit into the body of the subject. The control device is characterized in that the condition is displayed on the setting screen. In an extracorporeal circulation device that circulates the blood of a subject outside the body using a circulation circuit, a control method for a control device that controls to display a setting screen for setting the blood flow rate in the circulation circuit on a display means. And
In order to complete the blocking by the blocking means before the bubbles detected by the detecting means for detecting bubbles in the circulating circuit pass through the blocking means for blocking the path of the circulating circuit into the body of the subject. The condition is displayed on the setting screen.   A program for causing a computer to execute the control method according to claim 7.

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