NO743005L - - Google Patents
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- Publication number
- NO743005L NO743005L NO743005A NO743005A NO743005L NO 743005 L NO743005 L NO 743005L NO 743005 A NO743005 A NO 743005A NO 743005 A NO743005 A NO 743005A NO 743005 L NO743005 L NO 743005L
- Authority
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- Norway
- Prior art keywords
- pressure
- liquid
- gas
- blood
- line
- Prior art date
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- 239000007789 gas Substances 0.000 claims description 96
- 239000007788 liquid Substances 0.000 claims description 72
- 239000008280 blood Substances 0.000 claims description 54
- 210000004369 blood Anatomy 0.000 claims description 54
- QVGXLLKOCUKJST-UHFFFAOYSA-N atomic oxygen Chemical compound [O] QVGXLLKOCUKJST-UHFFFAOYSA-N 0.000 claims description 30
- 229910052760 oxygen Inorganic materials 0.000 claims description 30
- 239000001301 oxygen Substances 0.000 claims description 30
- 230000036772 blood pressure Effects 0.000 claims description 16
- 239000012528 membrane Substances 0.000 claims description 13
- 230000008384 membrane barrier Effects 0.000 claims description 10
- 238000013022 venting Methods 0.000 claims description 7
- CURLTUGMZLYLDI-UHFFFAOYSA-N Carbon dioxide Chemical compound O=C=O CURLTUGMZLYLDI-UHFFFAOYSA-N 0.000 claims description 6
- 238000011144 upstream manufacturing Methods 0.000 claims description 5
- 239000012530 fluid Substances 0.000 claims description 4
- 239000000463 material Substances 0.000 claims description 4
- 238000005086 pumping Methods 0.000 claims description 4
- 229910002092 carbon dioxide Inorganic materials 0.000 claims description 3
- 239000001569 carbon dioxide Substances 0.000 claims description 3
- 230000004888 barrier function Effects 0.000 claims description 2
- 238000007654 immersion Methods 0.000 claims 1
- 238000004064 recycling Methods 0.000 claims 1
- 210000003462 vein Anatomy 0.000 description 10
- 210000001367 artery Anatomy 0.000 description 8
- 230000008859 change Effects 0.000 description 4
- 230000010412 perfusion Effects 0.000 description 4
- 239000011148 porous material Substances 0.000 description 4
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 4
- 230000017531 blood circulation Effects 0.000 description 3
- 230000036765 blood level Effects 0.000 description 3
- 230000007423 decrease Effects 0.000 description 3
- 230000005484 gravity Effects 0.000 description 3
- 230000002209 hydrophobic effect Effects 0.000 description 3
- 206010001526 Air embolism Diseases 0.000 description 2
- 238000009825 accumulation Methods 0.000 description 2
- 238000010276 construction Methods 0.000 description 2
- 230000001419 dependent effect Effects 0.000 description 2
- 238000010586 diagram Methods 0.000 description 2
- 230000008020 evaporation Effects 0.000 description 2
- 238000001704 evaporation Methods 0.000 description 2
- 239000012982 microporous membrane Substances 0.000 description 2
- 210000000056 organ Anatomy 0.000 description 2
- 238000006213 oxygenation reaction Methods 0.000 description 2
- -1 polytetrafluoroethylene Polymers 0.000 description 2
- 230000001105 regulatory effect Effects 0.000 description 2
- 238000009736 wetting Methods 0.000 description 2
- 239000004743 Polypropylene Substances 0.000 description 1
- 208000007536 Thrombosis Diseases 0.000 description 1
- 230000009471 action Effects 0.000 description 1
- 230000006978 adaptation Effects 0.000 description 1
- 230000033228 biological regulation Effects 0.000 description 1
- 238000011109 contamination Methods 0.000 description 1
- 230000006872 improvement Effects 0.000 description 1
- 238000000034 method Methods 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 239000002245 particle Substances 0.000 description 1
- 239000004033 plastic Substances 0.000 description 1
- 229920003023 plastic Polymers 0.000 description 1
- 229920001155 polypropylene Polymers 0.000 description 1
- 229920001343 polytetrafluoroethylene Polymers 0.000 description 1
- 239000004810 polytetrafluoroethylene Substances 0.000 description 1
- 229920000915 polyvinyl chloride Polymers 0.000 description 1
- 239000004800 polyvinyl chloride Substances 0.000 description 1
- 230000004044 response Effects 0.000 description 1
- 229920002379 silicone rubber Polymers 0.000 description 1
- 239000004945 silicone rubber Substances 0.000 description 1
- 239000000758 substrate Substances 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
- A61M1/3601—Extra-corporeal circuits in which the blood fluid passes more than once through the treatment unit
- A61M1/3603—Extra-corporeal circuits in which the blood fluid passes more than once through the treatment unit in the same direction
-
- 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
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
- A61M1/1698—Blood oxygenators with or without heat-exchangers
-
- 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
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S128/00—Surgery
- Y10S128/03—Heart-lung
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
Beskyttelsessystem for masseoverforinge-anordninger Protection system for mass transfer devices
Foreliggende oppfinnelse angår en sikkerhetsanordningThe present invention relates to a safety device
for et masseoverforingssystem, og nærmere bestemt et system til å forhindre en for stor mengde gass fra å overfores til en væske på den motsatte side av en membranavsperring. for a mass transfer system, and more particularly a system for preventing an excessive amount of gas from being transferred to a liquid on the opposite side of a membrane barrier.
Systemet ifolge oppfinnelsen er' spesielt nyttig som gassembolibeskyttelsessystem for ekstrakorpora1 blodoxygenator hvor både oxygen og carbondioxyd overfores over en membranavsperring som separerer blodet og oxygenet. En oxygenator med hvilken foreliggende oppfinnelse effektivt kan utnyttes er beskrevet i US patent soknad nr. 170.163, innlevert 9.august 1971 av Ronald J. Leonard. The system according to the invention is particularly useful as a gas embolism protection system for extracorporeal blood oxygenators where both oxygen and carbon dioxide are transferred across a membrane barrier that separates the blood and oxygen. An oxygenator with which the present invention can be effectively utilized is described in US patent application No. 170,163, filed August 9, 1971 by Ronald J. Leonard.
Det skal imidlertid forståes at foreliggende oppfinnelse kan anvendes med mange forskjellige typer av masseoverforingsanordninger, særlig de som anvender en poros hydrofob membranavsperring som separerer en væske og en gass. However, it should be understood that the present invention can be used with many different types of mass transfer devices, especially those that use a porous hydrophobic membrane barrier that separates a liquid and a gas.
Oppdagelsen av de mikroporose, ikke-fuktende membraner med regulert pores torreise har muliggjort konstruksjonen av raerabranoxy-genatorer med hoy overføringshastighet. Membranene har åpne porer som tillater relativt hurtig overforing av oxygen, likesom de ikke-fuktende egenskaper forhindrer blodtap fra systemet. Under drift av oxygenatoren er det viktig at blodtrykket overskrider oxygentryk-ket, fordi en ombytning på grunn av uhell av oxygen og blodtrykk ville kunne resultere i at store mengder oxygen hurtig kom inn i blodet i oxygenatoren. I oxygenatorer med hoy stromningshastighet vil hurtig oxygenakkumulering kunne overflomme et hvilket som helst reservoar eller boblefelle og tillate at gass ble fort inn i pasien-ten. Storrelsen av reservoarene eller boblefellene er begrenset som et resultat av nodvendigheten av å begrense begynnelsesvolumet. The discovery of the microporous, non-wetting membranes with regulated pore dry travel has enabled the construction of raerabranoxy generators with high transfer rates. The membranes have open pores that allow relatively rapid transfer of oxygen, as well as the non-wetting properties prevent blood loss from the system. During operation of the oxygenator, it is important that the blood pressure exceeds the oxygen pressure, because an accidental exchange of oxygen and blood pressure could result in large amounts of oxygen quickly entering the blood in the oxygenator. In oxygenators with a high flow rate, rapid oxygen accumulation will be able to flood any reservoir or bubble trap and allow gas to quickly enter the patient. The size of the reservoirs or bubble traps is limited as a result of the need to limit the initial volume.
Ekstrakorporale oxygenatorer krever vanligvis en relativt hoy volumet risk gasstromningshastighet, og det er viktig at gass-rommet er tett med., god blanding for å sikre en effektiv gassoverfor-ing over den mikroporose membran. Da dette resulterer i et visst gasstrykkfa 11 i oxygenatoren, er gassarbeidstrykket vanligvis storre enn atmosfæretrykk. Hvis blodtrykket ble redusert til null, ville gasstrykket være storre enn blodtrykket. En slik ombytning' av gass- og blodtrykk ville lett kunne skje ved tomgang når der ik-ke er noen blodstrom, i oxygenatoren. Extracorporeal oxygenators usually require a relatively high volumetric gas flow rate, and it is important that the gas space is tight with good mixing to ensure efficient gas transfer across the microporous membrane. As this results in a certain gas pressure fa 11 in the oxygenator, the gas working pressure is usually greater than atmospheric pressure. If the blood pressure were reduced to zero, the gas pressure would be greater than the blood pressure. Such an exchange of gas and blood pressure could easily occur at idle when there is no blood flow in the oxygenator.
Det er uhyre vanskelig, om ikke umulig, for en operator å opprettholde de variable trykk i en oxygenator i den rette stilling. Det er således et mål med oppfinnelsen å tilveiebringe et automatisk system for trykkregulering av et masseoverforingssystem slik som en oxygenator. It is extremely difficult, if not impossible, for an operator to maintain the variable pressures in an oxygenator in the correct position. It is thus an aim of the invention to provide an automatic system for pressure regulation of a mass transfer system such as an oxygenator.
Et annet mål med oppfinnelsen er å tilveiebringe et system for å forhindre tilfeldig ombytning av gass- og væsketrykk i et masseoverforingssystem uten anvendelse av anordninger som har beve-1 gelige deler, fjærer, små åpninger eller membraner som kan odeleg-ges eller gjentettes og derved fremkalle feil på systemet. Another aim of the invention is to provide a system to prevent accidental exchange of gas and liquid pressure in a mass transfer system without the use of devices that have moving parts, springs, small openings or membranes that can be destroyed or resealed and thereby cause errors on the system.
Andre mål og fordeler ved oppfinnelsen fremgår av den ef-terfolgende beskrivelse. Other aims and advantages of the invention appear from the following description.
Ifolge oppfinnelsen er der skaffet et sikkerhetssystem for et masseoverforingssystem av den type hvor en membranavsperring separerer en væske og en gass, og som innbefatter et væskeinn-lop, et væskeutlop og et gassinnlop og -utlop. Forbedringen omfatter midler til å opprettholde hele tiden et væsketrykk som er hoye re enn gasstrykket. En gasstrykk-d.etektoranordning er koblet til gassinnlopet, og hvor gasstrykk-detektoranordningen omfatter midler ti 1 å utlufte gassen for å forhindre at gasstrykket overskrider væsketrykket . According to the invention, a safety system has been provided for a mass transfer system of the type where a membrane barrier separates a liquid and a gas, and which includes a liquid inlet, a liquid outlet and a gas inlet and outlet. The improvement includes means to maintain at all times a liquid pressure that is higher than the gas pressure. A gas pressure detector device is connected to the gas inlet, and where the gas pressure detector device comprises means for venting the gas to prevent the gas pressure from exceeding the liquid pressure.
I en utforelsesform av oppfinnelsen omfatter de væsketrykk-vedlikeholdende midler et væskereservoar anbragt ved et høyere horisontalt plan enn væskeinnlopet, hvorved væsketrykket opprettholdes på grunn av tyngdekraften. En forste pumpe er lokalisert nedstrøms i reservoaret fort å trekke væske derfra, og hvor reservoaret er sammenbrytbart for å forhindre et negativt trykk på masseoverforings-anordningen hvis pumpevirkningen er for stor. In one embodiment of the invention, the liquid pressure-maintaining means comprise a liquid reservoir placed at a higher horizontal plane than the liquid inlet, whereby the liquid pressure is maintained due to gravity. A first pump is located downstream in the reservoir to draw liquid therefrom, and where the reservoir is collapsible to prevent a negative pressure on the mass transfer device if the pumping action is too great.
I en utforelsesform av oppfinnelsen omfatter gasstrykk-detektoranordningen et manometer med et væskenivå som'forhindrer gass fra å utluftes medmindre gasstrykket overskrider et på forhånd maksimalt gasstrykk. Manometrets væskenivå er slik at det tillater gass å utluftes hvis gasstrykket overskrider det maksimale gasstrykk, hvor det maksimale gasstrykk er et trykk som er lavere enn det minimale trykk av væsken i oxygenatoren. In one embodiment of the invention, the gas pressure detector device comprises a manometer with a liquid level which prevents gas from venting unless the gas pressure exceeds a predetermined maximum gas pressure. The manometer's liquid level is such that it allows gas to vent if the gas pressure exceeds the maximum gas pressure, where the maximum gas pressure is a pressure lower than the minimum pressure of the liquid in the oxygenator.
I en utforelsesform av oppfinnelsen er der anbragt et annet manometer, og som er opererbart som svar på et trykk av væsken for variabelt å justere det førstnevnte manometer. In one embodiment of the invention, another manometer is placed there, and which is operable in response to a pressure of the liquid to variably adjust the first-mentioned manometer.
En detaljert forklaring av oppfinnelsen gis i den efter-folgende beskrivelse under henvisning til de vedfoyede tegninger, hvor A detailed explanation of the invention is given in the following description with reference to the attached drawings, where
Fig. 1 er et skjematisk stromningsdiagram over et væskestromnings-sikkerhetssystem for masseoverforingsanordninger ifolge oppfinnelsen. Fig. 2 er et skjematisk stromningsdiagram for et modifisert væskestromnings-sikkerhetssystem f or masseoverforingsanordninger ifolge en annen utforelsesform av oppfinnelsen. I fig. 1 er der vist et masseoverforingssystem i form av et ekstrakorporalt oxygenatorsystem innbefattende et hovedkonsoll 10 til hvilket et venereservoar 12 og et arteriereservoar 14 er forbundet. Konsoll 10 har et oxygenutlop 15 til hvilket en ledning 16 er forbundet for å mate en regulert strømning av oxygen til inn-løpet 18 av en oxygenator 20. Efter å ha passert gjennom oxygenator 20 fjernes brukt gass via utlop 19. Hovedkonsoll 10 inneholder e t gasstromningsrotometer, en oxygenatormellomtrykkskontroll, en. temperaturmåler, og de nødvendige' velgerknapper og brytere, hvilket Fig. 1 is a schematic flow diagram of a liquid flow safety system for mass transfer devices according to the invention. Fig. 2 is a schematic flow diagram for a modified liquid flow safety system for mass transfer devices according to another embodiment of the invention. In fig. 1 shows a mass transfer system in the form of an extracorporeal oxygenator system including a main console 10 to which a venous reservoir 12 and an arterial reservoir 14 are connected. Console 10 has an oxygen outlet 15 to which a line 16 is connected to feed a regulated flow of oxygen to the inlet 18 of an oxygenator 20. After passing through oxygenator 20, spent gas is removed via outlet 19. Main console 10 contains a gas flow rotometer , an oxygenator intermediate pressure control, a. temperature gauge, and the necessary' selector buttons and switches, which
er velkjent innen faget. Konsoll 10 'er lokalisert innen operatorens rekkevidde, men utenfor området for mulig væskeforurensning. is well known in the field. Console 10' is located within the operator's reach, but outside the area of possible liquid contamination.
Oxygenator 20 er en typisk oxygenator hvor oxygen og carbondioxyd overfores i motsatte retninger over en membranavsperring som separerer blodet og oxygenet. Slike oxygenatorer er beskrevet i US patentsoknad nr. 170.163, innlevert 3.august 1971 av Ronald J. Leonard. Oxygenator 20 is a typical oxygenator where oxygen and carbon dioxide are transferred in opposite directions over a membrane barrier that separates the blood and oxygen. Such oxygenators are described in US Patent Application No. 170,163, filed August 3, 1971 by Ronald J. Leonard.
Det skal forståes at systemet ifolge foreliggende oppfinnelse er spesielt egnet for bruk med en hvilken som helst oxygenator som anvender en mikroporos, hydrofob membran. Et typisk egnet membranmateriale er polytetrafluorethylenark med en porestorrelse mindre enn 0,5 mikron og med tykkelse på 0,0127 cm. En annen mulig membran er formet av polypropylenark med en tykkelse på 0,00254 cm og en porestorrelse på 0,1 mikron. Membranene kan lamineres til en sikt for å styrke underlaget. It should be understood that the system according to the present invention is particularly suitable for use with any oxygenator that uses a microporous, hydrophobic membrane. A typical suitable membrane material is polytetrafluoroethylene sheet with a pore size of less than 0.5 micron and with a thickness of 0.0127 cm. Another possible membrane is formed from polypropylene sheet with a thickness of 0.00254 cm and a pore size of 0.1 micron. The membranes can be laminated to a sieve to strengthen the substrate.
En blodledning 22 er koblet fra et utlop 24 på vené-reservoar 12 til blodinnlop 26 på oxygenator 20. Blodet og oxygenet st.roramer gjennom oxygenator 20 på motsatte sider av membranen inne-holdt deri, pg blodet fjernes gjennom ledning 28 til en varmeveksler 30 som regulerer blodtemperaturen. En typisk varmeveksler som kan anvendes med systemet ifolge oppfinnelsen er beskrevet i US patentskrift 3.640.340, bevilget 8.februar 1972. Blodet fores derefter gjennom ledning 32 til et innlop 34 på arterie-reservoaret 14. A blood line 22 is connected from an outlet 24 on vein reservoir 12 to blood inlet 26 on oxygenator 20. The blood and oxygen flow through oxygenator 20 on opposite sides of the membrane contained therein, as the blood is removed through line 28 to a heat exchanger 30 which regulates blood temperature. A typical heat exchanger that can be used with the system according to the invention is described in US patent 3,640,340, granted 8 February 1972. The blood is then fed through line 32 to an inlet 34 on the artery reservoir 14.
En arteriepumpe 36 anvendes for å pumpe oxygenert blod fra arterie-reservoar 14 gjennom ledning 38 inn i pasientens arterie. En venepumpe 40 anvendes for å pumpe blodet fra vene-reservoar 12 til blodinnlop 26. Ledningen 43 forer blodet fra pasientens vene til vene-reservoaret 12. De to pumper (venepumpe 40 og arteriepumpe 36) tjener til å beskytte oxygenatoren og varmeveksleren fra å overkomprimeres. Venepumpe 40 trekker, blodet fra vene-reservoaret 12 og driver det gjennom oxygenator 20 og varmeveksler 30, og inn i arterie-reservoar 14. Arteriepumpe 36 trekker blodet fra arterie-reservoar 14 og driver dette tilbake til en arterie i det perfuser-te organ. An artery pump 36 is used to pump oxygenated blood from artery reservoir 14 through line 38 into the patient's artery. A venous pump 40 is used to pump the blood from the venous reservoir 12 to the blood inlet 26. The line 43 carries the blood from the patient's vein to the venous reservoir 12. The two pumps (vein pump 40 and arterial pump 36) serve to protect the oxygenator and the heat exchanger from being overcompressed . Venous pump 40 draws the blood from the venous reservoir 12 and drives it through the oxygenator 20 and heat exchanger 30, and into the arterial reservoir 14. Arterial pump 36 draws the blood from the arterial reservoir 14 and drives it back to an artery in the perfused organ .
Da eksakt tilpasning av pumpehastigheten på de to pumper er vanskelig, om ikke umulig, er venepumpe 40 tilpasset til å pumpe ved en litt hoyere hastighet enn arteriepumpe 14. En resirkula-sjonsledning 42 mellom arterie-reservoar 14 og vene-reservoar 12 tillater at den ekstrastromning som dannes av venepumpe 40 fores tilbake til venereservoaret. Dette sikrer at arteriereservoaret 14 bar blod til alle tider, mens det beskytter oxygenatoren 20 fra å overkomprimeres på grunn av blodakkuarulering. As exact adaptation of the pumping speed of the two pumps is difficult, if not impossible, vein pump 40 is adapted to pump at a slightly higher speed than artery pump 14. A recirculation line 42 between artery reservoir 14 and vein reservoir 12 allows the extra flow generated by venous pump 40 is fed back to the venous reservoir. This ensures that the arterial reservoir 14 carries blood at all times, while protecting the oxygenator 20 from being overcompressed due to blood accumulation.
Venereservoar 12 og arteriereservoar 14 er fortrinnsvis formet av et polyvinylkloridplastmateriale av medisinkvalitet eller silicongummi, og er sammenbrytbare. I tilfelle av at kapasiteten av enten venepumpe 40 eller arteriepumpe 36 overskrider kapasiteten inn i et reservoar, vil det respektive reservoar sammenbryte og begrense utstrømningen, og derved forhindre et redusert trykk fra å dannes i oppstromsretning av reservoaret. Dette er spesielt viktig med hensyn til arteriereservoaret 14 fordi det er nødvendig å opprettholde et minimalt blodtrykk på oxygenatoren sålenge der er blod i systemet ved å opprettholde en blodtrykkssoyle i ledninger 2 2, 32 og 28. Vein reservoir 12 and artery reservoir 14 are preferably formed from a medical grade polyvinyl chloride plastic material or silicone rubber, and are collapsible. In the event that the capacity of either venous pump 40 or arterial pump 36 exceeds the capacity into a reservoir, the respective reservoir will collapse and restrict outflow, thereby preventing a reduced pressure from forming upstream of the reservoir. This is particularly important with respect to the arterial reservoir 14 because it is necessary to maintain a minimal blood pressure on the oxygenator as long as there is blood in the system by maintaining a blood pressure column in lines 2 2 , 32 and 28 .
Det er viktig at reservoar 14, og fortrinnsvis også reservoar 12 er understøttet slik at dets nedre kanter er minst 7,62 cm over den ovre åpning av oxygenatoren. På denne måte vil en tyngde-fremkaldt væsketrykksoyle alltid utvises på oxygenatoren av blodet i reservoaret. Tyngdesoylen av blodet ordnes som nedenfor beskre-. vet til alltid å være storre enn gasstrykket i oxygenatoren, for å sikre mot muligheten for at gassbobler kan passere gjennom den mikroporose membran. It is important that reservoir 14, and preferably also reservoir 12, is supported so that its lower edges are at least 7.62 cm above the upper opening of the oxygenator. In this way, a gravity-induced liquid pressure oil will always be expelled on the oxygenator by the blood in the reservoir. The gravity analysis of the blood is arranged as described below. know to always be greater than the gas pressure in the oxygenator, to ensure against the possibility that gas bubbles can pass through the microporous membrane.
En sikker og direkte metode for trykkontroll er skaffet ved at der til oxygeninnlopet 18 er koblet en gasstrykk-detektoranordning 60. Gasstrykk-detektoranordning 60 omfatter et manometer innbefattet en åpen beholder 62 med en væske 64, slik som vann, fyllt opp til et på forhånd bestemt nivå. En utluftningsledning 66 er koblet fra oxygeninnldp 18 til innsiden av beholder 62, idet den passerer nedover gjennom toppen av beholder 62 .under dannelse av manometerkonstruksjonen. Væske 64 er fyllt til det nivå som krever nok baktrykk i utluftningsledning 66 for således å forhindre gass fra å utluftes medmindre gasstrykket overskrides av det på forhånd bestemte maksimale gasstrykk, og som tillater gassen å utluftes hvis gasstrykket overskrider et slikt maksimalt gasstrykk. Det maksimale gasstrykk velges til å være et trykk som er lavere enn trykket av blodet i oxygenatoren, dannet ved trykksoylen i ledning 34, dvs. lavere enn trykket av blodet i oxygenatoren ved det verti-kalt hoyeste punkt av blodstrdmningsveien deri. Således må den. vertikale avstand mellom utlopet 34 på reservoar 14 og oxygeninnlo pet 18 på oxygenator 20 være storre enn den vertikale avstand mellom den nedre ende 68 av ledning 66 og overflaten 70 på væske 64. På denne måte må gasstrykket alltid være lavere enn blodsoylen, hvilken vanligvis er minimum 45 - 50 cm ved innlop 26. Således kan gassen ikke boble gjennom membranen inn i blodet. Vanligvis vil der fore-ligge en vann-trykksoyle på 35,6 cm i manometer 60 når gasstrykket er tilstrekkelig ti 1 å bevirke strømninger gjennom ledning 66. Når gass ikke strommer, er trykksoylen noe mindre siden vannet da befin-ner seg innen ledning 66, og således senker væskenivået i beholder 62. A safe and direct method for pressure control is provided by connecting a gas pressure detector device 60 to the oxygen inlet 18. The gas pressure detector device 60 comprises a manometer including an open container 62 with a liquid 64, such as water, filled up to a certain level. A vent line 66 is connected from oxygen inlet 18 to the interior of container 62, passing downwardly through the top of container 62 forming the manometer structure. Liquid 64 is filled to the level that requires enough back pressure in vent line 66 to thus prevent gas from being vented unless the gas pressure is exceeded by the predetermined maximum gas pressure, and which allows the gas to be vented if the gas pressure exceeds such maximum gas pressure. The maximum gas pressure is chosen to be a pressure which is lower than the pressure of the blood in the oxygenator, formed by the pressure column in line 34, i.e. lower than the pressure of the blood in the oxygenator at the vertically highest point of the blood flow path therein. Thus it must. vertical distance between the outlet 34 of the reservoir 14 and the oxygen inlet 18 of the oxygenator 20 be greater than the vertical distance between the lower end 68 of the line 66 and the surface 70 of the liquid 64. In this way, the gas pressure must always be lower than the blood pressure, which is usually minimum 45 - 50 cm at inlet 26. Thus the gas cannot bubble through the membrane into the blood. Usually there will be a water pressure column of 35.6 cm in manometer 60 when the gas pressure is sufficient to cause flows through line 66. When gas is not flowing, the pressure column is somewhat smaller since the water is then within line 66 , and thus lowers the liquid level in container 62.
Systemet er feilsikkert fordi at hvis væsken 64 skulle for-dampes, ville gassen utluftes ved et lavere trykk enn for fordampning. Således vil fordampning av væsken 64 bare fore til at gassen utluftes ved et lavere trykk, og oxygenatoren forblir sikker fra muligheten for at en gassemboli skjer gjennom membranen. The system is fail-safe because if the liquid 64 were to evaporate, the gas would be vented at a lower pressure than for evaporation. Thus, evaporation of the liquid 64 will only cause the gas to be vented at a lower pressure, and the oxygenator remains safe from the possibility of a gas embolism occurring through the membrane.
En ledning 43 koblet til pasientens vene forer blod til ve~nereservoaret 12. A line 43 connected to the patient's vein feeds blood to the vein reservoir 12.
Systemet kan også innbefatte et kardiotomireservoar 44, slik som vist i US patentskrift 3.507.395, hvis innlop er koblet til pasientens snittsted via sugeledning 46. ■ Det blod som tapes i pasientens snittsted, suges ved hjelp av sugepumpe 48 til hvilken ledning 46 er koblet. Ledning 50 forbinder utlopet av kardiotomireservoaret 44 til venereservoar 12 gjennom et eventuelt hje lpe.fi 1-ter 5.2 som filtrerer ut eventuelt gjenværende stivnede blodklumper og andre store partikler i blodet, og forer derefter blodet til venereservoaret. Kardiotomireservoaret er vanligvis også lokalisert over vene- og arteriereservoarene for således å hjelpe til å tilveiebringe en blod-tyngdesoyle. The system can also include a cardiotomy reservoir 44, as shown in US patent document 3,507,395, the inlet of which is connected to the patient's incision site via suction line 46. ■ The blood that is lost in the patient's incision site is sucked using suction pump 48 to which line 46 is connected . Line 50 connects the outlet of the cardiotomy reservoir 44 to the vein reservoir 12 through an optional aid lpe.fi 1-ter 5.2 which filters out any remaining congealed blood clots and other large particles in the blood, and then feeds the blood to the vein reservoir. The cardiotomy reservoir is also usually located above the venous and arterial reservoirs to thus help provide a blood-gravity balance.
Hvis koronarperfusjon eller annen lokalisert perfusjon av et organ er onsket, er en perfusjons ledning 54 koblet til et utlop på arteriereservoar 14, og væsken pumpes gjennom ledning 54 ved hjelp av en perfusjonspumpe 56. If coronary perfusion or other localized perfusion of an organ is desired, a perfusion line 54 is connected to an outlet on arterial reservoir 14, and the liquid is pumped through line 54 by means of a perfusion pump 56.
En modifisert gasstrykk-detektoranordning er illustrert i fig. 2. Da resten av systemet er identisk med det system som er vist i fig. 1, er de samme nummerangiveIser anvendt for den samme konstruksjon. Gasstrykk-detektoranordningen 60' i fig. 2 omfatter et manometer dannet av beholder 62', og som har en åpen topp og bunn. Beholder 62' inneholder væske, slik som vann.64', og har oxygenledning 66 innfort deri på lignende måte som den tidligere utforelsesform. Manometret som er dannet av beholder 62', væske 64' og ledning 66 drives på lignende måte som gass-detektoranordning 60 i fig. 1. Imidlertid tillater gass-detektoranordning 60' A modified gas pressure detector device is illustrated in fig. 2. Since the rest of the system is identical to the system shown in fig. 1, the same numerals are used for the same construction. The gas pressure detector device 60' in fig. 2 comprises a manometer formed by container 62', and which has an open top and bottom. Container 62' contains liquid, such as water 64', and has oxygen line 66 inserted therein in a similar manner to the previous embodiment. The manometer, which is formed by container 62', liquid 64' and line 66, is operated in a similar manner to gas detector device 60 in fig. 1. However, gas detector device allows 60'
i fig. 2 at det maksimale gasstrykk heves hvis blodtrykket heves, in fig. 2 that the maximum gas pressure is raised if the blood pressure is raised,
på grunn av en forandring i blodstromningshastigheten eller lignende. Imidlertid er det fremdeles nodvendig at gasstrykket begrenses og holdes mindre enn blodtrykket. For dette formål er der anordnet et lukket blodmanometer 70. Manometer 70 inneholder en mengde av blodet 72 som er avhengig av trykket i ledning 22, til hvilket dei-er forbundet. Dette bevirker et variabelt gasstrykk i rommet 74 over blodet 72 som også avhenger av trykket i ledning 22. Således er hoyden av væsken 64' derved avhengig av trykket i rom 74, ledning 76 og ledning 22. Utldpet av ledning 76 står i forbindelse med forseglet beholder 78 inn i hvilken beholder 62' er anbragt. due to a change in blood flow rate or the like. However, it is still necessary that the gas pressure be limited and kept less than the blood pressure. For this purpose, a closed blood manometer 70 is arranged. The manometer 70 contains a quantity of the blood 72 which is dependent on the pressure in the line 22, to which they are connected. This causes a variable gas pressure in the space 74 above the blood 72 which also depends on the pressure in line 22. Thus, the height of the liquid 64' is thereby dependent on the pressure in space 74, line 76 and line 22. The output of line 76 is connected to the seal container 78 into which container 62' is placed.
En mikroporos plugg 77 forhindrer blodet fra å fores inn i kontroll-manometer 60' og utgjor en steril avsperring gjennom hvilken bare gassen i rom 74. og beholder 78 kan passere. Plugg 77 kan være frem-stillet av samme porose, hydrofobe membranmateriale som anvendes i oxygenator 20. A microporous plug 77 prevents the blood from being fed into the control manometer 60' and forms a sterile barrier through which only the gas in chamber 74 and container 78 can pass. Plug 77 can be made of the same porous, hydrophobic membrane material used in oxygenator 20.
En forandring i blodnivå 72 vil fremkalle en trykkforan-dring i rom 74 og ledning 76 og derved skape en væskeforandring med hensyn til væsken 64'. Antar man at blodtrykket i ledning 22 okes av' en Sket stromningshastighet eller av en annen grunn, vil blodnivået 72 stige, hvorved trykket i den lukkede beholder 78 vil oke. Dette vil bevirke at væsken 64 vil stige i beholder 62', og derved tillate et hoyere oxygentrykk for utluftning fra ledning 66 vil skje. Hvis blodtrykket i ledning 22 på den annen side nedsettes, vil blodnivået 72 i manometer 70 nedsettes og derved nedsette trykket på væsken 64 og bevirke et fall i hoyden av væske 64' innen beholder 62'. Således vil gassen utluftes ved et lavere trykk enn nodvendig. A change in blood level 72 will cause a pressure change in room 74 and line 76 and thereby create a change in fluid with respect to fluid 64'. Assuming that the blood pressure in line 22 is increased by an increased flow rate or for another reason, the blood level 72 will rise, whereby the pressure in the closed container 78 will increase. This will cause the liquid 64 to rise in container 62', thereby allowing a higher oxygen pressure for venting from line 66 to occur. If the blood pressure in line 22, on the other hand, decreases, the blood level 72 in manometer 70 will decrease and thereby decrease the pressure on the liquid 64 and cause a drop in the height of liquid 64' within container 62'. Thus, the gas will be vented at a lower pressure than necessary.
Det ovenfor angitte system tilveiebringer ytterligere ef-fektivitet koblet med sikkerhet, idet hoyere gasstrykk kan anvendes når hoyere blodtrykk foreligger, men ved et plutselig fall i blodtrykket vil det begrensende maksimale gasstrykk også falle til et sikkert nivå. The above-mentioned system provides additional efficiency coupled with safety, as higher gas pressure can be used when higher blood pressure exists, but in the event of a sudden drop in blood pressure, the limiting maximum gas pressure will also fall to a safe level.
Et automatisk system for trykkontroll er folgelig tilveie-bragt for et masseoverforingssystem slik som en oxygenator. Syste met kan drives for å forhindre tilfeldig ombytning av gass- og væsketrykk i et masseoverforingssystem uten'anvendelse av anordninger med bevegelige deler, fjærer, små åpninger eller membraner. Oppfinnelsen tilveiebringer ikke bare et sikkerhetssystem, men tillater også effektiv drift av et oxygeneringssystem ved store hoyder, da manometrene 60, 60' tillater den sikre bruk av gasstrykk i en oxygenator som kan overskride det omgivende atmosfæretrykk. An automatic system for pressure control is thus provided for a mass transfer system such as an oxygenator. The system can be operated to prevent accidental exchange of gas and liquid pressure in a mass transfer system without the use of devices with moving parts, springs, small openings or diaphragms. The invention not only provides a safety system, but also allows efficient operation of an oxygenation system at high altitudes, as the manometers 60, 60' allow the safe use of gas pressure in an oxygenator that may exceed the ambient atmospheric pressure.
Ennvidere tillater anvendelse av manometrene 60, 60' kontinuerlig livreddende oxygenering av en pasient selv i det tilfelle hvor der foreligger skade på gassventilen eller lignende som bevirker okende trykk, da okende gasstrykk enkelt slippes ut av manometrene 60, 60', mens oxygenatoren forblir ved det maksimale gasstrykk som på forhånd er valgt. Furthermore, the use of the manometers 60, 60' allows continuous life-saving oxygenation of a patient even in the case where there is damage to the gas valve or the like that causes increasing pressure, as increasing gas pressure is simply released from the manometers 60, 60', while the oxygenator remains at that maximum gas pressure that is selected in advance.
Selvom to utforeIsesformer av oppfinnelsen er illustrert og beskrevet, skal det forståes at forskjellige modifikasjoner kan gjores uten å avvike fra oppfinnelsens ramme. Although two embodiments of the invention have been illustrated and described, it should be understood that various modifications can be made without deviating from the framework of the invention.
Claims (1)
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US390567A US3927980A (en) | 1973-08-22 | 1973-08-22 | Oxygen overpressure protection system for membrane-type blood oxygenators |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| NO743005L true NO743005L (en) | 1975-03-24 |
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ID=23542994
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| JP (1) | JPS5430237B2 (en) |
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1973
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1974
- 1974-04-30 ZA ZA00742754A patent/ZA742754B/en unknown
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- 1974-06-25 CA CA203,394A patent/CA1037881A/en not_active Expired
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- 1974-06-28 NL NL7408795.A patent/NL165935C/en not_active IP Right Cessation
- 1974-07-18 DE DE2434571A patent/DE2434571C2/en not_active Expired
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- 1974-08-21 DK DK447774A patent/DK447774A/da not_active Application Discontinuation
- 1974-08-21 NO NO743005A patent/NO743005L/no unknown
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| BR7405230A (en) | 1976-02-24 |
| DE2434571A1 (en) | 1975-03-06 |
| FR2241336A1 (en) | 1975-03-21 |
| US3927980A (en) | 1975-12-23 |
| CA1037881A (en) | 1978-09-05 |
| DE2434571C2 (en) | 1984-10-04 |
| GB1471308A (en) | 1977-04-21 |
| AR201146A1 (en) | 1975-02-14 |
| NL7408795A (en) | 1975-02-25 |
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| IL45020A (en) | 1977-05-31 |
| BE814984A (en) | 1974-09-02 |
| NL165935B (en) | 1981-01-15 |
| IT1017486B (en) | 1977-07-20 |
| AU6983874A (en) | 1975-12-11 |
| JPS5430237B2 (en) | 1979-09-28 |
| DK447774A (en) | 1975-04-28 |
| NL165935C (en) | 1981-06-15 |
| FR2241336B1 (en) | 1983-04-01 |
| ZA742754B (en) | 1975-05-28 |
| IL45020A0 (en) | 1974-09-10 |
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