WO1997046274A1 - Implantable drug pump - Google Patents

Implantable drug pump Download PDF

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Publication number
WO1997046274A1
WO1997046274A1 PCT/DE1997/000986 DE9700986W WO9746274A1 WO 1997046274 A1 WO1997046274 A1 WO 1997046274A1 DE 9700986 W DE9700986 W DE 9700986W WO 9746274 A1 WO9746274 A1 WO 9746274A1
Authority
WO
WIPO (PCT)
Prior art keywords
pump
insulin
drug pump
reflex arc
example
Prior art date
Application number
PCT/DE1997/000986
Other languages
German (de)
French (fr)
Inventor
Siegfried Kallert
Erhard Weidlich
Brigitte Stroetmann
Original Assignee
Siemens Aktiengesellschaft
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority to DE19621770.9 priority Critical
Priority to DE1996121770 priority patent/DE19621770C1/en
Application filed by Siemens Aktiengesellschaft filed Critical Siemens Aktiengesellschaft
Publication of WO1997046274A1 publication Critical patent/WO1997046274A1/en

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M5/00Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/14Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
    • A61M5/142Pressure infusion, e.g. using pumps
    • A61M5/14244Pressure infusion, e.g. using pumps adapted to be carried by the patient, e.g. portable on the body
    • A61M5/14276Pressure infusion, e.g. using pumps adapted to be carried by the patient, e.g. portable on the body specially adapted for implantation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M5/00Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/14Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
    • A61M5/168Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body
    • A61M5/172Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body electrical or electronic
    • A61M5/1723Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body electrical or electronic using feedback of body parameters, e.g. blood-sugar, pressure

Abstract

The invention relates to an implantable drug pump which uses the reflex arc which is still intact in many patients (for example diabetics) between the endogenous receptors and the cells, producing the material to be secreted, for controlling drug release. Consequently, practically physiological drug release is achieved thereby controlling the feared late symptoms, for example diabetes, in a particularly effective manner.

Description

description

Implantable drug pump

The invention relates to an implantable drug pump, such as a Insulmpumpe in which a kontinuierli¬ che Insulmmfusion is adjusted about the daily schedule of each schwan¬ kenden Glukoseoelastung such that a constant under physiological spread Glukosekonzen- tration is ensured in the blood.

The previously known Plane for the use of insulin pumps glukosekonzen- trationsabhangigen all based on the structure of a tecnmscnen control loop in which the current glucose concentration in the blood (or m thereof dependent Flussig- keitsraumen of the organism) by means of technical sensors is measured, and wherein m is a function of these measured values, if they deviate from the desired value, which is influ- Insulmpumpe beein¬ so that the glucose concentration value is fed back to the target value.

These previously Dekannten solutions adhere to the following deficiency

- There is no sufficiently long functional and technical lm studies plantierbaren sensors for measuring αer Glu¬ kosekonzentration in the blood and

- insulin is released into the blood concentration only after the deviation of the Glukosekon-

Here, this technical control of Insulinabgane differs in¬ provided by the physiological control off as she has no anticipatory control content, ie no control, which is not only comes to a wesentlicnen change in target Large An implantable glucose sensor is, for example, from US-5101 known 814th It includes living cells that respond to un¬ terschiedliche glucose concentrations with a unterschied¬ union electrical activity. The electrical ac- tivity is wirelessly transmitted from the body and, for example, measured by electrodes or optically recognized by elec- trochrome dyes.

Complete closed-loop control systems for glukosekonzentrati- onsabhängigen insulin dosage, for example, in the

US-5,474,552 or suggested in WO / 28878, wherein Insu¬ linpumpen or provide other metering devices in dependence on the measured by a glucose sensor glucose concentration for an appropriate insulin dosage.

Such systems are also proposed for the continuous dosage of other medications.

In the physiological control of the intact organism, it already comes to insulin during intensive Vor¬ provision of food, the sight, smell and especially the taste of food and the stay of chyme in the intestine, not only after the absorption and the appearance in the blood as by the known technical controls for insulin release.

Object of the present invention is, therefore, a pump element Medika¬ and in particular to provide an insulin pump is available, the similar nature as it makes, before the measurable change in the concentration of a substance

(Especially insulin) in the blood delivers a drug suitability for adjusting this concentration. It is also an object of the present invention to find a stable replacement for the be¬ knew technical Glukoεesensoren.

General recognition of the invention is first A n instead of the previously provided technical sensors for a substance the body's reflex arc intact, so physiological receptors can still be used to control the dosage of a drug. For example, con- NEN m such cases, where the diabetes by the failure of beta cells is caused, the body's glucose receptors are used as sensors.

2. When using this body's sensors LTN plantierbare drug pump is -similar to the natural

Make release of insulin by the beta cells in the healthy organism-the drug (eg insulin) before the change of a relevant concentration (eg Glukosekonzencration) in the correct amount of the body.

This makes it possible to replace a defective organ for Eigensubstanzab- gebung, such as the pancreas by the inventive drug pump while maintaining the natural Regel¬ circle about the body's sensors. So it is for example possible to regulate the glucose concentration of the blood so that it corresponds nissen particularly the normal physiological Verhalt¬ so that to erwar¬ also a particularly effective containment of the so dreaded Spatschaden

The invention builds on the fact that for example, in many cases of diabetes, the disease is due to a defect in the insulin-producing beta cells, wherein the reflex arc of the organism to activate these cells m most cases it is still intact. The inventive drug pump uses this reflex arc, is the body's control loop (eg the Insulmabgabe system) ge controls and so provides an optimal physiological medication management supply She uses not only receptors, the natural re- but zusä tzli ch the entire nachgeεchalteten neuronal processing apparatus that takes into account already possible an¬ particular acting on the concentration disturbances both anticipatory a l s also measuring, and even includes learning processes.

G Egens t at dd invention it is an implantable drug- pump for patients with intact reflex arc but defective O rganen the en d okrinen hydrogen generation, so stanzabge to Eigensub- b ung, wherein the control of the discharge amount, duration time of said un d drug pump to the excitations of the vegetati¬ ven N ervenfasern of the reflex arc between the body's sensors S un d is coupled to the defective organs.

In general, the coupling takes place-acres vegetative nerve fibers an d the drug pump via electrodes. It is pra kt severally, when the surface of the electrode in the way b lic k au fd ie h o h e electrical capacity which they have is Müs ¬ sen to register all action potentials femporos ges t a t e lt. T he femporόεe surface may additionally be aogedeckt from a turned b everträglichen material. In these ab d eckung drugs can be stored, which then dishes t and small doses of the nerve fiber and the body are given targeted.

I m S held T his invention is referred to as Reflexoogen between the rpereigenen intact sensors and the defective organs of s d o k rinen St o ff generation of Reflexoogen, the

First the p h en h ysiologisc receptors in the mouth (eg Glukoserezep- t Oren) an d the small intestine, but also in the liver and brain and

Second T he d azugehörigen afferent nerve fibers from the Rezepto ¬ ren to Z s t ra l nervous system and brain; 3. the neural processing in the brain, in Zentralnervensy ¬ s t em an d in the autonomic ganglia and

4th the endocrine producing Z e l s in the (defective) comprises organ d ie effεrenten nerve fibers.

Under ß-Ze l len in the sense of the present invention rela ¬ h ungsweise a preferred embodiment of the invention, the beta cells of the pancreas to be understood that produce the endogenous insulin and distribute.

As vegetative nerve fibers in the context of the present inventions fertil particularly the efferent fibers between the central nervous system and the beta cells of the pancreas are suitable. but Even¬ TULLE it is sufficient to use the excitement of a lighter zugängli¬ chen vegetative nerve and use the learning ability of the organism. This possible development is loading was part of the invention.

As an excitation in accordance with this invention, the potentials of the nerve fiber Aktionspo- be understood.

The coupling of the drug pump to the nerve fiber mit¬ means of an electrode is preferably carried out with metal (eg. B. Pla¬ tin-iridium) or carbon, wherein the finely porous sponge-shaped surface for example of Plantmschwarz or Platin¬, titanium nitride, titanium carbide or activated carbon may consist fabric. The tissue-compatible material, which is used to cover the electrode surface should be lonenleitend to be able to pass the action potentials or excitations of nerve fiber. Therefore, it oiokompatible, lonenleitende membranes, such as Mafion suitable but the invention should not be limited by the material of the electrode cover, since it is conceivable to produce covers so small thickness that the ionic conductivity of the material is no longer important.

As drugs especially those to be stored, the er¬ the healing of the electrode to the nerve fiber easier, such as antibiotics or corticosteroids.

The above definitions apply both to the description and to the claims and the Erläu¬ Chippings to the figure. In the following the invention will be illustrated now by way of example: The single figure shows a schematic diagram of an inventive Insulmpumpe. Far left of the picture you can see the nerve one that comes from the central nervous system. On the Erregun- gen of afferent nerve fibers from the various Gluko¬ of the body and their neural processing in the central nervous system based serezeptoren the action potentials of such ef ferenten nerve fibers. Nerve 1 is enclosed by the electrode 2 um¬. To the electrode, a differential amplifier 3 includes at which amplifies the incoming Emzel action potentials (AP) and forwards to the integrator. 5

In the integrator 5, the mean value of the temporal density of action potentials is determined. The line from the integrator 5 to the actual insulin pump 6 then transmits the number of action potentials per unit time (or the resulting voltage U) as a function of the number of action potentials per unit time (U = f (number AP / Zeitemheit) for insulin pump 6. The Insulmpumpe 6 characterized activated to a discharge of a certain Insuim-current, which in turn directly proportional to the previously arrived at the Insulmpumpe Span¬

Figure imgf000008_0001

From this figure is clear that the strong Insulmstrom- that freigege¬ of the inventive Insulmpumpe ben is controlled directly by the excitation of the nerves. 1 Just as with the healthy nature of the body, the distribution found in the inventive insulin supply eliminates even before the glucose through the intestinal absorption m reaches the blood. When glucose absorption then occurs ei¬ nem a much smaller rise in blood glucose concentration.

The device according to the invention is characterized auε characterized in that the intact parts of the physiological function of the circuit to the patient undergoing therapy control the device. This eliminates tation on the development of technical glucose sensors and their implant. With the inventive GERAT glycemic control is physiologically, which means that the controlled variable (the blood sugar concentration here) need not only differ from the setpoint so that gegenregulatorisch acting measures are initiated (insulin release), but that even before the deviation of the controlled variable ei¬ from setpoint ne , will start the expected deviation counteracting action.

As a result, the deviation of the blood sugar level of the normal concentration will be less than insulin pumps chen with Herkömmli¬ This in turn means that Spat- be reduced harm, or not occur

is set after the inventive GERAT example, in Diabe¬ experts has intact reflex arc but defective beta cells einge¬, it can serve as a substitute for the pancreas and other organ implants. Of this, the manifold problems of transplants, for example zusammenhangen with the immune system The inventive device can be used to Massenan- application and thus, unlike the pancreas Tranεplantationen, also for the treatment of a large number Dia¬ pray ill or sick with a defective endocrine substances distributing organ.

Claims

claims
1. The implantable drug pump for patients with intact reflex arc but defective organs for Eigensubstanzabgebung, wherein the control of the discharge amount, duration and time of the drug pump to the excitations of the vegetative Nervenfa¬ fibers of the reflex arc between the body's sensors and the defective organs is coupled.
2. Pump according to claim 1, in which the excitations of a vege¬ tative nerve fiber can be registered by means of a gekop¬ to the nerve fiber-coupled electrode.
is 3. A pump according to claim 2, wherein the surface of the electrical de finely porous designed and covered with a tissue-compatible Ma¬ TERIAL.
4. Pump carries medication according to claim 3, wherein the tissue-compatible Ab¬ cover and discharges.
5. Pump according to one of claims 1 to 4, characterized gekenn¬ characterized in that it is an insulin pump.
PCT/DE1997/000986 1996-05-30 1997-05-15 Implantable drug pump WO1997046274A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
DE19621770.9 1996-05-30
DE1996121770 DE19621770C1 (en) 1996-05-30 1996-05-30 implantable insulin pump

Publications (1)

Publication Number Publication Date
WO1997046274A1 true WO1997046274A1 (en) 1997-12-11

Family

ID=7795718

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/DE1997/000986 WO1997046274A1 (en) 1996-05-30 1997-05-15 Implantable drug pump

Country Status (2)

Country Link
DE (1) DE19621770C1 (en)
WO (1) WO1997046274A1 (en)

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4146029A (en) * 1974-04-23 1979-03-27 Ellinwood Jr Everett H Self-powered implanted programmable medication system and method
EP0481583A2 (en) * 1990-10-15 1992-04-22 Cardiac Pacemakers, Inc. Method and apparatus for cardioverter/pacer utilizing neurosensing
US5305745A (en) * 1988-06-13 1994-04-26 Fred Zacouto Device for protection against blood-related disorders, notably thromboses, embolisms, vascular spasms, hemorrhages, hemopathies and the presence of abnormal elements in the blood

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5101814A (en) * 1989-08-11 1992-04-07 Palti Yoram Prof System for monitoring and controlling blood glucose
US5569186A (en) * 1994-04-25 1996-10-29 Minimed Inc. Closed loop infusion pump system with removable glucose sensor
US5474552A (en) * 1994-06-27 1995-12-12 Cb-Carmel Biotechnology Ltd. Implantable drug delivery pump

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4146029A (en) * 1974-04-23 1979-03-27 Ellinwood Jr Everett H Self-powered implanted programmable medication system and method
US5305745A (en) * 1988-06-13 1994-04-26 Fred Zacouto Device for protection against blood-related disorders, notably thromboses, embolisms, vascular spasms, hemorrhages, hemopathies and the presence of abnormal elements in the blood
EP0481583A2 (en) * 1990-10-15 1992-04-22 Cardiac Pacemakers, Inc. Method and apparatus for cardioverter/pacer utilizing neurosensing

Also Published As

Publication number Publication date
DE19621770C1 (en) 1998-01-02

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