WO1999033502A1 - Appareil auxiliaire de circulation sanguine utilisant une pompe a flux sanguin continu et dispositif de diagnostic des conditions de la circulation sanguine dans l'organisme - Google Patents
Appareil auxiliaire de circulation sanguine utilisant une pompe a flux sanguin continu et dispositif de diagnostic des conditions de la circulation sanguine dans l'organisme Download PDFInfo
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- WO1999033502A1 WO1999033502A1 PCT/JP1998/005928 JP9805928W WO9933502A1 WO 1999033502 A1 WO1999033502 A1 WO 1999033502A1 JP 9805928 W JP9805928 W JP 9805928W WO 9933502 A1 WO9933502 A1 WO 9933502A1
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- blood
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- amplitude
- motor
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Classifications
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- 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
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/40—Details relating to driving
- A61M60/403—Details relating to driving for non-positive displacement blood pumps
- A61M60/408—Details relating to driving for non-positive displacement blood pumps the force acting on the blood contacting member being mechanical, e.g. transmitted by a shaft or cable
- A61M60/411—Details relating to driving for non-positive displacement blood pumps the force acting on the blood contacting member being mechanical, e.g. transmitted by a shaft or cable generated by an electromotor
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- 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
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/10—Location thereof with respect to the patient's body
- A61M60/104—Extracorporeal pumps, i.e. the blood being pumped outside the patient's body
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- 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
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/20—Type thereof
- A61M60/205—Non-positive displacement blood pumps
- A61M60/216—Non-positive displacement blood pumps including a rotating member acting on the blood, e.g. impeller
-
- 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
- A61M2205/00—General characteristics of the apparatus
- A61M2205/33—Controlling, regulating or measuring
- A61M2205/3331—Pressure; Flow
- A61M2205/3334—Measuring or controlling the flow rate
Definitions
- Blood flow circulatory assist device using continuous flow blood pump and diagnostic device for blood flow circulatory state of living body
- the present invention relates to a blood circulation assisting device using a continuous flow blood pump to assist in sending blood, and a diagnostic device for a blood circulation state of a living body using the blood circulation assisting device.
- a pulsating blood pump used for assisting blood circulation there are positive displacement pumps such as a diaphragm pump and a pusher plate pump.
- the pump ejection control that meets the demands of the living body is performed by driving the pump in a full filling-full ejection mode.
- the development of a positive displacement pump as an artificial heart is extremely difficult due to its complicated mechanism.
- continuous-flow blood pumps include rotary, precession, oscillating, or vibrations and waves in addition to typical pumps such as centrifugal, axial, and mixed-flow pumps.
- Pumps that use blood to eject blood have been developed to assist the circulation of living organisms. These are more promising than positive displacement pumps because their mechanism is simple and can be manufactured at low cost.
- continuous flow blood pumps are more difficult to control than positive displacement pumps.
- the ejection flow rate of the pump is estimated from the average value of the current consumed by the motor and the drive characteristics of the pump used.
- a method for controlling the flow rate to be constant has been proposed. In other words, with a continuous-flow blood pump, it is possible to determine the interrelationships among pump speed, generated head (pressure), ejection flow rate, and motor current consumption. Therefore, if the number of revolutions and the motor current consumption are known, it is possible to estimate the head generated by the pump and the ejection flow rate at that time.
- the first problem is that it is impossible to perform appropriate circulatory assist of blood of a living body by the control method.
- the blood flow required by a living organism varies greatly depending on the individual situation of the living organism. For example, the individual size of an individual
- Factors that affect the kinematic viscosity of blood include red blood cell count (or hematocrit), serum lipids, and serum total protein. These values vary depending on the physiological state of the living body. However, no method has been devised to continuously monitor the kinematic viscosity of blood or the concentration of blood components. Therefore, it is difficult to realize a method of controlling the liquid delivery so as to obtain a desired flow rate without being affected by the properties of blood, for example, kinematic viscosity.
- the present invention can provide appropriate circulatory assistance in accordance with the blood circulation state of a living body, and furthermore, a special monitor for monitoring the properties of blood. It is an object of the present invention to provide a blood circulation assisting device using a continuous flow blood pump, which can obtain a desired flow rate without requiring a special sensor. Disclosure of the invention
- the blood circulation assisting device includes: a continuous flow blood pump configured by a non-volume pump for assisting blood flow sending; one end being attachable to a blood removal site of a living body; A blood vessel connected to the inflow part of the blood flow pump; and a blood vessel connected at one end to the blood flow site of the living body and the other end connected to the outflow part of the continuous blood pump.
- a blood flow circulating assist device for removing blood and ejecting blood at a predetermined flow rate through the blood supply vessel by the continuous flow blood pump, wherein information corresponding to the flow rate of blood flowing through the continuous flow blood pump is directly or indirectly transmitted.
- a flow rate detecting means for obtaining information corresponding to the amplitude of the fluctuation of the flow rate from an output of the flow rate detecting means, and an output of the flow rate amplitude detecting means. Means for adjusting the value to a constant value.
- the flow amplitude detecting means gives an output according to the blood circulation state in the living body
- the circulation assist adapted to the blood circulation state in the living body is performed. It can be done easily.
- the object of the present invention can be achieved by using the device having the above-described configuration, the clinical background related to assisting blood circulation and the more detailed operation of the device having the above-described configuration will be described below.
- a continuous flow pump Under normal operating conditions, the flow ejected from the pump is a steady flow, and the current consumption does not show any pulsation.
- the heart of a living body shows a pulsatile flow unless it is arrested or arrhythmic comparable to arrest. Therefore, when a continuous flow pump is used in a living body to assist circulation, the flow that is ejected by the pump, which should be a steady flow, is affected by the heart of the living body and shows pulsation. As a result, the current consumption waveform of the motor driving the pump shows a pulsation.
- the present inventor paid attention to the pulsation that appears specifically when used in a living body, and based on the pulsation of the current consumption value instead of the average value of the current consumption in the evening, appropriate circulatory assistance was provided.
- the present invention was constructed by noticing that it could be performed.
- circulatory support refers to the case where no blood is ejected from the living heart and all blood is pumped out of the blood pump. However, this does not mean that the living heart is stopped. Therefore, the heart of the living body may be generating some pressure. .
- partial support refers to the state in which the heart of a living body is pumping blood, and the blood pump is also pumping blood at the same time.
- the driving force of the living body beats the driving force of the pump, and the circulation of the living body becomes a pulsating flow.
- the current consumption waveform of the motor also has a pulsation.
- the pump output becomes closer to the blood output of the living heart, and eventually becomes equivalent. In the present invention, this point is referred to as a point t (derived from a total assist point).
- point t derived from a total assist point.
- the current amplitude index is the value obtained by dividing the amplitude of the current fluctuation by the current average value at that time. The reason for using the current amplitude index is as follows.
- the amplitude of the current consumption tends to increase with the number of rotations even if the state of the living body does not change. Therefore, it is difficult to directly detect changes in the pulsatile flow in the circulation of the living body from changes in the amplitude of the current fluctuation.
- the absolute value of the amplitude of the current fluctuation includes the effect of the change in the motor speed. Therefore, it is desirable to use the current amplitude index as an index in order to extract only the change in the pulsatile flow in the circulation of the living body.
- the t-p point and the t-i point are the points corresponding to the above-mentioned point t, in order to distinguish the point where the circulating assistance of the power pump shifts from partial to complete by the identification method.
- a point identified from the systolic arterial pressure and the systolic left ventricular pressure is defined as a point t-P, and a point identified from the current amplitude index is defined as a point t-i.
- the two points substantially match.
- the point t is the point ti.
- the t point is a unique point that appears extremely clearly as the motor speed increases.
- the relationship between the motor rotation speed and the amplitude of the current fluctuation is represented by the motor rotation speed and the current amplitude index (the value obtained by dividing the amplitude by the current average value).
- point t which shifts to assist
- point s at which pump blood flow pulsation due to sucking starts.
- Point t is the point where the circulation assist of the pump shifts from partial assistance to complete assistance as described above. In order to be able to provide this complete support, the pump must drive all of the venous return and generate a head that can maintain the flow.
- the head is the pressure difference between the suction pipe and the discharge pipe of the pump. Since this blood pressure is defined by the amount of venous return and the peripheral vascular resistance of the living body, the point t mainly depends on the venous return and the peripheral vascular resistance.
- the circulation state of the living body changes and the rotation speed corresponding to point t changes.
- an increase in the number of revolutions means that if the blood pressure is unchanged, the venous return has increased, and if the venous return has not changed, it means that the blood pressure has increased.
- the reason why the number of rotations decreases is that a phenomenon opposite to the above phenomenon has occurred. That is, since the change in the point t corresponds to the change in the circulatory state of the living body, the pump speed is controlled, for example, to always be at the point t or near the point t, thereby responding to the change in the living body. Thus, circulatory support that is sufficient for the living body can be realized.
- the vicinity of the point t means a range in which sufficient accuracy can be obtained practically for estimating a change in the circulatory state of the living body.
- the number of rotations means a range in which sufficient accuracy can be obtained practically for estimating a change in the circulatory state of the living body.
- performing control based on the point t is an example showing that control according to the circulatory state of a living body can be performed using the amplitude of the flow rate fluctuation, here the amplitude of the current consumption fluctuation of the motor.
- the control criteria can be selected according to the purpose.
- Point s is the point at which the pulsation of the pump blood flow due to sucking begins to become prominent . If there is no problem in the blood inflow part of the devascularization of the pump and suction is unlikely to occur, the magnitude of the current value fluctuation at or near the s point reflects the steady flow of the pump And it is almost 0. Therefore, by knowing the magnitude of the current amplitude at the point s, the problem of the blood inflow part of the blood removal vessel of the pump, specifically, poor blood removal due to displacement of the blood removal vessel, the occurrence of thrombus and other obstacles, Alternatively, problems such as remarkable decrease in circulating blood volume (dehydration and shock) can be found, so that blood circulatory assistance can be appropriately controlled.
- the control can be performed to a practically satisfactory level by knowing the magnitude of the amplitude of the current value fluctuation near the s point.
- the vicinity of the s point means a range where practically sufficient accuracy can be obtained for estimating a change in the circulatory state of a living body. I do.
- the term “almost zero” refers to the magnitude of the current amplitude in a range where the problem can be found at or near the s point and the blood circulation assist can be appropriately controlled.
- the point s or the vicinity of the point s is a point at which no remarkable sticking occurs and the pressure generated by the living heart is minimized. This means that the effect of reducing the burden on the heart is safe and maximized. Therefore, by controlling the number of rotations of the pump so that it is always at or near the s point, a safe and maximum burden reducing effect can be realized for the heart.
- Measurement parameters reflected on continuous flow blood pumps under the influence of biological pulsation All indicators based on overnight can be used to control the pump system.
- the magnitude of the pulsation amplitude is used as such a control index.
- a numerical value that is indexed based on the amplitude of the pulsation of the current value may be used.
- the difference between the amplitude of the current fluctuation of the pump motor divided by the average current value, and the difference between the current consumption during the opening and closing operation of the pump at the same rotation speed Theoretical maximum amplitude.
- “during open operation” refers to the case where the operation is performed with the conduit connected to the outlet of the pump being opened
- “during shut-off operation” refers to closing the conduit connected to the outlet of the pump. Refers to driving. Sensor>
- a special sensor such as a sensor for monitoring the properties of blood is not required. Detection of blood circulation can be done simply by measuring the flow rate. The flow rate may be measured directly using a flow rate sensor or by other indirect measuring means.
- the current consumption of the motor of the continuous flow blood pump is used. Since the current consumption becomes electric power by integrating the voltage, electric power may be used. The current consumption can be extracted as motor internal data, so there is no need to use a sensor, in which case the equipment is simplified, reliability and safety are improved, long-term durability is improved, costs are reduced, and the size is reduced. Can be achieved.
- a flow sensor such as an ultrasonic flowmeter is used as a direct flow measurement means. Even in such a case, since the sensor is a commonly used sensor, the configuration of the device is much easier than when a special sensor for monitoring the properties of blood is required. is there. ⁇ Type of pump, installation location of the pump and period of assistance by the pump
- the pump used in the present invention may be a continuous flow blood pump, and is not limited to a specific pump.
- the pump may be either external or internal, with a short or long period of assistance. There are no restrictions on the site of pump blood removal or blood transfer. There is no right heart support or left heart support.
- the flow rate detecting means is configured by obtaining an output corresponding to a flow rate by using a means for measuring a current consumption or a power consumption value of the continuous flow blood pump motor.
- a flow rate sensor is arranged in the vicinity of the continuous flow blood pump, and an output corresponding to the flow rate is obtained to constitute a flow rate detection means.
- a simple device can be configured without requiring a special sensor for monitoring the properties of blood.
- the flow rate amplitude detecting means is configured to detect a maximum value and a minimum value of the output of the flow rate detecting means at predetermined time intervals, and to output the maximum value and the minimum value.
- the flow amplitude detecting means is configured to detect a maximum value and a minimum value of the output of the flow detecting means at a predetermined time interval, and to output a flow amplitude which is a difference between the maximum value and the minimum value.
- detecting the average value of the output of the flow rate detecting means and the magnitude of the output fluctuation at a predetermined time interval and outputting an amplitude index value obtained by dividing the magnitude of the amplitude by the average value. It constitutes an amplitude detecting means.
- a blood circulation assisting device includes a display unit for displaying an output of the flow amplitude detecting unit, and a unit for manually operating and adjusting the rotation speed of the motor. Thereby, a simple device capable of easily performing appropriate blood circulation assist can be provided.
- a control means is provided for controlling the number of revolutions of the motor driven by the pump so that the magnitude of the flow amplitude falls within a predetermined range according to the output of the flow amplitude detection means.
- a control unit is provided for controlling the number of revolutions of a motor driving the pump so that the magnitude of the flow amplitude index is within a predetermined range according to the output of the flow amplitude detection unit.
- the means are configured as follows. That is, the rotation speed of the motor of the continuous flow blood pump is changed while the device is mounted on the living body, and based on the change in the output of the flow amplitude, the circulating assistance by the pump is changed from partial assistance to complete assistance. It is configured to detect a point t, which is a transition point, and to control the number of rotations of the motor so as to have a predetermined relationship with the number of rotations of the motor corresponding to the detected point t. Alternatively, the motor is controlled so that the number of rotations corresponds to the point t or the vicinity of the point t. With them, optimal operation according to the clinical state of the living body can be realized.
- the means are configured as follows. That is, the rotation speed of the motor is changed in a state where the device is attached to the living body, and based on the change in the output of the flow amplitude, the blood of the devascularized blood is changed.
- the point S which is a point at which the fluctuation of the flow rate amplitude starts to become remarkable when the liquid inlet starts to stick to the living body wall, is detected, and a predetermined number of rotations of the motor corresponding to the detected point S is detected.
- the rotation speed of the motor is controlled so as to have a relationship.
- the s point is similarly detected based on the flow rate amplitude index, and the rotation speed of the motor is controlled so as to have a predetermined relationship with the rotation speed of the motor corresponding to the detected s point.
- the motor is controlled so that the number of rotations corresponds to between the vicinity of the point t and the vicinity of the point s.
- the blood circulation assist is configured so that the magnitude of the flow rate amplitude at the point s is as low as possible and almost zero.
- the rotation speed of the motor is changed over a predetermined range, the rotation speed of the motor is controlled so that the relationship between the rotation speed of the motor and the current amplitude index has a negative correlation.
- the apparatus further comprises a blood circulation assisting device having the above configuration, the device is mounted on a living body, and the rotation speed of the motor of the continuous flow blood pump is changed. Detects the point t, which is the point at which the circulating assistance by the pump shifts from partial assistance to complete assistance, and based on the detected t point or the magnitude of the flow amplitude at or near the t point, the inflow of the blood inflow port
- a diagnostic device for a blood circulation condition is configured to detect a condition and / or a full state of the heart.
- a point t is detected, a change in the motor rotation speed corresponding to the detected t point or near the t point is detected, and a change in the circulation state of the living body is detected based on the change in the rotation speed.
- the diagnostic device is configured as described above.
- the rotational speed of the motor corresponding to the point t or the vicinity of the point t increases, if the blood pressure does not change, it is determined that the venous return has increased. In such a case, the system is configured to judge that the blood pressure has increased.
- the s point is detected in the same manner as described above using the blood flow assisting device having the above configuration, and based on the detected s point or the magnitude of the flow amplitude at or near the s point, the inflow into the blood inlet is determined.
- a diagnostic device for blood circulation status is configured to detect the condition and the state of Z or heart filling.
- the s point is detected in the same manner, the rotational speed at or near the detected s point is detected, and the change in the circulation state of the living body is diagnosed based on the change in the rotational speed. According to these, it is possible to realize a diagnostic device for preventing injuries caused by sticking from occurring.
- the blood circulation assisting method for assisting blood circulation by attaching the blood circulation assisting device having the above-described configuration to a living body can easily realize circulation assist suitable for the blood circulation state in the living body.
- the diagnostic apparatus of the above configuration is attached to a living body, and the circulating state of the blood flow in the living body can be easily diagnosed by the method of diagnosing the blood circulation state.
- FIG. 1 is a graph showing an example of the relationship between the number of rotations of a motor driving a pump and one index of each monitor.
- FIG. 2 (a) is a block diagram showing a blood circulation assisting device according to an embodiment of the present invention.
- (B) of the figure is a block diagram showing a blood circulation assisting device according to another embodiment of the present invention
- FIG. 3 is a diagram showing the relationship between the number of rotations at points t_p and t-i
- FIG. Fig. 5 shows the relationship between the pump flow rate at point t-i and the left ventricle dp Z dt.
- Fig. 5 shows the relationship between the pump flow rate at point t-i and the left ventricular end-diastolic pressure.
- FIG. 6 is a diagram showing the relationship between the pump flow rate and the systolic aortic pressure at point t-i.
- the suction port of the pump 1 is connected to the blood removal vessel 2, and the discharge port is connected to the blood supply vessel 3.
- the free end of the blood removal vessel 2 is attached to the blood removal site of the living body, and the free end of the blood supply vessel 3 is attached to the blood transmission site.
- Pump 1 is driven by motor 4.
- the motor 4 is connected to a power source 6 via a control unit 5.
- the current measuring unit 7 is connected to measure the current consumption flowing through the motor 4.
- the output of the current measuring unit 7 is applied to the amplitude detecting unit 8.
- the amplitude detecting section 8 detects the amplitude of the current value fluctuation from the output of the current measuring section 7 and outputs it to the control section 5.
- the control unit 5 controls the rotation speed of the motor 4 based on the output of the amplitude detection unit 8.
- the current measurement unit 7 samples the current waveform at, for example, 120 Hz for 3 seconds and outputs AZD-converted data.
- the amplitude detector 8 calculates the maximum value and the minimum value using the data, and obtains the difference between them to obtain the amplitude of the current fluctuation.
- the value of the current flowing through the motor 4 detected by the current measuring unit 7 corresponds to the ejection flow rate of the pump 1. Therefore, the output of the amplitude detector 8 is The magnitude of the current amplitude index ultimately corresponds to the magnitude of the flow amplitude. That is, it will be apparent that the current measuring section 7 constitutes a flow rate detecting means and the amplitude detecting section 8 constitutes a flow rate amplitude detecting means.
- the amplitude detection unit 8 is not the value of the amplitude of the current fluctuation, but the current. It is desirable to obtain a current amplitude index, which is a value obtained by dividing the magnitude of the fluctuation amplitude by the current average value at that time, and output the value.
- the current measurement unit 7 sets a time for the measurement at least so as to be able to detect the amplitude of the flow rate fluctuation caused by the interval of the heart beat of the living body.
- the control by the control unit 5 is performed, for example, as follows.
- the rotation speed of the motor 4 is changed, and the t point or the s point is identified using the current amplitude index output from the amplitude detection unit 8.
- the motor can be controlled based on the rotation speed corresponding to the identified t point or s point. For example, control is performed so as to maintain the rotation speed near the point t.
- the identification of the t point or the s point is performed based on the characteristics shown in the graph shown in FIG. As shown in the figure, between points t and s, the current amplitude index stabilizes and drops to the right. In other words, the relationship between the motor speed and the current amplitude index has a negative correlation. Therefore, at fixed time intervals, the rotation speed of the motor 4 is forcibly changed over a sufficient rotation speed range, and if the above correlation is detected to be positive or negative, the rotation speed of the motor 4 becomes t and s. It can be easily detected whether or not the rotation speed is within the range between the points.
- the sufficient rotation speed range means that it is enough to exclude a temporary rise and fall of the current amplitude index, which appears at a rotation speed higher than the point s shown in Fig. 1, and is clinically appropriate. You only have to decide. Thus, the relationship between the motor speed and the current amplitude index is negative.
- the start of the rotational speed range that is correlated is detected, and the start point is identified as point t. Similarly, for the S point, the end of the same rotational speed range can be detected, and that point can be identified as the S point.
- Such processing can be easily realized by a computer if the output of the amplitude detection unit 8 is digitized as described above.
- the above knowledge that is, the rotation speed of the motor 4 is between the point t and the point s
- control utilizing the fact that the relationship between the rotational speed of the motor and the current amplitude index has a negative correlation is also effective. That is, the rotation speed of the motor 4 is forcibly changed for a certain period of time, the state of the correlation is detected, and the rotation speed of the motor 4 is controlled so that the correlation becomes negative. If no negative correlation is obtained in one operation, drive motor 4 again in a different speed range. With such control, the motor can be easily controlled so that the number of rotations is between the points t and s without actually detecting the points t and s.
- the rotation speed may be changed by increasing or decreasing the rotation speed of the motor 4 within a predetermined range.
- the timing of the detection of the t point or the s point as described above, or the detection of whether or not the rotation speed of the motor is in a desired range, may be appropriately determined according to the clinical situation.
- the current measuring unit 7 is used as a means for measuring the ejection flow rate by the pump 1 and a value corresponding to the flow rate is obtained from the current value, but the flow rate is directly measured using the flow rate sensor. It may be measured.
- a configuration is also possible in which an ultrasonic flowmeter is attached to the blood feeding tube 3 and the output is processed by the amplitude detector 8.
- the amplitude detection unit 8 serving as the flow amplitude detection means only needs to output the magnitude of the amplitude of the output fluctuation of the flow sensor, and it is necessary to convert the current value of the motor 4 into an index as in the above-described case. There is no. If the input signal from the current measurement unit 7 is digitized as described above, analysis, diagnosis, and control can be easily automated using a computer program.
- the configurations of the pump 1, the blood removal vessel 2, the blood supply vessel 3, the motor 4, the current measuring section 7, and the amplitude detecting section 8 are the same as those in the above-described embodiment, and therefore, the description is omitted. I do.
- the motor 4 is connected to the power supply 6 via the adjustment unit 9.
- the output of the amplitude detector 8 is applied to the display 10. That is, information indicating the amplitude of the detected current fluctuation is visually provided by the display unit 10. Based on the information, the operator can operate the adjustment unit 9 to adjust the operation of the motor 4 to an appropriate state.
- the information displayed on the display unit 10 can take various forms. For example, a numerical value representing the magnitude of the current amplitude, a maximum value and a minimum value of the amplitude, a current amplitude index value, and the like can be used. Alternatively, the waveform may indicate a change in the current amplitude or the current amplitude index.
- the device of the present embodiment When the device of the present embodiment is used, it is possible to display a change waveform of the current amplitude on the display unit 10 and visually identify the point t or the point s.
- diagnosis and control manually it is effective to equip the device with a function that indicates when the current drive of the pump is near point t-i or near point s. It is.
- These analysis, diagnosis, and control systems can be miniaturized and simplified by incorporating them into the motor controller, but they may be separate devices.
- Such a device can be used for both short-term and long-term assistance.
- Such a device can be installed outside the body or can be implanted inside the body.
- a device for diagnosing the state of blood circulation in a living body can be configured using the device of the above embodiment.
- Fig. 1 shows an example of the relationship between the rotation speed and one index of each monitor.
- the amplitude also tends to increase. Therefore, in order to clarify the change in the amplitude, the value obtained by dividing the amplitude by the current average value at that time was used as an index as the current amplitude index.
- the points identified from systolic arterial pressure and systolic left ventricular pressure are identified by t
- point t-i The point identified from point P and the current amplitude index is defined as point t-i. As is evident from Fig. 1, the current amplitude exponent peaked at t is minimum at point s. Both t-i point and s point are unique points, and identification is easy.
- the current waveform becomes a distorted waveform peculiar to sticking, and the current amplitude index increases again.
- the number of rotations at the point t 1 i was 280 000 rpm, and the number of rotations at the point s was 360 000 rpm. Focusing on the systolic arterial pressure and the systolic left ventricular pressure, as the rotational speed increases, the systolic arterial pressure and the systolic left ventricular pressure coincide until the point t_p, but after the point t-p And the systolic left ventricular pressure decreases. In this condition, the aortic valve does not open and no blood is pumped from the left ventricle to the aorta. This means that the pump has shifted from partial assistance to full assistance.
- the cardiac output before wearing the pump in this experiment was 0.92 L Zmi. Since the pump blood flow at the point ti in the graph of FIG. 1 is 1.1 L / min, the flow almost coincides with the venous return at the point ti. t From point i to point s, the pump blood flow is increasing, but considering that the arterial pressure has not increased, it is not an effective increase in blood flow to the living body, but rather a regurgitation at the aortic valve. It is thought to reflect an invalid increase in blood flow. from point s At high rpm, pump blood flow does not increase due to significant suction.
- the identification of the points t and S is possible by actively changing the rotation speed of the pump and automatically obtaining the relationship between the rotation speed and the current amplitude index using a computer.
- the operation of changing the rotation speed may be performed all the time, intermittently, or when any abnormality is detected.
- Eight beagle dogs were prepared for heart failure with temporary coronary artery blockade and tested for fluid infusion.
- the central and peripheral branches of the anterior descending coronary artery and the main branch of the circumflex branch (usually the blunt branch) were released after a total of 30 minutes of interruption.
- cardiac support was performed with a pump for 120 minutes, and finally, low-molecular-weight dextran (500 Om1) was rapidly infused to perform an infusion load.
- 30 minutes, 60 minutes, 90 minutes, 120 minutes, and a total of 7 rotations after infusion load were temporarily and continuously changed, and the t and s points were identified. The test was performed. Statistical processing was performed for the measurement of the identification test at t and s points for a total of 52 times.
- the dp / dt is obtained by differentiating the pressure change with time, shows the pressure change with time, and is a clinical index of the systolic force.
- the pump flow rate at point t-i is the left ventricular end diastolic pressure
- the pump flow at the point t-i is determined by the preload of the left ventricle (indicating the amount of blood returning to the heart), and is considered to be independent of the contractile force and the afterload of the left ventricle. This is impossible in terms of pumping out the amount of blood present in the heart, and without waste, it is close to controlling a natural heart or a pulsatile total artificial heart.
- a continuous flow blood pump can be controlled to the optimal state according to the blood circulation state of a living body. Therefore, no special sensor is required, and optimal blood circulation support can be realized with a simple device. Further, according to the present invention, it is possible to easily diagnose the circulation state of the living body itself.
Description
Claims
Priority Applications (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US09/582,465 US6572530B1 (en) | 1997-12-27 | 1998-12-24 | Blood circulation auxiliary device using continuous blood flow pump and diagnosis device for blood circulation state in organism |
EP98961572A EP1046403B1 (en) | 1997-12-27 | 1998-12-24 | Blood circulation auxiliary device using continuous blood flow pump |
JP53480799A JP3534419B2 (ja) | 1997-12-27 | 1998-12-24 | 連続流血液ポンプを用いた血流循環補助装置および生体の血流循環状態の診断装置 |
DE69842053T DE69842053D1 (de) | 1997-12-27 | 1998-12-24 | Blutzirkulationshilfsvorrichtung mit einer kontinuierlichen blutflusspumpe |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP9/367523 | 1997-12-27 | ||
JP36752397 | 1997-12-27 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO1999033502A1 true WO1999033502A1 (fr) | 1999-07-08 |
Family
ID=18489527
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/JP1998/005928 WO1999033502A1 (fr) | 1997-12-27 | 1998-12-24 | Appareil auxiliaire de circulation sanguine utilisant une pompe a flux sanguin continu et dispositif de diagnostic des conditions de la circulation sanguine dans l'organisme |
Country Status (6)
Country | Link |
---|---|
US (1) | US6572530B1 (ja) |
EP (1) | EP1046403B1 (ja) |
JP (1) | JP3534419B2 (ja) |
CN (1) | CN1168507C (ja) |
DE (1) | DE69842053D1 (ja) |
WO (1) | WO1999033502A1 (ja) |
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- 1998-12-24 WO PCT/JP1998/005928 patent/WO1999033502A1/ja active Application Filing
- 1998-12-24 CN CNB988138085A patent/CN1168507C/zh not_active Expired - Fee Related
- 1998-12-24 DE DE69842053T patent/DE69842053D1/de not_active Expired - Lifetime
- 1998-12-24 EP EP98961572A patent/EP1046403B1/en not_active Expired - Lifetime
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Cited By (7)
Publication number | Priority date | Publication date | Assignee | Title |
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JP2004501678A (ja) * | 2000-03-27 | 2004-01-22 | ザ・クリーブランド・クリニック・ファンデーション | ターボ形血液ポンプ用長期性能制御システム |
JP2002224066A (ja) * | 2001-02-01 | 2002-08-13 | Univ Nihon | 心機能評価装置 |
JP4674978B2 (ja) * | 2001-02-01 | 2011-04-20 | Cyberdyne株式会社 | 心機能評価装置 |
JP2006304836A (ja) * | 2005-04-26 | 2006-11-09 | Toray Medical Co Ltd | 脱血圧測定システムおよび方法 |
JP4589798B2 (ja) * | 2005-04-26 | 2010-12-01 | 東レ・メディカル株式会社 | 脱血圧測定システム |
JP2008279048A (ja) * | 2007-05-10 | 2008-11-20 | Tokyo Medical & Dental Univ | 心機能変化評価装置 |
WO2008140034A1 (ja) * | 2007-05-10 | 2008-11-20 | National University Corporation Tokyo Medical And Dental University | 心機能変化評価装置 |
Also Published As
Publication number | Publication date |
---|---|
CN1168507C (zh) | 2004-09-29 |
EP1046403A4 (en) | 2001-01-17 |
EP1046403A1 (en) | 2000-10-25 |
DE69842053D1 (de) | 2011-01-27 |
EP1046403B1 (en) | 2010-12-15 |
US6572530B1 (en) | 2003-06-03 |
JP3534419B2 (ja) | 2004-06-07 |
CN1290183A (zh) | 2001-04-04 |
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