WO2017002889A1 - Dispositif de purification du sang et procédé pour l'amorcer - Google Patents

Dispositif de purification du sang et procédé pour l'amorcer Download PDF

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Publication number
WO2017002889A1
WO2017002889A1 PCT/JP2016/069363 JP2016069363W WO2017002889A1 WO 2017002889 A1 WO2017002889 A1 WO 2017002889A1 JP 2016069363 W JP2016069363 W JP 2016069363W WO 2017002889 A1 WO2017002889 A1 WO 2017002889A1
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Prior art keywords
blood
dialysate
circuit
air trap
trap chamber
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PCT/JP2016/069363
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English (en)
Japanese (ja)
Inventor
拓 二階堂
洋一 鴨下
将太 中村
Original Assignee
ニプロ株式会社
拓 二階堂
洋一 鴨下
将太 中村
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Application filed by ニプロ株式会社, 拓 二階堂, 洋一 鴨下, 将太 中村 filed Critical ニプロ株式会社
Priority to JP2017526416A priority Critical patent/JPWO2017002889A1/ja
Publication of WO2017002889A1 publication Critical patent/WO2017002889A1/fr

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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
    • 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

Definitions

  • the present disclosure relates to a blood purification apparatus and a priming method thereof, and more particularly, to a blood purification apparatus blood having an air trap chamber on a blood path, and a priming method of such a blood purification apparatus.
  • the priming is, for example, flowing an electrolyte solution (for example, fresh dialysate) into a circuit including a blood circuit in the blood purification device before starting dialysis to clean and fill the circuit.
  • an electrolyte solution for example, fresh dialysate
  • Patent Document 1 An example of a priming method in a conventional blood purification apparatus is described in Japanese Patent Application Laid-Open No. 2004-313522 (Patent Document 1).
  • a priming operation dialysate is caused to flow through a circuit including an air trap chamber.
  • the operation of the pump for flowing the dialysate (blood pump) is determined by a program.
  • the air trap chamber is provided in order to reliably prevent air from being mixed into the blood during dialysis.
  • the liquid level in the air trap chamber is adjusted by the cooperation of a blood pump and a deaeration pump provided in the air trap chamber.
  • the members constituting the circuit are usually disposable. For this reason, in the blood purification apparatus, every time a dialysis treatment is performed, at least some of the members are replaced. For this reason, the volume of the circuit may differ every time the dialysis process is executed due to individual differences of members. For this reason, in the conventional blood purification apparatus, in the priming performed before each dialysis treatment, an operator such as a clinical engineer visually confirms the dialysate for final adjustment of the liquid level of the air trap chamber. It was necessary to fine tune the flow rate of
  • the present disclosure has been devised in view of such circumstances, and an object thereof is to reduce a burden on an operator for liquid level adjustment in an air trap chamber during priming of a blood purification apparatus.
  • a blood purifier an arterial blood circuit for flowing blood into the blood purifier, a venous blood circuit for flowing blood from the blood purifier, and an arterial blood circuit
  • a blood pump provided to send blood in the blood, a dialysate supply circuit for supplying dialysate to the blood purifier, a dialysate discharge circuit for discharging dialysate from the blood purifier, and an artery
  • An arterial air trap chamber provided in the side blood circuit, a venous air trap chamber provided in the venous side blood circuit, a connector provided downstream of the venous air trap chamber in the venous side blood circuit, and a dialysate supply circuit
  • a blood purification device is provided that includes a connection portion for connecting a connector to the dialysate discharge circuit.
  • the connector is provided at the downstream end of the venous blood circuit.
  • the blood purification apparatus further includes a connection line for connecting the dialysate supply circuit or the dialysate discharge circuit to at least one of the arterial air trap chamber and the venous air trap chamber, and the connection line is included in the connection line.
  • a switching unit that switches between blocking and opening the flow of dialysate, and the connection unit connects a dialysate supply circuit or a dialysate discharge circuit to the connector via a connection line.
  • the blood purification apparatus further includes a replacement fluid pump for sending dialysate to at least one of the arterial air trap chamber and the venous air trap chamber in the dialysis treatment.
  • the blood purification apparatus further includes a member for connecting the arterial blood circuit to the dialysate supply circuit or the dialysate discharge circuit, and the member is connected to the dialysate in the dialysate supply circuit or the dialysate discharge circuit.
  • the supply circuit or the dialysate discharge circuit is provided on the downstream side of the position where the connection portion is connected to the connector.
  • a blood purifier an arterial blood circuit for flowing blood into the blood purifier, a venous blood circuit for flowing blood from the blood purifier, and an arterial blood circuit
  • a priming method for a blood purification apparatus comprising: a blood pump provided for feeding blood in the blood; an arterial air trap chamber provided in an arterial blood circuit; and a venous air trap chamber provided in a venous blood circuit Is provided.
  • the priming method includes the step of sending dialysate to the arterial blood circuit and the venous blood circuit in a direction opposite to the direction in which the blood pump sends blood in the arterial blood circuit.
  • the blood purification device includes a replacement fluid circuit for supplying dialysate to at least one of the arterial air trap chamber and the venous air trap chamber, and at least one of the arterial air trap chamber and the venous air trap chamber in the dialysis process in the blood purification device.
  • a replacement fluid pump for sending the dialysate to one side is further provided, and the replacement fluid pump further includes a step of sending the dialysate to the replacement fluid circuit.
  • the dialysate supplied to the dialysate supply circuit or the dialysate discharge circuit passes through the connector to the venous blood circuit including the venous air trap chamber, the hemodialyzer, and the arterial air trap chamber. It may be supplied in the order of the arterial blood circuit. That is, the dialysate can flow in the direction opposite to the blood flow in the dialysis treatment. When the dialysate flows backward in the venous air trap chamber and the arterial air trap chamber, the level of the dialysate is maintained at such a level that no gas is mixed into the dialysate.
  • the liquid level in the air trap chamber can be adjusted without requiring fine adjustment by the operator during priming.
  • FIG. 1 shows the structure of an example of the blood purification apparatus containing 1st Embodiment of a dialysis apparatus. It is a figure which shows a state when priming is performed in the blood purification apparatus of FIG. It is a figure for demonstrating the priming method of the blood purification apparatus. It is a figure for demonstrating the priming method of the blood purification apparatus. It is a figure for demonstrating the priming method of the blood purification apparatus. It is a figure for demonstrating the priming method of the blood purification apparatus. It is a figure for demonstrating the priming method of the blood purification apparatus. It is a figure for demonstrating the priming method of the blood purification apparatus. It is a figure for demonstrating the adjustment aspect of the liquid level of the dialysate in a vein side air trap chamber.
  • FIG. 1 It is a figure which shows the modification of the structure of the air trap chamber in a blood purification apparatus. It is a figure which shows typically the supply aspect of the dialysate by priming in the trap chamber shown by FIG. It is a figure which shows an example of the blood purification apparatus of 2nd Embodiment. It is a figure for demonstrating washing
  • FIG. 1 is a diagram showing a configuration of an example of a blood purification apparatus including the first embodiment of a dialysis apparatus.
  • the blood purification apparatus according to the first embodiment is an example of a so-called online HDF (Hemo Dialysis Filtration) dialysis apparatus.
  • the configuration of the blood purification apparatus will be described with reference to FIG. FIG. 1 shows a state where the blood purification apparatus is used for dialysis treatment.
  • Blood purification apparatus 900 includes a dialysis unit having hemodialyzer 30 and dialysis apparatus 60.
  • the hemodialyzer 30 includes, for example, a semipermeable membrane made of a hollow fiber membrane.
  • the dialysis unit further includes a blood circuit BC having an upstream blood line BC1 and a downstream blood line BC2, a dialysate circuit DC having an upstream dialysate line DC1 and a downstream dialysate line DC2, and a replacement fluid circuit SC1.
  • a blood circuit BC having an upstream blood line BC1 and a downstream blood line BC2
  • a dialysate circuit DC having an upstream dialysate line DC1 and a downstream dialysate line DC2
  • SC1 replacement fluid circuit
  • FIG. 1 shows a state when the blood purification apparatus 900 is used for dialysis treatment.
  • the injection needle NU1 is connected to the connector CNA.
  • the injection needle NU1 is punctured into the shunt of the patient's arm AR.
  • upstream and downstream are based on the direction in which blood or dialysate should flow during dialysis.
  • a connector CNV which is an example of the “connector” of the present disclosure, is provided at the other end of the downstream blood line BC2.
  • the injection needle NU2 is connected to the connector CNV.
  • the injection needle NU2 is punctured into the vein of the patient's arm AR.
  • the blood circuit BC is provided with a blood pump 23 for sending blood, an artery-side air trap chamber 41, and a vein-side air trap chamber 42.
  • the blood of the patient P1 is introduced from the artery into the hemodialyzer 30 via the artery-side air trap chamber 41 by the blood pump 23, and then the vein is passed through the vein-side air trap chamber 42.
  • the arrow D01 indicates the liquid feeding direction of the blood pump 23.
  • Arrows R01 and R03 indicate the direction of blood flow in the dialysis treatment.
  • Each of the arterial air trap chamber 41 and the venous air trap chamber 42 may be provided with a pressure measuring device for measuring the pressure of blood taken from the patient and on the blood circuit BC.
  • the upstream dialysate line DC1 is connected to the dialysate inlet DF1 of the hemodialyzer 30.
  • the other end of the upstream dialysate line DC1 is connected to the dialyzer 60.
  • the dialysis device 60 includes a container that stores the dialysis fluid and a pump (dialysis fluid pump) that sends the dialysis fluid.
  • the dialyzer 60 introduces fresh dialysate into the dialysate inlet DF1 by driving the dialysate pump.
  • One end of the downstream dialysate line DC2 is connected to the dialysate outlet DF2 of the hemodialyzer 30.
  • the other end of the downstream dialysate line DC2 is connected to the dialyzer 60.
  • the dialysate after being used in the dialysis treatment is discharged from the dialysate outlet DF2 to the dialyzer 60.
  • arrow R04 indicates the direction in which the dialysate flows.
  • the dialyzer 60 further supplies (injects) fresh dialysate to the artery side air trap chamber 41 via the replacement fluid circuit SC1.
  • fresh dialysate as an example of a replacement fluid is supplied to the blood of the patient.
  • the replacement fluid circuit SC1 is connected to the replacement fluid pump 25 via a connection line SCA.
  • the dialysis machine 60 includes the dialysate pump described above. Further, on the replacement fluid circuit SC1, a replacement fluid pump 25 for sending the dialysate from the dialyzer 60 to the artery-side air trap chamber 41 is provided. An arrow D02 in FIG. 1 indicates the liquid feeding direction of the replacement fluid pump 25.
  • the operations of the dialysate pump and the replacement fluid pump 25 in the dialysis treatment are the amount of dialysate sent to the hemodialyzer 30 through the upstream dialysate line DC1 and the dialysate sent to the arterial air trap chamber 41 through the replacement fluid circuit SC1.
  • the sum of the amount of (replacement fluid) is controlled to be equal to the amount of dialysate returned to the dialyzer 60 through the downstream dialysate line DC2.
  • water removal When water removal is set, the amount of dialysate sent to the hemodialyzer 30 through the upstream dialysate line DC1 and dialysate (supplement) sent to the arterial air trap chamber 41 through the replacement fluid circuit SC. And the water removal set amount are controlled to be equal to the amount of dialysate returned to the dialyzer 60 through the downstream dialysate line DC2.
  • the connecting line SCA replaces the replacement fluid circuit SC1 and the venous air trap chamber. 42 is connected.
  • the operation of the dialysate pump and the replacement fluid pump 25 in the dialysis treatment is performed by the amount of dialysate sent to the hemodialyzer 30 through the upstream dialysate line DC1 and the venous air trap through the replacement fluid circuit SC1.
  • the sum of the amount of dialysate (replacement fluid) sent to the chamber 42 is controlled to be equal to the amount of dialysate returned to the dialyzer 60 through the downstream dialysate line DC2.
  • a connection line SCA connects the replacement fluid circuit SC1 to both the arterial air trap chamber 41 and the venous air trap chamber 42.
  • the operation of the dialysate pump and the replacement fluid pump 25 in the dialysis treatment is performed by the amount of dialysate sent to the hemodialyzer 30 through the upstream dialysate line DC1 and the arterial air trap through the replacement fluid circuit SC1.
  • the sum of the amount of dialysate (replacement fluid) sent to chamber 41 and venous air trap chamber 42 is controlled to be equal to the amount of dialysate returned to dialyzer 60 through downstream dialysate line DC2. .
  • the sum of the amount of dialysate (replacement fluid) to be sent and the water removal set amount is controlled to be equal to the amount of dialysate returned to the dialyzer 60 through the downstream dialysate line DC2.
  • the blood purification apparatus 900 of the present embodiment further includes a replacement fluid line SCB for sending dialysate to the upstream blood line BC1 during priming.
  • a replacement fluid line SCB for sending dialysate to the upstream blood line BC1 during priming.
  • the replacement fluid line SCB is connected to the upstream blood line BC1 via the connection line SCC.
  • One end of the replacement fluid line SCB is connected to the replacement fluid circuit SC1.
  • a connector CND is provided at the other end of the replacement fluid line SCB.
  • the connector CDN is closed with a cap CP.
  • the configuration in which the connector CDN is provided at the other end of the replacement fluid line SCB is an example of a blood purification device.
  • the configuration of the blood purification apparatus is not limited to that shown in FIG.
  • a mixed injection port or a three-way stopcock may be provided between the replacement fluid line SCB and the connection line SCC.
  • the replacement fluid line SCB may not be connected to the replacement fluid circuit SC1, and the replacement fluid line SCB and the replacement fluid circuit SC1 may be connected to the dialysate line DC1, respectively.
  • the circuit of the blood purification apparatus 900 is provided with a plurality of valves for adjusting the flow of the dialysate. Specifically, a valve VA1 and a valve VA2 are provided on the upstream dialysate line DC1. The valve VA1 is provided upstream from the branch point to the replacement fluid circuit SC1, and the valve VA2 is provided downstream from the branch point. A valve VA3 is provided on the downstream dialysate line DC2.
  • a valve VA4 is provided on the downstream side of the venous air trap chamber 42 on the downstream blood line BC2.
  • a valve VA5 is provided on the upstream blood line BC1 downstream of the branch point to the connection line SCC.
  • a valve VA6 is provided on the connection line SCC.
  • each description mode of the valves VA1 to VA6 represents an open / close state of each valve. More specifically, in FIG. 1, the valve VA6 is filled, but the valves VA1 to VA5 are not filled. Being filled indicates that the valve is closed. Not being filled indicates that the valve is open. That is, FIG. 1 shows that in the dialysis process, the valve VA6 is closed and the valves VA1 to VA5 are opened.
  • FIG. 2 is a diagram showing a state when priming is executed in the blood purification apparatus of FIG.
  • the connector CNV provided at the end of the downstream blood line BC2 is connected to the connector CND provided at the end of the replacement fluid line SCB.
  • the connector CNA provided at the end of the upstream blood line BC1 is attached to the drainage port P0.
  • the connector CNA does not need to be attached to the drainage port, and may be in a state where the drainage can be discharged, such as being inserted into or fixed to a drainage bottle or a priming cup. Thereafter, the drainage port P0 does not prevent the drainage bottle or the priming cup from being replaced.
  • FIG. 3 to 7 are diagrams for explaining the priming method of blood purification apparatus 900.
  • FIG. The priming includes five stages represented by the following (1) to (5).
  • the processor executes, for example, a program stored in a recording medium that is mounted on the dialysis apparatus 60 or detachable from the dialysis apparatus 60.
  • the operation of each part of the blood purification apparatus 900 is controlled.
  • the valves VA1, VA5, and VA6 are opened, and the valves VA2, VA3, and VA4 are closed.
  • the dialysate pump of the dialyzer 60 sends dialysate
  • the blood purification device 900 sends the dialysate as shown by arrows R11, R12, R13, R14, R15, and R16.
  • the dialysate flows from the upstream dialysate line DC1 into the upstream blood line BC1 via the replacement fluid circuit SC1 and the replacement fluid line SCB.
  • the dialysate that has reached the upstream blood line BC1 is discharged from the drainage port P0 via the upstream side of the branch point with the connection line SCC in the upstream blood line BC1.
  • the replacement fluid circuit SC1 and the replacement fluid line SCB are filled with the dialysate.
  • FIG. 3 to FIG. 7 the portions filled with the dialysate at each stage are shown hatched.
  • the valves VA1, VA5 are opened, and the valves VA2, VA3, VA4, and VA6 are closed.
  • the blood purification apparatus 900 sends the dialysate as indicated by arrows R21 to R27.
  • the arrow D21 indicates the liquid feeding direction of the replacement fluid pump 25.
  • the dialysate is filled in the replacement fluid circuit SC1 and the connection line SCA.
  • An air pump (not shown) that sucks air in each chamber in association with each of the arterial air trap chamber 41 and the venous air trap chamber 42 so that the liquid level in each chamber can be adjusted. Is provided. Therefore, instead of operating the blood pump 23 with the VA5 open, the dialysate pump and the replacement fluid pump 25 send dialysate with only the valve VA1 open, and the air pump is connected to the arterial air trap chamber.
  • the dialysate may be supplied to the replacement fluid circuit SC1 and the connection line SCA by sucking the air in 41.
  • the dialysate pump and the replacement fluid pump 25 send dialysate with only the valve VA1 being opened, and the air pump is used for venous air By sucking the air in the trap chamber 42, the dialysate may be supplied to the replacement fluid circuit SC1 and the connection line SCA.
  • FIGS. 4 to 7 the portion filled with the dialysate in the previous stage is shown in a solid color, and the portion filled with the dialysate in that stage is hatched.
  • the replacement fluid line SCB which has already been filled with dialysate as described with reference to FIG. 3 is shown filled.
  • the replacement fluid circuit SC1 and the connection line SCA filled with the dialysate at the stage shown in FIG. 4 are shown hatched.
  • valves VA1, VA4, and VA5 are opened, and the valves VA2, VA3, and VA6 are closed.
  • An arrow D31 indicates the liquid feeding direction of the blood pump 23.
  • the liquid feeding direction indicated by the arrow D31 is opposite to the liquid feeding direction in the dialysis process shown in FIG.
  • the blood purification apparatus 900 sends the dialysate as indicated by arrows R31 to R39.
  • the dialysate is sent to the downstream blood line BC2 via the upstream dialysate line DC1, the replacement fluid circuit SC1, the replacement fluid line SCB, and the connector CND (arrows R31 to R34).
  • the dialysate sent to the downstream blood line BC2 is sent to the lower end of the venous air trap chamber 42 (arrows R35, R36).
  • the dialysate outlet of the hemodialyzer 30 is passed through an inlet (an inlet 42A in FIG. 8 described later). It is sent to BF2 (arrow R37).
  • the dialysate sent to the dialysate outlet BF2 travels upward in the hemodialyzer 30 and is then sent to the lower end of the artery-side air trap chamber 41 via the dialysate inlet BF1.
  • the dialysate is supplied (filled) upward from its lower end, and then flows back through the upstream blood line BC1 through the outlet (arrow R38). Thereafter, the dialysate is discharged through the drain port P0 (arrow R39).
  • the hemodialyzer 30 (mainly the portion through which blood passes) and the blood circuit BC (upstream blood line BC1 and downstream blood line BC2).
  • the dialysate is supplied (filled).
  • the arterial air trap chamber 41 and the venous air trap chamber 42 are supplied with dialysate from their lower ends.
  • the liquid level of the dialysate in the arterial air trap chamber 41 and the venous air trap chamber 42 is maintained at the height of each inlet (an inlet 42A in FIG. 8 described later). That is, when the dialysate is supplied so as to flow backward in the blood circuit BC, the liquid level is automatically set to an appropriate position (the inlet is provided in the artery side air trap chamber 41 and the vein side air trap chamber 42). Height).
  • the liquid level adjustment mode in the arterial air trap chamber 41 and the venous air trap chamber 42 will be described in more detail with reference to FIG.
  • Dialysate circulation ( Figure 6)
  • dialysate is circulated in the blood circuit BC (upstream blood line BC1 and downstream blood line BC2). More specifically, at this stage, valves VA4 and VA6 are opened, and valves VA1, VA2, VA3, and VA5 are closed.
  • An arrow D41 indicates a liquid feeding direction by the blood pump 23. The liquid feeding direction indicated by arrow D41 is the same as the liquid feeding direction in the dialysis treatment indicated by arrow D01 in FIG.
  • the dialysate When the blood pump 23 sends the dialysate, the dialysate is circulated in the blood purification apparatus 900 in the upstream blood line BC1, the hemodialyzer 30, the downstream blood line BC2, and the replacement fluid line SCC.
  • the flow of dialysate is indicated by arrows R41 to R47.
  • the gas purge shown in FIG. 7 may be executed before the filling of the dialysate in the washing and filling of the replacement fluid line shown in FIG. 3, or may be executed simultaneously with the filling of the replacement fluid line. .
  • the simultaneous execution is preferable because the process (time required for priming) can be shortened.
  • FIG. 8 is a view for explaining a mode of supplying dialysate to the venous air trap chamber 42 (mode for adjusting the level of dialysate).
  • FIG. 8 shows three states 11 to 13 of the venous air trap chamber 42. In states 11 to 13, the liquid level SL indicates the liquid level of the dialysate in the venous air trap chamber. In FIG. 8, the state which looked at the inside of the vein side air trap chamber 42 from the side is shown typically.
  • the venous air trap chamber 42 is provided with an inlet 42A into which blood is introduced in the dialysis process at the upper part thereof, and an outlet 42B for delivering blood in the dialysis process at the lower end thereof.
  • the outlet 42B may be provided with a filter for removing the coagulated mass.
  • the dialysis fluid is supplied to the venous air trap chamber 42 in the order of state 11, state 12, and state 13.
  • the dialysate is discharged through the inlet 42A as indicated by the arrow F1 after the liquid level reaches the height of the inlet 42A.
  • the liquid level in the venous air trap chamber 42 is maintained at the height of the inlet 42A.
  • the artery side air trap chamber 41 has the same structure as the vein side air trap chamber 42. That is, the artery side air trap chamber 41 has an inlet and an outlet corresponding to the inlet 42A and the outlet 42B of the vein side air trap chamber 42. In the arterial air trap chamber 41 as well, the dialysis fluid level is maintained at the height of the inlet during priming.
  • the replacement fluid line SCB used for priming constitutes at least a part of the connection line.
  • the valve VA6 is an example of a switching unit.
  • the switching unit is connected to the arterial air trap chamber or the venous air trap chamber when dialysate is supplied to at least one of the arterial air trap chamber and the venous air trap chamber via the connection unit (CND) and the dialysate supply line. Between the two parts.
  • FIG. 9 is a view showing a modified example of the structure of the air trap chamber in the blood purification apparatus 900.
  • the air trap chamber 420 includes a main body 421 having a substantially cylindrical shape, an upper tube 422, and an outlet 423.
  • the upper tube 422 is constituted by, for example, a tube having a diameter smaller than that of the main body 421 and penetrates the upper portion of the main body 421.
  • blood is introduced from the upper tube 422 into the main body 421 in the air trap chamber 420, and the blood flows out from the main body 421 through the outlet 423.
  • FIG. 10 is a diagram schematically showing a mode of supplying dialysate to the trap chamber shown in FIG. 9 in priming.
  • three states 21-23 for the air trap chamber 420 are shown.
  • the liquid level SL indicates the liquid level of the dialysate in the air trap chamber 420.
  • the air trap chamber 420 is filled with dialysate in the order of state 21, state 22, and state 23. That is, in priming, in the air trap chamber 420, the dialysate is discharged through the upper tube 422 as indicated by the arrow F2 after the liquid level reaches the height of the lower end of the upper tube 422. Thereby, in priming, the liquid level in the air trap chamber 420 is maintained at the height of the lower end of the upper pipe 422.
  • ⁇ ⁇ Simplification of the priming operation can be cited as an incidental effect caused by the backflow of dialysate.
  • the dialyzer is installed so that the dialysate inflow side (dialysate inlet DF1) is positioned below the outflow side (dialysate outlet DF2) in order to promote the removal of bubbles in the dialyzer.
  • dialysate inlet DF1 dialysate inlet DF1
  • dialysate outlet DF2 outflow side
  • the circuit of the solution is performed by connecting the connector CNA and the connector CNV directly or via parts such as a Y-shaped connector.
  • the operator may have both hands blocked by holding the connector CNA and the connector CNV. It was. Thereby, the switching (replacement) operation to the injection needle NU1 has been complicated.
  • the connector CNA and the connector CNV are not connected directly or via components. The operator can attach the injection needle NU1 to the connector CNA by removing the drain port P0. Thereby, attachment of the injection needle NU1 to the connector CNA can be easily performed.
  • the blood purification apparatus according to the second embodiment is an example of a so-called online HD (Hemo Dialysis) dialyzer.
  • FIG. 11 is a diagram illustrating an example of a blood purification apparatus according to the second embodiment. As shown in FIG. 11, the blood purification apparatus 900A does not include the replacement fluid circuit SC1, the connection line SCA, and the replacement fluid pump 25 as compared with the blood purification device 900 shown in FIG.
  • FIG. 11 shows the state of the blood purification apparatus 900A during priming.
  • connector CNA is connected to the patient's artery side
  • connector CNV is connected to the patient's vein side.
  • FIG. 12 and 13 are views for explaining washing and filling of the replacement fluid line in blood purification apparatus 900A. Also in each figure after FIG. 12, like FIG. 3 and FIG. 4 etc., the part mainly filled with dialysate is shown hatched in the stage shown in each figure, and the dialysate has already been added. The main part that is filled is shown filled. Further, each of the valves VA1 to VA6 shows a closed state by being painted, and an open state by being outlined.
  • dialysate is sent out from dialyzer 60 with valves VA2 to VA4 closed and valves VA1, VA5 and VA6 opened. Arrows R121 to R123 indicate the flow of the dialysate.
  • the replacement fluid line SCB and the connecting line SCC are washed and filled with dialysate.
  • the dialysate is discharged through the connector CNA.
  • dialysate is delivered from dialyzer 60 with valves VA2, VA3, and VA6 closed and valves VA1, VA4, and VA5 open.
  • An arrow D131 indicates the liquid feeding direction of the blood pump 23.
  • Arrows R131 to R139 indicate the flow of dialysate.
  • the blood pump 23 sends the dialysate in the direction opposite to the direction of sending blood in the dialysis treatment, as indicated by the arrow D131. Further, as indicated by arrows R135 and 137, the dialysis fluid is supplied to the venous air trap chamber 42 and the arterial air trap chamber 41 in the opposite direction to the blood flow in the dialysis treatment.
  • a gas purge as described with reference to FIG. 7 is further performed before or after the washing and filling with the dialysate, or in parallel therewith.
  • FIG. 14 shows a modification of blood purification apparatus 900A.
  • the connector CNA is connected to the connector CNE on the downstream dialysate line DC2.
  • dialysate is sent to the dialyzer 60 via the connector CNA, the connector CNE, and the downstream dialysate line DC2. That is, in priming, the dialysate is discharged to the dialyzer 600 via the connector CNE.
  • a connector CNE for connecting the connector CNA may be provided. If the connector CNE is provided at the upstream dialysate line DC1 or the downstream dialysate line DC2, branch to the replacement fluid line SCB or downstream from the connector CNF, the upstream dialysate line DC1 and the downstream side Any of the dialysate line DC2 may be used.
  • the connector CNE By connecting the connector CNA to the closed circuit, a closed circuit can be formed. When a closed circuit is formed, it becomes easier to control the flow rate of the dialysate in the circuit, which can make the control of the priming operation more efficient.
  • FIG. 15 is a diagram illustrating an example of the blood purification apparatus 900X according to the third embodiment.
  • the blood purification apparatus 900X further includes a connector CNE in the downstream dialysate line DC2 as compared with the blood purification apparatus 900 shown in FIG.
  • connector CNA in priming, is connected to connector CNE as shown in FIG.
  • the dialysate is discharged to the dialyzer 600 via the connector CNE.
  • connector CNE In the dialysis treatment, in blood purification apparatus 900X, connector CNE is closed and injection needle NU1 (see FIG. 1) is connected to connector CNA.
  • the blood purification apparatus according to the fourth embodiment is an example of a so-called online HDF dialyzer.
  • FIG. 16 is a diagram illustrating an example of a blood purification apparatus according to the fourth embodiment.
  • the blood purification apparatus 900B does not include the replacement fluid line SCB, the connection line SCC, and the valve VA6 as compared with the blood purification apparatus 900 shown in FIG.
  • the blood purification apparatus 900B shown in FIG. 16 includes a connector CNF on the upstream dialysate line DC1.
  • the connector CNV is connected to the connector CNF.
  • FIG. 16 shows the state of blood purification apparatus 900B during priming.
  • connector CNA is connected to the patient's artery side
  • connector CNV is connected to the patient's vein side.
  • 17 and 18 are views for explaining washing and filling of the replacement fluid line in blood purification apparatus 900B.
  • dialysate is sent out from dialyzer 60 with valves VA2 to VA4 closed and valves VA1 and VA5 open.
  • the replacement fluid pump 25 sends the dialysate in the direction indicated by the arrow D161.
  • Arrows R161 to R162 indicate the flow of dialysate.
  • the replacement fluid circuit SC1 and the connecting line SCA are washed and filled with dialysate.
  • the dialysate is sent out from the dialyzer 60 with the valves VA2, VA3 closed and the valves VA1, VA4, VA5 opened.
  • the blood pump 23 sends the dialysate in the direction indicated by the arrow D171.
  • An arrow D131 is in the direction opposite to the blood feeding direction in the dialysis treatment.
  • Arrows R171 to R177 indicate the flow of dialysate.
  • each of the venous air trap chamber 42 and the arterial air trap chamber 41 flows in a direction opposite to the blood flow in the dialysis treatment.
  • a gas purge as described with reference to FIG. 7 is further performed before or after the washing and filling with the dialysate or in parallel therewith.
  • the blood purification apparatus according to the fifth embodiment is an example of a so-called off-line HD dialyzer.
  • FIG. 19 is a diagram illustrating an example of a blood purification apparatus according to the fifth embodiment.
  • the blood purification apparatus 900C does not include the replacement fluid circuit SC1, the connection line SCA, and the replacement fluid pump 25, as compared with the blood purification device 900B shown in FIG.
  • the blood purification apparatus 900C shown in FIG. 19 includes a connector CNF on the upstream dialysate line DC1.
  • the connector CNV is connected to the connector CNF.
  • FIG. 19 shows the state of blood purification apparatus 900C during priming.
  • connector CNA is connected to the patient's artery side
  • connector CNV is connected to the patient's vein side.
  • connector CNF and connector CNV may constitute two of the three lines whose flow paths are adjusted by the three-way cock.
  • FIG. 20 is a diagram for explaining washing and filling of the replacement fluid line in the blood purification apparatus 900C.
  • dialysate is sent out from dialyzer 60 with valves VA2 and VA3 closed and valves VA1, VA4 and VA5 opened.
  • the blood pump 23 sends the dialysate in the direction indicated by the arrow D191.
  • An arrow D191 is in the direction opposite to the blood feeding direction in the dialysis treatment.
  • Arrows R191 to R197 indicate the flow of dialysate.
  • each of the venous air trap chamber 42 and the arterial air trap chamber 41 flows in a direction opposite to the blood flow in the dialysis treatment.
  • a gas purge as described with reference to FIG. 7 is further performed before or after the washing and filling with the dialysate or in parallel therewith.
  • the dialysate supplied to the dialysate supply circuit or the dialysate discharge circuit is supplied via a connector to the venous blood circuit including the venous air trap chamber, the hemodialyzer, and the arterial blood circuit including the arterial air trap chamber.
  • the level of the dialysate is maintained at such a level that no gas is mixed into the dialysate.
  • the liquid level in the air trap chamber can be adjusted without requiring fine adjustment by the operator during priming.

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  • 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)

Abstract

Un objectif de la présente invention est de réduire le travail de l'opérateur d'un dispositif de purification du sang pendant l'amorçage lors du réglage du niveau de liquide dans la chambre du piège à bulles. Pendant un traitement de dialyse avec ce dispositif de purification du sang (900), un connecteur (CNA) est relié à une aiguille insérée dans un shunt artério-veineux d'un patient et un connecteur (CNV) est relié à une aiguille insérée dans une veine d'un patient. De plus, pendant l'amorçage, le connecteur (CNA) est relié à un orifice de drainage (P0) et le connecteur (CNV) est connecté à un connecteur (CND). Pendant l'amorçage, une chambre de piège à bulles artériel (41) et une chambre de piège à bulles veineux (42) sont alimentées en fluide de dialyse à partir de leurs extrémités inférieures.
PCT/JP2016/069363 2015-06-29 2016-06-29 Dispositif de purification du sang et procédé pour l'amorcer WO2017002889A1 (fr)

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2023182297A1 (fr) * 2022-03-25 2023-09-28 株式会社ジェイ・エム・エス Dispositif d'hémodialyse comprenant une ligne de remplacement de fluide

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Publication number Priority date Publication date Assignee Title
JP2004313522A (ja) * 2003-04-17 2004-11-11 Nikkiso Co Ltd 透析装置
JP2011161059A (ja) * 2010-02-10 2011-08-25 Nikkiso Co Ltd 血液浄化装置及びそのプライミング方法
JP2012095843A (ja) * 2010-11-02 2012-05-24 Nikkiso Co Ltd 血液浄化装置及びそのプライミング方法
WO2014024972A1 (fr) * 2012-08-09 2014-02-13 日機装株式会社 Dispositif de purification de sang et procédé d'amorçage correspondant

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Publication number Priority date Publication date Assignee Title
JP4286165B2 (ja) * 2004-03-10 2009-06-24 旭化成クラレメディカル株式会社 血液浄化装置のプライミング方法および血液浄化装置
JP4899866B2 (ja) * 2005-01-07 2012-03-21 株式会社ジェイ・エム・エス 自動プライミング方法
JP5399218B2 (ja) * 2009-11-24 2014-01-29 日機装株式会社 血液浄化装置
JP6070348B2 (ja) * 2013-03-27 2017-02-01 株式会社ジェイ・エム・エス 血液透析装置

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2004313522A (ja) * 2003-04-17 2004-11-11 Nikkiso Co Ltd 透析装置
JP2011161059A (ja) * 2010-02-10 2011-08-25 Nikkiso Co Ltd 血液浄化装置及びそのプライミング方法
JP2012095843A (ja) * 2010-11-02 2012-05-24 Nikkiso Co Ltd 血液浄化装置及びそのプライミング方法
WO2014024972A1 (fr) * 2012-08-09 2014-02-13 日機装株式会社 Dispositif de purification de sang et procédé d'amorçage correspondant

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2023182297A1 (fr) * 2022-03-25 2023-09-28 株式会社ジェイ・エム・エス Dispositif d'hémodialyse comprenant une ligne de remplacement de fluide

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