WO2017069171A1 - Dispositif de purification du sang - Google Patents

Dispositif de purification du sang Download PDF

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Publication number
WO2017069171A1
WO2017069171A1 PCT/JP2016/081011 JP2016081011W WO2017069171A1 WO 2017069171 A1 WO2017069171 A1 WO 2017069171A1 JP 2016081011 W JP2016081011 W JP 2016081011W WO 2017069171 A1 WO2017069171 A1 WO 2017069171A1
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WO
WIPO (PCT)
Prior art keywords
blood
dialysate
priming
blood purification
flow path
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Application number
PCT/JP2016/081011
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English (en)
Japanese (ja)
Inventor
洋明 望月
純明 松尾
Original Assignee
日機装株式会社
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
Application filed by 日機装株式会社 filed Critical 日機装株式会社
Priority to CN201680060936.0A priority Critical patent/CN108136100B/zh
Publication of WO2017069171A1 publication Critical patent/WO2017069171A1/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 invention relates to a blood purification apparatus for purifying a patient's blood while circulating it outside the body.
  • a blood purification apparatus for performing dialysis treatment purifies blood circulating extracorporeally in an arterial blood circuit and a venous blood circuit that constitute a blood circuit for circulating a patient's blood extracorporeally.
  • Blood purification means and a device body on which various treatment means such as a blood pump for performing blood purification treatment by the blood circuit and the blood purification means are provided.
  • Vascular access catheters or puncture needles can be attached to the tips of the arterial blood circuit and the venous blood circuit, respectively.
  • the blood of the patient flows through the arterial blood circuit and the venous blood circuit by driving the blood pump.
  • the blood is purified by the blood purification means.
  • a dialysate introduction line for introducing dialysate into the blood purification means and a dialysate discharge line for discharging drainage from the blood purification means are respectively connected to the blood purification means.
  • a blood purification unit a flow path for circulating blood in the blood circuit is provided. This is performed by filling the flow path (blood flow path) through which blood flows and the flow path (dialysis liquid flow path) through which dialysate flows with priming liquid.
  • the conventional blood purification apparatus has the following problems.
  • the blood purification means is set so that the flow direction of the dialysate in the dialysate flow channel faces the flow direction of the blood in the blood flow channel for reasons of dialysis efficiency.
  • the blood flow channel outlet blood outlet port
  • the blood purification treatment was performed while holding the blood purification means.
  • dialysate outlet dialyte outlet port
  • dialysate inlet dialyte inlet port
  • the present invention has been made in view of such circumstances, and can reliably perform filling of the priming liquid into the blood flow path and the dialysate flow path of the blood purification means, and medical engagement at the start of blood purification treatment.
  • An object of the present invention is to provide a blood purification apparatus that can eliminate the need for a person to reverse the blood purification means.
  • the invention described in claim 1 includes a blood introduction port through which blood can be introduced, a blood delivery port from which blood can be derived, and a blood flow extending through the blood introduction port and the blood delivery port so that blood can flow.
  • a dialysis fluid introduction port capable of introducing a dialysis fluid, a dialysis fluid derivation port capable of deriving a dialysis fluid, and the dialysis fluid introduction port and the dialysis fluid derivation port.
  • a blood purification system capable of purifying blood flowing through the blood flow path by interposing between the blood flow path and the dialysate flow path, and a dialysate flow path capable of flowing dialysate in a direction facing the circulating blood
  • a blood purification means having a membrane, an arterial blood circuit connected to a blood introduction port of the blood purification means, a venous blood circuit connected to the blood outlet port, and the arterial blood circuit From the tip of the vein to the blood circuit
  • a blood circuit capable of extracorporeally circulating the patient's blood to the tip, a dialysate introduction line connected to the dialysate introduction port of the blood purification means and capable of introducing dialysate into the blood purification means, and dialysis of the blood purification means
  • a dialysate drainage line connected to the fluid outlet port and capable of draining drainage from the blood purification means; and disposed in the arterial blood circuit, from the arterial blood circuit toward the venous blood circuit.
  • a blood pump that can circulate blood extracorporeally, and in the blood purification device that can be primed by supplying the priming liquid to the blood circuit by driving the blood pump, filling the priming liquid in priming And holding the blood purification means with the blood outlet port facing upward, and from the blood introduction port
  • the priming liquid introduced into the blood flow path of the liquid purification means is filtered through the blood purification membrane into the dialysate flow path, and is derived from the dialysate introduction port so that the dialysate flow path can be primed. It is characterized by that.
  • the priming fluid is stored in a priming fluid at least at a distal end portion of the arterial blood circuit of the arterial blood circuit and the venous blood circuit.
  • a bag is connectable, and the priming liquid in the priming liquid storage bag can be supplied to the blood circuit when the priming liquid is filled during priming.
  • the blood purification apparatus in the blood purification apparatus according to the first or second aspect of the present invention, includes a replacement fluid line capable of communicating a predetermined portion of the venous blood circuit with a dialysate introduction line, and the priming in priming
  • the gas discharged from the dialysate introduction port of the blood purification means can be discharged to the venous blood circuit through the replacement fluid line when the liquid is filled.
  • the blood purification apparatus further comprises a replacement fluid pump disposed in the replacement fluid line and capable of feeding dialysate from the dialysate introduction line to the venous blood circuit.
  • a replacement fluid pump disposed in the replacement fluid line and capable of feeding dialysate from the dialysate introduction line to the venous blood circuit.
  • the blood purification device in the blood purification device according to the third aspect, is disposed between the blood purification means in the venous blood circuit and a connection portion of the replacement fluid line, and the flow path is arbitrarily opened and closed. And opening and closing means, and closing the flow path by closing the opening and closing means when filling the priming liquid in priming, thereby allowing the gas discharged from the dialysate introduction port of the blood purification means to flow into the replacement fluid line Through the venous blood circuit.
  • a sixth aspect of the present invention is the blood purification apparatus according to any one of the third to fifth aspects, wherein the gas discharged to the venous blood circuit when the priming liquid is filled in priming is supplied to the venous blood It is possible to collect in a collection container connected to the tip of the circuit.
  • a seventh aspect of the present invention is the blood purification apparatus according to any one of the third to fifth aspects, wherein the blood circuit side air trap chamber is disposed at a connection portion of the venous side blood circuit with the replacement fluid line.
  • An air discharge line extending from the upper part of the blood circuit side air trap chamber and capable of discharging air in the blood circuit side air trap chamber; and air in the blood circuit side air trap chamber Air discharging means that can be discharged to the outside through the gas, and when the priming liquid is filled in priming, the gas discharged to the venous blood circuit is collected in the blood circuit side air trap chamber, It is characterized in that the air discharge means can be operated to discharge outside through the air discharge line.
  • the blood purification device further includes a liquid level detecting unit capable of detecting a liquid level of the blood circuit side air trap chamber. On the condition that the liquid level is detected, the discharge of gas by the air discharge means is stopped.
  • the invention according to claim 9 is the blood purification apparatus according to any one of claims 1 to 8, which is connected to a distal end portion of the dialysate introduction line and contains a dialysate introduced into the blood purification means.
  • a dialysate pump for sending dialysate from the solution storage bag to the blood purification means and a dialysate discharge line disposed in the dialysate discharge line to send the drainage discharged from the blood purification means to the drainage storage bag And a drainage pump.
  • the dialysate pump is reversed so that the flow rate of the dialysate pump is equal to or less than the flow rate of the blood pump when the priming solution is filled in priming.
  • the priming liquid introduced into the blood flow path of the blood purification means from the blood introduction port is filtered through the blood purification membrane into the dialysate flow path, and is derived from the dialysate introduction port.
  • the dialysate flow path can be primed.
  • the invention according to claim 11 is the blood purification apparatus according to claim 9 or claim 10, wherein the dialysate-side air trap chamber is disposed between the dialysate pump and the blood purification means in the dialysate introduction line.
  • An air discharge line extending from the upper part of the dialysate side air trap chamber and capable of discharging air in the dialysate side air trap chamber; and air in the dialysate side air trap chamber
  • An air discharging means that can be discharged to the outside through the priming liquid during priming, the gas discharged from the dialysate introduction port is collected in the dialysate side air trap chamber, It is characterized in that the air discharge means can be operated to discharge outside through the air discharge line.
  • a twelfth aspect of the present invention is the blood purification apparatus according to the eleventh aspect, further comprising a liquid level detecting unit capable of detecting the liquid level of the dialysate side air trap chamber, On the condition that the liquid level is detected, the discharge of gas by the air discharge means is stopped.
  • the blood purification means when the priming liquid is filled in priming, the blood purification means is held with the blood outlet port facing upward, and is introduced from the blood introduction port into the blood flow path of the blood purification means. Since the priming fluid is filtered through the blood purification membrane into the dialysate flow channel and is led out from the dialysate introduction port so that the dialysate flow channel can be primed, the blood flow channel and the dialysate flow channel of the blood purification means Can be reliably filled with priming liquid, and the work of reversing the blood purification means by the medical staff at the start of blood purification treatment can be made unnecessary.
  • a priming solution containing bag containing a priming solution can be connected to at least the tip of the arterial blood circuit of the arterial blood circuit and the venous blood circuit. Since the priming solution in the priming solution storage bag can be supplied to the blood circuit at the time of filling, the filling of the priming solution on the blood circuit side can be performed more reliably and smoothly.
  • a replacement fluid line capable of communicating a predetermined part of the venous blood circuit with the dialysate introduction line, and the priming fluid is discharged from the dialysate introduction port of the blood purification means when filling with the priming fluid in the priming. Since the gas thus discharged can be discharged to the venous blood circuit via the replacement fluid line, more efficient priming can be performed.
  • a replacement fluid pump which is arrange
  • the flow rate By setting the flow rate to be equal to or lower than the flow rate by the blood pump, the gas discharged from the dialysate introduction port of the blood purification means can be discharged to the venous blood circuit via the replacement fluid line. More efficient priming can be performed.
  • the priming liquid in the priming is provided between the blood purification means in the venous blood circuit and the connecting part of the replacement fluid line, and has an opening / closing means that can arbitrarily open and close the flow path. Since the gas discharged from the dialysate introduction port of the blood purification means can be discharged to the venous blood circuit via the replacement liquid line by closing the flow path by closing the opening / closing means when filling The gas discharged through the line can be discharged more reliably, and more efficient priming can be performed.
  • the gas discharged to the venous blood circuit can be collected in the collection container connected to the distal end portion of the venous blood circuit.
  • the gas replaced with the priming liquid at the time of filling the priming liquid can be recovered more reliably.
  • the seventh aspect of the present invention when the priming liquid is filled in the priming, the gas discharged to the venous blood circuit is collected in the blood circuit side air trap chamber, the air discharging means is operated, and the air discharge line Therefore, when the priming liquid is filled, the gas substituted for the priming liquid can be reliably discharged to the outside by using the blood circuit side air trap chamber and the air discharging means.
  • the liquid level detecting means capable of detecting the liquid level of the blood circuit side air trap chamber is provided, and the liquid level detecting means detects a liquid level of a predetermined height. Since the discharge of gas by the air discharge means is stopped, the priming liquid filling operation can be completed by detecting that the priming liquid has been completely replaced with gas by diverting the liquid level detection means. Efficient priming can be performed.
  • the blood purification device is connected to the distal end portion of the dialysate introduction line and contains the dialysate storage bag containing the dialysate introduced into the blood purification means, and the distal end portion of the dialysate discharge line.
  • a effluent storage bag capable of storing the effluent discharged from the means, a dialysis fluid pump disposed in the dialysis fluid introduction line, and for delivering the dialysis fluid in the dialysis fluid storage bag to the blood purification means, and a dialysis fluid discharge line
  • a drainage pump for feeding the drainage discharged from the blood purification means to the drainage storage bag, so that more efficient priming can be performed by using the dialysate pump or the drainage pump. Can be made.
  • the dialysate pump when the priming liquid is filled in the priming, the dialysate pump is reversely driven so that the flow rate of the dialysate pump is equal to or less than the flow rate of the blood pump, whereby blood purification means is provided from the blood introduction port.
  • the priming fluid introduced into the blood flow channel is filtered through the blood purification membrane into the dialysate fluid flow channel, and the dialysate fluid flow channel can be primed by being led out from the dialysate fluid introduction port.
  • the gas discharged from the dialysate introduction port is collected in the dialysate-side air trap chamber, the air discharge means is operated, and the air discharge line
  • the dialysate-side air trap chamber and the air discharge means can be used to reliably discharge the gas substituted for the priming solution to the outside when the priming solution is filled.
  • the liquid level detecting means capable of detecting the liquid level of the dialysate side air trap chamber is provided, and the liquid level of the predetermined height is detected by the liquid level detecting means. Since the discharge of gas by the air discharge means is stopped, the priming liquid filling operation can be completed by detecting that the priming liquid has been completely replaced with gas by diverting the liquid level detection means. Efficient priming can be performed.
  • the schematic diagram which shows the blood purification apparatus which concerns on embodiment of this invention Schematic diagram showing blood purification means applied to the blood purification apparatus
  • the flowchart which shows the process performed at the time of priming in the blood purification apparatus Schematic showing the blood purification device (when filling with priming solution) Schematic showing the blood purification device (when filling with priming solution) Schematic showing the blood purification device (when filling with priming solution) Schematic showing the blood purification device (when filling with priming solution) Schematic showing the blood purification device (when filling with priming solution) Schematic showing the blood purification device (with opening and closing means)
  • the schematic diagram which shows the blood purification apparatus which concerns on other embodiment of this invention.
  • the blood purification apparatus is applied to a hemodialysis apparatus for purifying a patient's blood while circulating it extracorporeally.
  • an arterial blood circuit 1a and a venous blood circuit 1b are used.
  • a blood pump P1 including a squeezing type pump, a dialysate introduction line L1 and a dialysate discharge line L2, and a dialysate pump P2 and a drain provided in the dialysate introduction line L1 and the dialysate discharge line L2, respectively.
  • a fluid pump P3, a fluid replacement line L3, a fluid replacement pump P4 disposed in the fluid replacement line L3, and a control means 11 are configured.
  • symbol P in the figure has shown the pressure detection means.
  • the arterial blood circuit 1a and the venous blood circuit 1b are each connected with a connector at the tip, and an arterial puncture needle and a venous puncture needle (not shown) can be connected via the connector.
  • the blood pump P1 is driven (forward rotation drive) in a state where the patient is punctured with the arterial puncture needle connected to the distal end of the arterial blood circuit 1a and the venous puncture needle connected to the distal end of the venous blood circuit 1b. ), The blood of the patient reaches the dialyzer 2 through the arterial blood circuit 1a, and after blood purification is performed by the dialyzer 2, returns to the patient's body through the venous blood circuit 1b. ing.
  • a double lumen catheter is inserted into the patient's subclavian vein or femoral vein, or into the patient's arm blood vessel. It may be.
  • a blood circuit side air trap chamber 3 is connected in the middle of the venous side blood circuit 1b, and the blood circulating outside the body returns to the patient after the bubbles are removed in the air trap chamber 3. Become. Furthermore, a clamp means 5 is disposed at the distal end of the venous blood circuit 1b, and the flow path at that position can be opened or closed by arbitrarily opening and closing the clamp means 5.
  • the venous blood circuit 1b includes a blood circuit side air trap chamber 3 disposed at a connection portion with the replacement fluid line L3, and extends from the upper part of the blood circuit side air trap chamber 3.
  • the air discharge line La that can discharge the air in the blood circuit side air trap chamber 3
  • the air discharge means 9 that can discharge the air in the blood circuit side air trap chamber 3 to the outside via the air discharge line La.
  • the blood circuit side air trap chamber 3 is provided with a liquid level detecting means 6 capable of detecting the liquid level of the blood circuit side air trap chamber 3.
  • the air discharge means 9 has a flow path communicating with the air discharge line La, the front end of the flow path is open to the atmosphere through a filter, and an electromagnetic valve Va and a squeeze pump are provided in the middle of the flow path. Pa is attached. Then, the solenoid valve Va is opened, and the iron pump Pa is driven to rotate in the forward direction, thereby releasing the air in the blood circuit side air trap chamber 3 to the outside and raising the liquid level of the blood circuit side air trap chamber 3. In addition, the squeezing type pump Pa can be driven to rotate in the reverse direction so that air can be introduced into the blood circuit side air trap chamber 3 and the liquid level of the blood circuit side air trap chamber 3 can be lowered. ing.
  • the dialyzer 2 extends over a blood introduction port 2a through which blood can be introduced, a blood extraction port 2b through which blood can be extracted, and the blood introduction port 2a and the blood extraction port 2b.
  • Blood flow path 2e through which blood can flow dialysate introduction port 2c through which dialysate can be introduced, dialysate exit port 2d through which dialysate can be derived, dialysate introduction port 2c, and dialysate exit port 2d
  • a dialysis fluid channel 2f that extends through the dialysis fluid in a direction opposite to the blood that circulates in the blood channel 2e, and is interposed between the blood channel 2e and the dialysis fluid channel 2f.
  • a blood purification film 2g capable of purifying blood flowing through the blood flow path 2e.
  • the dialyzer 2 has a blood inlet port 2a, a blood outlet port 2b, a dialysate inlet port 2c, and a dialysate outlet port 2d protruding from the casing, and of these, the blood inlet port 2a Is connected to the arterial blood circuit 1a, the blood outlet port 2b is connected to the venous blood circuit 1b, the dialysate inlet port 2c is connected to the dialysate inlet line L1, and the dialysate outlet port 2d is dialysate.
  • the discharge lines L2 are connected to each other.
  • the positional relationship in the vertical direction of the blood introduction port 2a that is the blood inlet and the dialysate introduction port 2c that is the inlet of the dialysate is reversed, and the blood flow path It is comprised so that a dialysate may distribute
  • a plurality of hollow fiber membranes are accommodated in the dialyzer 2, and these hollow fibers constitute a blood purification membrane 2g for purifying blood. That is, the inside of the blood purification membrane 2g constituting the hollow fiber is the blood flow path 2e, and the space between the housing and the hollow fiber is the dialysate flow path 2f.
  • the blood purification membrane 2g forms a hollow fiber membrane, and a large number of minute holes (pores) penetrating the outer peripheral surface and the inner peripheral surface are formed, and the blood flow channel 2e is circulated through the membrane. Impurities and the like in the blood to be permeated (filtered) into the dialysate flowing through the dialysate channel 2f.
  • the dialysate introduction line L1 includes a flow path for introducing dialysate into the dialyzer 2, one end of which is connected to the dialysate introduction port 2c of the dialyzer 2, and a dialysate pump P2 is disposed in the midway flow path.
  • the dialysate pump P2 is composed of a peristaltic pump that squeezes and feeds a flexible tube constituting the dialysate introduction line L1.
  • the other end of the dialysate introduction line L1 is connected to a dialysate storage bag B1 containing a predetermined volume of dialysate, and the dialysate storage bag B1 is driven by driving the dialysate pump P2 (forward rotation driving).
  • the inside dialysate can be introduced into the dialyzer 2.
  • the dialysate discharge line L2 includes a flow path for discharging drainage from the dialyzer 2, and one end is connected to the dialysate outlet port 2d of the dialyzer 2, and a drainage pump P3 is disposed in the midway path.
  • the drainage pump P3 is a peristaltic pump that squeezes and feeds a flexible tube constituting the dialysate discharge line L2.
  • the other end of the dialysate discharge line L2 is connected to a drainage storage bag B2 that can store a predetermined amount of drainage. By driving the drainage pump P3 (forward rotation driving), the dialyzer 2
  • the discharged dialysate (drainage) can be introduced into the drainage storage bag B2.
  • the dialysate in the dialysate storage bag B1 flows and is supplied toward the dialyzer 2 by the positive rotation drive of the dialysate pump P2, and the dialysate ( (Drainage) flows toward the drainage storage bag B2 and is discharged.
  • the weighing scales 4a and 4b are configured so that the dialysate storage bag B1 and the drainage storage bag B2 are respectively hooked and held on the hooks, and the weights of the dialysate storage bag B1 and the drainage storage bag B2 can be measured in real time. Has been.
  • the dialysate storage bag B1 and the drainage storage bag B2 are made of flexible storage containers. Among these, the drainage storage bag B2 stores the drainage therein before starting the blood purification treatment. It is not empty.
  • the driving of the blood pump P1, the dialysate pump P2, and the drainage pump P3 is controlled based on the weights measured by the weight scales 4a and 4b and preset values stored in advance. ing.
  • the driving speed of the drainage pump P3 is controlled so as to be the same driving speed as that of the dialysate pump P2 when water is not removed from the patient as a treatment condition.
  • the driving speed is controlled by adding the flow rate due to.
  • the driving speed of the drainage pump P3 can be automatically finely adjusted in order to correct the loss.
  • the replacement fluid line L3 is a flow path capable of communicating a predetermined portion of the venous blood circuit 1b (in this embodiment, the blood circuit side air trap chamber 3 connected to the venous blood circuit 1b) and the dialysate introduction line L1. Consists of.
  • the replacement fluid line L3 is provided with a replacement fluid pump P4. By driving the replacement fluid pump P4 (forward rotation driving), the dialysate is sent from the dialysate introduction line L1 to the venous blood circuit 1b.
  • a replacement fluid post-replacement fluid
  • the replacement fluid pump P4 is a peristaltic pump that, like the blood pump P1, squeezes and feeds a flexible tube that constitutes the replacement fluid line L3.
  • the dialysate introduction line L1 includes a dialysate side air trap chamber 7 disposed between the dialysate pump P2 and the dialyzer 2, and an upper portion of the dialysate side air trap chamber 7. And an air discharge line Lb that can discharge the air in the dialysate-side air trap chamber 7 and air that can discharge the air in the dialysate-side air trap chamber 7 to the outside via the air discharge line Lb.
  • the dialysis fluid side air trap chamber 7 is provided with a liquid level detection means 8 capable of detecting the liquid level of the dialysis fluid side air trap chamber 7.
  • the air discharge means 10 has a flow path communicating with the air discharge line Lb.
  • the front end of the flow path is open to the atmosphere through a filter, and a squeezing pump Pb is attached in the middle of the flow path. ing. Then, by driving the squeezing type pump Pb to rotate forward, the air in the dialysate side air trap chamber 7 can be released to the outside and the level of the dialysate side air trap chamber 7 can be raised. By driving the pump Pb to rotate in the reverse direction, air is introduced into the dialysate-side air trap chamber 7 so that the liquid level of the dialysate-side air trap chamber 7 can be lowered.
  • the control means 11 comprises a microcomputer or the like disposed in the blood purification device, and includes actuators (blood pump P1, dialysate pump P2, drainage pump P3, replacement fluid pump P4, etc.) and various sensors (liquid level detection means 6, 8). Etc.) and valve means (clamp means 5 etc.), respectively, for performing various controls.
  • actuators blood pump P1, dialysate pump P2, drainage pump P3, replacement fluid pump P4, etc.
  • various sensors liquid level detection means 6, 8). Etc.
  • valve means clamp means 5 etc.
  • the priming is a process performed by supplying the priming liquid to the blood circuit 1 (arterial blood circuit 1a and venous blood circuit 1b) by driving the blood pump P1, and as shown in FIG.
  • the filling step S1, the cleaning step S2, and the bubble removal step S3 are included.
  • the filling step S1 of the priming liquid is a process of replacing the gas (air) by filling the flow path of the blood circuit 1, the blood flow path 2e of the dialyzer 2 and the dialysate flow path 2f, and the washing process S2.
  • the step of discharging and cleaning the priming liquid filled in the priming liquid filling step S1 while supplying the priming liquid, and the bubble removing step S3 circulate the priming liquid in the channel filled and washed with the priming liquid. In this step, the remaining bubbles are captured and discharged to the outside.
  • a priming solution storage bag B3 containing a priming solution can be connected to the distal ends of the arterial blood circuit 1a and the venous blood circuit 1b according to the present embodiment, and the priming solution in priming can be connected. At the time of filling, the priming solution in the priming solution storage bag B3 can be supplied to the blood circuit 1.
  • the priming fluid storage bag B3 is connected to the distal ends of both the arterial blood circuit 1a and the venous blood circuit 1b, but at least the priming fluid is stored in the distal portion of the arterial blood circuit 1a. It is sufficient if the bag B3 is connected.
  • the blood outlet port 2b faces upward (dialysis liquid).
  • the dialyzer 2 blood purification means
  • the dialysate flow path 2f is filtered through the membrane 2g and led out from the dialysate introduction port 2c so that the dialysate flow path 2f can be primed.
  • the dialysate pump P2 and the drainage pump P3 have the same flow rate while the clamp means 5 is closed.
  • the pump is driven to rotate in the forward direction and other pumps such as the blood pump P1 and the replacement fluid pump P4 are stopped.
  • the dialysate in the dialysate accommodation bag B1 can be circulated and filled up to the connection part with the replacement fluid line L3 in the dialysate introduction line L1.
  • the blood pump P1 is driven to rotate forward and the replacement fluid pump P4 is driven to rotate forward.
  • the solenoid valve Va in the air discharge means 9 is opened, and the ironing pump Pa is driven to rotate in the forward direction, and other ironing pumps such as the dialysate pump P2 and the drainage pump P3 are stopped.
  • the flow rate of the replacement fluid pump P4 is set to be equal to or lower than the flow rate of the blood pump P1, and the driving speed of the ironing type pump Pa is controlled by the control means 11.
  • the priming solution (physiological saline solution) in the priming solution storage bag B3 flows through the arterial blood circuit 1a to the blood channel 2e of the dialyzer 2, and is filtered by the blood purification membrane 2g to be dialyzed solution channel. 2f, and after being discharged from the dialysate introduction port 2c, it is circulated and filled to the venous blood circuit 1b via the replacement fluid line L3, and is replaced with the gas (air) in the flow path. .
  • the gas discharged to the venous blood circuit 1b that is, the air replaced with the priming solution
  • the air discharging means 9 is operated. Is discharged to the outside through the air discharge line La.
  • the blood pump P1 and the replacement fluid pump P4 are stopped on the condition that the liquid level detecting means 6 has detected a liquid level of a predetermined height, and the solenoid valve Va in the air discharging means 9 is closed and the ironing pump Pa is stopped.
  • the priming operation as described above, as shown in FIG. 8, it is disposed between the dialyzer 2 and the connecting part of the replacement fluid line L3 in the venous blood circuit 1b, and the flow path can be arbitrarily opened and closed.
  • a gas discharged from the dialysate introduction port 2c of the dialyzer 2 (substitute air) by having the opening / closing means 12 and closing the flow path by closing the opening / closing means 12 when filling the priming liquid in the priming. May be discharged to the venous blood circuit 1b through the replacement fluid line L3.
  • the gas discharged from the dialysate introduction port 2c of the dialyzer 2 (that is, the air replaced with the priming liquid) is supplied via the replacement liquid line L3. Thus, it can be discharged to the venous blood circuit 1b.
  • the gas discharged from the dialysate introduction port 2c of the dialyzer 2 is set by setting the flow rate by the replacement fluid pump P4 to be equal to or less than the flow rate by the blood pump P1 ( That is, the air replaced with the priming solution can be discharged to the venous blood circuit 1b through the replacement fluid line L3.
  • the dialyzer 2 instead of the gas discharged from the dialysate introduction port 2c of the dialyzer 2 as described above (air replaced with the priming solution) flowing to the venous blood circuit 1b via the replacement fluid line L3, the dialyzer 2
  • the gas discharged from the dialysate introduction port 2c (air replaced with the priming solution) is collected in the dialysate-side air trap chamber 7 in the dialysate introduction line L1, and the air discharge means 10 is operated to discharge the air. You may comprise so that it may discharge outside via the line Lb.
  • the air replaced with the priming solution is collected in the dialysate-side air trap chamber 7, so that the air discharge is performed on condition that the liquid level detecting means 8 detects the liquid level of a predetermined height.
  • the gas discharge by the means 10 can be stopped.
  • the blood pump P1 is driven to rotate in the forward direction while maintaining the closed state of the clamp means 5, and the solenoid valve Va in the air discharge means 9 is opened so that the iron pump Pa
  • the air in the flow path from the connection part of the dialyzer 2 to the blood circuit side air trap chamber 3 in the blood flow path 2e of the dialyzer 2 and the venous side blood circuit 1b is replaced with the priming liquid.
  • the driving speed of the ironing type pump Pa is controlled so that the liquid level detected by the liquid level detecting means 6 is constant.
  • the clamp means 5 is opened while the positive rotation drive of the blood pump P1 is maintained, the solenoid valve Va in the air discharge means 9 is closed, and the ironing pump Pa is stopped to discharge to the venous blood circuit 1b.
  • the gas thus collected can be collected in a collection container (in this embodiment, a priming solution storage bag B3) connected to the tip of the venous blood circuit 1b. Thereby, it is possible to fill the space between the tip of the venous blood circuit 1b and the blood circuit side air trap chamber 3 with the priming liquid.
  • the priming fluid storage bag B3 when the priming fluid storage bag B3 is connected to the distal end portion of the venous blood circuit 1b, the electromagnetic valve Va in the air discharge means 9 is opened while the clamp means 5 is opened.
  • the priming pump Pa may be driven to rotate in the normal state so that the air in the flow path to the distal end of the venous blood circuit 1b and the blood circuit side air trap chamber 3 may be replaced with the priming liquid. Since the filling step S1 of the priming liquid is completed as described above, the series of priming is completed by sequentially performing the cleaning step S2 and the bubble removal step S3.
  • a priming solution collection bag that is connected only during priming can be dispensed with.
  • the cost for priming can be reduced.
  • since it has the replacement fluid line L3 capable of communicating the predetermined part of the venous blood circuit 1b and the dialysate introduction line L1, at the time of discharging the priming fluid in priming (washing step S2) If the priming solution supplied to the blood circuit 1 flows to the dialysate discharge line L2 through the replacement fluid line L3 and is discharged, efficient replacement of the replacement fluid line L3 can be performed. Then, when blood purification treatment is performed after priming is completed, the priming fluid storage bag B3 is removed from the distal ends of the arterial blood circuit 1a and the venous blood circuit 1b, and a puncture needle is connected.
  • the dialyzer 2 when filling the priming liquid in priming, the dialyzer 2 is held with the blood outlet port 2b facing upward, and the priming introduced from the blood introduction port 2a to the blood flow path 2e of the dialyzer 2
  • the solution physiological saline solution in the priming solution storage bag B3
  • the solution is filtered through the blood purification membrane 2g into the dialysate flow channel 2f, and is led out from the dialysate introduction port 2c so that the dialysate flow channel 2f can be primed.
  • the blood flow path 2e and the dialysate flow path 2f of the dialyzer 2 can be reliably filled with the priming solution, and the work of reversing the dialyzer 2 by the medical staff at the start of blood purification treatment is not required. Can do.
  • the operation of replacing the storage bags such as the dialysate bag B1 and the drainage bag B2 can be omitted, and the workability can be further improved.
  • a priming solution storage bag B3 containing a priming solution can be connected to at least the tip of the arterial blood circuit 1a of the arterial blood circuit 1a and the venous blood circuit 1b.
  • the priming liquid in the priming liquid storage bag B3 can be supplied to the blood circuit 1, so that the filling of the priming liquid on the blood circuit 1 side can be performed more reliably and smoothly.
  • the replacement fluid line L3 that allows the predetermined part of the venous blood circuit 1b and the dialysate introduction line L1 to communicate with each other, and the gas discharged from the dialysate introduction port 2c of the dialyzer 2 when filling with the priming fluid in priming. Since it can be discharged to the venous blood circuit 1b via the replacement fluid line L3, more efficient priming can be performed.
  • it has a replacement fluid pump P4 that is disposed in the replacement fluid line L3 and can send dialysate from the dialysate introduction line L1 to the venous blood circuit 1b.
  • the replacement fluid pump P4 When filling the priming fluid in priming, By setting the flow rate of the replacement fluid pump P4 to be equal to or less than the flow rate of the blood pump P1, the gas discharged from the dialysate introduction port 2c of the dialyzer 2 can be discharged to the venous blood circuit 1b via the replacement fluid line L3.
  • the replacement fluid pump P4 can be used for more efficient priming.
  • the opening / closing means 12 (see FIG. 8) that is disposed between the dialyzer 2 and the connecting part of the replacement fluid line L3 in the venous blood circuit 1b, and can arbitrarily open and close the flow path.
  • the opening / closing means 12 is closed to close the flow path, so that the gas discharged from the dialysate introduction port 2c of the dialyzer 2 can be discharged to the venous blood circuit 1b via the replacement fluid line L3.
  • the gas discharged through the replacement fluid line L3 can be more reliably discharged, and more efficient priming can be performed.
  • the gas discharged to the venous blood circuit 1b is collected in a recovery container (in this embodiment, a priming liquid containing bag B3) connected to the tip of the venous blood circuit 1b. Since the gas can be recovered, the gas replaced with the priming liquid can be more reliably recovered when the priming liquid is filled. In addition, you may make it connect the collection container for exclusive use for collect
  • the air discharging means 9 is operated, and the air is discharged via the air discharging line La. Since it can be discharged to the outside, the blood circuit side air trap chamber 3 and the air discharge means 9 can be diverted to reliably discharge the gas replaced with the priming liquid when filling the priming liquid.
  • the liquid level detection means 6 capable of detecting the liquid level in the blood circuit side air trap chamber 3 is provided, and the air discharge is performed on condition that the liquid level detection means 6 detects a liquid level of a predetermined height. Since the discharge of the gas by the means 9 is stopped, it is possible to detect that the priming liquid has been completely replaced with the gas by diverting the liquid level detecting means 6 and to finish the filling operation of the priming liquid. Priming can be performed.
  • dialysate introduction line L1 connected to the distal end of the dialysate introduction line L1, connected to the dialysate storage bag B1 containing the dialysate introduced into the dialyzer 2 and the distal end of the dialysate discharge line L2, and discharged from the dialyzer 2
  • a effluent storage bag B2 that can store effluent
  • a dialysis fluid introduction line L1 a dialysis fluid pump P2 that feeds the dialysis fluid in the dialysis fluid storage bag B1 to the dialyzer 2
  • a dialysis fluid discharge line L2 Equipped with a drainage pump P3 that is disposed and feeds the drainage discharged from the dialyzer 2 to the drainage storage bag B2, so that the dialysate pump P2 or the drainage pump P3 can be used for more efficient priming. Can be performed.
  • the dialysate pump P2 when filling the priming solution in the priming, the dialysate pump P2 is driven in reverse so that the flow rate of the dialysate pump P2 is equal to or less than the flow rate of the blood pump P1, whereby the blood flow path of the dialyzer 2 from the blood introduction port 2a. Since the priming solution introduced into 2e is filtered through the blood purification membrane 2g into the dialysate flow path 2f and led out from the dialysate introduction port 2c, the dialysate flow path 2f can be primed. More efficient priming can be performed by cooperation of P2 and blood pump P1.
  • the gas discharged from the dialysate introduction port 2c is collected in the dialysate-side air trap chamber 7 and the air discharge means 10 is operated to pass through the air discharge line Lb. If the gas can be discharged to the outside, the dialysate-side air trap chamber 7 and the air discharge means 10 can be used to reliably discharge the gas replaced with the priming liquid when the priming liquid is filled.
  • the liquid level detection means 8 capable of detecting the liquid level in the dialysate side air trap chamber 7 is provided, and the air discharge is performed on condition that the liquid level detection means 8 detects a liquid level of a predetermined height. If the gas discharge by the means 10 is stopped, the filling operation of the priming liquid can be completed by detecting that the priming liquid has been completely replaced with the gas by diverting the liquid level detecting means 8. More efficient priming can be performed.
  • the compound pump 13 arrange
  • the dialysate introduction line L1 is connected to a water supply means (not shown), and is connected to a storage tank T1 containing the A stock solution and a storage tank T2 containing the B stock solution, and the pump 15 , 16 is driven to supply the A stock solution and the B stock solution to the dialysate introduction line L1, so that a dialysate having a predetermined concentration is prepared and introduced into the dialyzer 2.
  • the dialyzer 2 blood purification means
  • the dialyzer 2 blood purification means
  • the blood outlet port 2b facing upward, and the blood flow path 2e of the dialyzer 2 from the blood introduction port 2a. It is possible to filter the priming liquid introduced into the dialysate flow path 2f through the blood purification membrane 2g and lead out from the dialysate introduction port 2c to prime the dialysate flow path 2f.
  • the present invention is applied to a blood purification apparatus that does not include the blood circuit side air trap chamber 3, the dialysate side air trap chamber 7, and the air discharge means 9, 10, or a blood purification apparatus that does not include the replacement fluid line L3 and the replacement fluid pump P4. Also good.
  • the blood purification means is not limited to the one provided with the blood purification membrane 2g made of a hollow fiber membrane, and may have other forms that can purify and treat blood.
  • the present invention is not limited to the treatment, and may be another treatment for purifying the patient's blood while circulating it extracorporeally.
  • the blood purification means When filling the priming liquid in priming, the blood purification means is held with the blood outlet port facing upward, and the priming liquid introduced from the blood introduction port into the blood flow path of the blood purification means is passed through the blood purification membrane.
  • a blood purification apparatus to which other functions are added may be used.

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  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Biomedical Technology (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
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  • Hematology (AREA)
  • Life Sciences & Earth Sciences (AREA)
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  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
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Abstract

L'invention concerne un dispositif de purification du sang avec lequel un trajet d'écoulement de sang et un trajet d'écoulement de dialysat d'un moyen de purification du sang peuvent être remplis de manière fiable avec une solution d'amorçage, et le travail d'inverser le moyen de purification de sang par un professionnel de la santé au début d'une thérapie de purification de sang peut être évité. Dans ce dispositif de purification du sang, un trajet d'écoulement de dialysat (2f) peut être amorcé par les étapes consistant : à maintenir un dialyseur (2) dans un état dans lequel un orifice de distribution de sang (2b) est orienté vers le haut pendant le remplissage d'une solution d'amorçage dans l'amorçage ; à amener la solution d'amorçage, qui a été introduite depuis un orifice d'introduction de sang (2a) dans un trajet d'écoulement de sang (2e) du dialyseur (2), à être filtrée pour le trajet d'écoulement de dialysat (2f) par l'intermédiaire d'une membrane de purification du sang (2g) ; et puis à évacuer la solution d'amorçage à partir d'un orifice d'introduction de dialysat (2c).
PCT/JP2016/081011 2015-10-21 2016-10-19 Dispositif de purification du sang WO2017069171A1 (fr)

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10279098B2 (en) 2015-04-07 2019-05-07 Nxstage Medical, Inc. Blood treatment device priming devices, methods, and systems
CN113646022A (zh) * 2019-04-01 2021-11-12 日机装株式会社 血液净化装置

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2024004226A (ja) * 2022-06-28 2024-01-16 日機装株式会社 血液浄化装置

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2465555A1 (fr) * 2010-12-20 2012-06-20 Gambro Lundia AB Procédé et système permettant de fournir un amorcement et une restitution de liquides pour le traitement sanguin extracorporel
JP2013248334A (ja) * 2012-06-04 2013-12-12 Nikkiso Co Ltd 血液浄化装置及びそのプライミング方法

Family Cites Families (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5910252A (en) * 1993-02-12 1999-06-08 Cobe Laboratories, Inc. Technique for extracorporeal treatment of blood
CN100460026C (zh) * 2006-04-12 2009-02-11 重庆山外山科技有限公司 医用血液透析滤过机
ES2402306T3 (es) * 2007-04-12 2013-04-30 Gambro Lundia Ab Método y aparato para cebar un circuito de sangre extracorporal
JP5323459B2 (ja) * 2008-11-28 2013-10-23 旭化成メディカル株式会社 血液体外循環装置及びそのプライミング方法
JP5548001B2 (ja) * 2010-03-25 2014-07-16 日機装株式会社 血液浄化装置
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
DE102012024341B3 (de) * 2012-12-13 2014-02-13 Fresenius Medical Care Deutschland Gmbh Vorrichtung und Verfahren zum Überwachen eines extrakorporalen Blutkreislaufs zur Erkennung von Luftblasen
US9623164B2 (en) * 2013-02-01 2017-04-18 Medtronic, Inc. Systems and methods for multifunctional volumetric fluid control

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2465555A1 (fr) * 2010-12-20 2012-06-20 Gambro Lundia AB Procédé et système permettant de fournir un amorcement et une restitution de liquides pour le traitement sanguin extracorporel
JP2013248334A (ja) * 2012-06-04 2013-12-12 Nikkiso Co Ltd 血液浄化装置及びそのプライミング方法

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10279098B2 (en) 2015-04-07 2019-05-07 Nxstage Medical, Inc. Blood treatment device priming devices, methods, and systems
US10987461B2 (en) 2015-04-07 2021-04-27 Nxstage Medical, Inc. Blood treatment device priming devices, methods, and systems
US11679190B2 (en) 2015-04-07 2023-06-20 Nxstage Medical, Inc. Blood treatment device priming devices, methods, and systems
US11969534B2 (en) 2015-04-07 2024-04-30 Nxstage Medical, Inc. Blood treatment device priming devices, methods, and systems
CN113646022A (zh) * 2019-04-01 2021-11-12 日机装株式会社 血液净化装置

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CN108136100B (zh) 2020-10-13

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