WO2017182476A1 - Système de refroidissement et/ou de réchauffement endovasculaire et/ou extracorporel d'un corps humain ou animal - Google Patents

Système de refroidissement et/ou de réchauffement endovasculaire et/ou extracorporel d'un corps humain ou animal Download PDF

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Publication number
WO2017182476A1
WO2017182476A1 PCT/EP2017/059202 EP2017059202W WO2017182476A1 WO 2017182476 A1 WO2017182476 A1 WO 2017182476A1 EP 2017059202 W EP2017059202 W EP 2017059202W WO 2017182476 A1 WO2017182476 A1 WO 2017182476A1
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WO
WIPO (PCT)
Prior art keywords
cooling
heat exchanger
hose
hypothermia
dad
Prior art date
Application number
PCT/EP2017/059202
Other languages
German (de)
English (en)
Inventor
Giorgio Cattaneo
Michael BÜCHERT
Tobias Jost
Original Assignee
Acandis Gmbh & Co. Kg
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Filing date
Publication date
Application filed by Acandis Gmbh & Co. Kg filed Critical Acandis Gmbh & Co. Kg
Publication of WO2017182476A1 publication Critical patent/WO2017182476A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
    • A61F7/0085—Devices for generating hot or cold treatment fluids
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
    • A61F7/007—Heating or cooling appliances for medical or therapeutic treatment of the human body characterised by electric heating
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
    • A61F2007/0054—Heating or cooling appliances for medical or therapeutic treatment of the human body with a closed fluid circuit, e.g. hot water
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
    • A61F7/007—Heating or cooling appliances for medical or therapeutic treatment of the human body characterised by electric heating
    • A61F2007/0075—Heating or cooling appliances for medical or therapeutic treatment of the human body characterised by electric heating using a Peltier element, e.g. near the spot to be heated or cooled
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
    • A61F7/12—Devices for heating or cooling internal body cavities
    • A61F2007/126—Devices for heating or cooling internal body cavities for invasive application, e.g. for introducing into blood vessels

Definitions

  • the invention relates to a hypothermia device and a system with such a hypothermia device for intravascular and / or extracorporeal cooling of a human or animal body.
  • the invention is particularly concerned with improvements of hypothermia devices or hypothermia systems used for therapeutic purposes, in particular for the supportive treatment of strokes.
  • hypothermia The importance of therapeutic hypothermia has increased significantly in recent years. Studies have shown that in diseases that cause circulatory disorders, a targeted hypothermia
  • Cure can improve.
  • the hypothermia is used to calculate the hypothermia
  • Oxygen demand of affected tissue areas is reduced. This leaves more time to effectively remedy the circulatory problem.
  • Treatment is to use intravascular cooling systems.
  • a cooling catheter is introduced into a blood vessel, which is coupled with an extracorporeally arranged cooling device.
  • the catheter forms a coolant circuit with the cooling device so that blood flowing past the tip of the catheter is immediately cooled.
  • Such catheters are currently known in particular for use in larger blood vessels of the trunk area.
  • an extracorporeal cooling device or hypothermia device is provided in each case, which has a pump which is used to maintain the hypothermia
  • the extracorporeal cooling unit is equipped with a
  • Hose set connectable the hose set is designed as a disposable item.
  • the tube set comprises several tube sections and usually connects a cooling bag or a cooling cassette with a cooling catheter or a
  • the tubing set is connected to a coolant reservoir, such as a saline bag, which may be used as a
  • the coolant or saline circulates through the tubing set by the action of the pump of the refrigerator.
  • the coolant flows from the coolant tank or to the coolant cassette and then reaches the cooling catheter and / or the extracorporeal cooling element.
  • the cooling unit must have a sufficiently high cooling capacity in order to achieve efficient hypothermia.
  • the Applicant known cooling devices that use Peltier elements for cooling, use a flow pump. Although such flow pumps do not produce pulsatile ejection, their performance in terms of mean flow rate and pressure in the refrigerant circuit is limited.
  • Hypothermia devices or hypothermia continue to develop such that the known from the prior art disadvantages are at least partially avoided.
  • the invention proposes, in particular medical, device which is suitable for intravascular and / or extracorporeal cooling and / or heating of a human or animal body and has at least one heat exchanger unit which at least one
  • Temperierelement for tempering for example, a Peltier element for cooling, a flowing through a hose set temperature control, in particular coolant comprises.
  • the device has at least one
  • Fluid delivery unit for example a pump, preferably a peristaltic pump, which is provided for generating a Temperierbachströmung within the tubing set.
  • the tempering preferably has a Peltier element or consists thereof.
  • the terms "tempering” and “cooling” and terms composed thereof for example
  • the device for intravascular and / or extracorporeal cooling and / or heating of a human or animal body is referred to below as a "hypothermia device", in the context of the present application, this also means a device, in particular a medical device, which has a cooling function and / or or has a warming function The device may be adapted to maintain a body temperature.
  • the peristaltic pump at least three Abklemmimplantation to sections
  • Hose pump can be designed so that pressure fluctuations in the
  • Temperature control during operation of the peristaltic pump have a pressure amplitude which is less than 30% of the mean pressure of the funded by the peristaltic pump temperature control.
  • the mean pressure is preferably determined by averaging the pressure over a predetermined period of time.
  • the pressure amplitude can have at most 20%, in particular at most 15%, in particular at most 10%, in particular at most 5%.
  • the pressure amplitude describes the value of the maximum deflection of the pressure curve with respect to the arithmetic mean value of the pressure oscillation. To be distinguished from this is the peak-valley value, which corresponds to a difference between a maximum and a subsequent minimum of a vibration. For a sinusoidal waveform, the pressure amplitude is half the peak-to-valley value.
  • the peristaltic pump generates a pulsating output so that the fluid pressure fluctuates between a maximum and a minimum. These pressure fluctuations are preferably limited so that their amplitude does not exceed the above-mentioned proportions of the mean pressure.
  • the pressure on the pressure side of the peristaltic pump preferably fluctuates less than +/- 30%, in particular at most +/- 20%, in particular at most +/- 15%, in particular at most +/- 10%, in particular at most +/- 5%, around the mean pressure.
  • the peristaltic pump can be designed so that a
  • Temperierbachströmung with an average flow rate of at least 80 ml / min at a back pressure of at least 3 bar is adjustable or achievable.
  • the average flow rate may, in particularly preferred embodiments, be at least 100 ml / min, preferably at least 120 ml / min.
  • the back pressure against which the peristaltic pump must work may be determined by the dimensioning of a cooling catheter.
  • the device with a cooling catheter to a system
  • cooling catheter is combinable, wherein the cooling catheter is dimensioned so that the
  • Peristaltic pump counteracts a back pressure on the pressure side, which is between 2 bar and 4 bar, in particular between 2.5 bar and 3.5 bar.
  • the device provided in the hose pump preferably forms a
  • Peristaltic pump that generates a pulsatile coolant flow. It is
  • the hose pump at the back pressure of at least 3 bar, in particular at least 3.5 bar, in particular at least 4 bar, a flow rate of at least 80 ml / min, in particular at least 100 ml / min, in particular at least 120 ml / min generated. This ensures good circulation so that rapid hypothermia is achieved.
  • the at least three Abklemm imagery the peristaltic pump at the same time reduce the pressure fluctuations in the hose set, so that the hose set is spared.
  • the peristaltic pump has at least four Abklemmimplantation.
  • a peristaltic pump designed in this way achieves a high flow rate while at the same time keeping pressure fluctuations of the pulsatile flow low.
  • the flow rate can be increased at a constant medium pressure.
  • the device is well suited for use with comparatively long catheters, especially when the catheters are relatively small
  • the hose pump may have a clamping section for clamping the
  • the distance between the Abklemmissen and the length of the clamping portion are coordinated so that the hose portion which is inserted into the clamping portion, always of at least one
  • Abklemmelement is squeezed or clamped. It can preferably be provided that the hose section always, d. H. in each operating state of the peristaltic pump is squeezed or at least touched by at least two Abklemmemia.
  • the hose set that can be used with the device described here, in particular with the peristaltic pump, preferably has one
  • Hose section for clamping in the clamping section of the hose pump the inner diameter is preferably at most 5 mm, in particular at most 4 mm, in particular at most 3.5 mm, in particular at most 3 mm, in particular at most 2 mm.
  • the peristaltic pump of the device in particular the
  • hypothermia device at least 200 U / min, in particular at least 250 U / min, in particular at least 300 U / min reach.
  • the at least one peristaltic pump can be signal-connected to a controller for monitoring the power consumption of the peristaltic pump.
  • the amount of coolant present in the hose set can be detected via the power consumption of the peristaltic pump with suitable calibration. For example, a relative deviation of the coolant volume over time can be detected.
  • a relative deviation of the coolant volume over time can be detected.
  • the same inferences can be drawn if the tempering elements, in particular Peltier elements, are coupled to a temperature sensor so that the surface temperature of the tempering elements or Peltier elements can be measured.
  • the monitoring of the power consumption of the pump, in particular the peristaltic pump can also be detected if the
  • Catheter tube or a hose portion of the tubing set is kinked. Then the power consumption of the pump increases, since the pump counteracting backpressure of the coolant increases. Furthermore, leakage monitoring can be detected by monitoring the power consumption of the pump. In this case, the fluid pressure in the system, in particular in the hose set, which results in a reduction of the current consumption of the pump decreases.
  • At least two peristaltic pumps are provided.
  • the two peristaltic pumps can be
  • hypothermia device can be operated with more than one hose set or with more than one coolant circuit. In particular, so can the
  • Extracorporeal cooling can be used. This can be two separate
  • Tubesets be provided, wherein a first tube set is connected to a first hose pump of Hypothermiemelds and with a
  • Cooling catheter forms a coolant circuit.
  • a second tube set may be connected to the second peristaltic pump of the hypothermia device and form a second coolant circuit with extracorporeal cooling elements, for example cooling ceilings or cooling bags.
  • the two peristaltic pumps can be controlled separately from each other. This allows flow parameters to be set separately in two different tubing sets. This is advantageous if at the same time an intravascular and an extracorporeal cooling should take place. For example, by setting a suitable flow rate, a relatively reduced cooling can be set for the tubing set, which is extracorporeal
  • Cooling elements is connected (extracorporeal coolant circuit) to protect the skin of the patient from damage.
  • a relatively high flow rate can be set for the tube set that is coupled to the cooling catheter (intracorporeal coolant circuit) in order to achieve rapid and targeted cooling of a specific body area.
  • the flow rate or flow rate in the extracorporeal is connected (extracorporeal coolant circuit) to protect the skin of the patient from damage.
  • the hose pump is assigned a hose clamp in which a clip region of the hose section can be axially fixed.
  • the Peltier element of the heat exchanger unit may be thermally coupled to a cooling plate which limits a gap for receiving a heat exchanger bag of the hose set.
  • the gap may be accessible through an insertion opening in a housing of the hypothermia device, so that the
  • Heat exchanger bag or a heat exchanger cassette of the tubing set is simply used in the heat exchanger unit.
  • the heat exchanger bag or the heat exchanger cassette touches the cooling plate so that a good thermal coupling between the cooling plate and the heat exchanger bag
  • heat exchanger bag and “heat exchanger cartridge” are used interchangeably in the context of the present application.
  • the cooling plate is used for direct transfer of heat energy in the
  • Heat exchanger bag or the heat exchanger cassette It is preferably provided that the inclusion of the heat exchanger bag or the
  • Heat exchanger cassette is formed by a gap in which the
  • Heat exchanger bag or the heat exchanger cartridge is clamped.
  • the clamping ensures a good thermal connection between the
  • the gap for receiving the heat exchanger bag has a width of at most 15 mm. The limited width of the gap causes the
  • Heat input must be made by the Peltier elements in the cooling bag over a limited depth, which improves the overall heat transfer. This improves the thermal performance of the hypothermia device.
  • the gap has a width of at most 10 mm, in particular at most 8 mm, in particular at most 6 mm, in particular at most 4 mm. In this case, a minimum width of the gap of at least 1 mm can be provided.
  • the Peltier element of the heat exchanger unit preferably has a cooling surface which bears directly against the cooling plate. The cooling plate is so far between the Peltier element and the gap or arranged in the gap heat exchanger bag. For a good one
  • Heat transfer is provided that the cooling plate touches both the Peltier element, and the heat exchanger bag directly.
  • the gap is bounded directly by the Peltier element.
  • the cooling plate may be formed by the Peltier element itself.
  • the cooling surface is at least 150 cm 2 , in particular at least 200 cm 2 , in particular at least 230 cm 2 , in particular at least 300 cm 2 , in order to provide a good thermal heat transfer performance.
  • the cooling surface is preferably at most 600 cm 2 , in particular at most 500 cm 2 , in particular at most 400 cm 2 , in particular at most 350 cm 2 .
  • the limitation of the cooling surface contributes to the miniaturization of the device, in particular the hypothermia device. This creates conditions for a high mobility of the device.
  • the Peltier element in operation has a cooling surface, in particular a cooling surface, and a cooling surface opposite
  • the cooling surface and the heat-dissipating surface preferably have identical dimensions. In particular, that can
  • Peltier element be formed as a cuboid whose two largest rectangular surfaces are arranged opposite and parallel to each other, wherein one of these surfaces forms the cooling surface and the other surface of the heat-dissipating surface.
  • the heat exchanger unit preferably has at least one heat sink, wherein the at least one Peltier element is thermally coupled to the heat sink, in particular attached to the heat sink.
  • the Peltier element can abut with its heat-dissipating surface on the heat sink.
  • the heat sink can be made of a good heat-conducting metal,
  • the Heatsink have a plurality of cooling fins to increase the contributing to the cooling surface.
  • the use of the heat sink on the Peltier element increases the thermal performance of the Peltier element for cooling the coolant in the heat exchanger bag.
  • a further improvement of the thermal performance is achieved by having the heat exchanger unit in at least one cooling fan in preferred embodiments of Hypothermie réelles.
  • the cooling fan may be connected to the heat sink.
  • the cooling fan may be attached to the heat sink.
  • the cooling fan is arranged so that a through the
  • Cooling fan generated air flow perpendicular to the Peltier element meets and / or is aligned perpendicular to the cooling fins.
  • cooling fins it is preferably provided that the cooling fan is placed on the cooling fins, in particular screwed.
  • the cooling fan is placed on the cooling fins, in particular screwed.
  • the Peltier element can also be enclosed by a thermal insulation.
  • the thermal insulation is preferably arranged between the cooling plate and the heat sink.
  • the thermal insulation has a thickness which corresponds to the thickness of the Peltier element, so that between the Peltier element and the cooling plate and between the Peltier element and the heat sink, a direct heat transfer contact continues.
  • the thermal insulation preferably extends around the narrow sides of the Peltier element and fills the free space or space between the cooling plate and the heat sink, which is not filled by the Peltier element.
  • the cooling plate and the heat sink may have larger dimensions than the Peltier element, so that it is advantageous to fill the remaining distance between the heat sink and the cooling plate outside the Peltier element by a thermal insulation.
  • the gap, in which the heat exchanger bag of the tubing can be arranged is formed as a recess in the cooling plate.
  • the cooling plate may have a slot-like recess which - a Receiving opening for inserting the heat exchanger bag except - fully enclosed by the cooling plate.
  • the heat exchanger bag of the tubing set can be used directly in this recess.
  • the recess in the cooling plate may be closed on one side, in particular downwards, in order to improve the cooling performance.
  • the recess in the cooling plate may be closed on one side, in particular downwards, in order to improve the cooling performance.
  • Cooling plate to facilitate.
  • the cooling plate is associated with a cooling plate, so that the recess - tube bushings for the tube set except - up, especially - at a bottom closed recess - completely, by the cooling plate and the cooling plate cover is enclosed.
  • the cooling plate cover is formed of the same material as the cooling plate and thermally coupled to the cooling plate.
  • a closed gap is formed, in which the heat exchanger bag can be arranged. This significantly improves the thermal performance since the heat exchanger bag is in operation
  • the recess in the cooling plate is dimensioned so that the heat exchanger bag can be arranged therein with full contact with the cooling plate.
  • the receiving volume of the recess is
  • hypothermia device in the hypothermia device is preferably provided that the heat exchanger bag is clamped in the gap so that a good
  • Heat exchanger bag supports or stabilizes. This is especially true for the cooling plate, which has a recess into which the heat exchanger bag is fully usable.
  • the support of the heat exchanger bag through the cooling plate makes it possible to keep the wall thickness of the heat exchanger bag low in order to achieve a good heat transfer. At the same time is made possible by the support of the heat exchanger bag through the cooling plate, the
  • the gap into which the heat exchanger bag can be arranged is limited by the cooling plate on the one hand and a pressure plate on the other hand.
  • the pressure plate fulfills the task of producing a good thermal contact between the heat exchanger bag and the cooling plate.
  • each cooling plate is thermally coupled to a Peltier element.
  • the gap is limited by two cooling plates, each cooling plate is thermally coupled to a Peltier element.
  • Heat exchanger unit of Hypothermiencings have a plurality of Peltier elements.
  • the plurality of Peltier elements of a single cooling plate for example a cooling plate with a recess for receiving the
  • Heat exchanger bag or be assigned to a plurality of cooling plates.
  • each cooling plate can have a plurality of Peltier elements. It is also possible that a Peltier element is thermally coupled to a plurality of cooling plates.
  • Peltier elements which are each thermally connected to a cooling plate. It has been shown that not only the thermal performance of the
  • Heat exchanger unit and the compact design for efficient mobile use of hypothermia are useful.
  • Hypothermia device also depends on the power consumption. It is important that the hypothermia device can be used in a hospital as desired, wherein the electric current consumption of the Peltier elements must be taken into account so that sufficient electrical power is available in different rooms of the hospital.
  • the Peltier element in the hypothermia device has an electrical power consumption which is at most 200 W, in particular at most 180 W, in particular at most 150 W.
  • the electrical power consumption in preferred variants is at least 80 W, in particular at least 100 W, in particular at least 120 W, in particular at least 150 W. This relates only to the power consumption of the individual Peltier element.
  • the total electrical power consumption of the hypothermia device is preferably higher. However, it is preferably provided that the total electrical power consumption is at most 1 kW.
  • the electrical power consumption of the individual Peltier element can be dependent on other system parameters. In particular, the coolant rate and / or coolant temperature may be the power consumption of the
  • the above values refer to an operating condition of the device at a cooling liquid rate of at least 80 ml / min at a
  • Peltier element preferably at least 100 W, in particular at least 150 W.
  • the Peltier elements are constructed of several Peltier layers.
  • several Peltier individual elements can be coupled to form a common Peltier element.
  • the aforementioned electrical power values are sufficient to achieve the desired high thermal performance for rapid hypothermia.
  • a coolant in particular 0.9% saline solution at a flow rate of at least 80 ml / min, at least 100 ml / min, from an initial temperature of at least 20 ° C, in particular at least 25 ° C, in a short time to a target temperature of at most 5 ° C, in particular at most 2 ° C, is brought.
  • the hypothermia device has a chassis.
  • the chassis may comprise a plurality of rollers which allow the hypothermia device to be moved in all horizontal spatial directions.
  • the hypothermia device is coupled to a patient lying on the operating table via a hose set, it may happen when moving or moving the operating table, that an unwanted tension is applied to the hose set.
  • the invention provides in a preferred embodiment that the hypothermia device additionally has a fastening device for fixing the hypothermia device to a, in particular height-adjustable, operating table.
  • Fastening device is preferably relatively movable relative to the chassis that the chassis relative to the operating table has at least one, in particular a vertical degree of freedom of movement.
  • the device in particular the hypothermia device, with the
  • Movement direction of the movement of the operating table does not follow.
  • the chassis follows the operating table in all horizontal directions of movement, but not in a vertical direction of movement.
  • the operating table can be height adjustable so far, without the chassis follows the height adjustment.
  • the freedom of movement of the chassis in a direction of movement can be achieved in that the chassis blocks movement in a predetermined direction of movement.
  • Movement direction of the operating table therefore does not follow, because the Fastening device decoupled the chassis of the device and the operating table in a direction of movement so that no movement force from
  • the hypothermic device has a total of three degrees of freedom, which are referred to as X-direction, Y-direction and Z-direction.
  • X-direction the degree of freedom of movement
  • Y-direction the degree of freedom of movement
  • Z-direction the degree of freedom of movement
  • the fastening device relative to the chassis can be relatively bewegbar so that the chassis relative to the operating table
  • the chassis of the hypothermia device preferably has a vertical degree of freedom of movement relative to the operating table.
  • this vertical degree of freedom of movement is limited on the one hand by the ground and on the other hand possibly by the weight of the hypothermia device.
  • the fastening device of Hypothermie réelles is coupled to the chassis directly or indirectly so that the
  • Hypothermia device while maintaining a ground contact of the chassis of a rotary motion and / or a horizontal displacement movement of the
  • Operating table can follow, but the chassis retains floor contact with a height adjustment of the operating table.
  • the fastening device is coupled to the chassis directly or indirectly so that the device, while maintaining a ground contact of the chassis of a single horizontal direction,
  • the X-direction a movement of the operating table must follow or follow and in at least one other direction, for example, the Y-direction or the Z-direction, has a degree of freedom of movement.
  • the device may be coupled to the operating table such that it must follow or follow movements in the patient axis (X direction), perpendicular to the patient axis (Y direction), for example because the device is blocked in this direction or not Motive power in this
  • the device can have a degree of freedom of movement in the vertical (Z-direction). With these settings can be ensured that the
  • Chassis of the hypothermia device is coupled so that when fixing the fastening device to an operating table, a distance between the fastening device and the chassis with a lifting movement of the
  • Operating table is changeable. This prevents that by raising the operating table and the hypothermia device is raised. Otherwise, because of the relatively high weight of the hypothermia device
  • Height adjustment of the fastening device thus makes it possible for the hypothermia device to maintain continuous contact with the ground and at the same time not restrict the operating table in its height adjustment function.
  • the relative movement between the fastening device and the chassis can be accomplished by movably connecting the fastening device to a housing of the hypothermia device. It is alternatively or additionally conceivable that the chassis with the heat exchanger unit
  • the relatively movably connected may be provided between the chassis and the heat exchanger unit telescopic arms, so that when starting the operating table, the distance between the chassis and the heat exchanger unit is increased, but the chassis maintains ground contact.
  • the heat exchanger unit follows in this case the operating table.
  • the connection between the chassis and the heat exchanger unit is preferably supported by hydraulic, pneumatic or electric power lifts, for example by at least one linear drive or at least one servomotor. Concretely between the chassis and the heat exchanger unit telescopic legs
  • the fastening device may in particular have a holding element for connection to the operating table.
  • the holding element may for example form a clamp for fixing to a rail of the operating table.
  • Most surgical tables in a plane just below the support plane for the patient at least a side, rail-like railing on which additional medical equipment can be attached. For example, infusion stands or monitoring monitors can be attached to the railing.
  • the invention preferably uses the already existing on the operating table railing for fixing the Hypothermie réelles, so that the
  • Hypothermia device is universally applicable to known surgical tables.
  • the fastening device via a movable bearing with the
  • Heat exchanger unit in particular with a housing of
  • the movable bearing can have a single, in particular vertical, degree of freedom.
  • floating bearing is achieved that the fastening device is adjustable in height and can therefore follow the height adjustment of an operating table.
  • the floating bearing has only a single degree of freedom, it is ensured that the
  • Hypothermia device can follow all other horizontal movements of the operating table. This ensures that between the patient and the
  • Hypothermia device is a constant horizontal distance and thus the hose set is not exposed to undesirable mechanical stress.
  • the non-locating bearing can also have at least one rail fastened to the heat exchanger unit, in particular to the housing, and oriented vertically and at least one sliding shoe arranged on the fastening device.
  • Such a design of the floating bearing is particularly easy to implement and allows the desired limitation of at least one
  • the fastening device may also have an articulated arm with at least two hinges.
  • Such an articulated arm which is preferably coupled with one of its hinges to the heat exchanger unit, in particular the housing of the heat exchanger unit and connected to the other of its hinges to the operating table, also allows a, in particular vertical, degree of freedom of movement of the chassis when the hypothermia device with the fastening device fixed to an operating table.
  • hinges each have a single plane of rotation. This show the swivel joints
  • the plane of rotation is aligned vertically, in particular perpendicular to a displacement plane of the chassis.
  • the plane of rotation can be aligned parallel to the articulated arm. This ensures that the articulated arm with the hinges compensates for a height adjustment of the operating table.
  • the articulated arm also allows for a separate displacement of Hypothermie réelles the operating table within narrow limits, especially if in addition to the articulated arm a floating bearing is provided.
  • the movable bearing as described above, be formed by a corresponding rail and a shoe.
  • the fastening device in particular the articulated arm, is designed to be telescopic in a preferred embodiment of the hypothermia device.
  • the articulated arm may have an integrated floating bearing or sliding joint, which is formed by a telescopic mechanism. This makes it possible to move the hypothermia device within the limits of the telescopic distance from the operating table.
  • the telescopic section is preferably selected so that it is possible to displace the hypothermia device relative to the operating table without damaging the tubing set or without applying a mechanical tension to the tubing set.
  • the device described above is preferably part of a system for
  • the system includes, in addition to the hypothermia device, a tubing set, wherein the hypothermia device is connected or connectable through the tubing set to a cooling catheter (intravascular hypothermia) and / or to an extracorporeal cooling element (extracorporeal hypothermia).
  • a cooling catheter intravascular hypothermia
  • extracorporeal cooling element extracorporeal hypothermia
  • the heat exchanger unit has a universal fluid connection.
  • the universal fluid connection is used to connect the heat exchanger unit with a cooling catheter or an extracorporeal cooling element.
  • a fluid connection which can have, for example, a fluid inlet and a fluid outlet, can be used universally.
  • a cooling catheter or an extracorporeal cooling element can be connected via the universal fluid connection.
  • different tubing sets can be connected to the universal fluid connection.
  • “universal” means that the fluid connection can be used both for the cooling catheter and for the extracorporeal cooling element.
  • the universal design of the fluid connection is not absolutely sufficient to the extent that any cooling catheter or any other cooling catheter can be used
  • Cooling element is connectable. It is sufficient if there is a type of cooling catheters and a type of extracorporeal cooling elements, each having the same connections and connectable with the so far universal fluid connection of Hypothermie réelles.
  • a kit in particular for use with a previously described device or for use in a previously described system comprising a cooling catheter and at least one extracorporeal cooling element, for example a cooling neck brace, a cooling vest and / or a cooling bag, which are arranged in a common packaging, wherein the cooling catheter and the extracorporeal cooling element have the same or different connections for connection to a hose set and / or a device previously described.
  • the cooling catheter and the extracorporeal cooling element for example a cooling neck brace, a cooling vest and / or a cooling bag, which are arranged in a common packaging, wherein the cooling catheter and the extracorporeal cooling element have the same or different connections for connection to a hose set and / or a device previously described.
  • Extracorporeal cooling element can in particular in a common
  • Sterilgutverpackung be arranged. Specifically, it can be provided that the cooling catheter has two different connections for different tubing sets. Likewise, a
  • Tubing sets to the cooling catheter or the extracorporeal cooling element can be avoided.
  • the heat exchanger unit may have a first fluid port for connection to a cooling catheter and a second fluid port
  • the first fluid port and the second fluid port may both be formed as universal fluid ports. In this case it is for the
  • Hose set is connected, which forms several sub-circuits.
  • the system may in particular comprise a tube set forming two partial circuits, wherein a first partial circuit, the cooling catheter and a second
  • Subcircuit includes the extracorporeal cooling element. It can be provided in particular that the hose set is a valve, in particular a
  • the hose set has a valve that regulates the amount of fluid to the sub-circuits. Both partial circuits can be flowed through simultaneously with coolant. The valve is used to
  • the valve realizes a predetermined fluid distribution, that is, neither switchable nor regulatable.
  • a valve may be formed for example by a Y-piece.
  • the device has a height from the bottom to the at least one fluid connection, which is at least 700 mm, in particular at least 800 mm, in particular at least 900 mm, in particular at least 1000 mm.
  • the height from the bottom to the fluid connection should not be more than 1400 mm, in particular not more than 1200 mm. If the device is equipped with a height-adjustable chassis, the height information given above refers to the fully shut down state.
  • the width and / or the depth of the device are preferably at most 500 mm, in particular at most 400 mm, in particular at most 300 mm.
  • the width and / or the depth of the device is at least 200 mm.
  • the device is preferably narrower than tiet.
  • the ratio between the width and the depth of the device can be at most 0.9, in particular at most 0.8, in particular at most 0.7, in particular at most 0.6, in particular at most 0.5.
  • hypothermia device it can be provided in the hypothermia device that two peristaltic pumps are provided, wherein the two peristaltic pumps are provided for independent tubing sets.
  • the system may include a hypothermic device with two peristaltic pumps for independent tubing sets.
  • the flow rates and / or pressures within the individual tubing sets or coolant circuits can be set independently. In this respect, it is preferable if the
  • Peristaltic pumps are controlled separately from each other.
  • Cooling catheter or extracorporeal cooling element is assigned. In this respect, two completely separate coolant circuits can be established. Alternatively, all pumps, especially peristaltic pumps, by a single
  • Hose set to be fluidly connected to the same cooling catheter or extracorporeal cooling element.
  • a peristaltic pump receives two sections of tubing of different tubing sets and simultaneously pumps coolant through two separate coolant circuits. It can also be provided that the hose sections of different hose sets have different dimensions, so that different flow rates are set in the separate coolant circuits.
  • the at least one hose set preferably comprises one
  • Heat exchanger bag The heat exchanger bag can be in a gap
  • the cooling plate is preferably thermally coupled to the at least one Peltier element of the heat exchanger unit.
  • the heat exchanger bag is preferably up to a coolant pressure of at least 2 bar, in particular at least 3 bar,
  • the heat exchanger bag may have a wall thickness which is at most 500 ⁇ , in particular at most 400 ⁇ , in particular at most 350 ⁇ , in particular at most 250 ⁇ , in particular at most 200 ⁇ .
  • the wall thickness of the heat exchanger bag is preferably at least 50 ⁇ , in particular at least 100 ⁇ .
  • the heat exchanger bag can be replaced by at least two wall elements,
  • edges may in particular be glued or welded.
  • Part of the tubing set may further each have an inlet tube and a
  • the inlet hose and the outlet hose preferably extend between the wall elements, in particular the films, into an interior space of the heat exchanger bag.
  • the inlet tube and the outlet tube can be adhesively bonded to the wall elements of the heat exchanger bag or
  • the inlet tube preferably has an inner diameter of at least 3 mm, in particular at least 4 mm, in particular at least 5 mm, in particular at least 7 mm.
  • the outlet hose preferably has an inner diameter which is at most 4 mm, in particular at most 3 mm, in particular at most 2 mm.
  • Exhaust hose can be greater than 1 mm, in particular greater than 2 mm, to reduce heat losses.
  • the tubing set may also include a patient connection tube connectable or connected to the outlet tubing.
  • the Patient connection tube of the same dimensions as the outlet tube.
  • the inlet tube which also has the same dimensions as the patient connection tube.
  • heat exchanger bag and the gap can be so each other
  • the gap limits an expansion of the heat exchanger bag.
  • the gap may be dimensioned such that the
  • Heat exchanger bag is supported by the cooling plate. This ensures that the heat exchanger bag withstands high coolant pressure.
  • the heat exchanger bag is clamped between two cooling plates or between a cooling plate and a pressure plate.
  • the clamping of the heat exchanger bag on the one hand causes a good fixation of the
  • Heat exchanger bag increases its stability, in particular its
  • the heat exchanger bag is arranged or can be arranged on a pressure side of the hose pump. In other words, that is
  • Heat exchanger bag downstream of the peristaltic pump in the flow direction of the coolant This has the advantage of being pumped by the pulsatile
  • Heat exchanger unit and the coolant improves and reduces the burden on the subsequent hoses and the cooling catheter or a cooling lock.
  • Hose pump in particular in the flow direction of the coolant in front of the hose pump, be arranged or be arranged.
  • the cooling catheter used for this purpose is suitable for being positioned in intracerebral, in particular in intracranial, vessels.
  • a cooling catheter is provided in the system for intracerebral positioning or intracranial blood vessels is suitable. This makes the system suitable for supporting stroke therapy.
  • the cooling catheter may in particular have a length which is between 70 cm and 120 cm.
  • a cooling fluid lumen may be formed within the cooling catheter, which in particular extends from a proximal end of the catheter to a distal end of the catheter.
  • Coolant lumen can have a length between 70 cm and 120 cm, in particular between 75 cm and 120 cm, in particular between 80 cm and 120 cm, in particular between 85 cm and 120 cm, in particular between 90 cm and 120 cm.
  • the cooling liquid lumen preferably has a flowthrough
  • Cross-sectional area that is at most 2 mm 2, in particular at most 1.5 mm 2, particularly not more than 1 mm 2, in particular at most 0.8 mm 2.
  • the extracorporeal cooling element that can be connected to the hypothermia device can be suitable or adapted, for example, for cooling a neck area or a neck area of a human body.
  • the extracorporeal cooling element may be formed by a cooling bag, which is shaped in the manner of a neck brace. In this way, that can be done by the
  • Carotid artery flowing blood can be cooled externally. Moreover, it can be provided that the cooling plate on a the
  • Heat exchanger bag facing side structuring in particular in the form of a negative meandering shape having.
  • the structuring of the cooling plate is transferred to the heat exchanger bag, so that when the heat exchanger bag in the gap within the heat exchanger bag a
  • Structuring for example, a meandering coolant guide results.
  • the heat exchanger bag has a structuring, in particular a meandering channel structure.
  • the cooling plate may be flat in this case.
  • the cooling plate has a structuring, which corresponds to a negative form of the structuring of the heat exchanger bag.
  • a negative form of the structuring of the heat exchanger bag In particular, a negative
  • the system may also include a temperature sensor for measuring the temperature of a patient.
  • the temperature sensor can in particular as
  • the forehead temperature sensor is on the forehead of a
  • the forehead temperature sensor can be glued to the forehead of the patient.
  • the forehead temperature sensor is preferably connectable to a controller of the hypothermia device, so that the cooling capacity of the heat exchanger unit is measured on the basis of the patient's forehead
  • Body temperature is adjustable.
  • Hypothermia device a hose set, a cooling catheter and a
  • Temperature sensor in particular a forehead temperature sensor, provided, wherein the temperature sensor and the cooling catheter in a common
  • the temperature sensor can form a set with the cooling catheter, which, in particular in a delivery state of the system, is arranged in a common sterile goods packaging.
  • the temperature sensor in particular the forehead temperature sensor, may be designated as a disposable item.
  • the temperature sensor in particular the forehead temperature sensor, can be marketed with the cooling catheter in a common sterile-product packaging independently of the other components of the system.
  • a set is explicitly disclosed which comprises or consists of a temperature sensor, in particular a forehead temperature sensor, and a cooling catheter.
  • the cooling catheter and the forehead temperature sensor are preferably packaged together in a sterile manner.
  • the set can be a uniform
  • the cooling catheter and the Vortrntemperatursenor have manageable Sterilgutverpackung in which the cooling catheter and the Vortrntemperatursenor are arranged together.
  • the cooling catheter and / or the extracorporeal cooling unit with or without the aforementioned temperature sensor, in particular
  • the system described herein may comprise a plurality of sensors connected to the hypothermia device, in particular a controller of the
  • Hypothermia device are connectable.
  • one or more of the following sensors or a combination of the sensors may be part of the system: Temperature sensor for measuring the temperature of the temperature control medium or
  • Resistance sensor for measuring the electrical resistance of the
  • Tempering agent or coolant in the hose set
  • the preferably provided fluid flow sensor or flow sensor can be designed as an ultrasonic sensor.
  • the fluid flow sensor, in particular the ultrasonic sensor be suitable to air bubbles in
  • Fluid flow sensor have a rotary impeller to visualize the fluid flow.
  • hypothermia device has an air bubble trap, which is preferably arranged in the flow direction of the coolant behind the peristaltic pump or behind the heat exchanger. Furthermore, a sensor for filling level monitoring of the coolant level in the coolant reservoir and / or in the heat exchanger bag may be provided.
  • hypothermia system according to the invention according to a preferred embodiment; a cross-sectional view through the heat exchanger unit of Figure 4 along the line V-V. the cross-sectional view of Figure 5 with arranged between two cooling plates heat exchanger bag.
  • Fig. 10 is a plan view of an arrangement of an inventive
  • Fig. 11 is a side view of an arrangement of an inventive
  • FIG. 12 is a detail view of the arrangement of FIG. 11, where the
  • Attachment device of Hypothermiegoings is coupled via a movable bearing with the housing of Hypothermie réelles;
  • FIG. 13 is a detail view of the arrangement of FIG. 11, where the
  • Hypothermia device is coupled via an articulated arm with the operating table; 14 is a detail view of the arrangement of FIG. 11, where the
  • Hypothermia device is coupled via a telescopic articulated arm with the operating table;
  • Fig. 15 is a detail view of a housing of the invention
  • Fig. 16 is a side view of an arrangement of an inventive
  • Fig. 1 shows the overview of a hypothermia system according to a preferred embodiment.
  • the system generally includes a hypothermia device 100, at least one tube set 200, and a cooling catheter 240 or extracorporeal
  • the system can in particular either the
  • Cooling catheter 240 or an extracorporeal cooling element 250 include. It is also possible that the system has both a cooling catheter 240, as well
  • Extracorporeal cooling element 250 comprises.
  • the tubing set 200 connects the cooling catheter 240 and / or the extracorporeal cooling element 150 to the
  • the hypothermia apparatus 100 generally includes a heat exchange unit 110 and a peristaltic pump 120. Further, the hypothermia apparatus 100 includes an input and output unit illustratively shown in the drawings as a display 151.
  • the peristaltic pump 120, the heat exchanger unit 110 and the input and output unit or the display 151 are preferably arranged in or on a common housing 152.
  • the hypothermia device 100 may further include an infusion stand 155 connected to the housing 152.
  • the hose set 200 has a plurality of hose lines and a
  • the hose pump 120 has for this purpose a clamping section 123, in which the hose section 213 can be inserted.
  • the hose portion 213 is formed of a particularly flexible material, so that it by Abklemmimplantation 121 of
  • Peristaltic pump 120 can be clamped or squeezed. By clamping the hose portion 213, coolant contained in the hose set 200 is conveyed by the hose pump 120.
  • the hose set 200 essentially forms a coolant circuit.
  • the tube set 200 may be closed together with a cooling catheter and / or an extracorporeal cooling element
  • the tubing set 200 is connectable to a coolant bag 212, which is preferably suspended from the IV pole 155 during operation of the system.
  • the coolant bag 212 may include, for example, a common saline solution in the medical field.
  • the coolant bag 212 may be formed by a commercially available infusion fluid bag, for example filled with saline solution.
  • the coolant bag 212 is connected to the heat exchanger bag 211 through the hose set 200 or a hose line of the hose set 200 to form the coolant circuit. from
  • Heat exchanger bag 211 extends a hose line to the hose section 213, which is inserted into the hose pump 120. After the hose section 213, a main circuit 210 of the hose set 200 divides into two partial circuits 220, 230. A first partial circuit 220 leads to a cooling catheter 240, wherein the
  • Cooling catheter 240 is preferably designed as an intravascular cooling catheter, in particular as an intracerebral cooling catheter.
  • the cooling catheter 240 has for this purpose a coolant inlet 242 and a coolant outlet 243.
  • Cooling catheter 240 may have in the region of its tip one or more cooling balloons, through which the coolant flows.
  • the second subcircuit 230 comprises an extracorporeal cooling element 250.
  • the extracorporeal cooling element 250 may, for example, be a cooling ceiling, a
  • the extracorporeal cooling element 250 is also flowed through by a coolant.
  • the two partial circuits 220, 230 are then brought together again in the main circuit 210. Coolant, which has previously passed through the subcircuits 220, 230, thus passes back into the coolant bag 212 via a corresponding hose line.
  • Coolant which has previously passed through the subcircuits 220, 230, thus passes back into the coolant bag 212 via a corresponding hose line.
  • FIG. 1 it is provided that the division of the main circuit 210 into the first subcircuit 220 and the second
  • Subcircuit 230 takes place only after the peristaltic pump 120.
  • the coolant is only by a single peristaltic pump 120 through all circuits 210, 220, 230 promoted.
  • FIG. 2 An alternative design of the hypothermia system is shown in FIG. 2 shown.
  • the hypothermia device 100 has a heat exchanger unit 110 and an input and output unit in the form of a display 151.
  • the heat exchanger unit 110 and the display 151 are held in a housing 152, which also carries an infusion stand 155.
  • FIG. 1 are at the embodiment of FIG. 1
  • the hose set 200 comprises a main circuit 210 and two subcircuits 220, 230.
  • the main circuit 210 is divided in the flow direction of the coolant before the peristaltic pumps 120 into the two subcircuits 220, 230, so that each subcircuit 220, 230 is assigned its own peristaltic pump 120.
  • a hose section 213 is arranged, which can be inserted into a peristaltic pump 120, in particular a clamping section 123 of the peristaltic pump 120.
  • Fig. 3 shows another variant of a hypothermia system, wherein the
  • Hypothermia device 100 is shown with the housing 152. From the housing 152 protrudes the peristaltic pump 120, wherein in the embodiment of FIG. 3, a single peristaltic pump 120 is provided. In addition, an insertion opening 156 is provided in the housing 152, which has access to the
  • Heat exchanger unit 110 offers.
  • Heat exchanger bag 211 of the tubing set 200 are inserted via the insertion opening 156 in the heat exchanger unit 110.
  • Hose set 200 represented by corresponding arrows. It can be seen that the coolant is conducted from the coolant bag 212 to the heat exchanger bag 211 and from there via the peristaltic pump 120 into the two subcircuits 220, 230.
  • the coolant circulates through the cooling catheter 240, in particular the cooling balloons 241.
  • the coolant circulates through an extracorporeal cooling element 250, which in the illustrated embodiment is designed as a cooling sleeve 242.
  • the cooling cuff 242 forms a cervical collar or can be placed around the neck of a patient 400.
  • the coolant flows from the sub-circuits 220, 230 back into the main circuit 210 and enters the coolant bag 212.
  • FIG. 4 shows a side view of a heat exchanger unit 110, wherein a cooling fan 115 can be seen, which is fixedly mounted on a heat sink 114.
  • the heat sink 114 has a plurality of ribs.
  • the cooling fan 115 is aligned so that between the ribs of the heat sink 114, a strong air flow to
  • FIG. 5 shows a cross-sectional view along the line V-V of FIG. 4 and illustrates the structure of the heat exchanger unit 110.
  • Heat exchanger unit 110 includes in the embodiment shown here, two Peltier elements 111, each having a heat sink 114 and a
  • Cooling fan 115 are assigned.
  • Each Peltier element 111 is thermally direct coupled to a heat sink 114.
  • each Peltier element 111 has a heat-emitting side, which rests against the heat sink 114.
  • each Peltier element 111 has a cooling surface or a cooling side, which is directly thermally coupled to a cooling plate 112. This is concrete
  • Peltier element 111 disposed between the heat sink 114 and the cooling plate 112 and contacts both the heat sink 114, and the cooling plate 112th
  • the Peltier element 111 is smaller than the one
  • Heatsink 114 and the cooling plate 112. In this respect, remains between the heat sink 114 and the cooling plate 112, a free space that is not filled by the Peltier element 111.
  • the Peltier element 111 forms a spacer so far, wherein the distance between the heat sink 114 and the cooling plate 112 in the present case is filled by a thermal insulation 113.
  • the Peltier element 111 is embedded in a thermal insulation 113, wherein the thermal insulation 113 surrounds the Peltier element 111 only on its narrow sides.
  • a gap 116 is formed between the cooling plates 112 of the heat exchanger unit 110.
  • the gap 116 serves to receive the heat exchanger bag 211 of the hose set 200.
  • the gap 116 is dimensioned as small as possible and preferably has a width of at most 15 mm in order to achieve a good and efficient heat transfer between the heat exchanger unit 110 and the coolant in the heat exchanger bag 211 ,
  • FIG. 6 shows the heat exchanger unit 110, wherein a heat exchanger bag 211 is arranged in the gap 116.
  • the heat exchanger bag 211 is clamped by the cooling plates 112 so that there is good thermal contact.
  • the clamping fixation can be achieved, for example, in that the two cooling plates 112, preferably together with the respective
  • Peltier elements 111, heat sinks 114 and cooling fans 115 are electromotively, mechanically or pneumatically adjustable, so that the width of the gap 116 is variable.
  • a heat exchanger bag 211 can be easily inserted into a relatively wide gap 116. Once the heat exchanger bag 211 is disposed in the gap 116, the cooling plates 112, Peltier elements 111, heat sink 114 and cooling fan 115 can be moved together, preferably as a moving unit, by an electric motor, so that the width of the gap 116 is reduced. Thereby, the heat exchanger bag 211 is clamped between the cooling plates 112.
  • FIG. 7 An alternative design of the cooling plate 112 of the heat exchanger unit 110 is shown in FIG. 7. Accordingly, it may be provided in a preferred embodiment that the heat exchanger unit 110 has a single cooling plate 112.
  • the gap 116 for receiving the heat exchanger bag 211 can insofar as
  • Recording or slot-like insertion in the cooling plate 112 may be formed. As shown in FIG. 7 is clearly visible, the heat exchanger bag 211 is completely surrounded by the cooling plate 112 in this variant.
  • the cooling plate 112 is in the embodiment of FIG. 7 connected on both sides with a heat sink 114. Each heat sink 114 has one
  • the Peltier elements 111 Preferably, the heat exchanger unit according to FIG. 7 two Peltier elements 111, each between a
  • Heat sink 114 and the cooling plate 112 and arranged thermally with the
  • Heat sink 114 and the cooling plate 112 are coupled.
  • Variants of hypothermia 100 can be used.
  • the ornamental shape of hypothermia 100 can be used.
  • Peristaltic pump 120 has three in the illustrated embodiment
  • the Abklemm implant 121 may be cylindrical. In particular, the Abklemm implant 121 may be formed by rollers.
  • the hose pump 120 shown here has three
  • the Abklemm implant 121 are rotatably connected via a frame 126 with a shaft 122.
  • the shaft 122 is preferably coupled to an electric motor.
  • the peristaltic pump 120 further includes a chucking portion 123 into which a hose portion 213 of the hose set 200 is inserted.
  • Hose section 213 passes through two hose passages 124 in the clamping section 123. It can be clearly seen that the clamping section 123 on the Abklemmimplantation 121 is tuned so that always a Abklemmelement 121 the tube section 213 touches or squeezes. In particular, the length of the clamping portion 123 and the distance between the individual
  • Clamping elements 121 touched and preferably at least slightly squeezed.
  • the hose pump 120 is also associated with a hose clamp 125.
  • the hose clamp 125 makes it possible to fix the hose section 213 to the hose pump 120.
  • the hose section 213 can have a clip region 127 which is bounded by two annular stops 128.
  • the two stops 128 cause an axial fixation of the tube portion 213.
  • the axial fixation avoids a displacement of the tube portion 213 due to the pump rotation.
  • H is not shown, but preferably provided, another hose clamp 125 on the opposite side of
  • the hose clamp 125 is dimensioned or designed so that a radial squeezing, d. H. a diameter reduction of the hose portion 213, in particular in the clip area 127, is avoided.
  • Fig. 10 shows a top view of the preferred arrangement of a
  • Hypothermia device 100 on an operating table 300 preferably has at least one rail 310, which is provided for fixing additional medical devices or accessories. Furthermore, the
  • Operating table a support surface for a patient 400 and a table frame 320.
  • the table frame 320 is preferably height adjustable.
  • the operating table 300 is displaceable on the table frame 320 in at least one, preferably two horizontal directions. The displacement of the
  • the hypothermia device 100 preferably comprises a housing 152, wherein the housing 152 comprises an insertion opening 156 for a heat exchanger bag 211. Furthermore, a display 151 and the hose pump 120 can be seen on the housing 152.
  • the housing 152 also includes a handle 150 for grasping and moving the hypothermia device 100.
  • the hypothermia device 100 has a chassis 153.
  • the chassis 153 is formed by a plurality of driving rollers 154, which are pivotally connected to the housing 152.
  • an infusion stand 155 is also attached.
  • the hypothermia device 100 further comprises a fastening device 140, which is shown in FIGS. 10 and 11 is shown very schematically.
  • the hypothermia device 140 is shown in FIGS. 10 and 11 is shown very schematically.
  • Fastener 140 allows the connection of the
  • the connection of the hypothermia device 100 by means of the fastening device 140 on the operating table 300 is preferably such that the hypothermia device 100 can follow the horizontal movements of the operating table 300 by means of a chassis 153.
  • a chassis 153 At the same time is the
  • Fixing device 140 such adjustable in height relative to the chassis 153 formed that the operating table 300 is further adjustable in height, without the hypothermia device 100 follows this height adjustment.
  • Hypothermia device 100 thus remains in constant contact with the ground.
  • Fig. 11 is an arrangement of Hypothermiencings 100 with a
  • Fixing device 140 is fixed.
  • FIG. 11 still one
  • the hypothermia device 100 is preferably used in angiography areas, whereby an angiographic examination, for example for determining the position of a circulatory disorder in the brain, takes place under hypothermic therapy.
  • FIGS. 12-14 Details of the fastening device 140 are shown in FIGS. 12-14.
  • Fig. 12 shows an exemplary embodiment of the fastening device 140, in which the fastening device 140 is arranged on the hypothermia device 100 or on the housing 152 by means of a loose bearing 142.
  • Fastening device 140 comprises a holding element 141, which with the
  • Holding element 141 is in the embodiment of FIG. 12 formed as a hook 141 which is hooked from above into the railing 310.
  • the floating bearing 142 is oriented vertically. In other words, the floating bearing 142 is designed so that a vertical sliding movement of the fastening device 140 along the housing 152 is released.
  • the holding element 141 is coupled to a sliding shoe 144 of the movable bearing 142 by a rigid connection.
  • Fig. 15 shows a concrete preferred embodiment of
  • FIG. 12 a detail of a perspective view of the Hypothermiencing 100 is shown, wherein the housing 152 with the handle 150 can be seen. There are two on the case
  • the fastening device is formed by two independent hooks 141a, each hook 141a comprising two sliding shoes 144, which are height-displaceable along the rails 143.
  • the hooks 141 a can be hooked into a rail 310 of an operating table 300. With a height adjustment of the operating table 300, the sliding shoes 144 allow a height adjustment of the hook 141 a, so that the
  • FIG. 13 an alternative fastening device 140 is shown, wherein the fastening device 140 has an articulated arm 145.
  • the articulated arm 145 comprises two pivot joints 146.
  • the axes of rotation of the pivot joints 146 extend horizontally.
  • the planes of rotation of the hinges 146 are arranged in a common plane of rotation, wherein the common plane of rotation is preferably aligned vertically to the ground, in particular horizontal to the ground and parallel to the axis of a patient.
  • the articulated arm 145 is concretely coupled to the housing 152 of the hypothermia device 100 by means of a first pivot joint 146.
  • a second pivot 146 couples the hinge arm 145 to the support member 141 of FIG.
  • Fixing device 140 is in the embodiment of FIG. 13 and 14 formed as a terminal 141 b.
  • the clamp 141b differs from the hook 141a shown in FIG. 12, in that in addition a
  • Clamping element is provided, with which the retaining element 141 can be clamped non-positively with the rail 310.
  • the distance between the hypothermia device 100 and the operating table 300 is also changed by a height adjustment of the operating table 300. It is provided that the tube set 200 has a sufficient length to compensate for this change in distance between hypothermia device 100 and the operating table 300, which is triggered by a height adjustment of the operating table 300.
  • FIG. 14 shows a further exemplary embodiment of a fastening device 140.
  • the fastening device 140 is substantially analogous to that
  • the articulated arm 145 is telescopic.
  • the articulated arm 145 has a telescopic mechanism 147, which allows a length adjustment of the articulated arm 145.
  • FIG. 16 A further possibility for adjusting the height of the hypothermia device 100 when adjusting the height of an operating table 300, to which the hypothermia device 100 is fixed, is shown in FIG. 16.
  • the hypothermia device 100 shown here differs from the hypothermia device 100 according to FIG. 12 only in that, on the one hand, the chassis 153 can be moved relative to the housing 152 and, on the other hand, the fastening device can be moved by a fixed bearing 148 with the housing
  • Housing 152 is connected.
  • the casters 154 of the chassis 153 are connected by telescopic legs 157 to the housing 152 of the hypothermia device 100.
  • the telescopic legs 157 make it possible to vary the distance between the chassis 153 and the housing 152.
  • the housing 152 a height adjustment of
  • the weight of the heat exchanger unit 110 in particular all contained in the housing 152 and fixedly attached to the housing 152 components continue to be supported by the chassis 153 and not mainly the rail 310 of the operating table 300 charged, the telescopic legs 157 may be hydraulically or electromechanically adjustable.
  • the hypothermia device 100 can for this purpose have at least one sensor and / or a control signal input, so that a control for the telescopic legs 157 information about the current height of the operating table 300 are transferable.
  • distance sensors may be provided on the holding element 141, which detect a height adjustment of the operating table 300 and transmit a corresponding signal to the controller. The controller can then track the telescopic legs. It is also possible that the control via the control signal input with a control signal output of
  • Operational table 300 is connectable to receive a signal about the height position directly from the operating table 300.
  • Tube set 200 is preferably used for the treatment of stroke diseases. Particularly preferred is the combination of the
  • the cooling catheter 240 may have correspondingly small dimensions to allow advancement of the cooling catheter 240 into the small intracranial blood vessels.
  • the cooling catheter 204 preferably has a cross-sectional diameter at least in the region of the cooling balloons 241 which is at most 3 mm, in particular at most 2 mm.
  • the heat exchanger bag 211 may have dimensions of 200 mm x 150 mm, in particular 180 mm x 130 mm.
  • the heat exchanger bag 211 may have a length of 160 mm to 200 mm, in particular 180 mm.
  • Heat exchanger bag 211 between 110mm and 150mm, in particular 130mm amount.
  • the length of the heat exchanger bag 211 is shown in FIG. 1 and 2 are arranged vertically in the drawing plane, d. H. the tube feeds of the tubing set 200 open longitudinally into the heat exchanger bag 211.
  • the width of the heat exchanger bag 211 is along the side of the
  • Heat exchanger bag 211 measured, in which the hose feeders open.
  • the width of the heat exchanger bag 211 can be seen in the horizontal direction in the plane of the drawing.
  • the device may be designed such that condensation occurring in the collecting device and / or can be dissipated in the ground direction.
  • the collecting device can be configured as a collecting trough or as a catch basin, for example.
  • the collecting device can be removed from the device. This facilitates the cleaning of the collecting device. It is of particular advantage if the condensation can be dissipated in the direction of the ground or down out of the device.
  • Temperature control element and / or the cooling plate 112 is arranged.
  • the collecting device can be arranged in the lower region in the direction of the ground in the device.
  • the device has at least one inlet and / or outlet for inlet and / or outlet of a fluid flow, in particular an air flow on.
  • a fluid flow in particular an air flow on.
  • Several inlets and / or outlets can be arranged on the device.
  • Hypothermia device 100 connects to the operating table 300, the at least one inlet and / or outlet can be arranged on the opposite side of the fastening device 140.
  • the fastening device 140 is at least in the embodiment of FIG. 10 to 16 arranged on a lateral side of the device. The with the fastening device 140th
  • Called transverse side In other words, the side of the device opposite the human or animal body or else the fastening device 140 can form the free transverse side.
  • the at least one inlet can be arranged, for example, on the free transverse side or on a side adjoining the free transverse side, in particular a front side or a rear side.
  • the front side is preferably the one substantially vertical side which faces a user looking at the display.
  • the rear side preferably extends parallel to the front side.
  • the transverse sides connect the front side and the rear side and are preferably also oriented substantially vertically.
  • the arrangement of the at least one inlet on the front, rear or free transverse side allows the most efficient air intake of cool ambient air for cooling of the human or animal body. In particular, avoiding air inlets on the transverse side facing the operating table 300 or the transverse side equipped with the fastening device 140 prevents the air suction from being obstructed by the operating table 130 or cloths present thereon.
  • the at least one outlet can be arranged on an underside of the device in the bottom direction.
  • the air flow is preferably directed to the ground. It is also conceivable that the at least one outlet is formed on the device such that an exiting air flow in
  • Ground direction is dischargeable.
  • a plurality of outlets may be arranged in the bottom area of the appliance in the bottom direction and may be designed such that an outgoing airflow in the bottom direction can be discharged. As a result, an impairment and distraction of the attending physician can be efficiently avoided.

Landscapes

  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Thermotherapy And Cooling Therapy Devices (AREA)

Abstract

L'invention concerne un dispositif de refroidissement et/ou de réchauffement endovasculaire et/ou extracorporel d'un corps humain ou animal, comportant au moins une unité échangeur de chaleur (110) qui comporte au moins un élément Peltier (111) pour le refroidissement d'un produit de mise à température s'écoulant dans un ensemble de tuyaux flexibles (200), et au moins une pompe péristaltique (120) pour produire un écoulement de produit de mise à température dans l'ensemble de tuyaux (200), l'élément Peltier (111) étant thermiquement couplé à une plaque de refroidissement (112) qui délimite une fente (116) destinée à recevoir un sachet échangeur de chaleur (211) de l'ensemble de tuyaux (200), la fente (116) présentant une largeur maximale de 15 mm.
PCT/EP2017/059202 2016-04-18 2017-04-18 Système de refroidissement et/ou de réchauffement endovasculaire et/ou extracorporel d'un corps humain ou animal WO2017182476A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102016107110.2A DE102016107110B4 (de) 2016-04-18 2016-04-18 Gerät und System zur intravaskulären und/oder extrakorporalen Kühlung und/oder Erwärmung eines menschlichen oder tierischen Körpers
DE102016107110.2 2016-04-18

Publications (1)

Publication Number Publication Date
WO2017182476A1 true WO2017182476A1 (fr) 2017-10-26

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DE (1) DE102016107110B4 (fr)
WO (1) WO2017182476A1 (fr)

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN112618144A (zh) * 2019-09-24 2021-04-09 锐可医疗科技(苏州)有限公司 一种冷热敷系统

Citations (4)

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Publication number Priority date Publication date Assignee Title
US6019783A (en) * 1999-03-02 2000-02-01 Alsius Corporation Cooling system for therapeutic catheter
WO2001058397A1 (fr) * 2000-02-09 2001-08-16 Radiant Medical, Inc. Catheters a echanges thermiques a lumieres multiples
US6878156B1 (en) * 2002-07-26 2005-04-12 Alsius Corporation Portable cooler for heat exchange catheter
US20150223972A1 (en) * 2014-02-07 2015-08-13 Zoll Circulation, Inc. Heat exchange system for patient temperature control with multiple coolant chambers for multiple heat exchange modalities

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Publication number Priority date Publication date Assignee Title
US7588549B2 (en) * 2006-08-03 2009-09-15 Terumo Cardiovascular Systems Corporation Thermoelectric temperature control for extracorporeal blood circuit
JP2008173139A (ja) 2007-01-16 2008-07-31 Asahi Kasei Kuraray Medical Co Ltd 液体加温／冷却用の体外循環回路および体外循環システム
WO2011121514A2 (fr) * 2010-03-29 2011-10-06 Eliahu Arad Système et procédé de manipulation de la température d'un patient
DE102012006149A1 (de) * 2012-03-28 2013-10-02 Fresenius Medical Care Deutschland Gmbh Heizvorrichtung zum Erwärmen von Dialysierflüssigkeit, Dialysierflüssigkeits-Schlauchsatz, Set, medizinische Vorrichtung und Verfahren

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6019783A (en) * 1999-03-02 2000-02-01 Alsius Corporation Cooling system for therapeutic catheter
WO2001058397A1 (fr) * 2000-02-09 2001-08-16 Radiant Medical, Inc. Catheters a echanges thermiques a lumieres multiples
US6878156B1 (en) * 2002-07-26 2005-04-12 Alsius Corporation Portable cooler for heat exchange catheter
US20150223972A1 (en) * 2014-02-07 2015-08-13 Zoll Circulation, Inc. Heat exchange system for patient temperature control with multiple coolant chambers for multiple heat exchange modalities

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DE102016107110B4 (de) 2023-06-15

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