WO2018190433A1

WO2018190433A1 - Method and device for determining state of connection of liquid replenishing line to blood circuit in hemodialysis device

Info

Publication number: WO2018190433A1
Application number: PCT/JP2018/015595
Authority: WO
Inventors: 幸次中馬越; 英次金津
Original assignee: 株式会社ジェイ・エム・エス
Priority date: 2017-04-13
Filing date: 2018-04-13
Publication date: 2018-10-18
Also published as: JP6900756B2; CN110494174A; CN110494174B; JP2018175439A

Abstract

The objective of the present invention is to provide a determining method and a determining device which enable easy determination of a state of connection of a liquid replenishing line to a blood circuit in a hemodialysis device. This method for determining the state of connection of a liquid replenishing line 140 to a blood circuit 110A in a hemodialysis device 100A comprises: a pump operating step of causing a blood pump 111a and a replacement fluid pump 140a to operate in the blood circuit 110A in a state in which one end side of an artery side line 111 and one end side of a vein side line 112 are connected to one another and the blood circuit 110A is not full of liquid; a bubble detecting step of detecting bubbles by means of a bubble detector 111b (112b) in a state in which a preset first time has elapsed after the blood pump 111a and the replacement fluid pump 140a were operated; and a determining step of determining whether the liquid replenishing line 140 is connected to the artery side line 111 or is connected to the vein side line 112 in accordance with whether or not bubbles are detected.

Description

Method and apparatus for determining connection state of replenisher line to blood circuit in hemodialyzer

The present invention relates to a determination method and a determination apparatus for a connection state of a replenisher line to a blood circuit in a hemodialysis apparatus.

Conventionally, a hemodialysis apparatus has a hemodialyzer such as a dialyzer or hemodiafilter for purifying a patient's blood, a blood circuit connected to the hemodialyzer to circulate the patient's blood, and dialysate to the hemodialyzer. It is mainly composed of a dialysate circuit for introducing and deriving, and a replenisher line for feeding a replenisher in an amount corresponding to the amount of water removed by the hemodialyzer to the blood circuit.
As for hemofiltration dialysis performed using a hemodialyzer, an on-line system using a dialysate as a replenisher is known in addition to an off-line system using physiological saline as a replenisher (see Patent Document 1). In addition, there are two methods for supplying the replenisher to the blood circuit: a pre-dilution method where the replenisher is injected into the blood circuit upstream of the hemodialyzer, and a post-dilution method downstream. It is done.

In the case of the predilution method, the blood is diluted with a replenisher and enters the hemodialyzer for filtration. Therefore, while blood concentration is difficult to occur in the hemodialyzer, the removal efficiency of the uremic substance is lower than the post-dilution method when the replenisher amount is equal because the blood concentration is reduced. In order to increase the removal efficiency, a larger amount of replenisher is required than in the case of the post-dilution method, and the amount of replenisher per treatment is generally 24 to 96 liters.
On the other hand, in the case of the post-dilution method, the blood enters the hemodialyzer without being diluted, is filtered, and is diluted with a replenisher according to the amount of water removed. Since water is removed to such an extent that blood concentration does not occur in the hemodialyzer, the amount of replenisher is smaller than that of the predilution method, and the amount of replenisher per treatment is about 20 liters.

Japanese Patent Laying-Open No. 2015-80595

As described above, since the amount of the replenisher varies depending on the liquid feeding method, a connection error of the replenisher line to the blood circuit may lead to a serious danger. Therefore, when assembling the circuit of the hemodialyzer, it is necessary to check whether the connection state of the replenisher line to the blood circuit corresponds to the liquid feeding method.
However, the assembled blood circuit and dialysate circuit are intricately attached to the hemodialysis machine, and it is instantly judged visually whether the replenisher line is connected to the correct position with respect to the blood circuit. It is difficult to do.

Therefore, an object of the present invention is to provide a determination method and a determination device that can easily determine the connection state to the blood circuit of the replenisher line.

The present invention relates to a hemodialyzer, an artery side line having one end connected to the subject's artery and the other end connected to the hemodialyzer, and one end connected to the hemodialyzer and the other end connected to the subject's vein. A blood circuit having a venous line connected to a blood line, a blood pump disposed in the arterial line, a dialysate introduction line for introducing dialysate into the hemodialyzer, and a dialysate derived from the hemodialyzer A dialysate circuit having a dialysate lead-out line, a replenisher line connected to the arterial line or the venous line and supplying a replenisher to the blood circuit, and a replenisher pump disposed in the replenisher line A method of determining a connection state of the replenishment liquid line to the blood circuit in a hemodialysis apparatus comprising: a bubble detector disposed on the artery side line or the vein side line and detecting a bubble A pump operation step of operating the blood pump and the replacement fluid pump in the blood circuit in a state where one end side of the arterial line and one end side of the venous line are connected and not filled with liquid; After operating the blood pump and the replacement fluid pump, a bubble detection step of detecting bubbles with the bubble detector in a state where a preset first time has elapsed, and whether bubbles have been detected with the bubble detector And a determination step of determining whether the replenishment liquid line is connected to the artery side line or the vein side line depending on whether or not.

In addition, the bubble detector is disposed on one end side of the arterial line with respect to the connection site of the replenishment liquid line, and in the pump operation step, the blood pump is directed toward one end side of the arterial line. When the bubble is not detected in the determination step, it is determined that the replenisher line is connected to the artery side line, and when the bubble is detected, the replenisher line is It is preferable to determine that it is connected to the vein line.

The present invention also relates to a hemodialyzer, an artery side line having one end connected to the subject's artery and the other end connected to the hemodialyzer, and one end connected to the hemodialyzer and the other end to the subject. A blood circuit having a venous line connected to a vein of the blood, a blood pump arranged in the arterial line, a dialysate introduction line for introducing dialysate into the hemodialyzer, and a dialysate from the hemodialyzer A dialysis fluid circuit having a dialysis fluid derivation line for deriving blood, a replenishment fluid line connected to the arterial line or the venous line, and supplying a replenishment fluid to the blood circuit, and a replacement fluid disposed in the replenishment fluid line An apparatus for determining a connection state of the replenisher line to the blood circuit in a hemodialysis apparatus, comprising: a pump; and a bubble detector disposed on the artery side line or the vein side line to detect bubbles. A pump operating unit for operating the blood pump and the replacement fluid pump in the blood circuit in a state where one end side of the artery side line and one end side of the vein side line are connected and not filled with fluid. A bubble detector that detects bubbles with the bubble detector in a state in which a preset first time has elapsed after the blood pump and the replacement fluid pump are operated by the pump operation unit, and the bubble detection It is related with the determination apparatus provided with the determination part which determines whether the said replenishment liquid line is connected to the said artery side line, or is connected to the said venous side line by whether the bubble was detected by the vessel.

Further, the bubble detector is disposed in the artery side line, the pump operation unit operates the blood pump to flow a replenisher toward one end side of the artery side line, and the determination unit includes: When no bubble is detected, it is determined that the replenisher line is connected to the arterial line, and when a bubble is detected, it is determined that the replenisher line is connected to the venous line. It is preferable.

The present invention also relates to a hemodialyzer, an artery side line having one end connected to the subject's artery and the other end connected to the hemodialyzer, and one end connected to the hemodialyzer and the other end to the subject. A blood circuit having a venous line connected to a vein of the blood, a blood pump arranged in the arterial line, a dialysate introduction line for introducing dialysate into the hemodialyzer, and a dialysate from the hemodialyzer A dialysis fluid circuit having a dialysis fluid derivation line for deriving blood, a replenishment fluid line connected to the arterial line or the venous line, and supplying a replenishment fluid to the blood circuit, and a replacement fluid disposed in the replenishment fluid line A front in a hemodialysis apparatus comprising: a pump; an arterial bubble detector that is disposed in the artery side line and detects bubbles; and a venous bubble detector that is disposed in the vein line and detects bubbles. A method for determining the state of connection of the replenisher line to a blood circuit, wherein the blood circuit is filled with liquid and the replenisher line is filled with gas from the dialysate circuit to the hemodialyzer. The pump operation step of operating the replacement fluid pump while injecting the dialysate by reverse filtration into the fluid, and after the operation of the replacement fluid pump, detection of bubbles by the arterial bubble detector and the venous bubble detector The bubble detection step of starting and detecting bubbles, and when one of the artery-side bubble detector or the vein-side bubble detector detects bubbles earlier than the other, the replenishment liquid line is the artery-side line or And a determination step of determining that it is connected to any one of the vein-side lines.

In the pump operation step, the dialysate is back-filtered and injected from the dialysate circuit to the hemodialyzer when the blood circuit is filled with liquid and the replenisher line is filled with gas. However, the blood pump is operated so that the liquid flows to one end side of the arterial line at a flow rate smaller than the injection amount of the dialysate, and the replacement fluid pump is operated. In the determination step, the arterial bubble detector When the bubble is detected first, it is determined that the replenishment liquid line is connected to the arterial line, and when the bubble is first detected by the venous bubble detector, the replenishment liquid line is It is preferable to determine that it is connected to the venous line.

The present invention also relates to a hemodialyzer, an artery side line having one end connected to the subject's artery and the other end connected to the hemodialyzer, and one end connected to the hemodialyzer and the other end to the subject. A blood circuit having a venous line connected to a vein of the blood, a blood pump arranged in the arterial line, a dialysate introduction line for introducing dialysate into the hemodialyzer, and a dialysate from the hemodialyzer A dialysis fluid circuit having a dialysis fluid derivation line for deriving blood, a replenishment fluid line connected to the arterial line or the venous line, and supplying a replenishment fluid to the blood circuit, and a replacement fluid disposed in the replenishment fluid line A front in a hemodialysis apparatus comprising: a pump; an arterial bubble detector that is disposed in the artery side line and detects bubbles; and a venous bubble detector that is disposed in the vein line and detects bubbles. An apparatus for determining a connection state of the replenisher line to a blood circuit, wherein the blood circuit is filled with a liquid and the replenisher line is filled with a gas from the dialysate circuit. A pump operating unit that operates the replacement fluid pump while performing reverse filtration of the dialysate and injecting the blood pump and the replacement fluid pump by the pump operating unit, and then the arterial bubble detector and the vein When one of the bubble detector and the arterial bubble detector or the venous bubble detector detects bubbles by starting detection of bubbles by the side bubble detector, And a determination unit that determines that a replenisher line is connected to either the arterial line or the venous line.

In addition, the pump operating unit reversely injects dialysate from the dialysate circuit into the hemodialyzer when the blood circuit is filled with liquid and the replenisher line is filled with gas. The blood pump is operated so that the fluid flows to one end side of the arterial line at a flow rate smaller than the injection amount of the dialysate, and the replacement fluid pump is operated. When the air bubble is detected by the arterial bubble detector, it is determined that the replenisher line is connected to the arterial line, and the venous bubble detector It is preferable to determine that the replenisher line is connected to the venous line when bubbles are detected.

In addition, it is preferable that the liquid feeding amount of the replacement pump is smaller than the blood pumping amount and smaller than the amount obtained by subtracting the blood pump feeding amount from the dialysate injection amount.

In addition, a notification is issued when the setting unit for setting a method for supplying a replenisher to the blood circuit, the liquid feeding method set in the setting unit, and the connection state determined by the determination unit do not correspond to each other. And a notification unit.

According to the present invention, the presence or absence of bubbles can be detected by the bubble detector disposed in the blood circuit, and the connection state of the replenisher line to the blood circuit can be easily determined based on the detection result.

It is a figure which shows schematic structure of the hemodialysis apparatus in 1st Embodiment. It is a block diagram which shows the structure of the hemodialysis apparatus provided with the determination apparatus which concerns on 1st Embodiment. It is a figure which shows the flowchart of the determination method which concerns on 1st Embodiment of this invention. In 1st Embodiment, the connection state of the circuit in a predilution system is shown. In 1st Embodiment, the connection state of the circuit in a post-dilution system is shown. The priming of the blood circuit in 1st Embodiment is shown. It is a figure which shows the flowchart of the determination method which concerns on the modification of this invention. It is a figure which shows schematic structure of the hemodialysis apparatus in 2nd Embodiment. It is a block diagram which shows the structure of the hemodialysis apparatus provided with the determination apparatus which concerns on 2nd Embodiment. It is a figure which shows the flowchart of the determination method which concerns on 2nd Embodiment of this invention. The priming of the blood circuit in 2nd Embodiment is shown. In 2nd Embodiment, the connection state of the circuit in the case of predilution is shown. In 2nd Embodiment, the connection state of the circuit in the case of post-dilution is shown.

Hereinafter, preferred embodiments of a hemodialysis apparatus including the determination method and determination apparatus of the present invention will be described with reference to the drawings. The hemodialysis apparatus of the present invention purifies the blood of renal failure patients and drug addicts, removes excess water in the blood, and replenishes the blood as necessary (replacement fluid).

In addition, the hemodialysis apparatus of the present embodiment automatically and continuously performs each process such as a priming process, a blood removal process, a fluid replacement process, and a blood return process by controlling the flow of the dialysate in the blood circuit. Automatic hemodialysis machine. By applying the determination method of the present invention to the hemodialysis apparatus in the priming step, it is possible to determine the connection state of the replenisher line to the blood circuit using the priming step.

<First Embodiment>
The overall configuration of the hemodialysis apparatus 100A according to the first embodiment will be described with reference to FIGS. FIG. 1 is a diagram showing a schematic configuration of a hemodialysis apparatus 100A according to the first embodiment of the present invention, and FIG. 2 is a block diagram showing a configuration of the hemodialysis apparatus 100A.

As shown in FIGS. 1 and 2, a hemodialysis apparatus 100A includes a blood circuit 110A for flowing blood, a blood pump 111a, an arterial bubble detector 111b, a venous bubble detector 112b, and a hemodialyzer. 120, a dialysate circuit 130, a dialysate feeding part 133, a replenisher line 140, a replacement fluid pump 140a, and a control device 150 as a determination device.

The blood circuit 110 A includes an artery side line 111, a vein side line 112, and a drainage line 113. The arterial side line 111, the venous side line 112, and the drainage line 113 are all composed mainly of a flexible soft tube through which fluid can flow.

One end side of the artery side line 111 is connected to a blood introduction port 122a of the hemodialyzer 120 described later. In the artery side line 111, a blood pump 111a, an artery side bubble detector 111b, an artery side clamp 111c, and an artery side connection portion 111d are arranged.
The blood pump 111a sends out liquid such as blood and priming liquid inside the artery side line 111 by squeezing the tube constituting the artery side line 111 with a roller.
The arterial-side bubble detector 111b only needs to be arranged on one end side of the arterial-side line 111 with respect to a connection point with a later-described replenisher liquid line 140. In this embodiment, the arterial-side bubble detector 111b It is arranged upstream and detects the presence or absence of bubbles in the tube.

The arterial clamp 111c is disposed upstream of the arterial bubble detector 111b. The artery side clamp 111c is controlled according to the detection result of the bubbles by the artery side bubble detector 111b, and opens and closes the flow path of the artery side line 111.
The artery side connection portion 111 d is disposed on the other end side of the artery side line 111. A needle that is punctured into a patient's blood vessel is connected to the artery side connection portion 111d.

One end side of the venous side line 112 is connected to a blood outlet port 122b of the hemodialyzer 120 described later. In the vein side line 112, a drip chamber 112a, a vein side bubble detector 112b, a vein side clamp 112c, and a vein side connection part 112d are arranged.
The drip chamber 112a stores a certain amount of blood in order to remove bubbles mixed in the venous line 112, coagulated blood, and the like.
The venous bubble detector 112b is disposed downstream of the drip chamber 112a and detects the presence or absence of bubbles in the tube.

The vein side clamp 112c is disposed downstream of the vein side bubble detector 112b. The vein-side clamp 112c is controlled according to the detection result of the bubbles by the vein-side bubble detector 112b, and opens and closes the flow path of the vein-side line 112.
The vein side connection portion 112d is disposed on the other end side of the vein side line. A needle that is punctured into a patient's blood vessel is connected to the vein side connection portion 112d.

The drain line 113 is connected to the drip chamber 112a. A drain line clamp 113 a is disposed on the drain line 113. The drainage line 113 is a line for discharging the priming liquid in a priming process described later.

The hemodialyzer 120 includes a container main body 121 formed in a cylindrical shape, and a dialysis membrane (not shown) accommodated in the container main body 121. As the hemodialyzer 120, a dialyzer or a hemodiafilter is used. The inside of the container main body 121 is partitioned into a blood side channel and a dialysate side channel by a dialysis membrane (both not shown). The container body 121 is formed with a blood inlet 122a and a blood outlet 122b that communicate with the blood circuit 110A, and a dialysate inlet 123a and a dialysate outlet 123b that communicate with the dialysate circuit 130.

According to the blood circuit 110A and the hemodialyzer 120 described above, blood extracted from the artery of the subject (dialysis patient) flows through the artery side line 111 by the blood pump 111a and passes through the blood side flow path of the hemodialyzer 120. To be introduced. The blood introduced into the hemodialyzer 120 is purified by dialysate flowing through a dialysate circuit 130 described later via a dialysis membrane. The blood purified in the hemodialyzer 120 is circulated through the venous line 112 and returned to the subject's vein.

In this embodiment, the dialysate circuit 130 is configured by a so-called sealed capacity control type dialysate circuit 130. The dialysate circuit 130 includes a dialysate supply line 131a, a dialysate drainage line 131b, a dialysate introduction line 132a, a dialysate lead-out line 132b, and a dialysate feed section 133.

The dialysate feeding section 133 includes a dialysate chamber 1331, a bypass line 1332, and a water removal / back filtration pump 1333.
The dialysate chamber 1331 is composed of a hard container that can store a fixed volume (for example, 300 ml to 500 ml) of dialysate, and the inside of the container is a liquid diaphragm (diaphragm) and contains a liquid supply container 1331a and a drainage container. It is divided into parts 1331b.
The bypass line 1332 connects the dialysate outlet line 132b and the dialysate drain line 131b.

The water removal / back filtration pump 1333 is disposed in the bypass line 1332. The water removal / reverse filtration pump 1333 has a direction in which the dialysate inside the bypass line 1332 is circulated to the dialysate drain line 131b (water removal direction) and a direction in which the dialysate derivation line 132b is circulated (reverse filtration direction). It is comprised by the pump driven so that liquid feeding is possible.

The dialysis fluid supply line 131a has a proximal end side connected to a dialysis fluid supply device (not shown) and a distal end side connected to the dialysate chamber 1331. The dialysate supply line 131 a supplies the dialysate to the liquid supply container 1331 a of the dialysate chamber 1331.

The dialysate introduction line 132 a connects the dialysate chamber 1331 and the dialysate introduction port 123 a of the hemodialyzer 120, and dialyzes the dialysate contained in the solution feeding portion 1331 a of the dialysate chamber 1331 into the dialyzer of the hemodialyzer 120. Introduce into the liquid side channel.

The dialysate outlet line 132 b connects the dialysate outlet 123 b of the hemodialyzer 120 and the dialysate chamber 1331, and leads the dialysate discharged from the hemodialyzer 120 to the drainage storage part 1331 b of the dialysate chamber 1331. To do.

The proximal end side of the dialysate drainage line 131b is connected to the dialysate chamber 1331 and discharges the dialysate drainage stored in the drainage storage part 1331b.

According to the dialysate circuit 130 described above, the amount of dialysate derived from the dialysate chamber 1331 (liquid supply accommodation) is determined by partitioning the inside of the hard container constituting the dialysate chamber 1331 with the soft diaphragm (diaphragm). The amount of dialysate supplied to the portion 1331a) and the amount of drainage recovered in the dialysate chamber 1331 (drainage storage portion 1331b) can be made equal.
As a result, in a state where the water removal / reverse filtration pump 1333 is stopped, the flow rate of the dialysate introduced into the hemodialyzer 120 and the amount of dialysate (drainage) derived from the hemodialyzer 120 are the same. Can be.

In addition, when the dewatering / reverse filtration pump 1333 is driven so as to send the liquid in the reverse filtration direction, a part of the drainage discharged from the dialysate chamber 1331 passes through the bypass line 1332 and the dialysate lead-out line 132b. It is again collected in the dialysate chamber 1331. Therefore, the amount of dialysate derived from the hemodialyzer 120 is dialyzed through the bypass line 1332 from the amount recovered in the dialysate chamber 1331 (that is, the amount of dialysate flowing through the dialysate introduction line 132a). The amount is reduced by the amount of liquid. As a result, the amount of dialysate derived from the hemodialyzer 120 flows through the dialysate introduction line 132a by the amount of dialysate (drainage) recovered through the bypass line 1332 and again into the dialysate chamber 1331. Less than the dialysate flow rate. That is, when the water removal / reverse filtration pump 1333 is driven so as to send the liquid in the reverse filtration direction, a predetermined amount of dialysate is injected (reverse filtration) into the blood circuit 110A in the hemodialyzer 120.

On the other hand, when the water removal / reverse filtration pump 1333 is driven so as to send the liquid in the water removal direction, the amount of the dialysate flowing through the dialysate lead-out line 132b is the dialysate recovered in the dialysate chamber 1331. (Ie, the amount of dialysate flowing through the dialysate introduction line 132a) plus the amount of dialysate flowing through the bypass line 1332. As a result, the amount of dialysate flowing through the dialysate outlet line 132b is equal to the dialysate introduction line 132a by the amount of dialysate (drainage) discharged through the bypass line 1332 to the dialysate drain line 131b. More than the amount of dialysate circulating. That is, when the water removal / back-filtration pump 1333 is driven so as to send liquid in the water removal direction, the hemodialyzer 120 performs a predetermined amount of water removal from the blood.

The replenisher line 140 is a line for supplying dialysate directly to the blood circuit 110A. As shown in FIG. 1, the upstream side of the replenisher line 140 is connected between the dialysate chamber 1331 and the dialysate inlet 123a in the dialysate inlet line 132a of the dialysate circuit 130. As shown by the solid line in FIG. 1, when the downstream side of the replenisher line 140 is connected between the blood pump 111a and the hemodialyzer 120 in the artery side line 111, pre-dilution hemofiltration dialysis is performed ( (See FIG. 4A). Further, as shown by the broken line in FIG. 1, when the downstream side of the replenisher line 140 is connected to the drip chamber 112a in the venous side line 112, post-dilution blood filtration dialysis is performed (see FIG. 4B).

The control device 150 as a determination device is configured by an information processing device (computer), and includes a pump operation unit 151, a bubble detection unit 152, a clamp operation unit 153, a determination unit 154, a setting unit 155, and a notification. Part 156.

The pump operation unit 151 controls the operations of various pumps arranged in the blood circuit 110 A, the dialysate circuit 130, and the replenisher solution line 140.
The bubble detection unit 152 operates the artery-side bubble detector 111b and the vein-side bubble detector 112b as necessary to detect bubbles, and acquires the detection result.

The clamp operation unit 153 performs operations (opening / closing) of various clamps arranged in the blood circuit 110A, the dialysate circuit 130, and the replenishment liquid line 140 in accordance with the operation of various pumps and the detection result of the air bubbles by the air bubble detection unit 152. Control.

In the determination method described in detail later, the determination unit 154 determines whether the replenishment liquid line 140 is connected to the artery side line 111 or the vein side line 112 based on the detection result of the bubbles by the bubble detection unit 152. It is determined whether or not.

The setting unit 155 sets a method for feeding a replenisher to the blood circuit 110A. Specifically, it is set whether the hemodialysis treatment given to the patient is a pre-dilution method or a post-dilution method.

The notification unit 156 notifies when the liquid feeding method set in the setting unit 155 does not correspond to the connection state of the replenishment liquid line 140 determined by the determination unit 154 to the blood circuit 110A.

As described above, the control device 150 described above operates by controlling the operation of the hemodialysis device 100A by executing a control program for each step described below.
Each process includes a priming process that is a preparatory process for cleaning and cleaning the blood circuit 110A and the hemodialyzer 120, a blood removal process for filling the blood circuit 110A into the blood circuit 110A after puncture, and a blood removal process. Subsequently, a dialysis step for dialysis and purification of blood, a rapid replenishment step performed when blood pressure drops during dialysis treatment, a blood return step for returning the blood in blood circuit 110A to the patient's body, and the like.

In the present invention, in the priming process performed after assembling the circuit by connecting each circuit or each line, it is determined whether or not the replenishment liquid line 140 connected to the blood circuit 110A is in a connection state corresponding to the liquid feeding method. I do. When the connection state does not correspond to the liquid feeding method, the circuit is connected again and the priming process is completed with the correct connection state. Thereafter, blood filtration dialysis is performed in the dialysis step through a blood removal step while supplying a replenisher to the blood circuit 110A by a predilution or postdilution method.

Next, the determination method according to the first embodiment will be described with reference to FIGS. FIG. 3 is a diagram illustrating a flowchart of the determination method according to the first embodiment. FIG. 4A illustrates a circuit connection state in the pre-dilution method, and FIG. 4B illustrates a circuit connection state in the post-dilution method.

The determination method according to the present embodiment is suitable when priming is performed by connecting the arterial side connecting portion 111d and the venous side connecting portion 112d as shown in FIGS. 4A and 4B. In this case, the priming liquid is discharged from the drain line 113.
The liquid feeding method is set in the setting unit 155 in advance before the start of the priming process. As shown in FIGS. 4A and 4B, the arterial side connection portion 111d and the venous side connection portion 112d are connected, and the drainage line clamp 113a, the arterial side clamp 111c, the venous side clamp 112c, and the replacement fluid line clamp 140b. Is opened. Since it is before the start of the priming process, the blood circuit 110A is not filled with the priming solution and is in a state of being filled with air. In this state, determination by the determination method shown in FIG. 3 is started and a priming step is performed.

Step S10A after the start of the determination is a pump operation process in which the water removal / back-filtration pump 1333, the replacement fluid pump 140a, and the blood pump 111a are operated by the pump operation unit 151. By operating the pump in step S10A, a replenisher solution (dialysate) is supplied as a priming solution from the replenisher solution line 140 to the blood circuit 110A at a predetermined amount (for example, 50 mL / min) to supply the replenisher solution line 140. Priming.
In the present embodiment, as an example, the blood pump 111a is operated so as to feed the artery side line 111 toward the artery side connection portion 111d (see FIGS. 4A and 4B).

Step S 20 A is a bubble detection process in which the bubble detector 152 is operated to detect the presence or absence of bubbles when the first time has elapsed since the start of various pump operations.
Here, the first time is the time when the priming liquid sent from the replenisher line 140 to the blood circuit 110A reaches the bubble detector without passing through the hemodialyzer 120, and the priming liquid passes through the hemodialyzer 120. What is necessary is just to set to the time between the time which reaches | attains a bubble detector. That is, the first time may be appropriately set so that the bubble detection result by the bubble detector differs depending on the circuit connection state when the first time elapses. In the present embodiment, the first time is 10 seconds.

In addition, since the priming solution is fed from the hemodialyzer 120 side to the artery side connection portion 111d side in the artery side line 111, it reaches the artery side bubble detector 111b earlier than the vein side bubble detector 112b. Therefore, in this case, it is preferable to use the arterial bubble detector 111b that can set the first time short as the bubble detector. When the blood pump 111a is operated in the opposite direction, the vein-side bubble detector 112b can set the first time shorter, so that the vein-side bubble detector 112b is preferably used as the bubble detector.

Step S30A is a determination step in which the determination unit 154 determines the connection state of the replenisher line 140 to the blood circuit 110A based on the detection result of the bubbles.
In the present embodiment, the blood pump 111a operates so as to feed the artery side line 111 toward the artery side connection portion 111d. Therefore, in the bubble detector, as shown in FIG. , The priming liquid has already reached the artery-side bubble detector 111b when the first time has elapsed, and no bubbles are detected. On the other hand, as shown in FIG. 4B, when the replenishment liquid line 140 is connected to the venous side line 112, the priming liquid has not reached the arterial side bubble detector 111b when the first time elapses. Is detected. Therefore, when bubbles are detected, it is determined that the replenisher line 140 is connected to the venous line 112, and when bubbles are not detected, the replenisher line 140 is connected to the artery side line 111. Determined.

In step S 40, control device 150 determines whether or not the liquid feeding method set by setting unit 155 corresponds to the connection state determined by determination unit 154. When it corresponds (Yes), the determination is terminated, and when it does not correspond (No), notification is performed in step S50, and the determination is terminated.
In this embodiment, Table 1 shows conditions for notification by the notification unit 156.

After completion of the determination, if the connection state is correct, the priming of the replenisher line 140 is completed. If the connection state is incorrect, the operation of various pumps is stopped, the replenisher line 140 is correctly connected to the blood circuit 110A, and then the replenisher line 140 is primed again. After completion of the priming of the replenishment liquid line 140, various pumps are operated as shown in FIG. 5 to perform priming of the blood circuit 110A, and the priming process is completed in a correct connection state corresponding to the liquid feeding method.

According to the determination method described above, the connection state of the replenisher line 140 to the blood circuit 110A can be determined by priming the replenisher line 140 before priming the blood circuit 110A in the priming step. it can.

According to the hemodialysis apparatus 100A provided with the determination method and determination apparatus (control apparatus 150) according to the first embodiment described above, the following effects are obtained.

(1) In the blood circuit 110A in a state where one end side (arterial side connection portion 111d) of the arterial side line 111 and one end side (venous side connection portion 112d) of the venous side line 112 are connected and not filled with liquid, The pump operating unit 151 performs a pump operating process for operating the blood pump 111a and the replacement fluid pump 140a to flow the replenisher into the blood circuit 110A from the replenisher line 140, and the bubble detector 152 is in a state where the first time has elapsed. The

bubble detector

111b or 112b performs a bubble detection step of detecting bubbles, and the determination unit 154 determines a connection state of the replenishment liquid line 140 to the blood circuit 110A based on whether or not bubbles are detected. To do. Accordingly, it is possible to easily determine the connection state of the replenisher line 140 to the blood circuit 110A using the priming process in the hemodialysis apparatus 100A.

(2) The bubble detector 111b is arranged on one end side of the arterial line 111 from the connection location of the replenishment liquid line 140, and the pump operation unit 151 connects the blood pump 111a to one end of the arterial line 111 in the pump operation process. The determination unit 154 determines that the replenishment liquid line 140 is connected to the venous side line 112 when the bubble is not detected in the determination step, and the bubble is detected. In this case, it is determined that the replenisher line 140 is connected to the venous line 112. As a result, since the replenisher is flowed toward one end of the arterial line 111, the first time in the bubble detection process can be set shorter than when the bubble detector is disposed on the venous line 112. it can. Therefore, the connection state can be determined in a shorter time.

(3) The determination device (the control device 150) is determined by the setting unit 155 that sets the method for supplying the replenisher to the blood circuit 110A, the liquid supply method that is set in the setting unit 155, and the determination unit 154. And a notification unit 156 that performs notification when the connection state does not correspond. Thereby, when the connection state of the replenisher line 140 to the blood circuit 110A is incorrect, it is possible to promptly notify the medical staff.

<Modification>
Next, a modification of the first embodiment will be described with reference to FIG.
In the determination method according to the modification, the connection state is determined based on whether or not the priming liquid has reached the bubble detector before the first time elapses. Since the configuration of the hemodialysis apparatus 100A is the same except that the time point at which detection of bubbles is started is different from that of the first embodiment, the description thereof is omitted.

As in the first embodiment, the liquid feeding method is set in the setting unit 155 in advance before starting the priming process. As shown in FIGS. 4A and 4B, the arterial side connection portion 111d and the venous side connection portion 112d are connected, and the drainage line clamp 113a, the arterial side clamp 111c, the venous side clamp 112c, and the replacement fluid line clamp 140b. Is opened. Since it is before the start of the priming process, the priming liquid is not filled in the blood circuit 110A and the replenishing liquid line 140, and the air is filled. In this state, determination by the determination method shown in FIG. 6 is started and a priming step is performed.

Step S10A after the start of determination is a pump operation step in which the water removal / back-filtration pump 1333, the replacement fluid pump 140a, and the blood pump 111a are operated by the pump operation unit 151. The replenisher solution line 140 is primed by supplying a replenisher solution (dialysate) as a priming solution from the replenisher solution line 140 to the blood circuit 110A at a predetermined amount (for example, 50 mL / min).

Step S 20 A ′ is a bubble detection process in which the bubble detector 152 is operated to detect the presence or absence of bubbles after the operation of various pumps is started. The bubble detection result is that bubbles are present until the priming liquid reaches the bubble detector, and bubbles are absent when the priming liquid reaches.

In step S30A ′, the replenishing liquid line is determined by the determination unit 154 depending on whether or not the priming liquid has reached the bubble detector before the first time has elapsed since the start of the pump operation, that is, whether or not the bubble has been detected. 140 is a determination step of determining a connection state to 140 blood circuits 110A. Here, the first time can be set similarly to the case of the first embodiment.
In the modified example, the blood pump 111a operates to send the liquid to the arterial side connecting portion 111d side in the arterial side line 111. Therefore, in the bubble detector, the replenisher line 140 is connected to the arterial side line 111 as shown in FIG. If connected, the priming liquid has already reached the arterial bubble detector 111b when the first time has elapsed, and no bubbles are detected. On the other hand, as shown in FIG. 4B, when the replenishment liquid line 140 is connected to the venous side line 112, the priming liquid has not reached the arterial side bubble detector 111b when the first time elapses. Is detected. Therefore, when the priming liquid reaches and the bubbles are not detected before the first time elapses, it is determined that the replenishment liquid line 140 is connected to the artery side line 111, and the first time elapses. If the priming liquid does not reach and bubbles are detected, it is determined that the replenishing liquid line 140 is connected to the venous side line 112.

In step S 40, control device 150 determines whether or not the liquid feeding method set by setting unit 155 corresponds to the connection state determined by determination unit 154. When it corresponds (Yes), the determination is terminated, and when it does not correspond (NO), the notification unit 156 notifies in step S50, and the determination ends.
Table 2 shows the conditions under which notification is performed by the notification unit 156 in the modification.

If the connection state is incorrect after the determination, the operation of various pumps is stopped, the replenisher line 140 is correctly connected to the blood circuit 110A, and then the replenisher line 140 is primed again. After the priming of the replenisher line 140 is completed, the blood circuit 110A is primed. Specifically, as shown in FIG. 5, the arterial clamp 111c, the venous clamp 112c, and the drain line clamp 113a are opened, and the replenisher line clamp 140b is closed. Various pumps are operated as shown in FIG. 5 by the pump operating unit 151, and the dialysate is injected into the hemodialyzer 120 by reverse filtration to prime the blood circuit 110A.
In this way, various pumps are operated to prime the blood circuit 110A, and the priming process is completed in a correct connection state corresponding to the liquid feeding method.

According to the determination method described above, the replenisher solution 140 is primed before the blood circuit 110A is primed in the priming step, and the presence or absence of detection of bubbles after the first time has passed is confirmed. The connection state of the line 140 to the blood circuit 110A can be determined.

According to the hemodialysis apparatus 100A including the determination method and the determination apparatus (control apparatus 150) according to the modification described above, the same effects as the effects (1) to (3) described above can be obtained.

Second Embodiment
Next, a second embodiment will be described with reference to FIGS.
The overall configuration of the hemodialysis apparatus 100B of the second embodiment will be described with reference to FIGS. FIG. 7 is a diagram showing a schematic configuration of a hemodialysis apparatus 100B according to the second embodiment of the present invention, and FIG. 8 is a block diagram showing the hemodialysis apparatus 100B.
In the second embodiment, the blood circuit 110B in the hemodialysis apparatus 100B does not include the drainage line, but includes the ventilation line 114, and the hemodialysis apparatus 100B includes the liquid level adjustment pump 114b. This is different from the hemodialysis apparatus 100A of the first embodiment. Other configurations are denoted by the same reference numerals, and description thereof is omitted.

As shown in FIGS. 7 and 8, the hemodialysis apparatus 100B includes a blood circuit 110B for flowing blood, a blood pump 111a, an arterial bubble detector 111b, a venous bubble detector 112b, and a hemodialyzer. 120, a dialysate circuit 130, a dialysate feeding part 133, a replenishment liquid line 140, a replacement fluid pump 140a, a control device 150 as a determination device, and a liquid level adjustment pump 114b.

The blood circuit 110B includes an artery side line 111, a vein side line 112, and a ventilation line 114.
One end of the venous side line 112 is connected to the blood outlet 122b of the hemodialyzer 120. In the vein side line 112, a drip chamber 112a, a vein side bubble detector 112b, a vein side clamp 112c, and a vein side connection part 112d are arranged.
The drip chamber 112a stores a certain amount of blood in order to remove bubbles mixed in the venous line 112, coagulated blood, and the like.
The venous bubble detector 112b is disposed downstream of the drip chamber 112a and detects the presence or absence of bubbles in the tube.
The vein side clamp 112c is disposed downstream of the vein side bubble detector 112b. The vein-side clamp 112c is controlled according to the detection result of the bubbles by the vein-side bubble detector 112b, and opens and closes the flow path of the vein-side line 112.
The vein side connection portion 112d is disposed on the other end side of the vein side line. A needle that is punctured into a patient's blood vessel is connected to the vein side connection portion 112d.

The ventilation line 114 is a tube provided to allow the air in the drip chamber 112a to flow in and out, and one end side is connected to the upper part of the drip chamber 112a. The ventilation line 114 is provided with a ventilation line clamp 114 a that is configured by an electromagnetic valve and opens and closes the flow path of the ventilation line 114. Further, on the other end side of the ventilation line 114, a liquid level adjusting pump 114b for adjusting the liquid level height of the liquid by flowing air into and out of the drip chamber 112a is disposed.

According to the blood circuit 110B and the hemodialyzer 120 described above, the blood taken out from the artery of the subject (dialysis patient) flows through the artery side line 111 by the blood pump 111a and passes through the blood side flow path of the hemodialyzer 120. To be introduced. The blood introduced into the hemodialyzer 120 is purified by dialysate flowing through a dialysate circuit 130 described later via a dialysis membrane. The blood purified in the hemodialyzer 120 is circulated through the venous line 112 and returned to the subject's vein.

Next, a determination method according to the second embodiment will be described with reference to FIGS. FIG. 9 is a diagram illustrating a flowchart of the determination method according to the second embodiment, and FIG. 10 is an explanatory diagram when priming the blood circuit 110B in the priming step. FIG. 11A shows a circuit connection state in the pre-dilution method, and FIG. 11B shows a circuit connection state in the post-dilution method.

The determination method according to the present embodiment is suitable when priming is performed without connecting the artery side connection portion 111d and the vein side connection portion 112d as shown in FIGS. In this case, the priming solution is discharged from the artery side connection portion 111d and the vein side connection portion 112d, respectively.
In the determination method according to the present embodiment, the blood circuit 110B is primed in advance before the determination is started, the blood circuit 110B is filled with a priming solution (reverse filtration dialysate), and the replenishment solution line 140 is supplied with a priming solution ( In a state where the dialysate as a replenisher is not filled (filled with gas), the connection state is determined.

As shown in FIG. 10, the arterial side clamp 111c, the venous side clamp 112c, and the vent line clamp 114a are opened, and the replenisher line clamp 140b is closed. Various pumps are operated as shown in FIG. 10 by the pump operating unit 151, and dialysate is injected from the dialysate circuit 130 into the hemodialyzer 120 by back filtration to prime the blood circuit 110B. The priming of the replenisher line 140 is not performed, and the connection state described below is determined in a state where the replenisher line 140 is filled with air. The liquid level of the drip chamber 112a is adjusted to a predetermined liquid level by the liquid level adjusting pump 114b during priming of the blood circuit 110B. Thereafter, the clamp operation unit 153 operates the ventilation line clamp 114a to close the liquid level, thereby maintaining the liquid level.

A liquid feeding method is set in the setting unit 155 in advance before starting the determination.
As shown in FIG. 9, the step S10B after the start of the determination is such that the arterial side clamp 111c, the venous side clamp 112c and the replenisher line clamp 140b are opened and the vent line clamp 114a is closed, 151 is a pump operation step of operating the water removal / back-filtration pump 1333, the replacement fluid pump 140a, and the blood pump 111a. As shown in FIGS. 11A and 11B, the pump operating unit 151 operates various pumps so that dialysate is injected into the hemodialyzer 120 at a flow rate of 350 mL / min by reverse filtration. Liquid) is sent to blood circuit 110B at a flow rate of 50 mL / min. Further, the blood pump 111a is operated so as to send liquid at a flow rate of 200 mL / min toward the artery side connection portion 111d side. Therefore, the priming solution (reverse filtration dialysate, replenisher) is discharged from the artery side connection portion 111d at a flow rate of 200 mL / min and from the vein side connection portion 112d at a flow rate of 200 mL / min.

When the replenishment liquid line 140 is connected to the artery side line 111, a part of the air filled in the replenishment liquid line 140 reaches the artery side bubble detector 111b first. The other part may be set so as to reach the venous bubble detector 112b later through the hemodialyzer 120, and if the replenisher line 140 is connected to the venous line 112, the air It may be set so that a part of the blood reaches the venous bubble detector 112b first, and the other part reaches the arterial bubble detector 111b later through the hemodialyzer 120.
In this embodiment, the amount of fluid supplied by the replacement pump 140a is smaller than the amount of fluid pumped by the blood pump 111a, and the amount of blood pump 111a fed from the amount of dialysate injected into the hemodialyzer 120 by reverse filtration. The amount was set to be smaller than the amount obtained by subtracting the liquid amount. As a result, the air sent from the replenisher line 140 to the blood circuit 110B is sent to either the artery side bubble detector 111b or the venous side bubble detector 112b without passing through the hemodialyzer 120.

In step S20B, the bubble detector 152 starts the bubble detection by operating the arterial bubble detector 111b and the venous bubble detector 112b after the pump operation unit 151 starts the operation of various pumps. It is a bubble detection process.
As shown in FIG. 11A, when the replenishment liquid line 140 is connected to the artery side line 111, the air filled in the replenishment liquid line 140 reaches the artery side bubble detector 111b and is detected. In addition, as shown in FIG. 11B, when the replenisher line 140 is connected to the venous line 112, the air filled in the replenisher line 140 reaches the venous bubble detector 112b and is detected. The

Step S30B is a determination step in which the determination unit 154 determines the connection state of the replenisher line 140 to the blood circuit 110B based on the detection result of the bubbles.
The determination unit 154 indicates that the replenishment liquid line 140 is connected to the artery side line 111 when the bubble detection unit 152 starts the bubble detection and the artery side bubble detector 111b detects the bubble first. When the bubble is detected first by the vein-side bubble detector 112b, it is determined that the replenisher line 140 is connected to the vein-side line 112.

In step S 40, control device 150 determines whether or not the liquid feeding method set by setting unit 155 corresponds to the connection state determined by determination unit 154. When it corresponds (Yes), the determination is terminated, and when it does not correspond (No), notification is performed in step S50, and the determination is terminated.
In this embodiment, the conditions under which the notification unit 156 performs notification are shown in Table 3.

After the determination, if the connection state is correct, the priming is continued, the air is removed from the blood circuit 110B and the replenisher line 140, and the priming process is completed. If the connection state is incorrect, the operation of the various pumps is stopped, the replenisher line 140 is correctly connected to the blood circuit 110B, and then the replenisher line 140 and the blood circuit 110B are primed again to supply the liquid. The priming process is completed with the correct connection state corresponding to the method.

According to the determination method described above, in the priming step, the blood circuit 110B is primed and filled with the priming liquid, the priming of the replenisher liquid line 140 filled with air is performed, and the arterial line 111 and vein By detecting bubbles on the side line 112, the connection state of the replenisher line 140 to the blood circuit 110B can be determined.

According to the hemodialysis apparatus 100B provided with the determination method and determination apparatus (control apparatus 150) according to the second embodiment described above, the following effects are obtained.

(4) In a state where the blood circuit 110B is filled with liquid and the replenisher line 140 is filled with gas, the pump operating unit 151 reversely injects dialysate from the dialysate circuit 130 into the hemodialyzer 120 and injects it. In addition, the blood pump 111a is operated so as to flow the liquid to the one end side of the arterial line 111 at a flow rate smaller than the injection amount of the dialysate, and the pump operation step for operating the replacement fluid pump 140a is performed. After operating the blood pump 111a and the replacement fluid pump 140a, the bubble detector 152 performs a bubble detection step of detecting bubbles by starting detection of bubbles by the arterial bubble detector 111b and the venous bubble detector 112b. The determination unit 154 determines that the replenishment liquid line 140 is not in the artery when the bubble is detected by the artery-side bubble detector 111b. A determination step is performed in which it is determined that the replenisher line 140 is connected to the venous line 112 when it is determined that the replenishment liquid line 140 is connected to the venous line 112 when the venous bubble detector 112b first detects the bubble. did. Accordingly, it is possible to easily determine the connection state of the replenisher line 140 to the blood circuit 110B using the priming process in the hemodialysis apparatus 100B.

(5) The liquid feeding amount of the replacement pump 140a is smaller than the blood pumping amount of the blood pump 111a, and smaller than the amount obtained by subtracting the liquid feeding amount of the blood pump 111a from the dialysate injection amount. As a result, the air sent from the replenisher line 140 to the blood circuit 110B is sent to either the artery side bubble detector 111b or the venous side bubble detector 112b without passing through the hemodialyzer 120.

(6) The determination device (the control device 150) is determined by the setting unit 155 that sets the method for supplying the replenisher to the blood circuit 110B, the liquid supply method that is set in the setting unit 155, and the determination unit 154. A notification unit 156 that performs notification when the connection state does not correspond to the connection state is further provided. Thereby, when the connection state of the replenisher line 140 to the blood circuit 110B is incorrect, it is possible to promptly notify the medical staff.

As described above, the preferred embodiments and modifications of the connection state determination supplementary method and determination apparatus of the present invention have been described. However, the present invention is not limited to the above-described embodiments and modifications, and changes may be made as appropriate. Is possible.
For example, in the first embodiment and the modification, as an example, in the state where the blood pump is operated so that the blood is fed from the hemodialyzer side to the arterial side connection side in the arterial side line, The presence or absence of bubbles (whether or not the priming liquid has reached) is detected by the side bubble detector, but is not limited thereto. The blood pump may be operated so that liquid is fed from the arterial connection side to the hemodialyzer side in the artery side line, and the presence or absence of bubbles (whether the priming solution has reached) is detected by the venous side bubble detector. May be.

In the second embodiment, in the pump operation step, the dialysate circuit 130 reversely injects the dialysate into the hemodialyzer 120 and injects the fluid at a flow rate smaller than the dialysate injection amount. The blood pump 111a is operated so as to flow to one end side of the blood and the replacement fluid pump 140a is operated. However, the present invention is not limited to this. That is, the pump operation process may be performed without operating the blood pump.

100A,

100B Hemodialysis apparatus

110A, 110B Blood circuit 111 Arterial side line 111a Blood pump 111b Arterial side bubble detector 111d Arterial side connection
112 Venous side line 112b Venous side bubble detector 112d Venous side connection part 120 Hemodialyzer 130 Dialysate circuit 131a Dialysate supply line 131b Dialysate drainage line 132a Dialysate introduction line 132b Dialysate lead-out line 133 Dialysate feed part 133 1331 Dialysate chamber 1332 Bypass line 1333 Dewatering / back-filtration pump 140 Replenisher line 140a Replacement fluid pump 150A, 150B Control device (determination device)
151 Pump Operation Unit 152 Bubble Detection Unit 153 Clamp Operation Unit 154 Determination Unit 155 Setting Unit 156 Notification Unit

Claims

A hemodialyzer,
One end side is connected to the subject's artery and the other end side is connected to the hemodialyzer, and one end side is connected to the hemodialyzer and the other end side is connected to the subject's vein. Blood circuit,
A blood pump disposed in the arterial line;
A dialysate introduction line for introducing dialysate into the hemodialyzer, and a dialysate circuit having a dialysate lead-out line for deriving dialysate from the hemodialyzer;
A replenisher line that is connected to the arterial line or the venous line and sends replenisher to the blood circuit;
A replenisher pump disposed in the replenisher line;
A bubble detector that is disposed in the arterial line or the venous line and detects bubbles;
A determination method of a connection state of the replenisher line to the blood circuit in a hemodialysis apparatus comprising:
In the blood circuit in which one end side of the arterial line and one end side of the venous line are connected and not filled with fluid, a pump operation step of operating the blood pump and the replacement fluid pump;
A bubble detection step of detecting bubbles with the bubble detector in a state where a preset first time has elapsed after operating the blood pump and the replacement fluid pump;
A determination method comprising: determining whether the replenisher line is connected to the artery-side line or the vein-side line depending on whether or not bubbles are detected by the bubble detector.
The bubble detector is disposed on one end side of the connection line of the replenisher line in the arterial line,
In the pump operation step, the blood pump is operated to flow a replenisher toward one end side of the arterial line,
In the determination step, it is determined that the replenisher line is connected to the arterial line when no bubbles are detected, and the replenisher line is connected to the venous line when bubbles are detected. The determination method according to claim 1, wherein the determination method is determined to be.
A hemodialyzer,
One end side is connected to the subject's artery and the other end side is connected to the hemodialyzer, and one end side is connected to the hemodialyzer and the other end side is connected to the subject's vein. Blood circuit,
A blood pump disposed in the arterial line;
A dialysate introduction line for introducing dialysate into the hemodialyzer, and a dialysate circuit having a dialysate lead-out line for deriving dialysate from the hemodialyzer;
A replenisher line that is connected to the arterial line or the venous line and sends replenisher to the blood circuit;
A replenisher pump disposed in the replenisher line;
A bubble detector that is disposed in the arterial line or the venous line and detects bubbles;
An apparatus for determining a connection state of the replenisher line to the blood circuit in a hemodialysis apparatus comprising:
In the blood circuit in a state where one end side of the artery side line and one end side of the venous side line are connected and not filled with fluid, a pump operation unit that operates the blood pump and the replacement fluid pump;
After the blood pump and the replacement fluid pump are operated by the pump operation unit, a bubble detection unit that detects bubbles by the bubble detector in a state where a preset first time has elapsed,
And a determination unit that determines whether the replenisher line is connected to the artery-side line or the vein-side line depending on whether or not bubbles are detected by the bubble detector.
The bubble detector is disposed on the artery side line,
The pump operation unit operates the blood pump to flow a replenisher toward one end side of the arterial line,
The determination unit determines that the replenisher line is connected to the arterial line when no bubble is detected, and the replenisher line is connected to the vein line when a bubble is detected. The determination apparatus according to claim 3, wherein the determination apparatus determines that the
A setting unit for setting a method for feeding a replenisher to the blood circuit;
The determination apparatus according to claim 3, further comprising: a notification unit that performs notification when the liquid feeding method set in the setting unit does not correspond to the connection state determined by the determination unit.
A hemodialyzer,
One end side is connected to the subject's artery and the other end side is connected to the hemodialyzer, and one end side is connected to the hemodialyzer and the other end side is connected to the subject's vein. Blood circuit,
A blood pump disposed in the arterial line;
A dialysate introduction line for introducing dialysate into the hemodialyzer, and a dialysate circuit having a dialysate lead-out line for deriving dialysate from the hemodialyzer;
A replenisher line that is connected to the arterial line or the venous line and sends replenisher to the blood circuit;
A replenisher pump disposed in the replenisher line;
An arterial bubble detector that is disposed in the arterial line and detects air bubbles;
A vein-side bubble detector that is disposed in the vein-side line and detects bubbles;
A determination method of a connection state of the replenisher line to the blood circuit in a hemodialysis apparatus comprising:
In a state where the blood circuit is filled with liquid and the replenisher line is filled with gas, the replacement fluid pump is operated while the dialysate is back-filtered and injected from the dialysate circuit to the hemodialyzer. A pump operation process;
A bubble detection step of detecting bubbles by starting detection of bubbles by the arterial bubble detector and the venous bubble detector after operating the replacement fluid pump;
When one of the artery-side bubble detector or the vein-side bubble detector detects bubbles before the other, the replenisher line is connected to either the artery-side line or the vein-side line. A determination method comprising: determining step.
In the pump operation step, in a state where the blood circuit is filled with liquid and the replenisher line is filled with gas, while dialysate is back-filtered and injected from the dialysate circuit to the hemodialyzer, Operate the blood pump so that the fluid flows to one end side of the arterial line at a flow rate smaller than the dialysate injection amount, and operate the replacement fluid pump,
In the determination step, it is determined that the replenishment liquid line is connected to the artery side line when bubbles are detected first by the artery side bubble detector, and bubbles are first detected by the vein side bubble detector. The determination method according to claim 6, wherein when it is detected, it is determined that the replenisher line is connected to the vein line.
The liquid supply amount of the replacement fluid pump is smaller than the liquid feed amount of the blood pump, and is smaller than an amount obtained by subtracting the liquid feed amount of the blood pump from the injection amount of the dialysate. Judgment method.
A hemodialyzer,
One end side is connected to the subject's artery and the other end side is connected to the hemodialyzer, and one end side is connected to the hemodialyzer and the other end side is connected to the subject's vein. Blood circuit,
A blood pump disposed in the arterial line;
A dialysate introduction line for introducing dialysate into the hemodialyzer, and a dialysate circuit having a dialysate lead-out line for deriving dialysate from the hemodialyzer;
A replenisher line that is connected to the arterial line or the venous line and sends replenisher to the blood circuit;
A replenisher pump disposed in the replenisher line;
An arterial bubble detector that is disposed in the arterial line and detects air bubbles;
A vein-side bubble detector that is disposed in the vein-side line and detects bubbles;
An apparatus for determining a connection state of the replenisher line to the blood circuit in a hemodialysis apparatus comprising:
In a state where the blood circuit is filled with liquid and the replenisher line is filled with gas, the replacement fluid pump is operated while the dialysate is back-filtered and injected from the dialysate circuit to the hemodialyzer. A pump operating unit;
After the blood pump and the replacement fluid pump are operated by the pump operation unit, a bubble detection unit that detects bubbles by starting detection of bubbles by the arterial bubble detector and the venous bubble detector;
When one of the artery-side bubble detector or the vein-side bubble detector detects bubbles before the other, the replenisher line is connected to either the artery-side line or the vein-side line. A determination unit.
In the state where the blood circuit is filled with liquid and the replenisher line is filled with gas, the pump operating unit is configured to reversely inject dialysate from the dialysate circuit to the hemodialyzer, Operate the blood pump so that the fluid flows to one end side of the arterial line at a flow rate smaller than the dialysate injection amount, and operate the replacement fluid pump,
The determination unit is configured such that after the bubble detection is started by the bubble detection unit and the bubble is first detected by the artery-side bubble detector, the replenishment liquid line is connected to the artery-side line. The determination apparatus according to claim 9, wherein the determination is made and it is determined that the replenishment liquid line is connected to the vein-side line when bubbles are first detected by the vein-side bubble detector.
The liquid supply amount of the replacement fluid pump is smaller than the liquid feed amount of the blood pump, and is smaller than an amount obtained by subtracting the liquid feed amount of the blood pump from the injection amount of the dialysate. Judgment device.
A setting unit for setting a method for feeding a replenisher to the blood circuit;
The determination apparatus according to any one of claims 9 to 11, further comprising: a notification unit that performs notification when the liquid feeding method set in the setting unit does not correspond to the connection state determined by the determination unit. .