WO2023276388A1 - 血液浄化装置 - Google Patents
血液浄化装置 Download PDFInfo
- Publication number
- WO2023276388A1 WO2023276388A1 PCT/JP2022/016294 JP2022016294W WO2023276388A1 WO 2023276388 A1 WO2023276388 A1 WO 2023276388A1 JP 2022016294 W JP2022016294 W JP 2022016294W WO 2023276388 A1 WO2023276388 A1 WO 2023276388A1
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- WO
- WIPO (PCT)
- Prior art keywords
- blood
- agent
- blood purification
- dialysate
- line
- Prior art date
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- 239000008280 blood Substances 0.000 title claims abstract description 116
- 210000004369 blood Anatomy 0.000 title claims abstract description 116
- 238000000746 purification Methods 0.000 title claims abstract description 52
- 239000003795 chemical substances by application Substances 0.000 claims abstract description 92
- 239000000243 solution Substances 0.000 claims abstract description 89
- CURLTUGMZLYLDI-UHFFFAOYSA-N Carbon dioxide Chemical compound O=C=O CURLTUGMZLYLDI-UHFFFAOYSA-N 0.000 claims abstract description 76
- 229910002092 carbon dioxide Inorganic materials 0.000 claims abstract description 38
- 239000001569 carbon dioxide Substances 0.000 claims abstract description 37
- 238000005406 washing Methods 0.000 claims abstract description 32
- 238000010438 heat treatment Methods 0.000 claims abstract description 27
- 239000012530 fluid Substances 0.000 claims abstract 5
- 238000005238 degreasing Methods 0.000 claims description 39
- 239000007864 aqueous solution Substances 0.000 claims description 29
- 239000007788 liquid Substances 0.000 claims description 27
- BVKZGUZCCUSVTD-UHFFFAOYSA-M Bicarbonate Chemical compound OC([O-])=O BVKZGUZCCUSVTD-UHFFFAOYSA-M 0.000 claims description 20
- 238000004140 cleaning Methods 0.000 claims description 15
- 238000001514 detection method Methods 0.000 claims description 9
- 238000007599 discharging Methods 0.000 claims description 9
- 238000011144 upstream manufacturing Methods 0.000 claims description 7
- 239000004519 grease Substances 0.000 claims description 4
- 239000012466 permeate Substances 0.000 claims description 2
- CDBYLPFSWZWCQE-UHFFFAOYSA-L Sodium Carbonate Chemical compound [Na+].[Na+].[O-]C([O-])=O CDBYLPFSWZWCQE-UHFFFAOYSA-L 0.000 abstract description 58
- 229910000029 sodium carbonate Inorganic materials 0.000 abstract description 29
- 238000000034 method Methods 0.000 abstract description 27
- 239000011550 stock solution Substances 0.000 abstract 5
- 239000000385 dialysis solution Substances 0.000 abstract 2
- 239000003513 alkali Substances 0.000 abstract 1
- 238000007872 degassing Methods 0.000 description 33
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 26
- 238000003860 storage Methods 0.000 description 16
- 230000004087 circulation Effects 0.000 description 12
- 238000000502 dialysis Methods 0.000 description 9
- 230000009977 dual effect Effects 0.000 description 9
- 238000002347 injection Methods 0.000 description 8
- 239000007924 injection Substances 0.000 description 8
- 239000002699 waste material Substances 0.000 description 7
- 239000012528 membrane Substances 0.000 description 6
- 238000010586 diagram Methods 0.000 description 5
- UIIMBOGNXHQVGW-UHFFFAOYSA-M Sodium bicarbonate Chemical compound [Na+].OC([O-])=O UIIMBOGNXHQVGW-UHFFFAOYSA-M 0.000 description 4
- 239000012510 hollow fiber Substances 0.000 description 4
- 238000002156 mixing Methods 0.000 description 3
- 230000000717 retained effect Effects 0.000 description 3
- 238000003756 stirring Methods 0.000 description 3
- TWRXJAOTZQYOKJ-UHFFFAOYSA-L Magnesium chloride Chemical compound [Mg+2].[Cl-].[Cl-] TWRXJAOTZQYOKJ-UHFFFAOYSA-L 0.000 description 2
- WCUXLLCKKVVCTQ-UHFFFAOYSA-M Potassium chloride Chemical compound [Cl-].[K+] WCUXLLCKKVVCTQ-UHFFFAOYSA-M 0.000 description 2
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 description 2
- 239000000203 mixture Substances 0.000 description 2
- 230000002093 peripheral effect Effects 0.000 description 2
- 239000011734 sodium Substances 0.000 description 2
- 229910000030 sodium bicarbonate Inorganic materials 0.000 description 2
- 235000017557 sodium bicarbonate Nutrition 0.000 description 2
- 239000000126 substance Substances 0.000 description 2
- UXVMQQNJUSDDNG-UHFFFAOYSA-L Calcium chloride Chemical compound [Cl-].[Cl-].[Ca+2] UXVMQQNJUSDDNG-UHFFFAOYSA-L 0.000 description 1
- BVKZGUZCCUSVTD-UHFFFAOYSA-L Carbonate Chemical compound [O-]C([O-])=O BVKZGUZCCUSVTD-UHFFFAOYSA-L 0.000 description 1
- VMHLLURERBWHNL-UHFFFAOYSA-M Sodium acetate Chemical compound [Na+].CC([O-])=O VMHLLURERBWHNL-UHFFFAOYSA-M 0.000 description 1
- 239000005708 Sodium hypochlorite Substances 0.000 description 1
- 230000017531 blood circulation Effects 0.000 description 1
- 239000001110 calcium chloride Substances 0.000 description 1
- 229910001628 calcium chloride Inorganic materials 0.000 description 1
- 235000011148 calcium chloride Nutrition 0.000 description 1
- 238000007865 diluting Methods 0.000 description 1
- 239000012535 impurity Substances 0.000 description 1
- 229910001629 magnesium chloride Inorganic materials 0.000 description 1
- 235000011147 magnesium chloride Nutrition 0.000 description 1
- 238000007726 management method Methods 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 230000000149 penetrating effect Effects 0.000 description 1
- 239000011148 porous material Substances 0.000 description 1
- 239000001103 potassium chloride Substances 0.000 description 1
- 235000011164 potassium chloride Nutrition 0.000 description 1
- 239000000047 product Substances 0.000 description 1
- 102000004169 proteins and genes Human genes 0.000 description 1
- 108090000623 proteins and genes Proteins 0.000 description 1
- 239000001632 sodium acetate Substances 0.000 description 1
- 235000017281 sodium acetate Nutrition 0.000 description 1
- 239000011780 sodium chloride Substances 0.000 description 1
- 235000002639 sodium chloride Nutrition 0.000 description 1
- SUKJFIGYRHOWBL-UHFFFAOYSA-N sodium hypochlorite Chemical compound [Na+].Cl[O-] SUKJFIGYRHOWBL-UHFFFAOYSA-N 0.000 description 1
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
- A61M1/1654—Dialysates therefor
- A61M1/1656—Apparatus for preparing dialysates
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
- A61M1/1654—Dialysates therefor
- A61M1/1656—Apparatus for preparing dialysates
- A61M1/166—Heating
- A61M1/1664—Heating with temperature control
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
- A61M1/168—Sterilisation or cleaning before or after use
- A61M1/1686—Sterilisation or cleaning before or after use by heat
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
- A61M1/168—Sterilisation or cleaning before or after use
- A61M1/169—Sterilisation or cleaning before or after use using chemical substances
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/33—Controlling, regulating or measuring
- A61M2205/3331—Pressure; Flow
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/33—Controlling, regulating or measuring
- A61M2205/3368—Temperature
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/36—General characteristics of the apparatus related to heating or cooling
Definitions
- the present invention relates to a blood purification device that purifies the blood by extracorporeally circulating the patient's blood through a blood purifier and a blood circuit.
- a dialysis device as a blood purification device used in dialysis treatment or the like usually consists of a piping section having a dialysate introduction line for introducing dialysate into the blood purifier and a drainage discharge line for discharging drainage from the blood purifier. , a liquid feeding section for feeding dialysate and drainage liquid in the piping section, and a blood circuit for extracorporeally circulating the patient's blood is connected to a blood purifier.
- dialysis treatment blood purification treatment
- Such a blood purifying apparatus normally performs a degreasing step for degreasing cleaning by introducing an alkaline agent such as sodium carbonate or sodium hypochlorite into the flow path of the piping section and circulating it periodically. , hygiene has been maintained for a long time.
- an aqueous solution of sodium carbonate is produced by heating the undiluted solution of agent B for preparing a dialysate, and the obtained aqueous solution of sodium carbonate is used as an alkaline agent to be circulated in the piping section in the deoiling step. has been proposed (see, for example, Patent Document 1).
- agent B for preparing dialysate in dialysis treatment and using the generated aqueous sodium carbonate solution as an alkaline agent to circulate in the degreasing step, agent B remaining in dialysis treatment can be removed.
- the undiluted solution can be reused, the cost of using chemicals can be reduced, the types of chemicals used in the degreasing process can be reduced, and the labor for management can be reduced.
- agent B used in dialysis treatment can be diverted as an alkaline agent (sodium carbonate aqueous solution) used in the degreasing and washing step
- agent B Carbon dioxide (CO 2 ) generated when the undiluted solution is heated is expected to remain in the piping section, and there is a risk that degreasing and cleaning cannot be performed satisfactorily. It is also conceivable to deaerate and remove the carbon dioxide generated when the undiluted solution of B is heated. There was a fear that I would die.
- the present invention has been made in view of such circumstances, and the undiluted solution of agent B used in the blood purification treatment process can be diverted as an alkaline agent to be used in the degreasing and washing process, and during the degreasing and washing process, To provide a blood purification apparatus capable of removing the generated carbon dioxide to perform excellent degreasing and washing.
- a blood purification apparatus is a blood purification apparatus for extracorporeally circulating a patient's blood through a blood purifier and a blood circuit to purify the blood, wherein dialysate is introduced into the blood purifier.
- a piping part having a dialysate introduction line and a drainage discharge line for discharging drainage from the blood purifier, a liquid sending part for sending the liquid in the piping part, and the undiluted agent A and the undiluted agent B are connected to the piping.
- a blood purification treatment step in which the dialysate prepared by introducing the dialysate into the section, mixing it, and diluting it to a predetermined concentration is sent to the blood purifier to perform blood purification treatment, and the undiluted solution of agent B is supplied to the piping section.
- a control for executing a degreasing cleaning step of performing degreasing cleaning for removing grease from the piping portion by circulating a bicarbonate aqueous solution obtained by introducing and heating by controlling the liquid feeding unit The control unit discharges carbon dioxide generated when the bicarbonate aqueous solution is circulated to the outside of the piping unit while performing the degreasing/cleaning step.
- the carbon dioxide generated when the aqueous bicarbonate solution is circulated is discharged to the outside of the piping part while performing the degreasing and washing process, so that the undiluted solution of agent B used in the blood purification treatment process is removed. It can be diverted as an alkaline agent used in the oil cleaning process, and can remove the carbon dioxide generated during the oil removing process so that the oil removing process can be performed satisfactorily.
- Schematic diagram showing a blood purification device according to an embodiment of the present invention.
- the blood purification apparatus purifies the blood by extracorporeally circulating a patient's blood through a blood purifier and a blood circuit.
- a blood purifier As shown in FIG. 1, an arterial blood circuit K1 and a venous blood circuit K2 a dialyzer C as a blood purifier; a piping section having a dialysate introduction line L1 and a drainage discharge line L2; a duplex pump 1 as a liquid feeding section; is configured as
- a connector is connected to the tip of the arterial blood circuit K1, and an arterial puncture needle can be connected via the connector.
- the venous blood circuit K2 has a connector connected to its tip, through which a venous puncture needle can be connected, and a venous air trap chamber is connected in the middle.
- the dialyzer C (blood purifier) includes a blood inlet C1 (blood inlet port), a blood outlet C2 (blood outlet port), and a dialysate inlet C3 (dialysate flow path inlet: dialysate inlet). port) and a dialysate outlet C4 (dialysate flow path outlet: dialysate outlet port) are formed.
- a circuit K2 is connected respectively.
- the dialysate inlet C3 and the dialysate outlet C4 are connected to the dialysate inlet line L1 and the drainage discharge line L2, respectively.
- a plurality of hollow fiber membranes are accommodated in the dialyzer C, and these hollow fibers constitute a blood purification membrane for purifying blood.
- the dialyzer C there are a blood channel (a channel between the blood inlet C1 and the blood outlet C2) through which the patient's blood flows through the blood purification membrane and a dialysate channel (a dialysate) through which the dialysate flows.
- a channel between the inlet C3 and the dialysate outlet C4 is formed.
- the hollow fiber membrane that constitutes the blood purification membrane is formed with a large number of minute holes (pores) penetrating the outer peripheral surface and the inner peripheral surface to form the hollow fiber membrane. It is configured so that impurities in the blood can permeate into the dialysate.
- the blood pump When the patient is pierced by the arterial puncture needle connected to the distal end of the arterial blood circuit K1 and the venous puncture needle connected to the distal end of the venous blood circuit K2, the blood pump is driven.
- the blood passes through the arterial blood circuit K1 to reach the dialyzer C, is subjected to blood purification treatment by the dialyzer C, and then returns to the patient's body through the venous blood circuit K2.
- the patient's blood can be purified by the dialyzer C while being circulated extracorporeally by the blood circuit K.
- the main body of the apparatus includes a piping section having a dialysate introduction line L1 for introducing dialysate into the dialyzer C, a drainage discharge line L2 for discharging drainage from the dialyzer C, and the dialysate and drainage of the piping section. It has a dual pump 1 (liquid feeding section) for feeding liquid.
- the duplex pump 1 has a suction part 1a connected to the dialysate introduction line L1 and a discharge part 1b connected to the drainage discharge line L2, and is arranged across the dialysate introduction line L1 and the drainage discharge line L2.
- the dialysate is introduced from the dialysate introduction line L1 into the dialyzer C, and the dialysate introduced into the dialyzer C is discharged along with waste products and excess water in the blood through the drainage discharge line. It can be discharged from L2.
- Means other than the dual pump 1 for example, using a so-called balancing chamber or the like may be used.
- the piping unit includes, in addition to the dialysate introduction line L1 and the drainage discharge line L2, bypass lines L3 to L5 connected to the dialysate introduction line L1 and the drainage discharge line L2, drainage A bypass line L6 that bypasses the discharge portion 1b of the dual pump 1 in the discharge line L2, and an A agent undiluted solution introduction line L7 that connects the A agent undiluted solution storage tank T1 and the B agent undiluted solution storage tank T2 to the dialysate introduction line L1, respectively. and a B agent undiluted solution introduction line L8.
- Electromagnetic valves (V5 to V7) are connected to the bypass lines L3 to L5, respectively, and solenoid valves (V8, V9) are connected to the agent A undiluted solution introduction line L7 and the agent B undiluted solution introduction line L8, respectively.
- Injection pumps (8a, 8b) are connected to the agent A undiluted solution introduction line L7 and the agent B undiluted solution introduction line L8, respectively.
- the A agent undiluted solution in the agent undiluted solution storage tank T1 is introduced into the dialysate introduction line L1 through the A agent undiluted solution introduction line L7, and when the electromagnetic valve V9 is open, the injection pump 8b is driven to introduce the B agent undiluted solution.
- the B agent undiluted solution in the storage tank T2 is introduced into the dialysate introduction line L1 via the B agent undiluted solution introduction line L8.
- the dialysate introduction line L1 includes solenoid valves (V1, V3), a heat exchanger 3, a heating unit 4, a deaeration pump 7, a deaeration unit 5, stirring chambers (9a, 9b), and a capture unit (10 , 11) are connected respectively.
- the heat exchanger 3 has a flow path through which the clean water (RO water) supplied to the dialysate introduction line L1 flows and a flow path through which the waste liquid of the waste liquid discharge line L2 flows. to transfer the heat of the waste liquid to the clean water.
- RO water clean water
- the heating unit 4 consists of a heater attached to the dialysate introduction line L1, and is capable of heating the clean water supplied to the dialysate introduction line L1.
- a temperature sensor t is attached to the downstream side (right side in FIG. 1) of the heating section 4, and is configured to detect the temperature of the clean water heated by the heating section 4 (water temperature).
- An orifice 6 is formed downstream of the temperature sensor t, and clean water passing through the orifice 6 is introduced into the deaerator 5 by driving the deaeration pump 7. .
- the degassing section 5 consists of a chamber connected to the dialysate introduction line L1, and a circulation line L9 (circulation flow path) extends from the bottom thereof.
- This circulation line L9 is connected to a predetermined position (position between the heat exchanger 3 and the heating unit 4) on the upstream side of the degassing unit 5 in the dialysate introduction line L1, and supplies the dialysate introduction line L1. It is configured to circulate clean water that has been filtered.
- a degassing line N1 extending to a drainage discharge line L2 is connected to the upper part of the degassing part 5. Air bubbles collected by the degassing part 5 are discharged to the outside of the piping part via this degassing line N1. can be discharged to
- the A agent undiluted solution and the B agent undiluted solution are composed of solutions having different compositions that constitute the dialysate.
- the agent A undiluted solution (A undiluted solution) is composed of a mixed aqueous solution containing sodium chloride, potassium chloride, calcium chloride, magnesium chloride, sodium acetate, etc.
- the B agent undiluted solution (B undiluted solution) is composed of sodium bicarbonate. It consists of an aqueous solution of (NaHCO 3 ).
- the agent A undiluted solution and the agent B undiluted solution are stored in predetermined amounts in the agent A undiluted solution storage tank T1 and the agent B undiluted solution storage tank T2, respectively. to be introduced.
- the stirring chambers (9a, 9b) mix and dilute the A agent undiluted solution and the B agent undiluted solution introduced into the dialysate introduction line L1 through the A agent undiluted solution introduction line L7 and the B agent undiluted solution introduction line L8 with clean water.
- a dialysate having a predetermined concentration can be produced. That is, the clean water supplied to the dialysate introduction line L1 is heated by the heating unit 4 and degassed (discharged bubbles) by the deaeration unit 5 in the process of being circulated through the circulation line L9.
- a dialysate having a predetermined concentration is produced.
- the trapping part (10, 11) traps air bubbles contained while permeating the dialysate in the blood purification treatment process, has air bubble filters (10a, 11a), and is located upstream of the air bubble filters (10a, 11a). primary side portions (10b, 11b) in which trapped air bubbles are stored, and secondary side portions (10c, 11c) downstream of the air bubble filters (10a, 11a) and through which permeated dialysate flows. ).
- the primary side portion 10b of the catching portion 10 and the drainage discharge line L2 are connected by a bypass line L4, and the primary side portion 11b of the catching portion 11 and the drainage discharge line L2 are connected to a bypass line L5. connected.
- hydraulic pressure detection units (S1, S2) composed of sensors capable of detecting hydraulic pressure are provided. are arranged respectively. Then, on the condition that the liquid pressure detection units (S1, S2) detect a predetermined change in the liquid pressure in the blood purification treatment process, the solenoid valves (V6, V7) (on-off valves) are opened to open the primary side portion.
- the air bubbles (10b, 11b) are configured to be discharged to the outside of the piping section via the bypass lines (L4, L5) and the drainage discharge line L2.
- the solenoid valves (V2, V4), the pressurizing pump P, and the degassing chamber 12 are connected to the drainage discharge line L2, respectively.
- a water removal pump 2 is connected. This water removal pump 2 is for removing water (surplus water) from the patient's blood flowing through the dialyzer C to remove water. That is, when the water removal pump 2 is driven, the volume of the effluent discharged from the effluent discharge line L2 becomes larger than the amount of dialysate introduced from the dialysate introduction line L1, and the large volume is removed from the blood. Moisture is removed.
- the degassing chamber 12 consists of a chamber connected to the drainage discharge line L2, and the lower part thereof and a predetermined position of the detour line L6 are connected by a connection line L6a.
- a degassing line N2 extending to the downstream part of the liquid discharge line L2 is connected to the upper part of the degassing chamber 12, and air bubbles collected in the degassing chamber 12 are piped through this degassing line N2. It is possible to discharge to the outside of the part.
- a solenoid valve V10 is connected to the degassing line N2 and can be opened and closed at an arbitrary timing.
- the control unit 13 is composed of a microcomputer installed in the main body of the apparatus, and introduces the undiluted solution of the agent A and the undiluted agent B into the piping unit, mixes them, and dilutes the dialysate to a predetermined concentration.
- a blood purification treatment step is executed in which liquid is sent to the blood purification treatment. That is, in the blood purification treatment process, as shown in FIG. 2, the injection pumps (8a, 8b) are operated while the solenoid valves (V8, V9) are opened, and the dual pump 1 and the water removal pump 2 are driven.
- the undiluted solution of the agent A and the undiluted agent B introduced into the dialysate introduction line L1 are mixed with clean water to prepare a dialysate of a predetermined concentration, and the dialysate is sent to the dialyzer C to feed the patient's blood. can be purified and dewatered for dialysis treatment.
- control unit 13 controls the heating unit 4 and the degassing unit 5 to generate a predetermined volume of bicarbonate aqueous solution while discharging carbon dioxide.
- the production step and the degreasing cleaning step of performing degreasing cleaning to remove grease from the piping portion by circulating a bicarbonate aqueous solution obtained by introducing and heating the undiluted solution of agent B into the piping portion, are carried out by a double pump. 1 can be executed.
- the bicarbonate aqueous solution generating step is a step of generating an alkaline agent (sodium carbonate aqueous solution) used in the degreasing and washing step using the undiluted solution of agent B used in the blood purification treatment step.
- the alkaline agent generated in the aqueous carbonate solution generation step is circulated through the piping to remove oil and grease.
- the bicarbonate aqueous solution generation step as shown in FIG.
- the electromagnetic valves (V4, V5, V9) are opened, the other electromagnetic valves are closed, and the degassing pump 7 and injection pump 8b are driven.
- the dual pump 1, the water removal pump 2, etc. are stopped.
- the B agent undiluted solution in the B agent undiluted solution storage tank T2 can be introduced into the dialysate introduction line L1 and heated by the heating unit 4 while being circulated through the circulation line L9.
- agent B sodium hydrogen carbonate (NaHCO 3 )
- the undiluted solution of agent B is heated (heated to about 65° C. or more) in the heating unit 4 while being diluted by circulating in the circulation line L9, thereby producing sodium carbonate (Na 2 CO 3 ), water (H 2 O) and carbon dioxide (CO 2 ).
- an aqueous sodium carbonate solution aqueous bicarbonate solution as an alkaline agent used in the degreasing and washing step can be produced from the undiluted solution of agent B.
- the heating unit 4 heats the undiluted solution of agent B introduced into the piping unit, and the degassing unit 5 is generated when the undiluted agent B is heated in the heating unit 4.
- Carbon dioxide can be discharged to the outside of the piping section. That is, in the process of circulating the undiluted agent B in the circulation line L9, the heating unit 4 heats the undiluted agent B to generate a sodium carbonate aqueous solution (bicarbonate aqueous solution), and the degassing unit 5 discharges carbon dioxide. It is possible.
- the heating unit 4 and the degassing unit 5 provide clean water for preparing a dialysate having a predetermined concentration by mixing the undiluted solution of the agent A and the undiluted agent B while circulating them in the circulation line L9 in the blood purification treatment step.
- the undiluted solution of agent B can be heated in the step of producing an aqueous bicarbonate solution to produce an aqueous sodium carbonate solution while discharging carbon dioxide.
- the bicarbonate aqueous solution generating step of generating a predetermined volume of sodium carbonate aqueous solution while discharging carbon dioxide by the heating unit 4 and the degassing unit 5 the sodium carbonate aqueous solution is used to perform the degreasing and washing step. will be executed.
- the present embodiment has a reservoir for storing a predetermined volume of an aqueous sodium carbonate solution produced by heating the undiluted solution of agent B.
- This reservoir consists of a flow path of a predetermined portion that constitutes the piping part. It is assumed to include roads.
- the storage section includes the circulation line L9 on the upstream side (left side in FIG. 3) of the connection portion of the dialysate introduction line L1 with the agent B undiluted solution introduction line L8, the heat exchange flow path of the heat exchanger 3, and the bypass line L3. and is capable of storing the sodium carbonate aqueous solution produced in the bicarbonate aqueous solution producing step.
- the tip of the dialysate introduction line L1 and the tip of the drainage discharge line L2 are kept connected by the coupler D, and the solenoid valves (V1, V2, V5, V10) are opened and the other solenoid valves are closed, and the degassing pump 7, dual pump 1, dewatering pump 2 and pressurizing pump P are driven.
- the injection pumps (8a, 8b) are stopped.
- the solenoid valves (V5 to V7) are opened at an arbitrary timing when the bypass lines (L3 to L5) are degreased and cleaned. As a result, the sodium carbonate aqueous solution stored in the storage section can be circulated and de-oiled by the piping section.
- control unit 13 is capable of executing control for discharging carbon dioxide generated when the aqueous sodium carbonate solution is circulated to the outside of the piping unit while executing the degreasing and washing step. .
- control unit 13 controls the catching unit 10 on the condition that the hydraulic pressure detection unit S1 detects a predetermined change in hydraulic pressure (increase in hydraulic pressure in this embodiment) in the degreasing and washing process.
- the carbon dioxide captured by the air bubble filter 10a is discharged to the outside of the piping section.
- the carbon dioxide trapped by the bubble filter 10a of the trapping section 10 and retained in the primary side portion 10b is guided to the waste liquid discharge line L2 through the bypass line L4, and is guided to the degassing line of the degassing chamber 12. It will be discharged to the outside of the piping section via N2.
- the tip of the dialysate introduction line L1 and the tip of the drainage discharge line L2 are connected by a coupler D to short-circuit, and clean water is supplied from the dialysate introduction line L1 to each flow path constituting the piping section. (S1). As a result, the dialysate in the piping can be washed away.
- the B agent undiluted solution in the B agent undiluted solution storage tank T2 is introduced into the dialysate introduction line L1 (S2), and the bicarbonate aqueous solution producing step is executed.
- the undiluted solution of agent B is circulated through the circulation line L9, it is heated by the heating unit 4 to produce an aqueous solution of sodium carbonate (Na 2 CO 3 ) having a predetermined concentration, and carbon dioxide (CO 2 ) is removed through the degassing line N1. (S3).
- the generated aqueous sodium carbonate solution is passed through a circulation line L9 on the upstream side (left side in FIG. 3) of the connecting portion of the dialysate introduction line L1 with the agent B undiluted solution introduction line L8, the heat exchange passage of the heat exchanger 3, and the bypass line. It will be stored in the storage part formed by the channel including L3. Then, in S4, it is determined whether or not the injection amount of the undiluted B agent has reached a specified value or more, and if it is determined that it is equal to or greater than the specified value, the process proceeds to S5, where a degreasing and cleaning step is performed.
- the dual pump 1 and the like are driven to circulate the sodium carbonate aqueous solution stored in the storage section through each channel of the piping section (S5).
- the A agent undiluted solution storage tank T1 and the B agent undiluted solution storage tank T2 are removed from the A agent undiluted solution introduction line L7 and the Agent B undiluted solution introduction line L8.
- a sodium carbonate aqueous solution may be circulated through the agent B undiluted solution introduction line L8 for degreasing and washing.
- the washing action of the sodium carbonate aqueous solution enables the removal of patient-derived proteins, and the piping portion is degreased and washed.
- the carbon dioxide generated when the aqueous sodium carbonate solution is circulated is discharged to the outside of the piping part while the degreasing and washing step is being performed. It can be diverted as an alkaline agent used in the oil cleaning process, and can remove the carbon dioxide generated during the oil removing process so that the oil removing process can be performed satisfactorily.
- carbon dioxide since carbon dioxide is trapped by the air bubble filter 10a of the trapping unit 10 when the aqueous sodium carbonate solution is circulated in the degreasing and washing process, carbon dioxide can be reliably trapped.
- the carbon dioxide captured by the air bubble filter 10a of the capture unit 10 is discharged to the outside of the piping unit.
- the carbon dioxide generated can be automatically discharged to the outside of the piping section.
- the electromagnetic valve V6 on-off valve
- the bypass line L4 used in the blood purification treatment process can be effectively used to discharge carbon dioxide to the outside of the piping section.
- the present invention is not limited to these.
- the carbon dioxide generated in may be captured and discharged.
- the means used in the blood purification treatment process may be used as in the present embodiment, or special means for trapping that is not used in the blood purification treatment process may be used.
- an aqueous sodium carbonate solution obtained by introducing and heating the undiluted solution of agent B is circulated in the piping to degrease and wash the piping.
- the present invention is applied to a personal dialysis machine, but it can also be applied to other types of blood purification machines such as multi-person dialysis machines.
- Duplex pump (liquid delivery unit) 1a Suction section 1b Discharge section 2 Water removal pump 3 Heat exchanger 4 Heating section 5 Degassing section 6 Orifice section 7 Degassing pumps 8a, 8b Injection pumps 9a, 9b Stirring chambers 10, 11 Capture sections 10a, 11a Bubble filter 10b , 11b primary side portion 10c, 11c secondary side portion 12 degassing chamber 13 control portion L1 dialysate introduction line L2 drainage discharge line L3-L5 bypass line L6 detour line L6a connection line L7 agent A undiluted solution introduction line L8 agent B Undiluted solution introduction line L9 Circulation lines N1, N2 Degassing line C Dialyzer (blood purifier) C1 blood inlet C2 blood outlet C3 dialysate inlet C4 dialysate outlet K blood circuit K1 arterial blood circuit K2 venous blood circuit T1 agent A undiluted solution storage tank T2 agent B undiluted solution storage tank t temperature sensors S1, S2 liquid Pressure detector P Pressure pump
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Abstract
Description
本実施形態に係る血液浄化装置は、血液浄化器及び血液回路を通じて患者の血液を体外循環させ、血液を浄化するもので、図1に示すように、動脈側血液回路K1及び静脈側血液回路K2を有する血液回路Kと、血液浄化器としてのダイアライザCと、透析液導入ラインL1及び排液排出ラインL2等を有する配管部と、送液部としての複式ポンプ1と、制御部13とを有して構成されている。
先ず、透析液導入ラインL1の先端と排液排出ラインL2の先端とをカプラDにて接続して短絡するとともに、透析液導入ラインL1から清浄水を供給して配管部を構成する各流路に流通させることにより前洗浄動作を行う(S1)。これにより、配管部の透析液を洗い流すことができる。
1a 吸入部
1b 排出部
2 除水ポンプ
3 熱交換器
4 加熱部
5 脱気部
6 オリフィス部
7 脱気用ポンプ
8a、8b 注入ポンプ
9a、9b 撹拌チャンバ
10、11 捕捉部
10a、11a 気泡フィルタ
10b、11b 1次側部位
10c、11c 2次側部位
12 脱ガスチャンバ
13 制御部
L1 透析液導入ライン
L2 排液排出ライン
L3~L5 バイパスライン
L6 迂回ライン
L6a 接続ライン
L7 A剤原液導入ライン
L8 B剤原液導入ライン
L9 循環ライン
N1、N2 脱気ライン
C ダイアライザ(血液浄化器)
C1 血液導入口
C2 血液導出口
C3 透析液導入口
C4 透析液導出口
K 血液回路
K1 動脈側血液回路
K2 静脈側血液回路
T1 A剤原液収容タンク
T2 B剤原液収容タンク
t 温度センサ
S1、S2 液圧検出部
P 加圧ポンプ
Claims (4)
- 血液浄化器及び血液回路を通じて患者の血液を体外循環させ、前記血液を浄化する血液浄化装置であって、
前記血液浄化器に透析液を導入する透析液導入ライン、および前記血液浄化器から排液を排出する排液排出ラインを有する配管部と、
前記配管部の液体を送液させる送液部と、
A剤原液及びB剤原液を前記配管部に導入して混合し、且つ、所定濃度に希釈することにより作製された透析液を前記血液浄化器に送液して血液浄化治療を行う血液浄化治療工程、および前記配管部にB剤原液を導入して加熱することにより得られた重炭酸塩水溶液を流通させて前記配管部の油脂を除去する脱油脂洗浄を行う脱油脂洗浄工程を、前記送液部を制御することによって実行する制御部とを具備し、
前記制御部は、前記脱油脂洗浄工程を実行しながら、重炭酸塩水溶液を流通させる際に生じた二酸化炭素を前記配管部の外部に排出する、血液浄化装置。 - 前記透析液導入ラインは、前記血液浄化治療工程において透析液を透過させつつ含有する気泡を捕捉する捕捉部が接続され、
前記脱油脂洗浄工程で重炭酸塩水溶液を流通させる際に前記捕捉部が二酸化炭素を捕捉する、請求項1記載の血液浄化装置。 - 前記透析液導入ラインにおける前記捕捉部の下流側又は上流側に液圧を検出する液圧検出部をさらに具備し、
前記制御部は、前記脱油脂洗浄工程において前記液圧検出部が所定の液圧の変化を検出したことを条件として、前記捕捉部で捕捉した二酸化炭素を前記配管部の外部に排出する、請求項2記載の血液浄化装置。 - 前記捕捉部は、前記捕捉部の上流側であって捕捉された気泡が収容される1次側部位、及び前記捕捉部の下流側であって透過した透析液が流通する2次側部位を有し、
前記配管部は、前記1次側部位と前記排液排出ラインとを接続して連通させるバイパスラインと、前記バイパスラインを開閉して流路を開放又は閉止する開閉弁とを有し、
前記制御部は、前記脱油脂洗浄工程において前記液圧検出部が所定の液圧の変化を検出したことを条件として、前記開閉弁を開状態として前記1次側部位の二酸化炭素を前記バイパスライン及び排液排出ラインを介して前記配管部の外部に排出する、請求項3記載の血液浄化装置。
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JP2014023713A (ja) * | 2012-07-26 | 2014-02-06 | Shibuya Kogyo Co Ltd | 透析装置 |
JP2018118033A (ja) | 2016-12-16 | 2018-08-02 | ベー・ブラウン・アヴィトゥム・アー・ゲーB. Braun Avitum Ag | 酸性濃縮物による消毒と脱灰との組み合わせを含む体外血液処理装置における後処理および処理サイクルの準備の方法 |
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JP2014023713A (ja) * | 2012-07-26 | 2014-02-06 | Shibuya Kogyo Co Ltd | 透析装置 |
JP2018118033A (ja) | 2016-12-16 | 2018-08-02 | ベー・ブラウン・アヴィトゥム・アー・ゲーB. Braun Avitum Ag | 酸性濃縮物による消毒と脱灰との組み合わせを含む体外血液処理装置における後処理および処理サイクルの準備の方法 |
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