HK1090009B - Bulk compounder manifold - Google Patents
Bulk compounder manifold Download PDFInfo
- Publication number
- HK1090009B HK1090009B HK06111883.1A HK06111883A HK1090009B HK 1090009 B HK1090009 B HK 1090009B HK 06111883 A HK06111883 A HK 06111883A HK 1090009 B HK1090009 B HK 1090009B
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- HK
- Hong Kong
- Prior art keywords
- manifold
- outlet
- fluid
- tube
- cannula
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Description
The present invention relates to bulk nutritional compounders and more specifically to manifolds for use in bulk nutritional compounders.
Hyperalimentation therapy is the intravenous feeding of nutrients to patients. A typical solution would include a protein-carbohydrate mixture. It is used primarily to meet the patient's protein and caloric requirements which are unable to be satisfied by oral feeding. The protein may be in the form of free-amino acids or protein hydrolysate and the carbohydrate commonly is dextrose. In addition to the protein and carbohydrate, vitamins (water-soluble and fat-soluble) and electrolytes also can be supplied in this therapy.
Each of these parenteral ingredients and the combination thereof are particularly susceptible to the growth of deleterious organisms and it is desirable that they be administered to the patient in a sterile condition. In addition, the solutions are tailor made to specific patient requirements under the direction of a physician. Thus, because these protein and carbohydrate solutions must be combined close to their time of use, their compounding must be performed under sterile conditions to avoid organism growth.
As a part of this compounding, the solutions that are to be administered intravenously are transferred into a total parental nutrition bag (commonly referred to as a TPN bag). Such bags are designed for home use or use in a hospital or care facility. Once filled they can be stored for a limited period of time in a standard refrigerator. The bags are filled with the solutions by a pharmacist either by gravity or by a device known as a high speed bulk compounder. Such compounders typically are capable of supplying solutions from up to nine different source bags or containers to a receiving product bag at relatively high flow rates.
The source containers may be hung from a framework of the compounder while the receiving bag is hung from a load cell that measures the weight of the receiving bag. A pump set consisting of a number of pump legs (for example, nine or more such legs) or flow paths is designed to be used with the compounder. Each of the pump legs includes flexible tubing and terminates on one end with a piercing administration spike or similar connector that is used to connect the leg of the pump set to one of the source containers. The other end of each leg is coupled to one of the inlet ports of a common manifold equipped with an exit port that is adapted to be coupled to a fill tubing connected to the receiving TPN product bag.
In those instances where a high-speed compounder is used, each leg of the pump set is associated with a different peristaltic pump or pump station of the compounder. A microprocessor in the compounder controls each of the peristaltic pumps or pump stations to thereby control the amount of solution being supplied from each source container through the particular pump leg and the manifold to the receiving product bag. The amount of solution being supplied from each source container is in part determined by information being supplied to the microprocessor of the weight being measured at selected times by the load cell from which the receiving bag is suspended. The peristaltic pumps draw solutions from each of the source containers sequentially under the control of the microprocessor and the solutions flow through the common manifold and the fill tubing into the receiving product bag.
A typical compounder would have several source bags and affiliated tubes. Typically, there are six or nine pumping stations for six or nine different source solutions. The microprocessor in the compounder is programmed to sequentially fill the product bag with each ingredient, one at a time, by sequentially activating each of the six pump stations individually so that the solutions from each source bag are transferred via the common manifold and the fill tubing to the product bag. Then, after the product bag is supplied with the required amount of fluids, the fill tubing from the product bag is sealed.
Because all tubes in such a configuration flow into a common manifold, but only one fluid at a time is pumped through the common manifold, it is possible that some fluid from a particular source bag flows back through the common manifold and into a feed tube from another source bag containing a different fluid. The fluid that does flow back into a different feed tube is not weighed as a part of the product bag and the compounder microprocessor does not recognize that fluid as a part of the overall make-up of the product bag. The problem with this is that once the product bag receives the weight of a particular ingredient, the microprocessor shuts off that respective pump and turns to the next source bag. The microprocessor begins pumping the fluid from that second source bag into the product bag but in so doing causes the backed-up and stored fluid from the first product bag in that supply tube to now flow into the manifold and ultimately into the product bag. At that point, however, the weight gain in the product bag is recognized by the compounder microprocessor as being due to the second fluid. This error leads to the situation where too much of the first fluid is present in the product bag and not enough of the second fluid is present in the bag.
A related problem arises when one of the fluids to be introduced into the product bag is a lipid solution. Lipid solutions are essentially fat emulsions and typically are placed into a separate compartment within the product bag which is isolated from the remaining mixture until immediately before (or very soon before) the solution is administered to a patient. This isolation is necessary because the lipid solution, if mixed with the other ingredients ahead of time, clouds the overall solution mixture and renders it unusable. This phenomena is known in the art as "hazing." Because of the undesirability of mixing lipids with the other solutions prior to the time of administration, a problem has existed in the prior art where a residual amount of the lipid solution is allowed to remain in a common volume of the manifold after a lipid solution is pumped through but before the next non-lipid solution is pumped through. When the subsequent solution is pumped through, the residual lipid solution is carried into the product bag and hazing results.
The present invention provides a manifold for receiving fluid tubes in a bulk compounder. In its simplest form, the manifold comprises a plurality of inlets, each inlet defining an opening to a respective fluid passageway, and each passageway contains a check-valve. Included in this manifold is an outlet in fluid communication with the fluid passageways, and an inlet port which is coaxial with the outlet. The coaxial inlet port contains a check-valve. The plurality of inlets are disposed radially around a center inlet, and an outlet is provided in fluid communication with all of the fluid passageway and center inlet. The outlet and the center inlet have the same central axis.
Also included as a part of the present invention is a manifold set for receiving fluid tubes in a bulk compounder. The manifold set comprises a manifold and a cannula. The manifold comprises a plurality of inlets, each inlet defining an opening to a respective fluid passageway, each passageway containing a check-valve, an outlet in fluid communication with the fluid passageways; and an inlet port which is coaxial with the outlet, the coaxial inlet port also containing a check-valve. The cannula has at least one male blunt tip for insertion into the self-sealing membrane, and preferably includes a female port disposed within the male blunt tip.
In a preferred embodiment of the present invention, a manifold for receiving fluid tubes in a bulk compounder is provided having a plurality of inlets, each inlet defining an opening to a respective fluid passageway, with each passageway containing a check-valve.
Also included as a part of the present invention is a tube set for use in bulk compounding. The tube set comprises a plurality of pump sections, each pump section having a distal end. Also included is a plurality of tubes, each tube of the plurality having a distal end and a proximal end, with each proximal end of each tube of the plurality attached to the distal end of a respective pump section. Additionally, each distal end of each tube of the plurality is attached to a manifold, wherein the manifold comprises a plurality of inlets, each inlet defining an opening to a respective fluid passageway, each passageway containing a check-valve. The manifold includes an outlet in fluid communication with the fluid passageways.
A preferred tube set in accordance with the invention comprises a plurality of pump sections, each pump section having a distal end and a proximal end, a first plurality of tubes, each tube of the first plurality attached to the proximal end of a respective pump section, and a second plurality of tubes, each tube of the second plurality having a distal end and a proximal end, with each proximal end of each tube of the second plurality attached to the distal end of a respective pump section. The distal end of each tube of the second plurality is attached to a manifold. The manifold comprises a plurality of inlets, each inlet defining an opening to a respective fluid passageway, each passageway containing a check-valve, and an outlet in fluid communication with the fluid passageways.
Also included in the present invention is a method of minimizing error in the filling of a product bag in a bulk compounding system. The method comprises the steps of providing a manifold with a minimum common volume to minimize residual holding of any one ingredient solution, and passing individual ingredient solutions through the manifold to fill a product bag. Error is reduced because of the minimization of the manifold common volume step.
Still also in the present disclosure is a cannula for attaching two fluid channels. The cannula comprises at least one male blunt tip end for insertion into a first fluid source, and a female port formed within the male blunt tip end to allow connection of the cannula to a different fluid source wherein the different fluid source has a male end.
The invention is best understood from the following detailed description when read in connection with the accompanying drawings, in which:
- Fig. 1 is a partial cross-sectional view of a device according to the present invention, including a manifold body portion, valve housings, and an outlet tube connector;
- Fig. 2 illustrates a tube set in accordance with the present invention using the manifold of Fig. 1;
- Fig. 3a shows a cross-sectional view of the main body portion of the manifold of Fig. 1 without valve housings or the outlet tube connector shown in Fig. 1;
- Fig. 3b shows an exploded view of the main body portion shown in Fig. 3a;
- Fig. 3c shows an exploded view like that of Fig. 3b but with only six total inlet ports;
- Fig. 4 shows a top view of the manifold shown in Fig. 1;
- Fig. 5a shows a cross-sectional view of a valve housing in accordance with the present invention;
- Fig. 5b shows an exploded view of the valve housing shown in Fig. 5a;
- Fig. 6 is a cross-sectional view of an outlet tube connector in accordance with the present invention;
- Fig. 7 shows a cross-sectional view of a male blunt cannula;
- Fig. 8 shows the male blunt cannula of Fig. 7 inserted into an outlet tube connector.
The present invention provides a manifold having a one-way, valve, or check valve, disposed within each inlet of the manifold. Additionally, the manifold has a plurality of inlets, with at least one inlet disposed proximate to, and coaxially with, an outlet. The purpose of the coaxially disposed inlet/outlet is to minimize the volume through which the solution passed into the coaxial inlet must travel, thereby lowering the amount of potential residue that can be left behind by that particular solution. In a preferred embodiment, this line is used to transport a lipid solution. Other aspects of the manifold according to the present invention which will be described in more detail below also contribute to the reduction in common volume thereby reducing error in the final product bag composition due to residue buildup within the manifold.
In the case of a preferred embodiment, each of the three main components (main body portion 100, a plurality of valve housings 200, and an outlet tube connecter 300) can be fabricated independently and joined together to form a single device made up of its individual components. Preferably, each of these three main components is ultrasonically welded to its respective mate. The means of joining the components are discussed in detail below. The primary advantage to such a construction is ease of manufacture.
The manifold could be made from any of a number of suitable materials, including plastics, such as polycarbonates, that are suitable to handle the pharmaceutical and food preparations that will be passing therethrough. The suitable materials should also preferably be such that they can be injection molded to form the parts of the device, or the whole device, and one skilled in the art would know such materials.
More specifically, Fig. 1 shows valve housings 200 which are connected to their respective manifold main body portion openings 110. In a preferred embodiment, the valve housings 200 are connected to their respective manifold main body portion openings 110 by ultrasonic welding. Ultrasonic welding is a technique known to those skilled in the art for fastening plastic to plastic. Additional means of connection could be employed, however, including solvent welding, adhesives, snap-fittings, flanges, or any other suitable connection known to one skilled in the art.
As noted above, Fig. 3a shows gasket 260 which fluidly seals top 240 to bottom 250 and along with flow channels 222 formed in top 240 forms respective fluid passageways as discussed in more detail below. Top 240 and bottom 250 can be attached in any number of ways known to those skilled in the art, including by ultrasonic welding. In order to aidin ultrasonic welding, male protrusion 270 extending from top 240 into female portion 280 formed in bottom 250 can be molded into the respective halves.
As can be seen in Figs. 3b , 3c , and 4 , each fluid passageway (with the exception of center port 140) is configured in a radial pattern with its own respective radial flow path and flow channel 222, each of which leads to common central chamber 215. Such a configuration, along with the presence of gasket 260, helps further an important part of the invention as discussed above, namely the minimizing of any common volume within the manifold. By providing these individual flow paths from each manifold opening 110 all the way to common central chamber 215, only common central chamber 215 of the manifold sees fluid from all source bags, instead of the entire space between manifold top 240 and manifold bottom 250 (such as would be the case without gasket 260). This minimum volume is further aided by the fluid passageways preferably having a semi-circular cross-section that results in high flow rates.
Disposed between retention ring 420 and distal end 410 of outlet tube connector 300 is connector septum 440. This is generally a self-sealing membrane designed to close the opening when an outlet line is not connected to outlet tube connector 300. When a product bag is ready to be filled, a fill line to the product bag, typically having a spiked cannula (connector) or blunt cannula, is thrust or pushed into septum 440 to create a fluid communication between the fill line and manifold outlet tube connector 300. Self-sealing membranes of this type are known to those skilled in the art.
A preferred connection between the product bag fill line and outlet tube connector 300 is a blunt cannula connector. An exemplary blunt cannula is shown in Fig. 7. Fig. 7 shows a blunt male cannula 700 having a female port 710 on at least one end. Fig. 7 shows blunt male cannula 700 disposed on the end of product bag fill line 720. The end having female port 710 is the end which would be thrust into the septum in order to establish fluid flow as described above. The advantage to having a female port disposed within a male cannula is seen when one realizes how these TPN bags are typically used,
Often, after a TPN product bag has been filed in accordance with the above, it may be desirable to take additional steps. These additional steps would include possibly adding a very small amount of some additional ingredient, or withdrawing a small sample of the product composition. Often such an addition or sampling requires the addition or withdrawal of a small amount of fluid, such as 1 to 5 cc of fluid. The female port on male blunt cannula 700 as described above allows for the insertion of a standard syringe and subsequent sealing of that syringe against the female port wall to form a seal and allow the withdrawal or addition of a small amount of fluid. Moreover, after the product bag has been filled, the male blunt cannula can be withdrawn from the septum of the outlet tube connector 300. Then, a syringe can be inserted and lodged within female port 710 of male blunt cannula 700 to allow for the syringe to act on the fluid within the product bag.
Another aspect of the male blunt cannula is that it can be inserted through septum 440 and lodged within outlet tube connector 300 along the inside wall of outlet tube connector 300. Fig. 8 shows such a friction fit between male blunt cannula 700 and inner wall 810 of outlet tube connector 300. Such a fit is encouraged by the slightly decreasing inside diameter of outlet tube connector 300 as one moves from its distale end toward manifold outlet port 310. Such a slightly conical inner surface aids in the friction fit. An additional advantage of this configuration is that it further reduces the common volume of the manifold because the area outside the cannula wall, but inside outlet tube connector 300, shown in Fig. 8 as space 820, is removed from the flow volume.
It is noteworthy, also, that when the cannula is withdrawn from the manifold outlet tube connector 300, a vacuum is momentarily created within the manifold as the cannula is pulled out and the septum prevents air from filling the volume until the cannula is completely out of the outlet tube connector and the pressure within the system is allowed to stabilize. This vacuum can pull additional fluid which is residing in any (or all) of the feed tubes into the manifold. Such a pulling of fluid is, of course, undesirable, especially in the case of the lipid line for the reasons discussed above. In order to prevent such a pulling of fluid, the check-valves should be designed such that they do not break at the negative pressure created when the vacuum is made upon cannula withdrawal. This is especially important for the lipid line check-valve which, as discussed above, in the preferred embodiment is in the port closest to the outlet port. Thus, it is a feature of the present invention that the cracking pressure of the check valves (the pressure at which the check valve opens, or releases) exceed the absolute value of the vacuum pressure created upon cannula withdrawal. In one embodiment of the invention, the cracking pressure of at least the check valve-disposed in the lipid line (for example check-valve disk 150 in center port 140) exceeds the absolute value of the vacuum pressure created upon cannula withdrawal.
Included as a part of the present invention is a method of minimizing error in the filling of a product bag in a bulk compounding system. The method comprises the steps of providing a manifold with a minimum common volume to minimize residual holding of any one ingredient solution, and passing individual ingredient solutions through the manifold to fill a product bag. Error is reduced because of the minimization of the manifold common volume step.
Claims (15)
- A manifold (10) for receiving fluid tubes (201-209) in a bulk compounder, said manifold (10) comprising:a plurality of inlets (220), each inlet defining an opening to a respective fluid passageway (221), each said passageway (221) containing a check-valve (210);an outlet (215) in fluid communication with said fluid passageways (221);and a center inlet port (140) which is coaxial with said outlet (215), said center inlet port (140) containing a check-valve (150), wherein said center inlet port (140) which is coaxial with said outlet (215) is disposed proximate to the outlet (215);characterized in that the plurality of inlets (220) are disposed radially from said center inlet port (140): andsaid outlet (215) is in fluid communication with all of said fluid passageways (221) and said center inlet port (140): and thatsaid outlet (215) and said center inlet port (140) have the same central axis.
- The manifold of claim 1 further comprising a central chamber in fluid communication with each said fluid passageway (221) for fluidly connecting said fluid passageways (221) to said outlet (215).
- The manifold of claim 1 wherein said outlet (215) comprises an outlet port (310) having a self-sealing membrane (440) adapted to be penetrated by a cannula.
- The manifold of claim 1 wherein said outlet (215) comprises an outlet port (310) having a self-sealing membrane (440) adapted to be penetrated by a cannula, and wherein said coaxial inlet port check-valve (150) is adapted to have a cracking pressure greater than the vacuum pressure within said outlet port (310) when the cannula is pulled from said self-sealing membrane (440).
- The manifold of claim 4 wherein all said check-valves (210, 150) are adapted to have a cracking pressure greater than the vacuum pressure within said outlet port (310) when the cannula is pulled from said self-sealing membrane (440).
- A manifold set for receiving fluid tubes in a bulk compounder comprising: a manifold, according to one of claims 3 to 5 and a cannula (700) having at least one male blunt tip for insertion into said self-sealing membrane (440).
- The manifold set of claim 6 wherein said cannula (700) has a female port (710) at said male blunt tip end for receiving an additional male tip.
- The manifold of claim 1 wherein said center inlet (140) defines a center passageway containing a check-valve (150).
- A tube set for use in bulk compounding, said tube set comprising:a plurality of pump sections, each said pump section having a distal end;a plurality of tubes, each said tube of said plurality having a distal end and proximal end, each said proximal end of each tube of said plurality attached to said distal end of a respective pump section, and each said distal end of each tube of said plurality attached to a manifold (10) according to one of claims 1 to 5 or 8.
- The tube set of claim 9 wherein said plurality is six.
- The tube set of claim 9 wherein said plurality is nine.
- A tube set for use in bulk compounding, said tube set comprising:a plurality of pump sections, each said pump section having a distal end and a proximal end; a first plurality of tubes, each said tube of said first plurality attached to said proximal end of a respective pump section;a second plurality of tubes, each said tube of said second plurality having a distal end and proximal end, each said proximal end of each tube of said second plurality attached to said distal end of a respective pump section, and said distal end of each tube of said second plurality attached to a manifold (10) according to one of claims 1 to 5 or 8.
- The tube set of claim 12 wherein said first and second plurality are both six.
- The tube set of claim 12 wherein said first and second plurality are both nine.
- A method of minimizing error in the filling of a product bag in a bulk compounding system, said method comprising the steps of:providing a manifold according to one of claims 1 to 5 or 8; andpassing individual ingredient solutions through the manifold to fill a product bag;whereby error is reduced because of the minimization of the manifold common volume step.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US10/727,930 US6951228B2 (en) | 2003-12-04 | 2003-12-04 | Bulk compounder manifold |
| US10/727,930 | 2003-12-04 | ||
| PCT/US2004/032668 WO2005061328A1 (en) | 2003-12-04 | 2004-10-05 | Bulk compounder manifold |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| HK1090009A1 HK1090009A1 (en) | 2006-12-15 |
| HK1090009B true HK1090009B (en) | 2015-09-11 |
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