JP2000084071A - Blood treatment equipment with improved water removal rate control accuracy - Google Patents

Abstract

(57) [Summary] [PROBLEMS] To provide a high-performance and high-reliability blood processing apparatus with improved water removal amount control accuracy. For example, a value obtained by subtracting the initial total weight measured at the start of blood processing from the total weight of a dialysate container and a dialysate drainage container, and a water removal target that increases with the processing time according to a set water removal amount. The above object is achieved by controlling the correction pump by rotating the correction pump forward and backward until the difference between the two becomes zero while comparing the values.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a blood processing apparatus for supplying blood to a blood processing apparatus containing a semi-permeable membrane to perform blood processing and return the blood to the human body. It is about. The blood processing apparatus of the present invention can be suitably used for blood treatment by extracorporeal circulation such as continuous slow hemodialysis, continuous slow hemodialysis, continuous slow hemofiltration, and hemofiltration.

[0002]

2. Description of the Related Art In a conventional blood processing apparatus, in a hemodialysis and hemofiltration using a slow-release system or the like, it is necessary to install a water removal drainage channel and a water removal pump in order to remove water from the human body. . The control of the water removal amount was flow rate control of the water removal pump, and the rotation speed of the water removal pump was kept constant with respect to the set water removal flow rate. Also, due to the flow rate error existing in the water removal pump, it was necessary to store the water removal in a container and measure it. Such conventional devices have the following problems, and their solutions have been strongly demanded. The flow rate error of the dewatering pump is large, and the control accuracy is ± 1
At most about 0%. Since a dedicated pump for removing water is required, the number of pumps is increased, and the blood circuit set in the apparatus is also complicated. Since actual measurement of the amount of water removal is required, work on site is complicated, and measurement mistakes and the like often occur.

[0003]

SUMMARY OF THE INVENTION The present invention is directed to a blood processing apparatus which solves the above-mentioned problems of a conventional blood processing apparatus such as a continuous slow hemodialysis apparatus, that is, a. Improvement of water removal control accuracy. b. Realizing a shared blood circuit and improving operability by reducing the number of pumps. c. Improvement of workability by eliminating actual measurement of water removal amount. It is an object of the present invention to provide a high-performance and highly reliable blood processing apparatus that achieves the above.

[0004]

The inventor of the present invention has conducted various experiments to solve the above-mentioned problems, and has observed the amount of water removed with a conventional blood processing apparatus such as a continuous slow hemodialysis apparatus. The emphasis is placed on improving the accuracy of water removal control rather than actual measurement, and instead of a water removal method using a dedicated water removal pump, for example, the weight balance between the dialysate container, replenisher container, and drainage container Weighing scale used for control,
The use of a forward / reverse rotatable compensation pump used for weight compensation in the weight balance control of dialysate and replenisher and dialysis effluent and filtration effluent for water removal, improves the accuracy of water removal control. It has been found that the above problems can be solved because the weight accuracy can be improved to the order of the order of magnitude (about ± 1%) and the number of pumps can be reduced by one. That is, the present invention provides a blood circulation path for introducing a patient's blood into a blood processor containing a semipermeable membrane and returning the blood to the patient again,
A dialysate supply path for supplying dialysate from the dialysate container to the blood processor and a dialysate discharge path for discharging used dialysate from the blood processor to a dialysate drain container, or the blood circulation path And a replenisher supply path for replenishing the patient with a replenisher from the replenisher via the blood circulation path, and a filtrate discharge path for discharging the blood filtrate from the blood processor to the filtrate drain container,
Or a filtrate / dialysis for discharging a blood filtrate and a used dialysate from the blood processor to the filtrate / dialysate drainage container, the blood circulation path, the replenisher supply path, the dialysate supply path, and the blood processor. A blood treatment apparatus for performing hemodialysis or hemofiltration or hemofiltration dialysis, comprising a fluid discharge path, a flow path bypassing the dialysate discharge path, a forward / reverse rotatable correction pump installed in the bypass path, A weight measuring means for measuring the total weight of the dialysate container and the dialysate drainage container, and an initial total weight measurement measured at the start of blood treatment from the measured value of the total weight of the two containers measured by the weight measuring means A control device for rotating the correction pump forward and backward until the difference between the two values becomes zero while comparing the reduced value with the target water removal value that increases with the processing time according to the set water removal amount, or A flow that bypasses the filtrate discharge path A compensating pump installed in the bypass passage, capable of rotating forward and reverse, a weight measuring means for measuring the total weight of the replenisher container and the filtrate drainage container, and two containers measured by the weight measuring unit. The difference between the two values is zero while comparing the value obtained by subtracting the initial total weight measurement value measured at the start of blood treatment from the total weight measurement value with the water removal target value that increases with the processing time according to the set water removal amount. A control device for rotating the correction pump in the normal and reverse directions, or a flow path that bypasses the filtrate / dialysate discharge path, a correction pump capable of rotating in the normal and reverse directions installed in the bypass path, the dialysate A weight measuring means for measuring the total weight of the container, the replenisher container, and the filtrate / dialysate drainage container, and is measured at the start of blood processing from the measured values of the total weight of the three containers measured by the weight measuring means. Reduced initial gross weight measurement And a controller for rotating the correction pump forward and reverse until the difference between the two values becomes zero while comparing the value with a target water removal value that increases with the processing time according to the set water removal amount. The present invention relates to a processing device.

[0005]

BEST MODE FOR CARRYING OUT THE INVENTION Hereinafter, embodiments of the present invention will be described more specifically, but the present invention is not limited thereto.

FIG. 1 shows an example of continuous slow hemodiafiltration which is one embodiment of the apparatus of the present invention, and FIG. 2 shows an example of continuous slow hemodialysis.
FIG. 3 shows an example of continuous slow hemofiltration, FIG. 4 shows a test example of continuous slow hemofiltration, and FIG. 5 shows a test example of conventional slow continuous hemofiltration.

Example 1 In FIG. 1, a blood introduction tube 1 is set on a blood pump 2 on the way, and then connected to an inlet of a blood processor 3. A blood outlet tube 4 is connected to the outlet of the blood processor 3, and a blood circulation circuit is formed by the blood inlet tube 1 to the blood outlet tube 4.
The blood processor 3 here has a built-in diafiltration membrane in the form of a hollow fiber or a flat membrane. This filtration membrane has a pore size of 40
In general, a homogeneous microporous membrane or a microfiltration membrane, or a so-called asymmetric membrane composed of a porous support layer and a microporous structure layer can be preferably used. An example of such a film is ethylene vinyl alcohol (EV
A) Cellulose derivatives such as cellulose acetate, polyolefin, polyacrylonitrile,
A homogeneous microporous membrane or an asymmetric structure membrane made of polyamide, polyester, polysulfone, or the like is used. Among these,
EVA system with excellent biocompatibility, cellulose derivative, P
It is desirable to use a film such as an MMA film or polysulfone.
The blood processor 3 is provided with a dialysate inlet 5 and a used dialysate outlet 6, and the used dialysate outlet 6 is connected to a dialysate discharge channel 8. 9
After that, it is attached to the drainage container 10. Further, a dialysate supply path 12 connected to a dialysate container 11 is set in the dialysis pump 9, and the dialysate supply path 12 coming out of the dialysis pump 9 is connected to the dialysate inlet 5 of the blood processor 3. . The dialysate supply path 12 is provided with a heater or the like. The dialysate discharge channel 8 and dialysate supply channel 1
By setting 2 in the same dialysis pump 9, the same amount of dialysis drainage and dialysate is replaced. A filtrate discharge path 13 is branched from a dialysate discharge path connected to the used dialysate outlet 6, and the filtrate discharge path 13 is set in a replacement fluid pump 14 on the way, and a dialysate discharge path coming out of the dialysis pump 9 is provided. 8 is connected in the middle. Further, a replenisher supply channel 16 connected to a replenisher container 15 is set in the replenisher pump 14, and the replenisher supply channel 16 emerging from the replenisher pump 14 is connected to the blood outlet tube 4. The replenisher supply path 16 is provided with a heater and the like. By setting the filtrate discharge path 13 and the replenisher supply path 16 in the same replenisher pump 14, the same amount of filtrate and replenisher is replaced. On the other hand, the flow path 17 bypassing the dialysate discharge path 8 including the dialysis pump 9
A correction pump 18 capable of normal rotation and reverse rotation is set therein. The dialysate container 11 and the replenisher container 15 are attached to the same dialysis / replenisher weighing scale 19, and the drainage container 10 is attached to a drainage weighing scale 20. A value obtained by subtracting the initial total weight measurement value at the start of blood treatment from the total weight value of the dialysis / replenisher weight 21 and the drainage weight 22 measured by the weighing machine;
From the control circuit 24, a signal for rotating the correction pump 18 in the normal and reverse directions until the difference between the two becomes zero while comparing with the target water removal amount that increases in proportion to the processing time according to the water removal amount set by the water removal setter 23. To transmit the correction pump 18
High precision water removal control of continuous slow hemofiltration dialysis.

Example 2 In FIG. 2, the blood introduction tube 1 is set on the blood pump 2 on the way, and then connected to the inlet of the blood processor 3. A blood outlet tube 4 is connected to the outlet of the blood processor 3, and a blood circulation circuit is formed by the blood inlet tube 1 to the blood outlet tube 4.
The blood processor 3 is provided with a dialysate inlet 5 and a used dialysate outlet 6, and the used dialysate outlet 6 is connected to a dialysate discharge channel 8. 9
After that, it is attached to the drainage container 10. Further, a dialysate supply path 12 connected to a dialysate container 11 is set in the dialysis pump 9, and the dialysate supply path 12 coming out of the dialysis pump 9 is connected to the dialysate inlet 5 of the blood processor 3. . The dialysate supply path 12 is provided with a heater or the like. By setting the dialysate discharge line 8 and the dialysate supply line 12 in the same dialysis pump 9, the same amount of dialysis drainage and dialysate is replaced. On the other hand, dialysis pump 9
A correction pump 18 capable of normal rotation and reverse rotation is set in a flow path 17 that bypasses the dialysate discharge path 8 containing. The dialysate container 11 is attached to a dialysis / replenisher weighing scale 19, and the drainage container 10 is attached to a drainage weighing scale 20. A value obtained by subtracting the measured initial total weight at the start of blood treatment from the total weight of the dialysis / replenisher weight 21 and the drainage weight 22 measured by the weighing scale, and the water removal amount set by the water removal setter 23 The control circuit 24 sends a signal for rotating the correction pump 18 forward and backward until the difference between the two becomes zero while comparing the target amount of water removal which increases in proportion to the processing time according to the following. Performs water removal control of slow hemodialysis with high accuracy.

Example 3 In FIG. 3, the blood introduction tube 1 is set on the blood pump 2 on the way, and then connected to the inlet of the blood processor 3. A blood outlet tube 4 is connected to the outlet of the blood processor 3, and a blood circulation circuit is formed by the blood inlet tube 1 to the blood outlet tube 4.
The blood processor 3 is provided with a filtrate outlet 7, and the filtrate outlet 7 is connected to a filtrate discharge passage 13. The filtrate discharge passage 13 is set on a replacement fluid pump 14 on the way, and then drained. It is mounted on the container 10. Further, a replenishing solution supply path 16 connected to a replenishing solution container 15 is set in the replenishing solution pump 14, and a replenishing solution supply path 16 emerging from the
Is connected to the blood outlet tube 4. This replenisher supply path 1
6 is equipped with a heater and the like. By setting the filtrate discharge path 13 and the replenisher supply path 16 in the same replenisher pump 14, the same amount of filtrate and replenisher is replaced. On the other hand, a correction pump 1 capable of normal rotation and reverse rotation is provided in a flow path 17 that bypasses a filtrate discharge path 13 including a replacement fluid pump 14.
8 is set. The replenisher container 15 is attached to a dialysis / replenisher weighing scale 19, and the drainage container 10 is attached to a drainage weighing machine 20. A value obtained by subtracting the measured initial total weight at the start of blood treatment from the total weight of the dialysis / replenisher weight 21 and the drainage weight 22 measured by the weighing scale, and the water removal amount set by the water removal setter 23 The control circuit 24 sends a signal for rotating the correction pump 18 forward and backward until the difference between the two becomes zero while comparing the target amount of water removal which increases in proportion to the processing time according to the following. Performs high-precision water removal control for slow blood filtration.

Example 4 For a water model using a water tank 25 instead of a human body, a blood pump flow rate of 100 ml / min and a replacement fluid pump flow rate of 8
When the continuous slow filtration was performed for about 12 hours continuously with the blood processing circuit shown in FIG. 4 at a water removal setting of 500 ml / hour at a setting of 500 ml / min. The amount of water removed in the liquid container 10 is calculated by the following formula: [total weight at present (dialysis / replenisher weight 21 + drainage weight 22) −total weight at the start of processing (dialysis / replenisher weight 21 + drainage weight 2)
2)] is 5704 g, and the error is −
0.367%. On the other hand, for a water model using a conventional blood processing apparatus, a blood pump flow rate of 100 ml /
When the continuous slow filtration was performed continuously for about 12 hours in the blood processing circuit shown in FIG. 5 at a flow rate of 8 ml / min for the replacement fluid pump and a flow rate setting of 8 ml / min for the water removal pump 26, the scheduled water removal amount was 5760 ml. In contrast, the amount of water actually removed was 6320 ml, and the error was + 9.7%.

[0011]

As described above, according to the present invention, a. Improvement of water removal rate control accuracy, b. Realizing a shared blood circuit and improving operability by reducing the number of pumps, c. It is possible to obtain a high-performance and highly-reliable blood processing apparatus that achieves the improvement of workability by eliminating the actual measurement of the water removal amount.

[Brief description of the drawings]

FIG. 1 is a flow chart of a continuous slow hemofiltration / dialysis apparatus which is one embodiment of the blood processing apparatus of the present invention.

FIG. 2 is a flowchart of a continuous slow hemodialysis apparatus which is one embodiment of the blood processing apparatus of the present invention.

FIG. 3 is a flow chart of a continuous slow blood filtration apparatus which is one embodiment of the blood processing apparatus of the present invention.

FIG. 4 is a flow chart in which continuous slow filtration is actually performed using a water model using the blood treatment apparatus of the present invention.

FIG. 5 is a flow chart in which continuous slow filtration is actually performed using a water model using a conventional blood processing apparatus.

[Explanation of symbols]

 REFERENCE SIGNS LIST 1 blood introduction tube 2 blood pump 3 blood processor 4 blood outlet tube 5 dialysate inlet 6 dialysate outlet 7 filtrate outlet 8 dialysate discharge channel 9 dialysis pump 10 drainage container 11 dialysate container 12 dialysate supply channel 13 filtration Liquid discharge path 14 Refill pump 15 Replenisher container 16 Replenisher supply path 17 Bypass flow path 18 Correction pump 19 Diameter / replenisher weight meter 20 Drain weight meter 21 Dialysis / replenisher weight 22 Drain liquid weight 23 Dewatering setter 24 Control circuit 25 Water tank 26 Dewatering pump

 ──────────────────────────────────────────────────続 き Continued on the front page F term (reference) 4C077 AA05 BB01 BB02 DD07 HH02 HH05 HH06 HH16 JJ04 JJ05 JJ16 JJ17 KK27 LL02 LL05 NN18 PP04 PP09 PP12 PP13 PP15

Claims (1)

[Claims] 1. A blood circulation path for introducing a patient's blood into a blood processor containing a semipermeable membrane and returning the blood to the patient again, a dialysate supply path for supplying a dialysate from the dialysate container to the blood processor. From the dialysate discharge path for discharging spent dialysate from the blood processor to the dialysate drain container, or from the blood circulation path,
A replenisher supply path for replenishing the patient with replenisher from the replenisher via the blood circulation path, and a filtrate discharge path for discharging blood filtrate from the blood processor to a filtrate drain container, or Filtrate / dialysate discharge for discharging the blood filtrate and used dialysate from the blood processor to the filtrate / dialysate drain container, the blood circulation path, the replenisher supply path, the dialysate supply path, and the blood processor. A blood processing apparatus for performing hemodialysis or hemofiltration or hemofiltration dialysis, comprising: a flow path that bypasses the dialysate discharge path; a forward / reverse rotatable correction pump installed in the bypass path; The weight measuring means for measuring the total weight of the liquid container and the dialysate drainage container, and the initial total weight measurement value measured at the start of blood treatment from the measured value of the total weight of the two containers measured by the weight measuring means. Processing time according to the reduced value and the set water removal amount A control device for rotating the correction pump forward and backward until the difference between the two becomes zero while comparing with the water removal target value that increases together, or a flow path that bypasses the filtrate discharge path, A reciprocating rotation pump, a reciprocating fluid container, a weight measuring means for measuring the total weight of the replenisher container and the filtrate drainage container, and a measured value of the total weight of the two containers measured by the weight measuring device. From the initial total weight measured at the start of the blood treatment, and the correction pump until the difference between the two becomes zero, while comparing the water removal target value that increases with the treatment time according to the set water removal amount. A flow path that includes a control device that rotates forward and reverse, or that bypasses the filtrate / dialysate discharge path, a correction pump that is installed in the bypass path and that can rotate forward and reverse, the dialysate container, and the replenisher Container and drainage of filtrate and dialysate A weight measuring means for measuring the total weight of the vessel and a value obtained by subtracting the initial total weight measured at the start of the blood treatment from the measured value of the total weight of the three containers measured by the weight measuring means; A blood processing apparatus, comprising: a control device that rotates a correction pump forward and backward until a difference between the two becomes zero while comparing a water removal target value that increases with processing time according to a water removal amount.