JP4301006B2 - Artificial lung - Google Patents

Description

  The present invention relates to a hollow fiber type artificial lung which adds oxygen to blood in extracorporeal circulation to remove carbon dioxide.

  Conventionally, a bubble oxygenator and a hollow fiber oxygenator (membrane type) oxygenator are provided as oxygenators for adding oxygen to blood in extracorporeal circulation and removing carbon dioxide. A hollow fiber oxygenator is a device that contacts venous blood and oxygen-containing gas across a hollow fiber membrane to absorb oxygen into the venous blood and release carbon dioxide into the gas. Compared to a bubble oxygenator In recent years, hollow fiber oxygenators are becoming popular because they have advantages such as little blood damage and a small priming amount.

As the hollow fiber type artificial lung, those having various structures have been proposed so far (see, for example, Patent Documents 1 to 5).
Japanese Patent Laid-Open No. 64-8977 Japanese Patent Laid-Open No. 2-86817 Japanese Patent Laid-Open No. 2-99067 JP-A-2-213356 JP 2000-93509 A

  The blood outlet port connected to the blood outlet of the oxygenator is equipped with a sampling port for sampling the blood from the oxygenator and measuring the oxygen partial pressure, carbon dioxide partial pressure, temperature, etc. It is often done. When using an artificial lung, extract a part of the blood after gas exchange derived from the artificial lung through this sampling port, send it to the blood gas measurement device, and measure the gas component such as oxygen partial pressure of the blood, Determine whether the blood being delivered to the patient has sufficient oxygen partial pressure. In addition, blood temperature is monitored using another sampling port.

  However, the conventional artificial lung is configured so that the blood after gas exchange that has passed through the laminate of hollow fiber sheets housed in the blood gas exchange chamber smoothly reaches the blood outlet. If there is a variation in the oxygen partial pressure or temperature of the blood that has passed through each part of the exchange chamber, the blood is not sufficiently mixed, but is extracted from the blood outlet and extracted from the sampling port. The average oxygen partial pressure and temperature were not measured, and the measured oxygen partial pressure and temperature could vary.

  The present invention has been made in view of the above circumstances, and an object of the present invention is to provide an artificial lung capable of reducing variations in measured values such as oxygen partial pressure by mixing blood derived from a blood outlet and enhancing safety. .

In order to achieve the above object, the present invention comprises a blood gas exchange chamber having a blood inlet, a blood outlet, a gas inlet, and a gas outlet, in which a laminated body of hollow fiber sheets is housed, and from the blood inlet to the blood gas exchange chamber Gas exchange is performed between the blood introduced into the gas and the oxygen-containing gas introduced from the gas inlet through a hollow fiber membrane, and the blood after gas exchange is led out from the blood outlet and exhaust gas is discharged from the gas outlet. In the oxygenator in which the sampling port is provided in a branched state at the blood outlet, a mixing unit for mixing the blood after gas exchange is provided at or near the blood outlet. Provide an artificial lung.

  In the oxygenator of the present invention, the mixing part may be an annular convex part protruding from the peripheral edge of the blood outlet toward the blood gas exchange chamber side.

  In the oxygenator of the present invention, the mixing part may be an annular convex part having a notch in a part protruding from the peripheral edge of the blood outlet toward the blood gas exchange chamber side.

  In the oxygenator of the present invention, the mixing portion may be a plurality of plate-like convex portions that are formed to protrude on the blood outlet side of the blood gas exchange chamber.

  In the oxygenator of the present invention, the mixing portion is a plurality of plate-like convex portions formed to protrude toward the blood outlet side of the blood gas exchange chamber, and each of these plate-like convex portions has one end side in the longitudinal direction as a blood outlet. It can also be set as the structure arrange | positioned in a spiral shape toward.

  In the oxygenator of the present invention, the mixing part includes an annular convex part projecting from the peripheral edge of the blood outlet toward the blood gas exchange chamber side, and a plurality of plate-like convex parts formed to project to the blood outlet side of the blood gas exchange chamber. It can also be set as the structure which consists of a part.

  In the oxygenator of the present invention, the mixing part includes an annular convex part projecting from the peripheral edge of the blood outlet toward the blood gas exchange chamber side, and a plurality of plate-like convex parts formed to project to the blood outlet side of the blood gas exchange chamber. These plate-like convex portions can also be configured to be arranged in a spiral shape with one end in the longitudinal direction facing the blood outlet.

  In the oxygenator of the present invention, the mixing portion may be a plate-like member that is inserted on the blood outlet side of the blood gas exchange chamber and locally suppresses blood flow.

  The oxygenator of the present invention may have a configuration in which a heat exchanging part for adjusting the temperature of blood in the blood gas exchange chamber is provided.

  According to the present invention, since the mixing part for mixing the blood after gas exchange is provided at or near the blood outlet, the measured value such as oxygen partial pressure is obtained by mixing the blood derived from the blood outlet. This can reduce the variation and improve the safety.

Embodiments of the present invention will be described below with reference to the drawings.
FIGS. 1 to 3 are views showing a first embodiment of the oxygenator of the present invention, FIG. 1 is a perspective view showing a partial cross section of the oxygenator 1, FIG. 2 shows a head portion 13 of the oxygenator 1, (A) is a bottom view, (b) is a front sectional view, (c) is a side sectional view, and FIG. 3 is a perspective view of the head portion.
The artificial lung 1 includes a blood gas exchange chamber 3 in which a laminate 3A of hollow fiber sheets is housed, a heat exchanging unit 10 provided continuously therebelow, and a housing 2 surrounding them. .

  A tubular blood inlet port 4 serving as a blood inlet for introducing blood into the artificial lung 1 is provided on the lower side of the housing 2. Further, on the upper side of the housing 2, a tubular blood outlet port 5 connected to a blood outlet 15 through which blood exchanged in the blood gas exchange chamber 3 is led out from the artificial lung 1 is provided. A tubular gas inlet port 6 connected to a gas inlet for introducing oxygen-containing gas such as oxygen gas or oxygen-enriched air into the blood gas exchange chamber 3 is provided on one side surface of the housing 2. A gas outlet cover 7 is provided on a side surface facing the gas inlet port 6, and a gas outlet 7 </ b> A for discharging gas from the blood gas exchange chamber 3 by providing a notch or a slit is provided in the gas outlet cover 7.

  The blood gas exchange chamber 3 includes a laminated body 3A formed by laminating a plurality of hollow fiber braided sheets in multiple stages, and allows the oxygen-containing gas to pass through the hollow fiber while passing the laminated body. By flowing the blood, the blood and the oxygen-containing gas are brought into contact with each other through a hollow fiber membrane to perform gas exchange. It is also possible to adopt a configuration in which blood is passed through the hollow fiber and oxygen-containing gas is allowed to flow outside. By performing gas exchange through the hollow fiber membrane, oxygen can be added to the blood introduced into the artificial lung 1 and at the same time carbon dioxide can be removed into the gas. The blood to which oxygen has been added is led out from the blood outlet 15 through the blood outlet port 5 and sent to the patient via the extracorporeal circulation path. The gas after the gas exchange is discharged from the gas outlet 7 </ b> A of the gas outlet cover 7.

  The upper portion of the housing 2 is a head portion 13 made of a transparent synthetic resin. A blood outlet 15 is provided at the center of the head portion 13, and a blood outlet port 5 connected to the blood outlet 15 is provided on one surface side. The blood outlet port 5 is provided with a sampling port 8 and a blood temperature measuring adapter attachment port 9 in a branched state. The sampling port 8 is connected to a circuit that collects a small amount of blood in order to measure oxygen partial pressure, carbon dioxide partial pressure, oxygen saturation, etc. in the blood. A temperature sensor is inserted into the blood temperature measuring adapter mounting port 9.

  A heat exchanging portion 10 provided below the blood gas exchange chamber 3 is provided on a heat exchange water inlet port 11 provided on one side surface of the housing 2 and on a side surface facing the heat exchange water inlet port 11. The heat exchange water outlet port 12 and a large number of pipes through which the heat exchange water introduced from the heat exchange water inlet port 11 flows to the heat exchange water outlet port 12 are configured. The blood introduced from the blood inlet port 4 flows upward between the pipes through which the heat exchange water flows, and exchanges heat with the heat exchange water at the time of contact with the pipe, so that the blood has a desired temperature, For example, the temperature can be appropriately adjusted so as to maintain a low temperature during the operation and return to the normal body temperature after the operation.

As shown in FIGS. 2 and 3, the oxygenator 1 of the present embodiment has an annular convex portion 14 that protrudes from the periphery of the blood outlet 15 provided at the center of the head portion 13 as a mixing portion. . The protrusion height of the annular convex portion 14 is preferably about 0.5 to 10 mm.
By providing the annular convex portion 14, when blood that has been exchanged passes through the blood gas exchange chamber 3 and flows into the blood outlet 15, the blood that flows out from the peripheral edge of the blood gas exchange chamber 3 is annular. By flowing over the convex portion 14, the flow velocity of the blood flowing into the blood outlet 15 changes locally, and blood is mixed in the vicinity of the blood outlet 15. As a result, the blood gas concentration derived from the blood outlet port 5 is made uniform, and variations in blood gas analysis results such as oxygen partial pressure in the blood collected from the sampling port 8 can be reduced. Can be increased.

4 and 5 are views showing a second embodiment of the oxygenator 1 of the present invention. FIG. 4 (a) is a bottom view of the head portion 13, (b) is a front sectional view, and (c) is a side sectional view. FIG. 5 is a perspective view of the head unit 13.
In this embodiment, four plate-like convex portions 16 are formed so as to protrude around the blood outlet 15 provided in the center of the head portion 13 as a mixing portion. These plate-like convex portions 16 are formed along a direction that is obliquely separated from the blood outlet 15 from one longitudinal end side located in the vicinity of the blood outlet 15. The protruding height of these plate-like convex portions 16 is preferably about 0.5 to 10 mm. The length is preferably about 1 to 10 cm.

  In the present embodiment, when the plurality of plate-like convex portions 16 are provided around the blood outlet 15 of the head portion 13, the blood after the gas exchange passes through the blood gas exchange chamber 3 and flows into the blood outlet 15. In addition, the blood flows while being guided by the respective plate-like convex portions 16 and flows into the blood outlet 15 from an oblique direction, so that the blood is mixed in the vicinity of the blood outlet 15. As a result, the blood gas concentration derived from the blood outlet port 5 is made uniform, and variations in blood gas analysis results such as oxygen partial pressure in the blood collected from the sampling port 8 can be reduced. Can be increased.

  The number of the plate-like convex portions 16 formed is not limited to four as long as it is two or more. Further, the angle formed by the line connecting the longitudinal center of the plate-like convex portion 16 and the center of the blood outlet 15 and the longitudinal direction of the plate-like convex portion 16 is preferably in the range of 5 ° to 70 °, preferably 30 ° to About 60 ° is preferable. When this angle is less than 5 °, the blood mixing action by the plate-like convex portion 16 becomes insufficient, and when this angle exceeds 70 °, the blood flow is blocked by the plate-like convex portion 16 and the flow is poor. There is a possibility.

6 and 7 are views showing a third embodiment of the oxygenator 1 of the present invention. FIG. 6 (a) is a bottom view of the head portion 13, (b) is a front sectional view, and (c) is a side sectional view. FIG. 7 is a perspective view of the head unit 13.
In this embodiment, a U-shaped convex portion 17 is formed around the blood outlet 15 provided in the center of the head portion 13 so as to protrude as a mixing portion. The U-shaped convex portion 17 is formed with the notch directed toward the gas inlet port 6 side. The protruding height of the U-shaped convex portion 17 is preferably about 0.5 to 10 mm.

  In this embodiment, the U-shaped convex portion 17 is formed as a mixing portion around the blood outlet 15 provided at the center of the head portion 13 so that the blood after the gas exchange is exchanged with the blood gas. When flowing through the chamber 3 and flowing into the blood outlet 15, the amount of blood that has flowed out from the peripheral edge of the blood gas exchange chamber 3 flows over the U-shaped projection 17, so that the flow velocity of blood flowing into the blood outlet 15 is increased. It changes locally, and blood is mixed near the blood outlet 15. As a result, the blood gas concentration derived from the blood outlet port 5 is made uniform, and variations in blood gas analysis results such as oxygen partial pressure in the blood collected from the sampling port 8 can be reduced. Can be increased.

8 and 9 are views showing a fourth embodiment of the oxygenator 1 according to the present invention. FIG. 8 (a) is a bottom view of the head portion 13, (b) is a front sectional view, and (c) is a side sectional view. FIG. 9 is a perspective view of the head unit 13.
In the present embodiment, two arcuate convex portions 18 are formed as protruding portions around the blood outlet 15 provided in the center of the head portion 13 as a mixing portion. These arc-shaped convex portions 18 are formed with a notch therebetween facing the gas inlet port 6 and the gas outlet 7. The projecting height of the arc-shaped convex portion 18 is preferably about 0.5 to 10 mm.

  In the present embodiment, the arc-shaped convex portion 18 is formed as a mixing portion around the blood outlet 15 provided in the center of the head portion 13 so that the blood after the gas exchange is completed in the blood gas exchange chamber. When the blood flows into the blood outlet 15 through 3, the blood that flows out from the peripheral edge of the blood gas exchange chamber 3 flows over the arcuate convex portion 18, so that the flow velocity of the blood flowing into the blood outlet 15 is locally increased. The blood is mixed near the blood outlet 15. As a result, the blood gas concentration derived from the blood outlet port 5 is made uniform, and variations in blood gas analysis results such as oxygen partial pressure in the blood collected from the sampling port 8 can be reduced. Can be increased.

FIG. 10 is a perspective view of the head portion showing the fifth embodiment of the oxygenator 1 of the present invention.
In the present embodiment, an annular convex portion 19 is formed so as to protrude from the periphery of the blood outlet 15 provided in the center of the head portion 13, and obliquely outward from one end in the longitudinal direction located near the blood outlet 15. The plate-shaped convex part 20 which makes the four circular arc shape extended has the structure which protruded. These plate-like convex portions 20 are arranged in a spiral shape with the blood outlet 15 as the center.

  The protrusion height of the annular protrusion 19 is preferably about 0.5 to 10 mm. The protrusion height of the plate-like convex portion 20 forming each arc shape is preferably about 0.5 to 10 mm, and the length is preferably about 1 to 10 cm. The arrangement of the plate-like convex portions 20 each having an arc shape is sufficient as long as the blood that is guided by the plate-like convex portions 20 flows into the blood outlet 15 in a spiral shape (spiral shape). It can be set as appropriate according to the length of the plate-like convex portion 20, the curvature of the arc, and the like.

  In the present embodiment, an annular convex portion 19 is formed so as to protrude from the periphery of the blood outlet 15 provided in the center of the head portion 13, and obliquely outward from one end in the longitudinal direction located near the blood outlet 15. By forming the plate-like convex portions 20 having four arcs extending in a spiral shape, blood mixing near the blood outlet 15 is performed more effectively than in the above-described embodiments. As a result, the blood gas concentration derived from the blood outlet port 5 is made uniform, and variations in blood gas analysis results such as oxygen partial pressure in the blood collected from the sampling port 8 can be reduced. Can be increased.

FIG. 11 is an exploded perspective view showing a main part of a sixth embodiment of the oxygenator 1 according to the present invention.
In this embodiment, two plate-like shapes that cover both ends in the longitudinal direction of the laminate 3A as a mixing portion between the blood outlet side of the blood gas exchange chamber 3 and the head portion 13 having the blood outlet port 5 in the center. The member 21 is provided.

  These plate-like members 21 desirably cover both longitudinal ends of the laminated body 3A with a width that slightly hinders the flow of blood from the blood gas exchange chamber 3. A shield material such as an adhesive that holds both ends of the hollow fiber sheet is usually provided at both ends of the laminate 3A, and gas exchange of blood passing through the laminate 3A is not performed in the vicinity of the shield material. In some cases, the oxygen partial pressure is locally low. Covering both ends in the longitudinal direction of the laminate 3A with the plate-like member 21 suppresses the inflow of blood having a low oxygen partial pressure passing through the portion, and obtains a mixing effect by partially blocking the blood flow. Can do. The material of these plate-like members 21 does not dissolve or chemically change in blood and may be stable. For example, a synthetic resin sheet, a metal plate, or the like can be used.

  In this embodiment, two plate-like shapes that cover both ends in the longitudinal direction of the laminate 3A as a mixing portion between the blood outlet side of the blood gas exchange chamber 3 and the head portion 13 having the blood outlet port 5 in the center. By providing the member 21, inflow of blood having a low oxygen partial pressure is suppressed, and blood is mixed in the vicinity of the blood outlet 15. As a result, the blood gas concentration derived from the blood outlet port 5 is made uniform, and variations in blood gas analysis results such as oxygen partial pressure in the blood collected from the sampling port 8 can be reduced. Can be increased.

FIG. 12 is an exploded perspective view showing a main part of a seventh embodiment of the oxygenator 1 according to the present invention.
In the present embodiment, the longitudinal end portions and the widthwise central portion of the laminate 3A are provided as a mixing portion between the blood outlet side of the blood gas exchange chamber 3 and the head portion 13 having the blood outlet port 5 in the center. A plate-like member 22 having a substantially I-shape for covering is provided. The head portion 13 has a shape in which the central portion is raised, and the blood outlet port 5 is provided at the top of the raised portion. Therefore, the plate member 22 covers the portion immediately below the blood outlet 15 of the laminate 3A. Even in this case, the blood exiting the blood gas exchange chamber 3 can reach the blood outlet 15.

  It is desirable that the plate-like member 22 covers the both ends in the longitudinal direction and the center in the width direction of the laminate 3A with an area that slightly hinders the blood flow from the blood gas exchange chamber 3. A shield material such as an adhesive that holds both ends of the hollow fiber sheet is usually provided at both ends of the laminate 3A, and gas exchange of blood passing through the laminate 3A is not performed in the vicinity of the shield material. In some cases, the oxygen partial pressure is locally low. In addition, since the portion immediately below the blood outlet 15 is likely to flow straight toward the blood outlet 15, when mixing blood, it is preferable to block the portion immediately below the blood outlet 15 and flow the blood from the surroundings to the blood outlet 15 Efficiency becomes good. In the present embodiment, by covering both ends in the longitudinal direction of the laminate 3A with the plate-like member 22, it is possible to suppress the inflow of blood having a low oxygen partial pressure passing through that portion and partially block the blood flow. A mixing effect can be obtained. The material of the plate-like member 22 may be stable as long as it does not dissolve or chemically change in blood, and for example, a synthetic resin sheet, a metal plate, or the like can be used.

  In the present embodiment, the longitudinal end portions and the widthwise central portion of the laminate 3A are provided as a mixing portion between the blood outlet side of the blood gas exchange chamber 3 and the head portion 13 having the blood outlet port 5 in the center. By providing the substantially I-shaped plate-like member 22 to be covered, the inflow of blood having a low oxygen partial pressure is suppressed, and blood is mixed in the vicinity of the blood outlet 15. As a result, the blood gas concentration derived from the blood outlet port 5 is made uniform, and variations in blood gas analysis results such as oxygen partial pressure in the blood collected from the sampling port 8 can be reduced. Can be increased.

1 is a partial cross-sectional perspective view showing an artificial lung according to a first embodiment of the present invention. The head part of the artificial lung of 1st Example is shown, (a) is a bottom view, (b) is front sectional drawing, (c) is side sectional drawing. It is a perspective view which shows the head part of the oxygenator of 1st Example. The head part of the oxygenator of 2nd Example is shown, (a) is a bottom view, (b) is front sectional drawing, (c) is side sectional drawing. It is a perspective view which shows the head part of the oxygenator of 2nd Example. The head part of the oxygenator of 3rd Example is shown, (a) is a bottom view, (b) is front sectional drawing, (c) is side sectional drawing. It is a perspective view which shows the head part of the oxygenator of 3rd Example. The head part of the artificial lung of 4th Example is shown, (a) is a bottom view, (b) is front sectional drawing, (c) is side sectional drawing. It is a perspective view which shows the head part of the artificial lung of 4th Example. It is a perspective view which shows the head part of the oxygenator of 5th Example. It is a principal part disassembled perspective view of the artificial lung of 6th Example. It is a principal part disassembled perspective view of the artificial lung of 7th Example.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Artificial lung, 2 ... Housing, 3 ... Blood gas exchange chamber, 3A ... Laminate body, 4 ... Blood inlet port, 5 ... Blood outlet port, 6 ... Gas inlet port, 7 ... Gas outlet cover, 7A ... Gas outlet, DESCRIPTION OF SYMBOLS 8 ... Sampling port, 9 ... Adapter mounting port for blood temperature measurement, 10 ... Heat exchange part, 11 ... Heat exchange water inlet port, 12 ... Heat exchange water outlet port, 13 ... Head part, 14 ... Annular convex part, 15 ... Blood outlet, 16 ... plate-like convex part, 17 ... U-shaped convex part, 18 ... arc-shaped convex part, 19 ... annular convex part, 20 ... plate-like convex part, 21, 22 ... plate-like member.

Claims (9)

A blood gas exchange chamber having a blood inlet, a blood outlet, a gas inlet, and a gas outlet, having a blood gas exchange chamber in which a laminate of hollow fiber sheets is stored , passes through the hollow fiber introduced from the blood inlet to the blood gas exchange chamber. Gas exchange is performed between the blood and the oxygen-containing gas introduced from the gas inlet through the hollow fiber membrane, the blood after gas exchange is led out from the blood outlet, and the exhaust gas is gasified. In an oxygenator configured to drain from the outlet and provided with a sampling port in a branched state at the blood outlet,
An artificial lung characterized in that a mixing unit for mixing blood after gas exchange is provided at or near the blood outlet , and the mixing unit partially blocks the flow of blood after gas exchange .
The artificial lung according to claim 1, wherein the mixing portion is an annular convex portion that protrudes from the peripheral edge of the blood outlet toward the blood gas exchange chamber side.
The artificial lung according to claim 1, wherein the mixing part is an annular convex part having a notch in a part protruding toward the blood gas exchange chamber side from the peripheral edge of the blood outlet.
The artificial lung according to claim 1, wherein the mixing portion is a plurality of plate-like convex portions formed to protrude toward the blood outlet side on the blood gas exchange chamber side.
The mixing portion is a plurality of plate-like convex portions formed to protrude on the blood outlet side on the blood gas exchange chamber side, and each of these plate-like convex portions is formed in a spiral shape with one end in the longitudinal direction facing the blood outlet. The oxygenator according to claim 1, which is arranged.
The said mixing part consists of the cyclic | annular convex part which protruded toward the blood gas exchange chamber side from the periphery of the blood outlet, and the some plate-shaped convex part formed in the blood outlet side of the blood gas exchange chamber. The artificial lung described in 1.
The mixing portion is composed of an annular convex portion projecting from the peripheral edge of the blood outlet toward the blood gas exchange chamber side, and a plurality of plate-shaped convex portions formed to project toward the blood outlet side of the blood gas exchange chamber. The artificial lung according to claim 1, wherein each of the plate-like convex portions is arranged in a spiral shape with one end in the longitudinal direction facing the blood outlet.
The artificial lung according to claim 1, wherein the mixing unit is a plate-like member that is inserted on the blood outlet side of the blood gas exchange chamber and locally suppresses blood flow.
The artificial lung according to any one of claims 1 to 8, further comprising a heat exchange part that adjusts a temperature of blood in the blood gas exchange chamber.

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