JPH09308686A - Device for mixing, moving and irrigating solution - Google Patents

Abstract

PROBLEM TO BE SOLVED: To exactly send out two kinds of fluid at a specified flow ratio by providing the device with a pair of pump head tubes, which have a prescribed cross-sectional area ratio so that the flow ratio of two kinds of mother liquor can become a prescribed value, at a single pump head and a pressing means for sending out the mother liquor to this head. SOLUTION: A pair of pump head tubes 1 and 9 having different inner diameters are parallelly arranged and the upstream ends of the respective tubes 1 and 9 are connected to a supply source BS for every mother liquor and a chamber I or II. On the other hand, the downstream ends are joined by a mobile tube 10 and two kinds of mother liquor are sent out as a 3rd solution. Besides, between the respective supply sources BS and a section on the upstream side rather than a mixing point, recirculation branching paths 1R and 9R are connected to the respective tubes 1 and 9. When it is desired to move the unmixed blood or unmixed solution I or II at the moving terminal of heart stop method, a prescribed section on the upstream side rather than the mixing point is closed by a clamp E and operated so as to circulate any one of recirculation branching paths 1R and 9R.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention uses a liquid mixing / transferring device for mixing two different kinds of mother liquor to form and transfer a third solution having a composition different from the composition of the mother liquor, and such a device. The present invention relates to a perfusion device for cardioplegia solution. It should be noted that while the perfusion device of the present invention is useful in preparing and delivering blood cardioplegia solutions, it is equally effective in preparing and delivering colder crystalloid-based cardioplegia solutions.

[0002]

BACKGROUND OF THE INVENTION Surgery inside or on the surface of the heart involves selective perfusion of many substances (mainly potassium K and magnesium Mg) into the coronary arteriovenous tract of the heart. With the advent of methods to maintain inactivity (cardiac arrest), it has become possible to do it more safely. These substances are added to purify a crystalline base solution (crystalline cardioplegia) or a blood based solution (blood cardioplegia). Since the optimum temperature of these solutions is different, especially the lower temperature of the crystal-based solutions, the two different designs of the device to achieve each optimum temperature to achieve cardiac arrest. It was necessary to use, and it was not easy to switch from one device to the other or select any device.

Further, it has been a common practice to use two roller pumps in order to control the transfer rates of two or more kinds of solutions, especially drug solutions. Placing two or more pump head tubes with different inner diameters and the same wall thickness along the same transfer wall (raceway) of a single roller or finger type pump makes it possible to drive two or more pumps electrically. It has already been tried because it eliminates the need to synchronize manually. In any of these conventional devices (especially in the latter device), an air trap having a complicated structure is provided in order to enable filling (priming) in a state where bubbles are not mixed in the pump head tube member. A bubble removing member was incorporated.

Although the bubble removing member had a complicated structure, it was provided in the mixing chamber to act on both solution components. For this reason, it was not possible to separately fill each component system with different solutions from the beginning, and it was also not possible to perfuse a solution that did not contain one of the solution components, for example, blood that did not contain additives. A mixed transfer system with separate pumps was needed to reach the goal.

The present invention has been made in view of the above circumstances, and a common single pump head is used to cause two different fluids to flow at a specific flow rate ratio to form a mixed liquid. It is possible to provide a solution mixing transfer device and a perfusion device which can be used not only as a solution but also for perfusion of only one component and which has a relatively simple structure and is excellent in economic efficiency and reliability. To aim.

[0006]

In order to achieve the above object, the present invention provides a solution mixing and transferring apparatus for mixing two kinds of mother liquor to produce and transfer a third solution having a composition different from that of the mother liquor. , A pair of pump head tubes having a predetermined cross-sectional area ratio such that the flow rate ratio of the mother liquor becomes a predetermined value is provided in a single pump head,
A single pressing means for simultaneously handling the pair of pump head tubes and delivering the mother liquor at the flow rate ratio is provided, and a single transfer tube is provided at a site downstream of the pump heads of the pair of pump head tubes. The third solution is connected to transfer the third solution.

Here, the pair of pump head tubes have the same wall thickness but different tube diameters (thus, lumen cross-sectional areas).
Is preferable, and is selected so that a desired flow rate ratio can be obtained by setting a predetermined cross-sectional area ratio and a desired composition of the third fluid can be obtained. On the other hand, the single pressing means of the pump head may have any structure such as the conventional roller type and finger type as long as it can handle the pair of pump head tubes at the same time and send out the mother liquor at the predetermined flow rate ratio. Good, but preferably, a transfer wall or raceway on which the pair of pump head tubes are arranged at the same time, and a handling means such as a roller for handling the pump head tube with respect to the transfer wall to transfer the fluid. And a single drive source such as a motor for driving the handling means. It is needless to say that the tube diameter, wall thickness and the like of the transfer tube are set in consideration of the tube diameter and the like of the pair of pump head tubes.

According to the present invention, the pair of pump head tubes can be operated independently as two mutually parallel tube systems which are independent of each other. In a preferred embodiment, the recirculation branch channel is located upstream of a mixing point (downstream end of each head tube at a connection point of the transfer tube) at an upstream portion (arm portion) and a downstream portion (arm portion) of the pump head tube. A bubble removing means is provided in each of the recirculation branch channels connected in between.

[0009] In a further preferred aspect of the present invention, the bubble removing means provided in the recirculation branch channels is opened to the outside air, has a storage function, and is provided in series in each recirculation branch channel. Further, the solution mixing and transporting device of the present invention is specifically used mainly as a solution perfusion device of the cardiac arrest method, but in such a case, it is actually used for supporting the circulation of the patient. The extracorporeal circuit (cardiopulmonary bypass) from which blood is taken out has its own bubble removing member (cardiotomy storage container) and is used as a circulating component of the blood line. On the other hand, the bubble removing means for the solution of the second component or the additive is also provided in series in the recirculation branch channel, but the lumen of the recirculation branch channel is connected to one side and the chamber is connected to the other side. Provided in a chamber adapted to hold the added mother solution in the form of a coaxial rod, the fluid is guided by the rod back into the chamber without being scattered, and the bubbles coalesce through the chamber's air exhaust port. It is preferably configured to be removed from the chamber.

In another preferred aspect of the present invention, a standard tube connector can be attached and two connecting ends (pouch or sac), usually with blind plugs, are provided for recirculating diversion of the blood line. It is installed parallel to the road. When using the device of the present invention as a perfusion device, when it becomes necessary to perfuse unmixed blood,
The cardioplegia mixed solution transfer line is clamped and each component returns to the source through each recirculation shunt. The additive component recirculates back to its mother chamber and the unmixed blood flows through the recirculation shunt to the cardiopulmonary bypass cardiotomy reservoir.
By connecting one of the blind connection ends of the recirculation line to a cerebral canal or the like, unmixed blood can be perfused into the brain and other devices. Further, in a preferred aspect of the present invention, in order to be able to induce hypothermia in a short time, an efficient heat exchanger without a time delay is a main component, that is, a recirculation branch passage of a blood line. It is provided on the upstream side. With such a configuration, a single pump can safely perform alternate perfusion for both heart and brain organs at two different desired temperatures.

Since selective cerebral perfusion is not required for the majority of cardiac surgery, a hemoconcentrator can be placed in series between the two blind connecting ends, with respect to the heart and the hemoconcentrator. Similarly, perfusion can be performed alternately. Therefore, it is possible to concentrate blood using the pump used to transfer the cardioplegia solution.

Since the transfer of any cardioplegia solution is almost always necessary for cardiac surgery, connecting the device of the present invention for the purpose of a cardiopulmonary bypass device results in perfusion of the brain or hemoconcentrator. It eliminates the need for a separate circuit and pump and provides a safe connection at any time during surgery, especially after the initiation of cardiopulmonary bypass, which is not normally possible with commonly available devices. it can.

[0013]

BEST MODE FOR CARRYING OUT THE INVENTION Embodiments of the apparatus of the present invention will be described below with reference to the accompanying drawings, but the present invention is not limited to these embodiments.

FIG. 1 shows the basic structure of a solution mixing and transporting device or a perfusion device according to the present invention, showing a device having a flow ratio of a base liquid such as additive: blood of 1: 9. However, it goes without saying that the principle can be applied to many other flow ratios.

In this apparatus, a pair of pump head tubes 1 and 9 having different inner diameters and the same wall thickness are arranged side by side in parallel, and the upstream end of each pump head tube is provided with the supply source BS and supply of each mother liquor. Source (chamber) I or
While being respectively connected to II, the downstream ends merge to form one transfer tube 10. Then, the mother liquor flowing from the supply source BS and the supply source I or II is mixed in the transfer tube 10 to form and transfer the third solution.

Both pump head tubes 1 and 9 are provided along a single transfer wall or raceway (not shown) of a single pump head, and are handled by a common roller 12 of the pump head. Thus, each solution is transferred, the mixing ratio of the solution in the transfer tube 10 is set to a desired value by the cross-sectional area ratio of each tube, and the pump speed (only the total flow rate of the final mixture is determined) is set. Is irrelevant. In the illustrated example in which the ratio of the cross-sectional areas of the two tubes is 1: 9, the concentration of the additive in the mixed solution created after the mixing point (connection point of the transfer tube 10) is the mother liquor concentration in the source I or II. It becomes 1/10 of.

Each of the pump head tubes 1 and 9 is provided between each supply source provided at its upstream end (inlet arm) and a portion near the downstream end (outlet arm) and upstream of the mixing point. Are connected to the recirculation branch channels 1R and 9R. Therefore, when it is desired to transfer unmixed blood or unmixed solution I or II at the cardioplegia transfer end, a predetermined site upstream from the mixing point is blocked by the clamp E, and either recirculation diversion is performed. The roads 1R and 9R are distributed.

However, the configuration of the recirculation branch channels 1R, 9R enhances the usefulness of the entire system. That is, a single clamp A is used for both recirculation branch channels 1
By clamping the Aa positions of R and 9R, the mixed mother liquor, that is, the cardioplegia mixed solution can be transferred. on the other hand,
When the Ab position is clamped by the clamp A to open the recirculation shunt, the forward flow that creates the cardioplegia mixed solution is not formed, and the unmixed solution is recirculated to each recirculation shunt 1.
Circulating separately through R and 9R, unmixed blood from cardiopulmonary bypass is transported to different organs or devices.

Further, a bubble removing mechanism is provided for each perfusion component system, that is, for the additive in the supply chamber I or II, and for the blood line, in the cardiotomy storage container CR of the cardiopulmonary bypass circuit CPB. With such a configuration, each solution can be independently recirculated before mixing the components, and bubbles can be easily removed and filled.

Further, one recirculation branch channel 9R is provided with two connecting ends H and HR to which a tube connector is detachably attachable and a blind plug is always attached, as shown in FIG. A bag containing the brain perfusion line 9Rb, the hemoconcentrator HC as shown in FIG. 5, or the crystalline cardioplegia base solution as shown in FIG. 6 (III-CS).
And is detachably connected via a standard connector.

Also, both pump head tubes 1, 9
A three-way stopcock 13 is connected between the inlets of the chambers, so that the initial bubble removal in the chambers I and II and their recirculation branch channels can be easily performed.

Further, an efficient heat exchanger ΔT with no time delay is attached at a site slightly upstream of the mixing point of the blood perfusion line, and the blood temperature (T) is controlled by the action of this heat exchanger. It can be adjusted to the desired value and two different organs such as the heart and the brain can be perfused alternately at two different temperatures and compositions during surgery on the aortic arch.

FIG. 2 shows a bubble removing mechanism (bubble removing means) in the additive circulation path provided in the supply chamber I or II containing one mother liquor (additive solution). The bubble removing mechanism is coaxially inserted into a tube that serves as a recirculation diversion channel, and accommodates a rod Ir or IIr housed so as to almost reach the bottom of each supply chamber, and an opening 16 provided at the top of the chamber. And.
The rod Ir or IIr serves as a guide when the recirculating fluid falls into the chamber, prevents scattering and bubbling around the recirculating fluid, and the air in the fluid coalesces and is discharged from the chamber through the opening. . It should be noted that each chamber is provided with a scale in advance, and the total volume of the mixed solution can be easily calculated by multiplying the amount of the additive obtained from this scale by 10. Further, as can be seen from FIG. 2, each recirculation branch channel 1R is connected to each of the two supply chambers connected in parallel,
By switching clamp B from chamber I to chamber II or vice versa, two different compositions for the additive can be selected and switched almost instantly.

Although it is possible to provide a porous membrane filter in the recirculation branch passage so that air can be removed, if the rod is used as described above, only bubbles existing in the recirculation fluid can be removed. In addition, it is better because the generation of bubbles caused by the scattering of the fluid when returning to the chamber can be prevented.

FIG. 3 shows a chamber I or II made of a plastic bag in which the mother addition solution is stored.
It is a schematic diagram showing a modification of a bubble removal means of an additive system.
Instead of the rods Ir and IIr in the example shown in FIG.
The end of the recirculation line 1R is extended, the upper part formed in the chamber is disposed and attached in a funnel-shaped partition chamber, and the recirculation fluid overflows into the chamber from the end. When returned, the funnel-shaped portion does not scatter into the chamber, but flows down along the outer surface of the end portion or the inner wall of the plastic bag to reliably prevent scattering of fluid and formation of bubbles. Further, each of the chambers I and II is provided with an air exhaust hole 16 that is open to the atmosphere, and bubbles that have coalesced when the fluid returns to the chamber are exhausted to the outside. Further, a three-way stopcock 15 is provided on the supply line of the additive and is disposed above the funnel-shaped portion so that the added fluid does not scatter when flowing down in the chamber. In addition, the other structures such as pre-scaled marks in each chamber are the same as those in the example of FIG.

FIG. 4 is a schematic diagram of a cardioplegia solution transfer circulation device modified for use in intermittent cerebral perfusion. The recirculation branch channel 9R is provided with two connecting ends H and HR, and one connecting end H is connected to a line 9Rb for brain perfusion. It should be noted that this line can be connected at any time without interference with the main cardiopulmonary bypass. When the clamp C is held at a site downstream of the connection end H of the recirculation branch channel 9R, unmixed blood from the cardiopulmonary bypass can be perfused into the brain, and the additive can be recirculated to the chamber I or II. Come back. The blood line 9 is provided with an effective heat exchanger ΔT that enables control of the temperature (T) with a minimum time delay, so that the temperature of the transferred blood can be supplied to each organ as required during perfusion. Can be adjusted. The selection of the perfusion organ is made simple and safe by simply switching the clamp A from the Aa position (cardiac arrest mixed solution transfer position) to the Ab position (cerebral perfusion position with unmixed blood) (FIG. 1).
See also).

FIG. 5 is a schematic diagram of a cardiac arrest transfer circulator that can also be used as a hemoconcentration or hemodialysis system HC. The hemodialysis system HC is provided in series between the connection ends H and HR provided in the recirculation branch passage 9R. Thus, if the cardioplegia solution has not been transferred, the blood in the cardiopulmonary bypass can be concentrated by recirculating the blood through the hemodialysis system HC.

FIG. 6 is a schematic diagram showing the basic construction of a blood cardioplegia transfer circulator used in the crystalline cardioplegia. In order to carry out the so-called end-stage cardiac arrest warm blood method, which is often used even by those who basically depend on the crystalline solution, in the circulatory apparatus shown in FIG. 1, a bag III containing the crystalline solution CS is used.
Is connected to the connection end Cp, and the clamp D enables selection of either blood from the cardiopulmonary bypass BS or crystalloid solution CS. Since the crystalline solution CS requires a lower temperature, the connecting path CSR is connected to the connecting end H to transfer the contents of the bag III to the heat exchanger ΔT during intermittent heart surgery. It must be circulated through to cool to the desired temperature, while the recirculation shunt 9R is clamped by clamp C. During this recirculation / cooling stage, oxygenation takes place through the O ₂ port provided in the recirculation connection CSR. The above-mentioned bag III is used as a container for storing all the residuals of the filling liquid in the cardiopulmonary bypass circuit, and after the patient is separated from the cardiopulmonary bypass after the operation, residual blood can be injected and returned.

[Brief description of drawings]

FIG. 1 is a schematic configuration diagram of an apparatus according to a first embodiment of the present invention.

FIG. 2 is a schematic view showing a bubble removing means in an apparatus according to a modification of the present invention.

FIG. 3 is a schematic view showing a modified example of the bubble removing means.

FIG. 4 is a schematic configuration diagram when the device of the present invention is configured to be used for brain perfusion.

FIG. 5 is a schematic configuration diagram when the device of the present invention is configured to be used in combination with a blood concentrator or the like.

FIG. 6 is a schematic configuration diagram when the device of the present invention is particularly adapted to perfusion of a crystalloid cardioplegia solution.

[Explanation of symbols]

 1, 9 ... Pump head tube I, II ... Additive supply source BS ... Blood supply source 1R, 9R ... Recirculation branch channel 10 ... Transfer tube A, B, C, D, E ... Clamp 12 ... Roller 13, 14, 15 ... Three-way stopcock H, HR ... Connection end ΔT ... Heat exchanger 16 ... Air exhaust hole

─────────────────────────────────────────────────── ─── Continuation of the front page (51) Int.Cl. ⁶ Identification code Internal reference number FI Technical display location A61M 39/00 A61M 5/14 471

Claims (6)

[Claims] 1. A solution mixing and transferring apparatus for mixing and mixing two kinds of mother liquor to produce and transfer a third solution having a composition different from that of the mother liquor, so that the flow rate ratio of the mother liquor becomes a predetermined value. A pair of pump head tubes having a predetermined cross-sectional area ratio are arranged in a single pump head, and the pump head treats the pair of pump head tubes at the same time to deliver the mother liquor at the flow rate ratio with a single pressing force. A single transfer tube is connected to a portion of the pair of pump head tubes downstream of the pump head, and is configured to transfer the third solution. And a solution mixing and transferring device. 2. A recirculation diversion channel is connected between upstream and downstream portions of each pump head tube and a portion upstream of a connection point with a transfer tube, and each recirculation diversion channel has a bubble removing means. The solution mixing and transferring apparatus according to claim 1, further comprising: 3. The solution mixing and transferring apparatus according to claim 2, wherein the bubble removing means has a fluid storage function. 4. A perfusion device which mixes two kinds of mother liquor to produce and transfer a cardioplegia blood-based solution having a composition different from that of the mother liquor, wherein the flow rate ratio of the mother liquor becomes a predetermined value. A pair of pump head tubes having a predetermined cross-sectional area ratio are arranged in a single pump head, and the pump head treats the pair of pump head tubes at the same time to deliver the mother liquor at the flow rate ratio with a single pressing force. And a single transfer tube connected to the pair of pump head tubes downstream of the pump head so as to transfer the cardioplegic blood-based solution. A perfusion device. 5. A recirculation branch channel is connected between upstream and downstream portions of each pump head tube and a portion upstream of a connection point with a transfer tube, and each recirculation branch channel has a bubble removing means. And at least one pair of blind connecting ends to which a tube connector can be attached are provided in one of the recirculation branch channels, and the blind connecting ends are connected with a circulation path for perfusion to other organs and the like. The perfusion device according to claim 4, which is made possible. 6. The perfusion device according to claim 5, wherein a heat exchanger is provided at a portion of one side of the pump head tube upstream of the recirculation branch passage.