JP2022007398A - Dialysis liquid supply system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To reduce the remaining amount of a stock solution for dialysis discarded at the end of dialysis in a dialysate supply system including a dissolution tank, and to save powder for dialysis.
SOLUTION: A purified water production apparatus for producing purified water by back-penetration membrane filtration, a dissolution tank for preparing a stock solution for dialysis by dissolving a powder for dialysis in purified water, and a stock solution storage tank for storing the stock solution for dialysis. A dialysate storage tank that dilutes the undiluted dialysis solution with purified water to prepare and store the dialysate, a transfer pump that transfers the undiluted dialysis solution from the dissolution tank to the undiluted solution storage tank, and the undiluted dialysis solution from the undiluted solution storage tank. A dialysate supply system consisting of a stock solution pump that transfers to the dialysate storage tank, a liquid delivery pump that supplies dialysate from the dialysate storage tank to multiple dialysers, and a server that manages information output from multiple devices. A dialysate supply system in which the central management server monitors the remaining amount of the undiluted solution for dialysis in the undiluted solution storage tank based on the information on the operation history of the undiluted solution pump and the information on the liquid level in the undiluted solution storage tank. ..
[Selection diagram] Fig. 1

Description

The present invention is a plurality of dialysis monitoring devices installed in a machine room of a dialysis facility, in which a dialysis solution is prepared from undiluted dialysis solution prepared by dissolving powdered dialysis drug and clean water, and installed in the dialysis room. Regarding the system for supplying dialysate to.

In dialysis treatment, the blood of a dialysis patient is taken out into the extracorporeal circulation channel and introduced into a blood purifier, and the blood is brought into contact with the dialysate through a translucent membrane in the blood purifier. It is a treatment to remove waste products and excess water in the blood, adjust the electrolyte in the blood with the drug component contained in the dialysate, and then return the purified blood to the patient's body.

The dialysate used in dialysis treatment is prepared by mixing two different concentrated chemicals, A stock solution and B stock solution, and highly purified clean water (RO water) at a ratio specified by the pharmaceutical manufacturer. To. For the treatment of one patient, it is necessary to keep flowing 500 to 800 mL of dialysate per minute toward the blood purifier for 3 to 4 hours, which is one treatment time.

In the past, the A stock solution and the B stock solution were distributed as a liquid "liquid type" filled in a dedicated closed plastic container, but a large storage space is required in the dialysis facility, and the heavy chemical liquid container is transported. "Powdering" was attempted because of the heavy burden on medical staff and the concern that the drug solution components would deteriorate over time. Currently, the dialysis powder filled in a soft container is dissolved in clean water. It is common to obtain a stock solution for dialysis.

At the beginning of "powdering", medical staff put dialysis powder into a tank of about 200 L and diluted and mixed it with washing water, but it is not hygienic to store a large amount of dialysis stock solution. Since there is a concern that airborne bacteria may be mixed in during the mixing and stirring work, and the workload of medical staff is heavy, a dissolving device such as Patent Document 1 that can automatically perform from supply to dissolution of powder. Has been developed and is now an integral part of the dialysate supply system in blood purification systems.

In a general dissolving device, 20 to 30 bags of dialysis powder are opened by medical staff and put into the hopper at the top of the powder supply unit, and the upper and lower water levels are set in advance. Introduce a certain amount of warmed clean water between the water levels into the fixed dissolution tank, and while stirring the clean water, rotate the screw feeder at the bottom of the hopper to automatically add the dialysis powder. Measure the concentration with a conductivity meter installed in the circulation line of the melting tank and adjust it to the specified concentration. The prepared undiluted solution for dialysis is transferred to the storage tank on condition that the storage tank downstream of the dissolution tank is in an acceptable state, and enables the next dissolution operation in the dissolution tank.

A general-purpose and inexpensive liquid level gauge can be applied to the detection means for detecting the water level, and the detection accuracy is at a sufficiently reliable level. "Batch type" melting equipment is widely used.

In order to complete the work of charging the dialysis powder into the hopper by medical staff at once, it is desirable that the hopper has a certain volume so that a large amount of powder can be added, but it may change over time from the time of dissolution. It is desirable that the amount of undiluted dialysis solution produced and stored, which may deteriorate, is small. The volume of the dissolution tank of the dissolution device is often 10 L or less in order to dissolve the dialysate in the blood purification system to cover the amount of dialysate used and to dissolve in as small portions as possible. Even if it seems unnecessary to make an additional dialysate stock solution just before the end, there is a possibility that a large amount of dialysate stock solution must be discarded in order to avoid interruption of treatment. There was sex.

In order to solve such problems, use the dialysate stock solution required by the end of dialysis treatment by using the data on the amount of dialysate used in each dialysis machine, which is centrally managed by the central management server. A dissolution system of Patent Document 2 has been proposed, which calculates a planned amount and determines an excess or deficiency of a dialysate stock solution. However, usually, so-called supply devices such as RO devices, dissolving devices, and centrals installed in the machine room of dialysis facilities, and so-called dialysis devices such as dialysis monitoring devices and personal dialysis devices installed on the bedside of dialysis rooms. However, there may be cases where modification is required to enable exchange of data between the two, for example, when the products are manufactured by different dialysis machine manufacturers.

Further, in Patent Document 3, the remaining amount of the dialysate stock solution is detected in real time, and the time until the dialysate stock solution is emptied is estimated from the dialysate consumption rate to determine the excess or deficiency of the dialysate stock solution. A dissolution system with improved dialysis has been proposed. A pressure gauge installed on the bottom of the storage tank is disclosed as a means for detecting the remaining amount of dialysate stock solution in real time, which constitutes this system, but is based on a small amount of displacement of the storage tank due to the weight of the remaining amount of dialysate. With this measuring method, it may be difficult to measure the remaining amount accurately and accurately.

Further, although Patent Document 3 proposes an ultrasonic liquid level sensor, a magnetostrictive linear displacement sensor, or the like as other real-time detection means, there is a concern that the shaking liquid level during water supply may hinder accurate measurement. Above all, since these sensors are very expensive at present, the design concept is different from the current batch type melting device using a liquid level gauge that is inexpensive and has sufficient detection accuracy. There is a risk of significantly increasing the manufacturing cost of.

Japanese Unexamined Patent Publication No. 57-159529 Japanese Unexamined Patent Publication No. 2007-236532 Japanese Unexamined Patent Publication No. 2008-220784

With the so-called batch-type dissolution device, it was assumed from the beginning that a certain amount of excess dialysis stock solution would be prepared, but due to changes and deterioration over time, it could not be used for the next dialysis treatment and was discarded. There is a need for a dissolution device that can reduce the amount of this surplus undiluted solution for dialysis as much as possible from the viewpoint of cost and environment.

An object of the present invention is to reduce the remaining amount of dialysate stock solution that is not used and discarded at the end of dialysis in a system including a batch-type dissolution tank, and to enable saving of dialysis powder. Another object of the present invention is to provide a system that can be applied even to a system including dialysis machines of different dialysis machine manufacturers without significantly changing the configuration of the conventional dissolution tank.

In order to solve the above problems, the dialysate supply system according to the present invention comprises a purified water production apparatus that produces purified water by back-penetration membrane filtration, and a dialysis powder is dissolved in the purified water to prepare a stock solution for dialysis. A dissolution tank to be prepared, a stock solution storage tank for storing the undiluted solution for dialysis, a dialysate storage tank for preparing and storing the undiluted solution for dialysis by diluting the undiluted solution for dialysis with the purified water, and the undiluted solution for dialysis. A transfer pump that transfers the undiluted solution from the tank to the undiluted solution storage tank, an undiluted solution pump that transfers the undiluted solution for dialysis from the undiluted solution storage tank to the dialysate storage tank, and the dialysate from the dialysate storage tank to a plurality of dialysis machines. A dialysate supply system consisting of a liquid feed pump to be supplied and a server that manages information output from a plurality of devices, wherein the server has information on the operation history of the stock solution pump and the liquid in the stock solution storage tank. It is characterized in that the remaining amount of the undiluted solution for dialysis in the undiluted solution storage tank is monitored based on the information of the position. According to such a dialysate supply system, the central management server accurately calculates the remaining amount of undiluted dialysis solution in the undiluted solution storage tank based on the operation history information of the undiluted solution pump and the liquid level information of the undiluted solution storage tank. By determining the timing for replenishing and preparing the dialysis stock solution in the dissolution tank, it is possible to monitor the storage tank for the dialysate stock solution so that it does not become empty.

The dialysate supply system according to the present invention preferably monitors the consumption status of the dialysate based on the liquid level information of the dialysate storage tank. By calculating the amount of dialysate consumed per hour (consumption status), if it becomes possible to determine that the dialysis treatment is approaching the final stage, the additional dissolution operation will not be resumed immediately, and the latest solution will be obtained. It is possible to determine whether or not an additional melting operation is necessary in consideration of the consumption situation.

In the dialysate supply system according to the present invention, the server sets a predetermined schedule for supplementing and preparing the dialysate stock solution in the dissolution tank, the remaining amount of the dialysate stock solution, and the consumption of the dialysate. It is preferable to change it based on the situation. By such a change in schedule, it is possible to replenish and prepare the dialysis stock solution in a predetermined cycle in the normal mode, and suppress the excessive preparation of the dialysis stock solution in the solution saving mode. It is possible to reduce the amount of dialysis powder used.

According to the present invention, it is possible to reduce the remaining amount of the dialysate stock solution that is not used and discarded at the end of dialysis, and to save the amount of dialysis powder used.

It is a schematic block diagram which shows the general blood purification system. It is a schematic block diagram which shows the dialysate supply system which concerns on one Embodiment of this invention.

FIG. 1 shows the configuration of a typical blood purification system. The RO device 2 purifies the city water or well water taken in from the water source 1, and supplies the obtained RO water to the dissolving devices 3, 4 and the central 5. The dissolving devices 3 and 4 dissolve the dialysis A powder and the dialysis B powder with RO water to prepare the dialysis A stock solution and the dialysis B stock solution, respectively, and supply them to the central. Central prepares a dialysate by mixing and preparing A stock solution, B stock solution and RO water at a ratio of 1: 1.26: 32.74, and supplies the dialysate to a plurality of dialysis monitoring devices 6 in the dialysis room.

FIG. 2 shows the configuration of the dialysate supply system of the present invention. The dissolution devices 3 and 4 are provided with a dissolution tank 10 and a storage tank 15, respectively, and while the RO water is taken into the dissolution tank 10 and stirred, the dialysis powder agent previously charged into the hopper 8 by the medical staff is transferred to the screw feeder 9. Cut out little by little into the dissolution tank 10 and dilute and dissolve in RO water to prepare a dialysate stock solution. The concentration of the dialysate stock solution is measured by a conductivity meter 12 installed in the circulation line of the dissolution tank 10 and adjusted to a predetermined concentration. The dialysate stock solution prepared in the dissolution tank 10 is sent to the storage tank 15, and the dissolution tank 10 waits until the next dissolution operation.

The dialysate stock solution sent to the storage tank 15 is injected into the RO water line 20 of the central 5 by the stock solution pump 19, and the RO water, the A stock solution, and the B stock solution are mixed and diluted to become the dialysate. In order to accurately control the injection amount of dialysate stock solution, a high-precision metering pump is adopted for the stock solution pump 19, and the storage tanks of the dissolution devices 3 and 4 are based on the cumulative driving time of this pump and the like. How much dialysate stock solution was sent to Central 5 from the state detected by the liquid level gauge 18 or the liquid level gauge 17 of 15, and how much dialysate stock solution remained in the storage tank 15. Can be calculated.

The prepared dialysate is once stored in the dialysate tank 21, and when the level gauge 23 of the dialysate tank 21 detects it, it is determined that the dialysate tank 21 is full, and RO water or dialysate stock solution is used. Stop the uptake of the dialysate and discontinue the preparation of dialysate. When the dialysate in the dialysate tank 21 is consumed by the dialysis monitoring device 6 and the liquid level drops until the liquid level gauge 22 detects it, it is determined that the dialysate will soon run out and the preparation of the dialysate is restarted.

Here, the time from when the dialysate tank 21 is full to when it is almost exhausted, that is, from the detection by the liquid level gauge 23 to the detection by the liquid level gauge 22, is measured and based on the capacity of the dialysate tank obtained in advance. Then, the amount of consumption per hour (consumption status) at the present time is calculated.

When the consumption of the dialysate and the dialysate stock solution further increases and the liquid level of the storage tanks 15 of the dissolution devices 3 and 4 drops to the height of the liquid level gauge 17, the additional dissolution operation is usually resumed.

At the end of the dialysis treatment, the plurality of dialysis monitoring devices 6 sequentially finish the treatment, the hourly consumption of the dialysate decreases, and when the treatment of all the dialysis patients is finished, the dialysate is not consumed. When the consumption of the dialysate becomes such a situation that it can be judged that the dialysis treatment is approaching the final stage, even if the liquid level of the storage tanks 15 of the dissolution devices 3 and 4 drops to the height of the liquid level gauge 17. If the most recently obtained dialysate is consumed at the current hourly consumption, the rest of the dialysate stock solution will be left by the time the additional dissolution operation is completed, without immediately resuming the additional dissolution operation. Determine if it will be exhausted.

Generally, the height of the liquid level total 17 of the storage tanks 15 of the dissolution devices 3 and 4 is determined on the condition that an amount of dialysate stock solution that can cover the period until one dissolution operation is completed is left. However, although the completion time of one dissolution operation (about 7 minutes for our existing model) is determined by each dissolution device, how much dialysate stock solution remains to cover this period is the consumption. Since it changes depending on the situation, it was necessary to set it on the condition that it is consumed by the maximum supply capacity of the dialysate of the system at the design and development stage.

For example, in the case of a system having a dialysate supply capacity of 40 beds, it is generally possible to supply 500 mL of dialysate per bed per minute and 20 L of dialysate per minute at maximum. The height of the liquid level gauge 17 of the storage tanks 15 of the dissolution devices 3 and 4 is also determined by using this value of 20 L / min, so that the dialysate is never exhausted, 20 L is used. For 7 minutes, that is, the amount that can produce 140 L of dialysate, 4 L, which is 1/35 of 140 L from the preparation ratio of the previous dialysate for A stock solution, and 1/35 of 140 L for B stock solution. It was necessary to leave 5.04 L of dialysate stock solution, which is 26.

However, in the present invention, since the amount required to prevent the dialysate stock solution from being depleted during one dissolution operation is calculated from the latest dialysate consumption status, the dialysate stock solution in the storage tank is barely insufficient. It is possible to refrain from additional melting operations. Further, if the liquid level of the dialysate tank 23 does not drop from the height of the dialysate tank 23 for a certain period of time, or if the liquid level gauge 22 of the dialysate tank 23 does not detect it forever, the consumption of the dialysate is stopped or Judging that it is finished, no additional melting operation is performed.

In this way, the number of dissolutions is kept to the minimum necessary without interrupting the dialysis treatment, and the dialysate, the dialysate stock solution, and the dialysis powder can be saved. In addition, the necessity of additional dissolution is determined based on the actual consumption of dialysate and not on the operation schedule of the dialysis monitoring device. Therefore, it is independent regardless of the specifications of the dialysis monitoring device. It becomes a technology.

The present invention can be widely used as a dialysate supply system including a dissolution tank.

1 Water source 2 RO equipment (reverse osmosis type purified water production equipment)
3 Dissolving device (for powder A)
4 Dissolving device (for B powder)
5 Central (dialysate supply device for multiple people)
6 Dialysis monitoring device 7 Central management server 8 Hopper 9 Screw feeder 10 Dissolution tank 11 Transfer pump 12 Conductivity meter 13 Liquid level gauge 14 Liquid level gauge 15 Storage tank 16 Liquid level gauge (lower limit of storage tank)
17 Liquid level gauge (additional dissolution restart water level)
18 Liquid level gauge (upper limit of storage tank)
19 Undiluted solution pump 20 RO Water line 21 Dialysate tank 22 Liquid level gauge (lower limit of dialysate tank)
23 Liquid level gauge (upper limit of dialysate tank)
24 Liquid feed pump

Claims (3)

Purified water production equipment that produces purified water by reverse osmosis membrane filtration,
A dissolution tank in which a dialysis powder is dissolved in the purified water to prepare a dialysis stock solution,
A stock solution storage tank for storing the stock solution for dialysis and
A dialysate storage tank in which the undiluted solution for dialysis is diluted with the purified water to prepare and store the dialysate.
A transfer pump that transfers the undiluted solution for dialysis from the dissolution tank to the undiluted solution storage tank.
An undiluted solution pump that transfers the undiluted solution for dialysis from the undiluted solution storage tank to the dialysate storage tank, and
A liquid feed pump that supplies the dialysate from the dialysate storage tank to a plurality of dialyzer devices,
A dialysate supply system consisting of a server that manages information output from multiple devices.
The server monitors the remaining amount of the undiluted solution for dialysis in the undiluted solution storage tank based on the information on the operation history of the undiluted solution pump and the information on the liquid level of the undiluted solution storage tank. Supply system. The dialysate supply system according to claim 1, wherein the consumption status of the dialysate is monitored based on the liquid level information of the dialysate storage tank. Claimed that the server changes a predetermined schedule for replenishing and preparing the dialysate stock solution in the dissolution tank based on the remaining amount of the dialysate stock solution and the consumption status of the dialysate. 2. The dialysate supply system according to 2.

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