JP5558260B2 - Blood processor priming system - Google Patents

Description

  The present invention relates to priming performed before using a blood treatment device, and more particularly, to a system capable of performing priming automatically and efficiently.

  The blood processing system is a device for collecting blood from a patient's artery side, processing the blood with a blood processing device via a blood circuit, and then returning the blood to the vein side. Although blood treatment includes hemodialysis and blood purification, it is hemodialysis that is widely used as a blood treatment apparatus. In this case, for example, a hollow fiber type hemodialyzer is used as a blood treatment device, Blood is treated by introducing blood and dialysate into the hemodialyzer.

  When such blood treatment is performed, priming is usually performed in advance with a blood circuit and a blood treatment device using an isotonic solution (electrolyte solution) having the same osmotic pressure as blood such as physiological saline. The main purpose of priming is to clean the blood processor, to remove bubbles in the blood circuit and blood processor, and to fill and replace it with an isotonic solution. If blood is introduced with air bubbles remaining in the blood circuit or blood processing device, the blood may come into contact with the air and the blood may coagulate in the blood processing device, so removing air bubbles during priming is an important operation. . In particular, in the case of dry-type blood processors (that is, those that are not filled with sterilized water) or blood-processing devices that use hydrophobic materials that easily adhere to air bubbles, the air bubbles in the blood processing device are sufficiently removed. There is a need.

  However, air bubbles of several mm to 1 cm are likely to remain in the blood port portion at the inlet / outlet of the blood processing device during the priming process, particularly in blood processing devices using a highly hydrophobic material such as polypropylene in the blood port portion. Once air bubbles adhere to the blood port and stay, it becomes difficult to remove even if the amount of priming solution is increased or the flow rate is increased. It has been necessary to perform a manual operation for removing bubbles in the blood port by taking time and labor. Such a manual bubble removal operation has led to a reduction in work efficiency for a system that automatically performs a priming operation.

  As for the priming method, dialysate that has been filtered back through a blood treatment device without using physiological saline for the purpose of cost reduction (dialysis solution moved from the dialysate circuit side to the blood circuit side through the blood treatment device). An automatic priming method (Patent Document 1, Patent Document 2) and a priming method (Patent Document 3) that facilitates the removal of bubbles in the blood processing device have been proposed. Regarding the removal of bubbles, it could not be said that it was sufficiently achieved.

Japanese Patent Laid-Open No. 1-113064 JP 2008-12210 A JP-A-11-33111

  Accordingly, an object of the present invention is to provide a blood processor priming system capable of efficiently removing air bubbles adhering to and staying on the blood port portion of the blood processor automatically and without much effort as priming is being automated. There is to do.

  In order to solve the above-mentioned problems, as a result of intensive studies, bubbles of about several mm to 1 cm that have adhered and stayed in the blood port during the priming process are once flowed easily as one large bubble, and then the priming solution is flowed again. As a result, it was found that the remaining bubbles adhering to and staying in the blood port portion can be efficiently removed, and the present invention has been completed.

That is, a priming system for a blood treatment device according to the present invention includes a hollow fiber membrane hemodialyzer as a blood treatment device including a pair of blood ports , a dialysis port, and a hollow fiber membrane , and the pair of blood ports. in a system with a priming control means for automatically controlling the priming of the blood circuit for circulating blood into the hollow fiber membrane type hemodialyzer, the priming control means, at least the hollow fiber membrane type hemodialyzer and the blood circuit After priming with the priming liquid, the priming liquid in at least one of the pair of blood ports is temporarily replaced with air, and the portion replaced with air is filled with the priming liquid again. Become.

  In such a priming system for a blood processing device according to the present invention, in order to remove air bubbles adhering to and staying in the blood port during the priming process, after priming the blood processing device with the priming liquid, The priming liquid is temporarily replaced with air, and the small bubbles that are difficult to remove are replaced with air introduced from outside the blood circuit as if they were one large bubble. The replaced air exists as if it were one large bubble, so it is not left in a small bubble state, it becomes a state that is easily moved in an integrated state, and priming again to the part replaced with air By filling the liquid, it is easily moved out of the blood port, that is, to a place where bubbles do not easily adhere or stay (preferably released out of the system of the blood circuit) and into the blood port. The bubbles that have adhered and stayed are removed efficiently.

  Here, since the amount and position of the bubbles adhering and staying in the blood port during the priming process cannot be predicted and may be adhering and staying in the outer peripheral portion of the blood port, the outer peripheral portion is used in the present invention. Basically, all the priming liquid in the blood port is temporarily replaced with air in order to replace it with one large bubble including the bubbles. However, in the case where air bubbles adhering to and staying on the outer peripheral portion of the blood port are allowed as they are, or when the air port can be removed without replacing the entire blood port with air depending on the shape of the blood port, etc. Not limited to this, by replacing about 50% to 90% of the volume in the blood port with air, it is possible to improve residual bubbles adhering to and staying in the blood port.

The present invention can be applied to the priming of a blood treatment device in a hemodialysis device, a blood purification device, or the like, but is particularly suitable for application to a hemodialysis device using a hollow fiber type dialyzer that has become widespread in recent years. That is, a hollow fiber membrane hemodialyzer comprising a pair of blood ports, a dialysis port and a hollow fiber membrane , and a blood circuit for circulating blood into the hollow fiber membrane hemodialyzer via the pair of blood ports In the system including priming control means for automatically controlling priming, the priming control means includes at least one of the pair of blood ports after priming the hollow fiber membrane hemodialyzer and the blood circuit with a priming liquid . In a priming system for a blood treatment device (that is, a hollow fiber membrane hemodialyzer), the priming solution in one blood port is temporarily replaced with air, and the portion replaced with air is filled with the priming solution again. is there.

  In the priming of this hollow fiber membrane hemodialyzer, it is possible to perform priming more efficiently and economically by using a dialysis solution as a priming solution (isotonic solution).

  For example, a priming system for a blood treatment device according to the present invention includes a reverse filtration means for feeding dialysate from a dialysate circuit into a blood circuit through a hollow fiber membrane, and a hollow fiber membrane for dialysate in the blood circuit. And after priming the hollow fiber membrane hemodialyzer and the blood circuit with the dialysate by the back filtration by the back filtration means under the control of the priming control means. The priming system is characterized in that a part of the blood circuit is opened and the air for replacement is drawn in from the blood circuit part opened by the normal filtration by the normal filtration means.

  In this case, the amount of air drawn in for the replacement is set in advance by the normal filtration amount or the normal filtration time by the normal filtration means, and after reaching the set value, it is refilled with dialysate by the reverse filtration means. Can be. Alternatively, the pressure in the blood circuit and / or the pressure in the dialysate circuit is detected, and when the detected value reaches a predetermined value, the drawing of air for the replacement by the normal filtration is stopped. You can also. In the latter case, the pressure in the blood circuit and / or the pressure in the dialysate circuit is detected, and when the detected value reaches a predetermined value, the drawing of air for the replacement by the positive filtration is stopped. In addition, it is possible to switch to the inflow of dialysate from the dialysate circuit to the blood circuit by reverse filtration.

  According to the priming system for a blood processing device according to the present invention, it is possible to efficiently remove air bubbles adhering to and staying in the blood port portion of the blood processing device without much effort, and it is possible to perform pre-processing for blood processing. The preparation work can be performed very smoothly and efficiently in a short time.

1 is a system diagram of a blood processor priming system according to an embodiment of the present invention. FIG.

Hereinafter, preferred embodiments of the present invention will be described with reference to the drawings.
FIG. 1 shows a priming system for a blood processing apparatus according to an embodiment of the present invention, and particularly shows an example in which the present invention is applied to hemodialysis. Hereinafter, an example of a priming system using dialysis fluid as the priming fluid will be described. A priming system 100 shown in FIG. 1 includes a hemodialyzer (dialyzer) having a dialysis membrane as a blood processor 1, a dialysate supply / discharge device 7 having means for circulating a dialysate as a blood processor, and a body of a patient. As a dialysate circuit of the blood circuit 2 for guiding the blood of the blood to the blood processor 1, the blood circuit 3 for returning the blood from the blood processor 1 to the body of the patient, and the dialysate supply / discharge device 7 A dialysate supply line 4 for guiding the fluid to the blood processor 1 and a dialysate return line 5 for returning the used dialysate from the blood processor 1 are configured. The blood circuits 2 and 3 are connected to a hemodialyzer as the blood processor 1 via blood ports 1b and 1a, and the dialysate supply line 4 and dialysate return line 5 are connected to the dialysate ports 1c and 1d. Connected to the blood treatment device 1.

  The blood circuit comprises an arterial blood circuit 2 from the arterial puncture needle connection 16 to the blood processor 1 and a venous blood circuit 3 from the blood processor 1 to the venous puncture needle connection 17 when performing priming. The arterial puncture needle connection portion 16 and the venipuncture needle connection portion 17 are connected to each other to form a circulation path, and the dialysis fluid in the dialysis fluid circuit is passed between the blood circuits 2 and 3 and the blood treatment device 1. The dialysis fluid that has been back-filtered by being fed into the blood circuit through the hollow fiber membrane is circulated. The blood circuits 2 and 3 are provided with drip chambers 14 and 15 for trapping bubbles. The drip chambers 14 and 15 are provided with overflow lines 19a and 20a that can be opened and closed by the operation of the opening and closing electromagnetic valves 19 and 20, respectively, and can communicate with the atmosphere, and the blood circuit pressure measurement line 8a. 9a are connected to each other so that the pressure in the blood circuit can be detected by the arterial blood circuit pressure detecting means 8 and the venous blood circuit pressure detecting means 9.

  The blood circuit 2 is provided with a blood pump 11 composed of a tube pump provided with a roller that rotates so as to squeeze the blood circuit squirrel section 10 and an arterial-side bubble detection means 12. Side bubble detection means 13 is provided. The dialysate supply / discharge device 7 has a means for sending dialysate from the dialysate circuit side to the blood circuit side (reverse filtration) and dialysate (and blood during dialysis from the blood circuit side to the dialysate circuit side). A dialysate pump 6 is provided as a means for feeding (forward filtration) medium moisture and the like. When the dialysate supply / discharge device 7 detects a predetermined time or / and pressure (for example, a predetermined pressure detected by the dialysate system pressure detection means), the reverse filtration is interrupted and switched to normal filtration. Alternatively, it has an automatic system that interrupts forward filtration and switches to reverse filtration. These automatic operations are performed under the control of the automatic control device 23. At the same time, the automatic control device 23 controls the automatic operation of priming in the present invention.

  Air or priming fluid (dialysate) present in the blood circuit or blood processor generated during the priming process overflows in the drip chamber 14 of the arterial blood circuit 2 and the drip chamber 15 of the venous blood circuit 3. It can be discharged from lines 19a, 20a or / and blood circuit pressure measurement lines 8a, 9a. In addition, air can be drawn in from the overflow lines 19a and 20a of the drip chambers 14 and 15 and / or the blood circuit pressure measurement lines 8a and 9a.

By providing the above-described system in the blood circuit and the dialysate supply / discharge device, the following operations in the present invention can be performed automatically. The following operation is an example of removing bubbles from the blood port 1a.
(1) The dialysate is sent from the dialysate circuit side to the blood circuit side (reverse filtration), and at the same time, the blood pump 11 is operated from the arterial puncture needle connection portion 16 toward the blood processor 1 to perform priming. At this time, the overflow lines 19a and 20a of the drip chambers 14 and 15 are opened, and the dialysate (priming liquid) flows out of the overflow lines 19a and 20a.
(2) After the blood circuits 2 and 3 and the blood processor 1 are filled with the dialysate, the reverse filtration and the blood pump 11 are stopped, and the overflow line 19a of the arterial drip chamber 14 is closed.
(3) Next, by supplying the dialysate from the blood circuit side to the dialysate circuit side (forward filtration), air is introduced from the overflow line 20a of the venous drip chamber 15 to the blood port portion 1a. Air is drawn in, and the dialysate filled in the blood port 1a is temporarily replaced with air.
(4) Subsequently, the normal filtration is stopped and the overflow line 19a of the arterial drip chamber 14 is opened.
(5) Finally, reverse filtration and blood pump 11 are operated again, and blood port 1a is filled again with dialysate.
The above-mentioned operation can be optimized by setting the amount of liquid to be fed or the time to send the liquid according to the volume of the blood processing device or the blood circuit, and the above-described operation is performed a plurality of times in one priming. You can also. If necessary, only one of the blood port 1a and the blood port 1b and / or both the blood port 1a and the blood port 1b can be implemented.

  In the above operation example, the case where the replacement air is introduced from the overflow line of the drip chamber has been described. However, it is also possible to introduce the replacement air from the blood circuit pressure measurement lines 8a and 9a. For example, as shown in FIG. 1, blood circuit pressure measurement lines 8a and 9a are connected to a line having open / close electromagnetic valves 21 and 22 that can communicate with the atmosphere, and the open / close electromagnetic valves 21 and 22 are opened and closed. By controlling, it becomes possible to introduce replacement air.

  In the present invention, risk management during priming is also proposed. In FIG. 1, a blood circuit pressure measurement line 8a and detection means 8 on the arterial side, a blood circuit pressure measurement line 9a and detection means 9 on the venous side, and a dialysate system pressure detection means 18 are provided. Control is performed so that the operation of the dialysate pump 6 is automatically stopped when the inside of the circuit becomes abnormally pressurized or abnormally negative due to blockage due to blood circuit breakage or the like. It is possible to prevent the blood circuit from being damaged or leaking in advance.

  The circuit shown in FIG. 1 is assembled, and a hollow fiber type dialyzer “Toraylite” CX-1.6U manufactured by Toray Industries, Inc. is used as the blood processor 1, and blood circuits 2 and 3 are manufactured by Hanako Medical Co., Ltd. A priming experiment was performed under the conditions shown in Table 1 using H-721-TMA and dialysate that was reverse-filtered (delivered to the blood circuit through a hollow fiber membrane) as the priming solution.

  Regarding the operation of the comparative example, (1) the dialysate is sent from the dialysate circuit side to the blood circuit side (reverse filtration), and at the same time, the blood pump 11 is operated from the arterial puncture needle connecting portion 16 toward the blood processor 1. (At this time, the overflow lines 19a and 20a of the drip chambers 14 and 15 are opened), (2) The dialysis fluid (priming fluid) flows out of the overflow line, and the conditions shown in Table 1 were performed.

For the embodiment of the present invention, 1 minute before the completion of the priming of the comparative example, (1) the back filtration and blood pump 11 are temporarily stopped, the overflow line 19a of the arterial drip chamber 14 is closed, and (2) the forward filtration is 100 mL. Operated for 15 seconds per minute, air was introduced from the overflow line 20a of the venous drip chamber 15, (3) the air was drawn into the blood port 1a, and the dialysate filled in the blood port 1a was once replaced with air. Filtration is stopped, (4) the overflow line 19a of the arterial drip chamber 14 is opened, the reverse filtration and the blood pump 11 are operated again, and the blood port 1a is filled again with dialysate under the conditions described in Table 1. Carried out.
At that time, in each case, the experiment was conducted without touching the blood treatment device. After the completion of priming, the effect of the present invention was confirmed by sucking the remaining bubbles in the blood port portions 1a and 1b of the blood treatment device with a syringe and measuring the amount of remaining bubbles.

  As a result, the air bubbles that once adhered to the blood port were slightly improved, but not enough, even if the blood pump flow rate was increased or the priming time (reverse filtration time) was increased (comparison) In Examples 1 and 2, after priming the blood treatment device with the priming liquid according to the present invention, the priming liquid in the blood port is temporarily replaced with air, and then again filled with the priming liquid. Almost disappeared (Examples 1 and 2). The blood port portion 1b is on the side where the priming liquid flows in by the blood pump, and therefore no bubbles were attached or retained in any experiment.

  The priming system for a blood treatment device according to the present invention can be applied to any blood treatment device that requires priming, and is particularly suitable for application to hemodialysis.

DESCRIPTION OF SYMBOLS 1 Blood processor 1a, 1b Blood port 1c, 1d Dialysis port 2 Blood circuit extended to the artery side 3 Blood circuit extended to the vein side 4 Dialysate supply line 5 Dialysate return line 6 Dialysate pump 7 Dialysate supply Exhaust device 8 Arterial blood circuit pressure detection means 8a, 9a Blood circuit pressure measurement line 9 Vein side blood circuit pressure detection means 10 Blood circuit squirrel part 11 Blood pump 12 Arterial side bubble detection means 13 Vein side bubble detection means 14 Arterial drip chamber 15 Venous side drip chamber 16 Arterial puncture needle connecting portion 17 Venous puncture needle connecting portion 18 Dialysate system pressure detecting means 19, 20, 21, 22 Open / close solenoid valves 19a, 20a Overflow line 23 Automatic control device 100 Priming system

Claims (7)

A hollow fiber membrane type hemodialyzer as blood processing vessel provided with a pair of blood ports and the dialysis port and the hollow fiber membrane, circulating blood in the hollow fiber membrane type hemodialyzer via the pair of blood ports In the system having priming control means for automatically controlling the priming of the blood circuit, the priming control means includes at least the pair of blood ports after priming the hollow fiber membrane hemodialyzer and the blood circuit with the priming liquid . A priming system for a blood treatment device, wherein the priming liquid in one of the blood ports is temporarily replaced with air, and the priming liquid is filled again in the portion replaced with air. The priming solution in one of the pair of blood ports is temporarily replaced with air, and 50% to 90% of the volume in the blood port is replaced with air. A priming system for a blood processing device according to claim 1. The priming system for a blood processor according to claim 1 or 2, wherein a dialysis solution is used as the priming solution. Reverse filtration means for feeding dialysate in the dialysate circuit into the blood circuit through the hollow fiber membrane, and positive filtration means for feeding dialysate in the blood circuit to the dialysate circuit through the hollow fiber membrane And having a hollow fiber membrane hemodialyzer and a blood circuit primed with dialysate by back filtration by the back filtration means under control by the priming control means, and then opening a part of the blood circuit and the normal filtration means The priming system for a blood treatment device according to any one of claims 1 to 3 , wherein the air for replacement is drawn from a blood circuit portion opened by normal filtration according to claim 1.   The amount of air drawn for the replacement is set in advance by the normal filtration amount or the normal filtration time by the normal filtration means, and after reaching the set value, it is filled again with dialysate by the reverse filtration means, The priming system for a blood processor according to claim 4.   The pressure in the blood circuit and / or the pressure in the dialysate circuit is detected, and when the detected value reaches a predetermined value, the drawing of air for the replacement by the positive filtration is stopped. The priming system for a blood processor according to claim 4.   The pressure in the blood circuit and / or the pressure in the dialysate circuit is detected, and when the detected value reaches a predetermined value, the air replacement for the replacement by the normal filtration is stopped and the reverse filtration is performed. 7. The priming system for a blood treatment device according to claim 6, wherein the dialysis fluid is switched to the inflow of the dialysis fluid from the dialysate circuit to the blood circuit.

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