WO2007113936A1

WO2007113936A1 - Method of priming blood circuit

Info

Publication number: WO2007113936A1
Application number: PCT/JP2007/000318
Authority: WO
Inventors: Hiroshi Nimura; Yosuke Shimatani
Original assignee: Nikkiso Company Limited
Priority date: 2006-04-05
Filing date: 2007-03-28
Publication date: 2007-10-11
Also published as: JP4853956B2; JP2007275213A

Abstract

[PROBLEMS] To provide a method of priming a blood circuit whereby the labor of a worker in the course of priming can be relieved while elevating the operation efficiency to thereby inhibit human error, the extension of priming time can be avoided, and the discharge of a priming solution containing an anticoagulant can be avoided. [MEANS FOR SOLVING PROBLEMS] In a blood purification unit comprising an arterial side blood circuit (1) and a vein side blood circuit (2) and having another blood circuit for the extracorporeal circulation of the patient’s blood, a dialyzer (3), which is provided between the arterial side blood circuit (1) and a vein side blood circuit (2) and purifies the blood flowing in the blood circuits, and an anticoagulant-injection line (L4) from which an anticoagulant can be injected into the blood circuits, wherein the end section of the arterial side blood circuit (1) and the end section of the vein side blood circuit (2) are connected together to form a circulation circuit and a blood pump (4) is driven so that the anticoagulant is injected from the anticoagulant-injection line (L4) while circulating a priming solution in the circulation circuit.

Description

Specification

Blood circuit priming method

Technical field

The present invention relates to a blood circuit priming method for filling a priming solution containing an anticoagulant in a blood circuit of a blood purification apparatus.

Background art

[0002] As shown in FIG. 3, a dialysis machine as a blood purification apparatus has an arterial blood circuit 10 0 1 and a distal end 100 2 to which a venous puncture needle (not shown) is attached to the distal end 10 1 a. a blood circuit composed of a venous blood circuit 10 2 to which a venous puncture needle (not shown) is attached to a, and blood interposed between the arterial blood circuit 1 0 1 and the venous blood circuit 1 0 2 A dialyzer for purifying blood flowing through the circuit 10 3, a blood pump 1 0 4 disposed in the arterial blood circuit 1 0 1, an arterial blood circuit 1 0 1, and a venous blood circuit 1 0 2, respectively. The main part is composed of the arterial drip chamber 10 5 and the venous drip chamber 10 6, and a dialyzer body 10 8 that can supply dialysate to the dialyzer 10 3.

[0003] Further, from the middle of the arterial blood circuit 1001, a branch line L10202 is branched and extended, and a syringe 1009 containing an anticoagulant such as heparin is connected to the tip thereof Has been. Thus, at the time of dialysis treatment, it is possible to operate syringe 10 to inject an anticoagulant into blood circulating extracorporeally. Furthermore, a saline eating bag 1 containing a priming solution (saline solution) via a saline feeding line L 1 0 1 between the tip 1 0 1 a of the arterial blood circuit 1 0 1 and the blood pump 1 0 4. 0 7 is connected so that the blood circuit can be washed before dialysis treatment ■ replacement and fluid replacement during dialysis treatment can be performed.

[0004] However, at the time of rinsing ■ priming, the tip of the arterial blood circuit 10 0 1 before the arterial puncture needle and the venous puncture needle are usually attached, and the venous blood circuit 10 2 Connect the tip 1 0 2 a with, for example, a shunt connector cap to form a circulation circuit, and close the branch line L 1 0 2 with forceps. Keep it closed. When the blood pump 10 4 is driven in this state, the physiological saline as the priming solution in the saline bag 10 07 flows through the circulation circuit, so that, for example, the physiological line from the overflow line L 1 0 3 of the venous drip chamber 10 6 When the saline solution overflows, stop driving the blood pump 104.

[0005] This allows the blood circuit before dialysis treatment to be filled with physiological saline as a priming solution, and the blood circuit cleaning and priming operations are completed. Thereafter, in order to perform dialysis treatment, an arterial puncture needle and a venous puncture needle are attached to the tip 1 0 1 a of the arterial blood circuit 1 0 1 and the tip 1 0 2 a of the venous blood circuit 1 0 2, respectively. When the patient is punctured with the puncture needle and the blood pump 104 is driven, blood is circulated extracorporeally in the blood circuit, and purification treatment is performed by the dialyzer 103 in the process.

[0006] By the way, in order to avoid blood coagulation at the start of extracorporeal circulation, conventionally, an anticoagulant has been included in the priming solution filled in the circulation circuit. For example, after injecting a predetermined amount of anticoagulant into a raw bag 10 07 attached to the raw food line L 10 1 in advance to prepare a physiological saline solution containing a predetermined concentration of the anticoagulant, blood as described above By performing circuit cleaning and priming operations, a physiological saline containing an anticoagulant can be filled into the circulation circuit (prior art 1).

[0007] In addition, as described above, a physiological saline solution (which does not contain an anticoagulant) is filled in the circulation circuit, and is then replaced with a saline bag infused with an anticoagulant, and the blood pump 1 is again used. By driving 04, the physiological saline solution containing the anticoagulant is replaced with a priming solution of a physiological saline solution not containing the anticoagulant to fill the circulation circuit (prior art 2). Note that the prior art in which such an anticoagulant is contained in the priming solution is not related to the literature known invention, so there is no prior art document to be described.

Disclosure of the invention

Problems to be solved by the invention

[0008] However, in the above conventional blood circuit priming method, it is necessary to manually inject an anticoagulant or to replace the raw food bag manually. As a result, human error may occur, and operations are cumbersome and workability at the time of brimming is poor. In particular, in the prior art 1, since the priming solution containing the anticoagulant is discharged from the overflow line, it is not preferable from the viewpoint of environmental consideration and cost. On the other hand, the prior art 2 has a problem that a step for replacing the priming solution is required, and the priming time is prolonged.

[0009] The present invention has been made in view of such circumstances, and can reduce human labor during priming and improve workability while suppressing human error. It is an object of the present invention to provide a blood circuit braiding method capable of avoiding prolonged time and avoiding discarding of a priming solution containing an anticoagulant.

Means for solving the problem

The invention according to claim 1 comprises an arterial blood circuit in which an arterial puncture needle is attached to the tip and a venous blood circuit in which a venous puncture needle is attached to the tip, and the arterial puncture needle A blood circuit capable of extracorporeally circulating the patient's blood from the venous side puncture needle, and blood purification that is interposed between the arterial blood circuit and the venous side blood circuit of the blood circuit and purifies the blood flowing through the blood circuit Means, a blood pump that causes the blood in the blood circuit to flow and to circulate extracorporeally by driving, and a branch line that extends from the blood circuit and can inject an anticoagulant into the blood circuit. In the blood circuit priming method for filling a priming solution containing an anticoagulant in the blood circuit of the blood purification apparatus provided, the tip of the artery side blood circuit and the vein side interposing the blood purification means A circulation circuit is formed by connecting the tip of the blood circuit, and an anticoagulant is injected from the branch line while driving the blood pump and circulating a priming solution in the circulation circuit.

[001 1] The invention according to claim 2 is characterized in that, in the blood circuit priming method according to claim 1, the priming solution supplied into the circulation circuit is a physiological saline solution. [0012] The invention according to claim 3 is the blood circuit priming method according to claim 1, wherein the blood purification means includes a dialyzer for dialysis treatment of blood circulating extracorporeally, and supplies the dialyzer The dialysis solution is supplied into the circulation circuit to form a priming solution.

[0013] The invention according to claim 4 is the blood circuit priming method according to any one of claims 1 to 3, wherein the blood pump is driven to circulate the priming liquid in the circulation circuit. In the process, the anticoagulant is injected little by little over a predetermined time.

The invention's effect

[0014] According to the invention of claim 1, the arterial blood circuit tip interposing the blood purification means and the venous blood circuit tip are connected to form a circulation circuit, and the blood pump is driven. Since the anticoagulant is injected from the branch line while circulating the priming liquid in the circulation circuit, it is possible to reduce the labor of the worker at the time of priming and improve workability while suppressing human error. Longer priming time can be avoided and discarding of the priming solution containing the anticoagulant can be avoided.

[0015] According to the invention of claim 2, since the priming solution supplied into the circulation circuit is a physiological saline solution, a blood purification device that performs priming using a physiological saline solution that is currently widely used On the other hand, it can be easily applied.

[001 6] According to the invention of claim 3, the blood purification means comprises a dialyzer for dialysis treatment of blood circulating outside the body, and the dialysis solution for supplying the dialyzer is supplied into the circulation circuit for priming. Since it is a liquid, it can be easily applied to an on-line dialysis machine that performs priming by reverse filtration of the filtrate from the dialyzer.

[001 7] According to the invention of claim 4, in the process of driving the blood pump and circulating the priming liquid in the circulation circuit, the anticoagulant is injected little by little over a predetermined time. Compared with intensively injecting anticoagulant, the priming solution can be prepared to a substantially uniform concentration at an early stage. BEST MODE FOR CARRYING OUT THE INVENTION

Hereinafter, embodiments of the present invention will be specifically described with reference to the drawings.

The blood purification apparatus according to the present embodiment includes a dialysis apparatus for performing dialysis treatment. As shown in FIG. 1, a blood circuit composed of an arterial blood circuit 1 and a venous blood circuit 2, and an arterial blood A dialyzer 3 (blood purification means) that is interposed between the circuit 1 and the venous blood circuit 2 and purifies blood flowing through the blood circuit, a blood pump 4, an arterial drip chamber 5 and a venous drip chamber 6 And an anticoagulant injection line L 4 as a branch line, an overflow line L 5, and a dialyzer body 8 capable of supplying dialysate to the dialyzer 3.

[0019] The arterial blood circuit 1 has a tip 1a that can be connected to an arterial puncture needle, and a coronary blood pump 4 and an arterial drip chamber 5 for defoaming in the middle. While the venous blood circuit 2 is at its tip

2a can connect a venous puncture needle, and a venous drip chamber 6 is connected along the way. When the blood pump 4 is driven in a state where the patient has punctured the arterial puncture needle and the venous side puncture needle, the blood of the patient passes through the arterial blood circuit 1 and reaches the dialyzer 3, and then the dialyzer 3 Thus, blood purification is performed, and bubbles are removed in the venous drip chamber 6 and then returned to the patient's body through the venous blood circuit 2.

That is, the patient's blood is purified by the dialyzer 3 while circulating externally in the blood circuit. An overflow line L 5 is extended from the air layer (upper) side of the venous drip chamber 6, and clamping means K 2 that can block the flow path of the overflow line L 5 is provided in the middle of the overflow line L 5. It is arranged.

[0021] The dialyzer 3 has a blood introduction port 3a, a blood outlet port in its casing.

3 b, dialysate inlet port 3 c and dialysate outlet port 3 d are formed, of which blood inlet port 3 a has an arterial blood circuit 1 force and blood outlet port 3 b has a venous blood circuit 2 Each is connected. The dialysate inlet port 3 c and dialysate outlet port 3 d are connected to the dialysate main body 8 extending from the dialyzer body 8. Connected to inlet line L 1 and dialysate outlet line L 2 respectively.

[0022] A plurality of hollow fibers are accommodated in the dialyzer 3, the inside of the hollow fibers is used as a blood flow path, and a gap between the outer peripheral surface of the hollow fibers and the inner peripheral surface of the housing portion is dialyzed. It is a liquid flow path. A hollow fiber membrane is formed in the hollow fiber by forming a number of minute holes (pores) penetrating the outer peripheral surface and the inner peripheral surface, and impurities in the blood and the like are passed through the membrane in the dialysate. It is comprised so that it can permeate | transmit.

[0023] —On the other hand, the dialyzer main body 8 is provided with a water removal pump (not shown) for removing water from the blood of the patient flowing in the dialyzer 3, and further, a dialysate introduction line One end of L 1 is connected to dialyzer 3 (dialysate introduction port 3 c), and the other end is connected to a dialysate supply device (not shown) for preparing dialysate of a predetermined concentration. In addition, one end of the dialysate discharge line L 2 is connected to a dialer 3 (dialysate outlet port 3 d), and the other end is connected to a waste fluid means (not shown), which is supplied from a dialysate supply device. After the dialysate reaches the dialyzer 3 through the dialysate introduction line L 1, it passes through the dialysate discharge line L 2 and is sent to the waste fluid means.

[0024] Between the tip 1a of the arterial blood circuit 1 and the blood pump 4, a saline line L3 is extended, and a saline bag 7 containing a predetermined amount of a priming solution (saline solution) at the tip is provided. It is connected. The raw food line L 3 is provided with a drip chamber 10 and a clamping means K 1, and the supply of the brimming fluid to the blood circuit side can be stopped by the blockage of the flow path by the clamping means K 1. In monkey.

[0025] Further, an anticoagulant injection line L4 made of a tube having a smaller diameter than the tube constituting the blood circuit is branched and extended from between the blood pump 4 and the arterial drip chamber 5 in the arterial blood circuit 1. It is installed. The anticoagulant injection line L 4 is connected to a syringe 9 containing a predetermined amount of an anticoagulant (heparin or the like) at the tip during dialysis treatment. By operating the syringe 9, a blood circuit is obtained. Anticoagulant can be injected into the blood flowing through. Specifically, the syringe 9 is a driving means for a syringe (not shown) (for example, a dialyzer body) It is possible to inject a predetermined amount of the anticoagulant contained in the syringe 9 by sliding the plunger of the syringe 9 with the pusher of the drive means. Yes.

[0026] Next, a priming method for the dialysis machine will be described.

As shown in FIG. 1, after the distal end 1a of the arterial blood circuit 1 interposing the dialyzer 3 and the distal end 2a of the venous blood circuit 2 are connected to form a circulation circuit, the clamp means K 1 Open the raw food line L 3 with the open, and drive the blood pump 4.

[0027] The flow path of the anticoagulant injection line L4 is closed by forceps or the like, and a syringe 9 containing a predetermined amount of anticoagulant is connected to the tip. Thus, when the blood pump 4 is driven, the physiological saline solution (priming solution) in the saline bag 7 flows through the blood circuit (circulation circuit) and overflows from the overflow line L 5 to close the clamping means K 1. To do.

In such a state, maintaining the drive of blood pump 4 causes the physiological saline to circulate in the blood circuit (circulation circuit). Then, by removing the forceps and the like of the anticoagulant injection line L 4 to open the flow path, and driving the syringe drive means to slide the plunger of the syringe 9 at a predetermined speed, the blood circuit (Anticoagulant is injected into the circulation circuit). As a result, in the process in which the physiological saline circulates in the blood circuit (circulation circuit), the anticoagulant is dispersed, and after a predetermined time, a priming solution (physiological saline containing the anticoagulant) having a substantially uniform concentration is obtained. Will be prepared.

Here, in the present embodiment, in the process of driving the blood pump 4 to circulate the physiological saline in the circulation circuit, the plunger sliding speed of the syringe 9 is controlled for a predetermined time. It is configured to inject anticoagulant in small amounts. As a result, the priming solution can be prepared at a substantially uniform concentration at an early stage as compared with the case where the anticoagulant is injected intensively in a short time. Thereafter, the driving of blood pump 4 is stopped, and a series of priming operations are completed.

[0030] Thereafter, the tip 1a of the arterial blood circuit 1 of the blood circuit filled with physiological saline And the tip 2a of the venous blood circuit 2 are disconnected, and an arterial puncture needle and a venous puncture needle are attached to each of them and the patient is punctured. Dialysis treatment is performed by purifying and removing water with dialyzer 3 while circulating outside the body. At this time, an anticoagulant (or other drug or the like) may be continuously injected from the syringe 9 over the dialysis treatment time.

[0031] According to the blood circuit priming method, the distal end 1a of the arterial blood circuit 1 and the distal end 2a of the venous blood circuit 2 interposing the dialyzer 3 are connected to form a circulation circuit. At the same time, the blood pump 4 is driven to inject the anticoagulant from the anticoagulant injection line L 4 while circulating the physiological saline as the priming liquid in the circulation circuit. It is possible to suppress human error while improving workability by reducing the amount of priming, avoiding prolonged priming time, and avoiding discarding of priming solution containing anticoagulant .

[0032] Further, according to the present embodiment, the priming solution supplied into the circulation circuit is a physiological saline solution in the saline bag 7 connected to the blood circuit. It can be easily applied to hemodialyzers that perform priming using a liquid. In particular, since the anticoagulant is injected while circulating the physiological saline as the priming solution in the circulation circuit, the labor for preparing the physiological saline containing the anticoagulant in advance is saved, and the workability is further improved. be able to.

Next, a second embodiment according to the present invention will be described.

The blood purification apparatus according to the present embodiment includes a dialysis apparatus for performing dialysis treatment. As shown in FIG. 2, a blood circuit composed of an arterial blood circuit 1 and a venous blood circuit 2, and an arterial blood A dialyzer 3 (blood purification means) interposed between the circuit 1 and the venous blood circuit 2 to purify blood flowing in the blood circuit, a blood pump 4, an arterial drip chamber 5 and a venous drip chamber 6 And an anticoagulant injection line L 4 as a branch line, an overflow line L 5, and a dialyzer body 8 that can supply dialysate to the dialyzer 3. The The same components as those in the first embodiment are denoted by the same reference numerals, and detailed description thereof is omitted.

In the present embodiment, the raw meal line and the raw meal bag as in the first embodiment are not provided, and the dialysate supplied from the dialyzer body 8 to the dialyzer 3 is used as the priming liquid. The priming method in this embodiment will be described below. As shown in FIG. 2, after the distal end 1a of the arterial blood circuit 1 with the dialyzer 3 interposed therebetween and the distal end 2a of the venous blood circuit 2 are connected to form a circulation circuit, the dialysis machine body 8 Then, dialysate is supplied to dialyzer 3 via dialysate introduction line L1.

[0035] At this time, the amount of dialysate discharged on the dialysate discharge line L2 is regulated, and the dialysate supplied by increasing the pressure in the dialer 3 to be higher than a predetermined value is filtered back to the blood circuit side. Then, the blood pump 4 is driven to guide the back-filtered dialysate into the circulation circuit. Then, when the dialysate (priming solution) flows through the blood circuit (circulation circuit) and overflows from the overflow line L 5, the supply of dialysate from the dialyzer body 8 is stopped.

[0036] In such a state, the dialysate circulates in the blood circuit (circulation circuit) by maintaining the driving of the blood pump 4. Then, by removing the forceps and the like of the anticoagulant injection line L 4 and opening the flow path, the syringe driving means is driven to slide the plunger of the syringe 9 at a predetermined speed, thereby blood circuit (circulation) Inject anticoagulant into the circuit). As a result, the anticoagulant is dispersed in the process in which the dialysate circulates in the blood circuit (circulation circuit), and a priming solution having a substantially uniform concentration (dialysis solution containing the anticoagulant) is prepared after a predetermined time. Will be.

[0037] Here, also in the present embodiment, the plunger sliding speed of the syringe 9 is controlled in the process of driving the blood pump 4 and circulating the dialysate in the circulation circuit, as in the first embodiment. Thus, a small amount of anti-coagulant coagulant is injected over a predetermined time. As a result, the priming solution is prepared to a substantially uniform concentration at an early stage, compared to the case where the anticoagulant is injected intensively in a short time. be able to. Thereafter, the driving of blood pump 4 is stopped, and a series of priming operations are completed.

[0038] According to the present embodiment, as in the first embodiment, it is possible to reduce the labor of the worker at the time of priming, improve workability, suppress human errors, and reduce the priming time. It is possible to avoid a long time and to avoid discarding the priming solution containing the anticoagulant. At the same time, the dialysate to be supplied to the dialer 3 is supplied into the circulation circuit to be used as a priming solution, which makes it easy to use an online dialysis machine that performs priming by reverse filtration of dialysate from the dialyzer 3. Can be applied to.

[0039] Although the present embodiment has been described above, the present invention is not limited to this. For example, the anticoagulant is injected from the tip of a branch line different from the anticoagulant injection line L4. May be. For example, it can also be applied to a device that has a drug injection line (branch line) that is branched and extended from the blood circuit and into which hematopoietic factors (erythropoietin), iron agents, and the like are injected. The anticoagulant is injected from the drug injection line while circulating the priming solution filled in the solution.

[0040] Furthermore, the anticoagulant contained in the priming solution can be replaced with heparin, and can be another drug for the purpose of preventing the increase in blood coagulation ability at the start of extracorporeal circulation. In this embodiment, the force applied to the dialysis machine used during dialysis treatment is another apparatus that can purify the patient's blood while circulating it extracorporeally (for example, blood filtration dialysis, blood filtration, AFBF, etc.) The present invention may be applied to blood purification devices, plasma adsorption devices, and the like.

Industrial applicability

[0041] The arterial blood circuit tip interposing the blood purification means and the venous blood circuit tip are connected to form a circulation circuit, and the blood pump is driven to circulate the priming solution in the circulation circuit. As long as it is a priming method of a blood circuit in which an anticoagulant is injected from a branch line, it can be applied to other forms and uses. Brief Description of Drawings

FIG. 1 is a schematic diagram showing a dialysis device (blood purification device) applied to the first embodiment of the present invention.

FIG. 2 is a schematic diagram showing a dialysis device (blood purification device) applied to the second embodiment of the present invention.

FIG. 3 is a schematic diagram showing a dialysis apparatus applied to a conventional priming method.

Explanation of symbols

1 Arterial blood circuit

2 Venous blood circuit

1 a, 2 a i

3 Dialyzer (blood purification means)

4 Blood pump

5 Arterial drip chamber

6 Venous drip chamber

7 Raw food bag

8 Dialysis machine body

9 Syringe

1 Dialysate introduction line

2 Dialysate discharge line

3 raw food lines

4 Anticoagulant injection line (branch line)

5 overflow line

Claims

The scope of the claims

[1] An arterial blood circuit in which an arterial puncture needle is attached to the tip and a venous blood circuit in which a venous puncture needle is attached to the tip, and the patient's blood from the arterial puncture needle to the venous puncture needle A blood circuit that can be circulated;

A blood purification means for purifying blood flowing between the arterial blood circuit and the venous blood circuit of the blood circuit and flowing through the blood circuit;

A blood pump that causes the blood in the blood circuit to flow by driving and circulates extracorporeally; a branch line that extends from the blood circuit and that can inject an anticoagulant into the blood circuit;

In a blood circuit priming method for filling a priming solution containing an anticoagulant in the blood circuit of a blood purification apparatus comprising:

The arterial blood circuit tip and the venous blood circuit tip interposing the blood purification means are connected to form a circulation circuit, and the priming fluid is circulated in the circulation circuit by driving the blood pump. A blood circuit priming method, wherein an anticoagulant is injected from the branch line.

2. The blood circuit priming method according to claim 1, wherein the priming solution supplied into the circulation circuit is a physiological saline solution.

[3] The blood purification means comprises a dialer for dialysis treatment of blood circulating outside the body, and supplies a dialysis solution for supply to the dialyzer into the circulation circuit to form a priming solution. The blood circuit priming method according to claim 1.

[4] The anticoagulant is injected minutely over a predetermined time in the process of circulating the priming liquid in the circulation circuit by driving the blood pump. 4. The blood circuit priming method according to any one of 3 above.