Method for Bubble-Free Gas-Enrichment of a Flowing Liquid within a Conduit
20230022647 · 2023-01-26
Inventors
Cpc classification
B29C53/083
PERFORMING OPERATIONS; TRANSPORTING
B01F23/454
PERFORMING OPERATIONS; TRANSPORTING
B01F23/23413
PERFORMING OPERATIONS; TRANSPORTING
B01F23/232
PERFORMING OPERATIONS; TRANSPORTING
B01F25/31331
PERFORMING OPERATIONS; TRANSPORTING
A61M25/001
HUMAN NECESSITIES
Y10T29/49826
GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
International classification
B01F23/232
PERFORMING OPERATIONS; TRANSPORTING
B01F23/454
PERFORMING OPERATIONS; TRANSPORTING
B01F25/313
PERFORMING OPERATIONS; TRANSPORTING
Abstract
The present invention provides a system for enriching a flowing liquid with a dissolved gas inside a conduit. The system comprises two or more capillaries, each capillary delivering a stream of a gas-enriched liquid to the flowing liquid. The first ends of the capillaries are positioned to form an intersecting angle with respect to the effluent streams such that these streams of gas-enriched liquid collide with each other upon exit from the first ends of the capillaries, effecting localized convective mixing within the larger liquid conduit before these gas-enriched streams are able to come into close contact with the boundary surfaces of the conduit, whereby the gas-enriched liquid mixes with the flowing liquid to form a gas-enriched flowing liquid. In the preferred embodiment, no observable bubbles are formed in the gas-enriched flowing liquid. Methods of making and using such system are also provided.
Claims
1-39. (canceled)
40. A catheter, comprising: a catheter tube; a first capillary, wherein at least a portion of the first capillary is positioned in the catheter tube; and a second capillary, wherein at least a portion of the second capillary is positioned in the catheter tube; wherein the first capillary is configured to deliver a first stream of a gas-enriched liquid; wherein the second capillary is configured to deliver a second stream of gas-enriched liquid; wherein the first capillary and the second capillary are configured such that the first stream, upon exit from the first capillary, collides with the second stream, upon exit from the second capillary, effecting localized convective mixing within a conduit before either the first stream or the second stream come into contact with the conduit.
41. The catheter of claim 40, wherein the first capillary is configured to cause the first stream to have laminar flow, and wherein the second capillary is configured to cause the second stream to have laminar flow.
42. The catheter of claim 40, wherein no observable bubbles are formed in the gas-enriched flowing liquid where the localized convective mixing is configured to occur.
43. The catheter of claim 40, wherein the gas-enriched liquid has a hyperbaric dissolved oxygen concentration.
44. The catheter of claim 40, wherein the first capillary, the second capillary, or each of the first capillary and the second capillary has a single lumen with a diameter between about 25 microns to about 300 microns.
45. The catheter of claim 40, wherein the conduit includes a blood vessel and wherein the localized convective mixing is effected before the first stream and the second stream are configured to collide with walls of the blood vessel.
46. The catheter of claim 40, wherein the catheter tube comprises a passage configured to receive a guide wire.
47. The catheter of claim 40, wherein the first capillary and the second capillary each have an internal wall and an external wall to form respective lumens, wherein a first internal wall of the first capillary is connected to a second internal wall of the second capillary.
48. The catheter of claim 40, wherein the first capillary and the second capillary each have an internal wall and an external wall to form respective lumens, and wherein walls of the first capillary are not connected to walls of the second capillary.
49. The catheter of claim 40 further comprising a cartridge that is operatively coupled to the first capillary and the second capillary for providing the gas-enriched liquid.
50. The catheter of claim 49, wherein the cartridge comprises a housing and a gas-enrichment device disposed in the housing to form the gas-enriched liquid.
51. The catheter of claim 50, wherein the gas-enrichment device comprises a gas-pressurized atomizing chamber that is adapted to receive gas into an atomizer disposed within the atomizing chamber, wherein the atomizer is adapted to receive a liquid and to atomize the liquid upon delivery into the gas-pressurized atomizing chamber to form the gas-enriched liquid.
52. The catheter of claim 51, wherein the cartridge comprises a liquid supply device disposed in the housing to supply the liquid to the gas-enrichment device.
53. The catheter of claim 52, wherein the liquid supply device comprises: a liquid supply chamber having a liquid flow inlet and a liquid flow outlet; and a pump disposed within the liquid supply chamber, the pump adapted to draw the liquid into the liquid supply chamber through the liquid flow inlet in the liquid supply chamber, and deliver the liquid to the gas-enrichment device through the liquid outlet in the liquid supply chamber.
54. The catheter of claim 52, wherein the cartridge comprises a valve assembly disposed in the housing, the valve assembly having valves to control flow between the liquid supply device and the gas-enrichment device and to control flow of the gas-enriched liquid between the gas-enrichment device and the first capillary and the second capillary.
55. The catheter of claim 52, wherein the liquid supply device and the atomizing chamber are positioned coaxially.
56. The catheter of claim 40, further comprising a centering feature configured to prevent the catheter tube from touching walls of the conduit and prevent the first stream and the second stream from contacting the conduit prior to the first stream mixing with the second stream.
57. A catheter, comprising: a catheter tube; a first capillary, wherein at least a portion of the first capillary is positioned in the catheter tube and configured to deliver a first stream of gas-enriched liquid to a conduit; and a second capillary, wherein at least a portion of the second capillary is positioned in the catheter tube and configured to deliver a second stream of gas-enriched liquid to the conduit; a centering feature configured to prevent the catheter tube from touching walls of the conduit and prevent the first stream and the second stream from contacting the conduit prior to the first stream mixing with the second stream when the first capillary is delivering the first stream of gas-enriched liquid to the conduit to mix with the second stream and when the second capillary is delivering the second stream of gas-enriched liquid to the conduit to mix with the first stream.
58. The catheter of claim 57, wherein the centering feature is configured to expand once the catheter tube is positioned inside the conduit to center the catheter tube within the conduit.
59. The catheter of claim 57, wherein the centering feature comprise a wire loop.
Description
DESCRIPTION OF THE FIGURES
[0020] The aforementioned and other features of this invention and the manner of obtaining them will become more apparent, and will be best understood by reference to the following description, taken in conjunction with the accompanying drawings. These drawings depict only a typical embodiment of the invention and do not therefore limit its scope. They serve to add specificity and detail.
[0021]
[0022]
[0023]
[0024]
[0025]
[0026]
[0027]
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0028] The present invention provides a system for enriching a bodily liquid with a dissolved gas inside an enclosed area 1 of a body. As shown in
[0029] Henry’s Law describes the effect of pressure on the solubility of a gas in a liquid. The law states that the gas solubility at a fixed temperature is proportional to the partial pressure of the gas in phase equilibrium with the liquid. The simple equation for Henry’s Law is p.sub.A = Hx.sub.A, where p.sub.A represents the partial pressure of gas A, H is the Henry’s Law constant for gas A in the specified liquid, and x.sub.A is the mole fraction of gas A dissolved in the liquid. For example, at sea level total atmospheric pressure is 760 mmHg and approximately 20.8 percent of this air is oxygen gas. Using the ideal gas law, the partial pressure of oxygen at sea level is 158 mmHg (760 mmHg x 0.208 = 158.08 mmHg). The Henry’s Law constant for oxygen solubility in water at 25° C. = 4.55 x 10.sup.4 atmosphere/mole fraction O.sub.2, or 3.45 x 10.sup.7 mmHg/mole fraction O.sub.2, the details of which are described in A. X. Schmidt and H. L. List, Material and Energy Balances, Prentice-Hall, Englewood Cliffs, NJ, 1962. Thus, the mole fraction of oxygen dissolved in water that is exposed to air at standard temperature and pressure (STP) x.sub.O2 = pO.sub.2/H = 158/(3.45 x 10.sup.7) = 4.57 x 10.sup.-6.
[0030] Liquids may be enriched with gas to obtain gas-enriched liquids containing concentrations of the gas that exceed its solubility at ambient pressure; this condition is necessary to have a gas-supersaturated liquid. For example, compression of a gas/liquid mixture at a high pressure may be used to achieve a high dissolved gas concentration. As per Henry’s Law, the application of higher pressure will increase the partial pressure of the gas, and the solubility will increase proportionally. E.g., a gas-enriched liquid that has a greater dissolved oxygen concentration than 4.57 x 10-6 mole fraction in ambient conditions at STP must also have a higher equivalent partial pressure of oxygen than the ambient air level of about 158 mmHg. Such a liquid, for the purposes of the present invention, is defined as a “gas-enriched liquid”, meaning a liquid having a gaseous solute concentration that exceeds its equilibrium solubility limit in accordance with Henry’s Law.
[0031] The gas-enriched liquid of the present application may contain one or more dissolved gases such as oxygen, ozone, an inert gas (for example, helium), nitrogen, nitrous oxide, carbon dioxide and air. In one embodiment, gas-enriched liquid is oxygen-supersaturated liquid that contains a dissolved oxygen concentration (expressed in units of STP gas volume per volume solvent) between 0.5 and 3 ml O.sub.2/ml solvent; expressed in terms of x.sub.O2, this range is 3.68 x 10.sup.-4 to 2.2 x 10.sup.-3. For this specific example, the solvent is aqueous in nature. Compared to the amount of oxygen contained in water under ambient conditions, the upper end of this achievable concentration range is (2.2 x 10.sup.-3)/(4.57 x 10.sup.-6) = 483 times this level.
[0032] The oxygen-supersaturated liquid may be supplied to the capillaries at supply pressures from 100 to 10,000 psig, at any supersaturated concentration produced when saturating the fluid at the chosen supply pressure. The supply pressure (operating pressure) is controlled, and the total flow rate will vary depending upon the capillary diameter and length, number of capillaries, and liquid viscosity.
[0033] For physiologic applications, oxygen levels typically are described in terms of equivalent partial pressure of oxygen that is in equilibrium with the dissolved gas. Thus, measurements of oxygen concentration in the blood are reported as ‘pO2’ levels, in units of mmHg, even though the reported quantity is the dissolved gas concentration. For human arterial blood, normal oxygen levels, i.e., normoxia or (less commonly) normoxemia, range from 90 to 160 mmHg. Hypoxic blood, i.e., hypoxia or (less commonly) hypoxemia, is arterial blood with a pO.sub.2 less than 90 mmHg. Hyperoxemic blood, i.e., hyperoxia or hyperoxemia, is arterial blood with a pO.sub.2 greater than 160 mmHg. As used herein, hyperbaric blood is arterial blood with a pO.sub.2 greater than 160 mmHg, or the oxygen concentration of air at standard conditions. In one embodiment, the obtained gas-enriched bodily liquid is blood containing a hyperbaric concentration of oxygen.
[0034] For the purposes of the present invention, any gas-enriching device may be used to provide a gas-enriched liquid to the capillaries. For example, gas-enriched liquid may be prepared using apparatus and methods for preparing oxygen-supersaturated liquids disclosed in U.S. Pat. No. 5,407,426 to Spears entitled “Method and Apparatus for Delivering Oxygen into Blood”; U.S. Pat. No. 5,569,180 to Spears entitled “Method for Delivering a Gas-Supersaturated Fluid to a Gas-Depleted Site and Use Thereof”; U.S. Pat. No. 5,599,296 to Spears entitled “Apparatus and Method of Delivery of Gas-Supersaturated Liquids;” U.S. Pat. No. 5,797,874 to Spears entitled “Method of Delivery of Gas-Supersaturated Liquids;” U.S. Pat. No. 6,387,324 to Patterson entitled “Apparatus and Method for Blood Oxygenation”, and U.S. Pat. 6,613,280 to Myrick, entitled “System for Enriching a Bodily Fluid with a Gas,” each of which is incorporated herein in its entirety by reference.
[0035] The gas-enriched liquid introduced through the capillaries may be water, physiologic solution, or biocompatible liquid-liquid emulsions or microemulsions; these gas-enriched liquids may advantageously contain ancillary therapeutic agents that are desirable to be delivered in combination with the gas-enriched liquid. In the case of liquid-liquid emulsions or microemulsions (for example perflouorocarbons, or PFC’s), a dispersed non-aqueous phase may be incorporated stably into the solution by conventional means in order to enhance gas solubility or incorporate non-aqueous therapeutic agents. Examples of physiologic solutions include ion-balanced salt solutions, such as those which contain calcium, sodium, magnesium, potassium, and mixtures thereof. It will also be appreciated that suitable physiologic solutions may include pH buffers selected from a group consisting of phosphates, bicarbonates, and mixtures thereof. Additionally, the physiologic solution may comprise a physiologically balanced salt solution and an oncotic agent selected from the group consisting of albumen, hydroxyethyl starch, and mixtures thereof. It may also be helpful to provide a physiologic solution including a balanced salt solution and a perfluorocarbon, for example. It will be readily apparent that other equivalent substitutes may be selected, but for brevity they are not specifically enumerated here.
[0036] The system of the present invention may be used with any bodily liquid. For example, the system may be used to enrich blood, cerebrospinal fluid, or interstitial liquid. For example, in one embodiment, the bodily liquid is blood and the enclosed area is the coronary vasculature. The enclosed area may be a blood vessel and the surfaces surrounding the enclosed area are walls of the blood vessel.
[0037] Preferably, the angle α between the first ends of the capillaries is such that the exit jets from the capillaries, which are laminar jets, collide and form an efficient mixing zone, enabling rapid elimination of concentration gradients and realization of a uniform mixing cup concentration. In one embodiment, the α is between 20° and 150°. In another embodiment, α is between 30° and 120°. In still another embodiment, α is 90°.
[0038] In the preferred embodiment, no observable bubbles are formed in the gas-enriched bodily liquid. To help minimize or eliminate the formation of clinically significant bubbles, the blood contact surfaces of the capillaries are exposed to or coated with blood proteins for some brief time interval, usually at least several minutes, before initiating infusion of oxygen-supersaturated liquids. Exposure of the capillary surfaces to proteins is equivalent to providing a wettable surface-active coating, which acts to limit the potential for heterogeneous bubble nucleation from the surface. Similarly, other liquid contact surfaces are exposed to or pre-wetted with liquids and/or hydrophilic agents or coatings, e.g., saline, ethanol and benzalkonium heparin, before use. The liquid contact surfaces also do not include any substance which promotes such bubble formation, e.g., hydrophobic or non-water wettable surfaces that have low surface free energy and high observed contact angles with water, namely Teflon, Teflon-composite liners, silicone oils, etc. Hydrophilic liquid contact surfaces, achieved through judicious material selection or coating methods, are typically useful.
[0039] In the case of delivery of gas-enriched liquid to the vasculature, the system of the present invention may be used in conjunction with angiographic or guiding catheters, arterial sheaths, and/or other vascular access devices used in angioplasty and in other interventional cardiovascular procedures. In one embodiment depicted in
[0040] The first ends of the capillaries may be connected to each other in such a way that allows the effluent streams of the gas-enriched liquid to collide and convectively mix before exposing the boundary surfaces surrounding the enclosed area to highly supersaturated gas concentrations. Such an arrangement greatly improves lateral stability of the capillaries. For example, in embodiments shown in
[0041] In the embodiment shown in
[0042] In the embodiments shown in
Fluid Delivery Catheter
[0043] Typically, the fluid delivery catheter 500, as shown in
[0044] This oxygen-enriched saline is delivered from the fluid oxygenation device 54 to catheter 500 via the single lumen tube 40 and to the capillaries 10 and 11 via a transition 41. The catheter 500 is designed to create a relatively low pressure drop from the oxygenation device 54, through single lumen tube 40 and transition 41. Most of the pressure drop in the catheter occurs in capillaries 10 and 11.
[0045] In one embodiment, the capillaries in the catheter tip are also enclosed within a tip sleeve 16. Tip sleeve 16 may be attached to transition 41 by any suitable means. Methods of attachment of two elements are known by those skilled in the art and may include chemical adhesion or over molding. A tip cover 15 (not shown for clarity) could be adhesively attached, mechanically attached, or incorporated into the over molded tip sleeve 16. The internal form 17 aligns and supports the capillaries.
[0046] Alternatively, catheter 500 can form an integral catheter sleeve (not shown) with internal transition 41 from a single lumen tube 40 to the capillaries 10 and 11. The internal transition from single lumen tube 40 to multiple capillaries 10 and 11, can be achieved in a single, low profile transition 41. This transition would be joined to the capillaries 10 and 11, using chemical adhesives or solvent bonding.
Oxygenation Device (Cartridge)
[0047] Although, as discussed above, various gas-enriching devices may be suitable for supplying gas-enriched liquid to the capillaries, in one embodiment shown in
[0048] As mentioned previously, the oxygenation device 54 includes two chambers: a fluid supply chamber 58 and an atomization chamber 62. Although various relative positioning of two chambers is possible, in one embodiment, illustrated in
[0049] A liquid, such as physiologic liquid (or saline), is delivered from a suitable supply 56, such as an IV bag, to the fluid supply chamber 58 of the cartridge 54 under the control of a system controller (not shown). A suitable gas, such as oxygen, is delivered from a supply 60, such as a tank, to the atomization chamber 62 of the cartridge 54. Although the system of the present invention can operate with any gas, liquid, and bodily liquid, for clarity and simplicity the following description will refer to oxygen, saline, and blood, respectively. The saline from the fluid supply chamber 58 is pumped into the oxygen-pressurized atomization chamber 62 and atomized to create oxygen-enriched saline.
[0050] An appropriate delivery device, such as a tube 140, is coupled to a supply of physiologic liquid. In this example, the tube 140 is coupled at one end to an IV bag 56. The other end of the tube 140 is coupled to inlet port 142 of the fluid supply chamber 58. The inlet port 142 forms a fluid passageway that leads to the fluid supply chamber 58 through passageway 190. A check valve 146 is disposed in the inlet port 142 so that fluid may enter the passageway 190 through the inlet port 142, but fluid cannot exit through the inlet port 142.
[0051] As illustrated by
[0052] Referring to
[0053] Referring additionally to
[0054] In operation, the piston assembly 160 within the fluid supply chamber 58 acts as a piston pump. As the piston assembly 160 retracts, fluid is drawn into the chamber 58 from the fluid supply 56. No fluid can be drawn from passageway 190 because valve assembly is closed and a check valve 146 is closed in this direction. As the piston assembly 160 extends, the fluid within the chamber 58 is pressurized, typically to about 670 psi, and expelled from the fluid supply chamber 58 through the fluid passageway 190. The outlet of the fluid supply chamber 58 is coupled to an inlet of the atomization chamber 62 via an appropriate fluid passageway. Further shown in
[0055] As shown in
[0056] The nozzle 222 forms fluid droplets into which the oxygen within the atomization chamber 62 diffuses as the droplets travel within the atomization chamber 62 shown in
[0057] Since the atomizer 216 will not atomize properly if the level of the pool rises above the level of the nozzle 222, the level of the pool is controlled to ensure that the atomizer 216 continues to function properly. The system monitors a liquid level sensor (not shown) to maintain minimum level in atomization chamber 62. A second (Low) level sensor monitors if level is too low to safely operate, and can stop gas-enriched liquid delivery.
[0058] As shown in
[0059] Because it is desirable to control the extent to which the patient’s blood is enriched with oxygen, it may be desirable to dilute the oxygen-supersaturated liquid to reduce its oxygen content. Any suitable valve arrangement and type of valve may be used. For example, in one embodiment, the valves are needle valves that are normally biased in the closed position. Details of these valves are described in U.S. Pat. 6,613,280, the relevant content of which is incorporated herein by reference. A representative needle valve 230 is shown in
[0060] Although an atomizing chamber provides a convenient mechanism for diffusing relatively large amounts of gas into a liquid in a relatively short period of time, it is not the only way of dissolving gas within a liquid. Indeed, other devices, such as membrane oxygenators, gas spargers, bubblers, and thin film oxygenation devices, may be used to perform this function as well. Furthermore, although a piston pump similarly provides a compact and efficient method of pressurizing liquid prior to sending it to an oxygenator, such as the atomizer, other types of pumps or methods of pressurization may be used as well. Therefore, although a piston pump and atomizer are utilized in the exemplary embodiment of the system of the present invention, other devices may perform these functions.
[0061] With these generalities in mind, as shown in
[0062] Also, all of the valves used to operate the oxygenation device 54 are integrated within its unitary structure. Thus, the valves and their associated fluid passageways are protected against external contamination, and users are protected against any contamination that may arise from the use of the various fluids as well. As a result, the oxygenation device 54 is a relatively contamination-free cartridge that may be used during a surgical procedure on a patient, and then removed and replaced prior to performing a surgical procedure on the next patient.
[0063] Finally, the oxygenation device 54 allows to create oxygen-enriched saline and deliver it directly to the patient’s coronary vasculature through the fluid delivery catheter where it adequately mixes with the blood without creating bubbles.
Hardware Enclosure (Cartridge)
[0064] Although, as discussed above, various gas-enriching devices may be suitable for supplying gas-enriched liquid to the capillaries, in one embodiment shown in
Capillary Construction Methods
[0065] In another aspect, the present invention provides a method of assembling a system for enriching a flowing liquid with a dissolved gas inside a conduit. The method comprises: [0066] (a) providing two capillaries for delivery of a gas-enriched liquid, each with a first end and a second end; (b) positioning the first ends of the capillaries to form an intersecting angle with respect to the effluent streams such that these streams of gas-enriched liquid collide with each other upon exit from the first ends of the capillaries, effecting localized convective mixing within the larger liquid conduit before these gas-enriched streams are able to come into close contact with the boundary surfaces of the conduit.; and (c) operatively connecting second ends of the capillaries to a source of the gas-enriched liquid.
[0067] In one embodiment shown in
[0068] In one embodiment, the step (a2) further comprises a step of fixing the modified shape of the capillary. On one embodiment, discussed in more detail in Examples that follow, the fixing is carried out by placing the form tool and capillary in an oven and baked them at approximately 350° F. for about 60 minutes to stress relieve the capillary.
[0069] For example, in one embodiment, a single lumen polymer capillary tube, made from polyetherimide, is formed approximately 180° around a tool with a known radius, of 0.100 inch or smaller. The form tool and tube are placed in an oven and baked at approximately 350° F. to stress relieve the capillary. Baking also allows the capillary to retain its shape during the bonding process at assembly. The formed capillary is placed into a trimming fixture, and a circular segment is cut from the apex of the capillary, exposing the inner lumen. The radius of the capillary and the depth of the trimmed segment control the angle of the exit jet streams; this angle is preferably 90° included. As a final step, the overall length of the capillary is trimmed to the final size.
[0070] As shown in
[0071] The obtained capillaries 10 and 11 each having a single lumen or a single capillary 400 may be positioned inside a catheter as shown in
[0072] In another aspect, the present invention provides a method of enriching a flowing liquid with a dissolved gas inside a conduit. The method comprises: (a) providing two capillaries for delivery of a gas-enriched liquid, the capillaries having first and second ends, wherein the first ends of the capillaries are positioned to form an intersecting angle with respect to the effluent streams such that these streams of gas-enriched liquid collide with each other upon exit from the first ends of the capillaries, effecting localized convective mixing within the larger liquid conduit before these gas-enriched streams are able to come into close contact with the boundary surfaces of the conduit.; and (b) delivering the gas-enriched liquid through the capillaries to form a gas-enriched bodily liquid.
[0073] In one embodiment, the capillaries are contained within a tip of a catheter adapted for positioning within the body in a communication with the bodily liquid. The catheter may further comprises an aligning device. Then, the positioning step (b) of the above method further comprises a step of using the aligning device to position the catheter inside the body in a way that prevents a contact between the streams of the gas-enriched liquid with the surfaces surrounding the enclosed area prior to the mixing of the gas-enriched liquid with the bodily liquid.
[0074] The present invention may be embodied in other specific forms without departing from its essential characteristics. The described embodiments are to be considered in all respects only as illustrative and not as restrictive. The scope of the invention is, therefore, indicated by the appended claims rather than by the foregoing description. All changes which come within the meaning and range of the equivalence of the claims are to be embraced within their scope.