Adjustment Of Target Interface Position In A Centrifuge Based On Lipid Concentration
20230218814 · 2023-07-13
Inventors
Cpc classification
A61M1/3693
HUMAN NECESSITIES
A61M1/3696
HUMAN NECESSITIES
A61M1/3609
HUMAN NECESSITIES
International classification
Abstract
Systems and methods are provided for improving efficiency and quality of plasma being removed from a blood separation chamber. The system includes a separation chamber in which plasma is separated from cellular blood components, a pump for moving the plasma and an outlet line for removing the separated plasma from the blood separation chamber. An optical sensor assembly is configured to monitor the blood separation chamber and measure an interface position between the separated component and the plasma, and to generate an output indicative of the measured interface position. A controller is programmed to utilize a lipid concentration input of the blood and to set an original lipemia offset, a lipemia threshold and lipemia final setpoint from a predetermined database, and to use a proportional-integral-derivative control loop to assess the actual interface position plus the lipemia threshold to adjust and achieve a final lipemia setpoint for use during separation procedures.
Claims
1. A blood separation system, comprising: a blood separation chamber configured to process blood to separate at least one cellular component from plasma; an input device for providing a lipid concentration within the blood to be processed; a pump for moving the plasma; an outlet line associated with the blood separation chamber for removing at least a portion of the plasma from the blood separation chamber; an optical sensor assembly configured to directly monitor the interior of the blood separation chamber and to measure an interface position between the separated component and the plasma, and to generate an output indicative of the measured interface position; and a controller programmed to receive the lipid concentration within the blood from the input and to set an original lipemia offset, a lipemia threshold and lipemia final setpoint from a predetermined database, wherein the setpoint equals an ideal interface position that would be required to achieve acceptable separation efficiency of plasma without lipids plus the original lipemia offset, wherein the controller is further programmed with a proportional-integral-derivative control loop to continue to measure the interface position and to assess whether the actual interface position is greater than the ideal interface position plus the lipemia threshold, wherein the controller continues said measuring and assessing until the setpoint equals the final lipemia setpoint.
2. The blood separation system of claim 1, wherein the system further comprises a centrifuge and the blood separation chamber further comprises a centrifugal blood separation chamber configured to be received by the centrifuge.
3. The blood separation system of claim 1, wherein the input device for providing the lipid concentration within the blood to be processed further comprises the controller being programmed to accept a lipid concentration input from an operator input device or from a second optical sensor attached to a platelet poor plasma line from the separation chamber.
4. The blood separation system of claim 1, wherein the setpoint is adjusted to be increased to a higher position than the ideal position, wherein the increase is a lipemia offset defined by the difference between a measured artificial higher interface position and an actual interface position.
5. The blood separation system of claim 4, wherein the controller is further programmed such that when the setpoint is adjusted by increasing to a higher interface position than the ideal position an error signal is generated that represents the difference between the artificial interface position and the setpoint at the higher interface position.
6. The blood separation system of claim 5, wherein the controller is further programmed to set the flow rate of the plasma pump at which the plasma is removed from the blood separation chamber via an outlet line and such that the error signal causes control logic in the controller to increase the plasma pump flow rate to adjust by increasing the artificial interface position to move toward the increased setpoint, which in turn adjusts by increasing the actual interface position toward the higher ideal interface position.
7. The blood separation system of claim 6, wherein the controller is further programmed such that as the actual interface position begins to increase due to an increase in the plasma flow rate, the artificial interface position remains steady and the lipemia offset begins to decrease but the error signal, as measured between the setpoint and artificial interface position remains constant, wherein the proportional-integral-derivative control loop of the controller will continue to output a higher plasma rate which continues to pull the at least one cellular component layer higher.
8. The blood separation system of claim 7, wherein the controller is further programmed such that once the actual interface position reaches or surpasses the value of the original ideal interface position by a predetermined threshold dependent upon the lipemia concentration, an adjustment is made to a new final interface setpoint that is set to a higher location than the original ideal setpoint position to ensure an artificial interface position is not created again later in the separation procedure.
9. The blood separation system of claim 8, wherein the controller is further programmed to repeat the procedure as lipemia levels decrease overtime while collection is in process due to replenishment of lipid-free fluids to a blood source that compensate for removal of volumes from the blood source.
10. A method of separating blood, comprising: receiving an input providing a lipid concentration within blood to be processed; separating at least one cellular component of the blood from plasma in a blood separation chamber; monitoring the interior of the blood separation chamber and measuring an interface position between the separated component and the plasma using an optical sensor assembly; generating an output indicative of the measured interface position; operating a plasma pump to remove at least a portion of the separated plasma from the blood separation chamber; setting an original lipemia offset, a lipemia threshold and lipemia final setpoint received from a predetermined database, wherein the setpoint equals an ideal interface position that would be required to achieve acceptable separation efficiency of plasma without lipids plus the original lipemia offset; and utilizing a proportional-integral-derivative control loop to continue measuring the interface position and assessing whether the actual interface position is greater than the ideal interface position plus the lipemia threshold until the setpoint equals the final lipemia setpoint.
11. The method of claim 10, wherein the blood separation chamber is received and rotated by a centrifuge.
12. The method of claim 10, wherein receiving the input providing a lipid concentration within the blood to be processed further comprises accepting a lipid concentration input from an operator input device or from a second optical sensor attached to a platelet poor plasma line from the separation chamber.
13. The method of claim 10, further comprising adjusting the setpoint by increasing the setpoint to a higher position than the ideal position, wherein the increase is a lipemia offset defined by the difference between a measured artificial higher interface position and an actual interface position.
14. The method of claim 13, further comprising wherein adjusting the setpoint by increasing the setpoint to a higher interface position than the ideal position generates an error signal that represents the difference between the artificial interface position and the setpoint at the higher interface position.
15. The method of claim 14, further comprising setting a flow rate of the plasma pump at which the plasma is removed from the blood separation chamber via an outlet line and such that the error signal causes control logic in a controller to increase the plasma pump flow rate to adjust by increasing the artificial interface position to move toward the increased setpoint, which in turn adjusts by increasing the actual interface position toward the higher ideal interface position.
16. The method of claim 15, further comprising upon the increase in the plasma flow rate monitoring an increase in the actual interface position, monitoring the artificial interface position, a decrease in the lipemia offset, the error signal as measured between the setpoint and artificial interface position, and wherein the proportional-integral-derivative control loop of the controller continues to output a higher plasma rate which continues to pull the at least one cellular component layer higher.
17. The method of claim 16, further comprising monitoring the actual interface position such that once the actual interface position reaches or surpasses the value of the original ideal interface position by a predetermined threshold dependent upon the lipemia concentration, an adjustment is made to a new final interface set point that is set to a higher location than the original ideal setpoint position to ensure an artificial interface position is not created again later in the separation process.
18. The method of claim 17, further comprising repeating the procedure as the lipemia levels decrease overtime while collection is in process due to replenishment of lipid-free fluids to a blood source that compensate for removal of volumes from the blood source.
Description
BRIEF DESCRIPTION OF DRAWINGS
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DETAILED DESCRIPTION
[0043] The embodiments disclosed herein are for the purpose of providing a description of the present subject matter, and it is understood that the subject matter may be embodied in various other forms and combinations not shown in detail. Therefore, specific designs and features disclosed herein are not to be interpreted as limiting the subject matter as defined in the accompanying claims.
[0044] The method of the present disclosure is described herein in the context of an example apparatus.
[0045] Turning to discussion of the hardware and disposable flow circuit, the system 10 includes a centrifuge 14 used to centrifugally separate blood components. The system 10 may be programmed to separate blood into a variety of components (e.g., PRP and RBC). For illustrative purposes, a therapeutic plasma exchange procedure, in which the centrifuge 14 separates WB into cellular components (e.g., RBCs and platelets) and substantially cell-free plasma, will be described herein. However, the principles described and claimed herein may be employed with other blood separation procedures without departing from the scope of the present disclosure.
[0046] The illustrated centrifuge 14 is of the type shown in U.S. Pat. No. 5,316,667 to Brown et al., which is incorporated herein by reference. The centrifuge comprises a bowl 16 and a spool 18. The bowl 16 and spool 18 are pivoted on a yoke 20 between an operating position shown in
[0047] When in the loading/unloading position, the spool 18 can be opened by movement at least partially out of the bowl 16, as shown in
[0048] The blood separation chamber 22 can be variously constructed.
[0049] As
[0050] In a method of carrying out single-stage processing, one of the separated components is returned to the donor, while the other is removed from the first stage 24 and stored. For example, when carrying out a therapeutic plasma exchange procedure, WB in the first stage 24 is separated into cellular components (i.e., a high density component) and substantially cell-free plasma (i.e., a low density component). The plasma is removed from the first stage 24 via the first outlet port 30 for collection and storage, while the cellular components are removed from the first stage 24 via the second outlet port 28 and returned to the donor or patient. Alternatively, rather than collecting and storing the plasma, it may instead be discarded after separation or treated by a secondary device (e.g., an adsorption column) and returned to the donor or patient.
[0051] If multi-stage processing is required, one of the components will be transferred from the first stage 24 to the second stage 26 via a port 34 associated with the second stage 26. The component transferred to the second stage 26 is further fractionated into sub-components, with one of the sub-components being removed from the second stage 26 via an outlet port 36 and the other sub-component remaining in the second stage 26. In the illustrated embodiment, the ports 28, 30, 32, 34, and 36 are arranged side-by-side along the top transverse edge of the chamber 22.
[0052] While the same ports 28, 30, and 32 of the first stage 24 are used as in the above-described therapeutic plasma exchange procedure, the ports 28 and 32 have different functionality in a multi-stage separation procedure. In one method of multi-stage operation, blood enters the first stage 24 via the port 28 and is separated into red blood cells, RBCs, (i.e., the high density blood component), and platelet-rich plasma, PRP, (i.e., the low density blood component). The RBCs are returned to the donor (via the port 32), while the PRP is conveyed out of the first stage 24 (via the first outlet port 30) and into the second stage 26 (via the inlet port 34). In the second stage 26, the PRP is separated into platelet-poor plasma, PPP, and platelet concentrate. The PPP is removed from the second stage 26 (via the outlet port 36), leaving platelet concentrate in the second stage 26 for resuspension and transfer to one or more storage containers.
[0053] As best shown in
[0054] As
[0055] In a therapeutic plasma exchange procedure, the fluid passage 54 channels blood directly into the circumferential flow path immediately next to the low density collection region 52. As shown in
[0056] The movement of the component(s) of the RBC layer 56 displaces less dense blood components radially toward the low-G (inner) wall 64, forming a second, less optically dense layer 58. The less optically dense layer 58 includes plasma (and, hence, will be referred to herein as the “plasma layer”) but, depending on the speed at which the centrifuge 14 is rotated and the length of time that the blood is resident in the centrifuge, other components (e.g., platelets and smaller white blood cells) also may be present in the plasma layer 58.
[0057] As discussed previously, the transition between the formed cellular blood components and the liquid plasma component is generally shown as a line and referred to as the interface 60 (
[0058] The location of the interface 60 within the chamber 22 can dynamically shift during blood processing, as
[0059] As
[0060] Further details of the angled relationship of the ramp 66 and the first outlet port 30 can be found in U.S. Pat. No. 5,632,893 to Brown et al., which is incorporated herein by reference.
[0061] The ramp 66 forms a tapered wedge that restricts the flow of fluid toward the first outlet port 30. The top edge of the ramp 66 extends to form a constricted passage or fluid gap 68 along the low-G wall 64. The plasma layer 58 must flow through the constricted passage 68 to reach the first outlet port 30.
[0062] As
[0063] Further details of the separation chamber 22 and its operation may be found in U.S. Pat. No. 5,316,667, which is incorporated herein by reference.
[0064] The interface controller 12 (
[0065] The interface controller 12 is functional to determine the location of the interface 60 on the ramp 66 and, if the interface 60 is located at an improper location (e.g., in the locations of
[0066] Referring to
[0067] In the illustrated embodiment, seven light emitting diodes 76 comprise the light source 74. More or fewer diodes 76 may be used, depending upon the optical characteristics desired. Further, non-LED lights also may be employed without departing from the scope of the present disclosure.
[0068] The first optical sensor assembly 70 also includes a light detector 78 (
[0069] The yoke 20 and the first optical sensor assembly 70 rotate at a one omega speed, as the spool 18 and bowl 16 rotate at a two omega speed. The light source 74 directs light onto the rotating bowl 16. In the illustrated embodiment, the bowl 16 is transparent to the light emitted by the source 74 only in the region 80 where the bowl 16 overlies the interface ramp 66 (
[0070] The interface ramp 66 is made of a light transmissive material. The light from the source 74 will thereby pass through the transparent region 80 of the bowl 16 and the ramp 66 every time the rotating bowl 16 and first optical sensor assembly 70 align. The spool 18 also may carry a light reflective material 82 (
[0071] Such an arrangement optically differentiates the reflective properties of the interface ramp 66 from the remainder of the bowl 16. This objective can be achieved in other ways. For example, the light source 74 could be gated on and off with the arrival and passage of the ramp 66 relative to its line of sight. As another example, the bowl 16 outside the transparent region 80 could carry a material that reflects light, but at a different intensity than the reflective material 82 behind the interface ramp 66.
[0072] As the transparent interface region 80 of the bowl 16 comes into alignment with the first optical sensor assembly 70, the detector 78 will first sense light reflected through the plasma layer 58 on the ramp 66. Eventually, the RBC layer 56 adjacent the interface 60 on the ramp 66 will enter the optical path of the first optical sensor assembly 70. The RBC layer 56 absorbs light from the source 74 and thereby reduces the previously sensed intensity of the reflected light. The intensity of the reflected light sensed by the detector 78 represents the amount of light from the source 74 that is not absorbed by the RBC layer 56 adjacent to the interface 60. With this information, a processing element or module 86 (
[0073] When the location of the interface 60 on the ramp 66 has been determined, the processing element 86 outputs that information to an interface command element or module 88 (
[0074] When the control value is expressed in terms of a targeted red blood cell percentage value, a positive error signal indicates that the RBC layer 56 on the ramp 66 is too large (as
[0075] A negative error signal indicates that the RBC layer 56 on the ramp 66 is too small (as
[0076] During normal operation with clean plasma, the optical sensor will generate a pulse width, PW, signal based on the light transmitted through the fluid in the fluid gap. In such instance, as shown at A, the target Setpoint of the control logic represents the ideal interface position required to achieve an acceptable separation efficiency, as seen in
[0077] Instead, the Setpoint may be adjusted by increasing it to a higher location than the ideal position, such as equal to the difference between the artificial interface and the actual interface shown in
[0078] As the actual interface begins to increase due to an increase of the plasma flow rate, the artificial interface will likely remain at the same location, or change slightly, since its position is dictated by the decrease of the signal strength due to the lipemic plasma which is not likely to be a strong function of the actual interface position when low, depicted in the progression of the method shown in
[0079] Knowing the lipemia offset is important to the method and must be predetermined for varying concentrations of lipids. In order to access a predetermined database of lipemia offset values, the system must accept a known value as a user input 102 or be capable of (preferred) non-invasively measuring the lipemia value present throughout a procedure. This first step 102 of the method shown in
[0080] The second step 104 has the controller set the original lipemia offset, lipemia threshold, and lipemia final Setpoint based on a predetermined database relative to the input or measured lipid concentration. As shown at 106, the Setpoint is equal to the ideal position plus the original lipemia offset. In the next step 108, the system then uses the first optical sensor to measure the interface position. As shown at 110, if the controller determines (No) the interface position is not greater than the ideal position plus the lipemia threshold, then the portion of the process at 108 repeats involving measurement of the interface position and determining whether the interface position is greater than the ideal position plus the lipemia threshold, until (Yes) this is true, at which point 112 the Setpoint established is equal to a final lipemia setpoint. Upon reaching this conclusion, at 114 the method ends.
[0081] This new method helps to account for the presence of lipids in the blood to be processed and results in greater efficiency in processing and a higher quality product resulting from the blood separation.
[0082] It will be understood that the embodiments described above are illustrative of some of the applications of the principles of the present subject matter. Numerous modifications may be made by those skilled in the art without departing from the spirit and scope of the claimed subject matter, including those combinations of features that are individually disclosed or claimed herein. For these reasons, the scope hereof is not limited to the above description but is as set forth in the following claims, and it is understood that claims may be directed to the features hereof, including as combinations of features that are individually disclosed or claimed herein.