EXTRACORPOREAL CIRCULATION MANAGEMENT DEVICE WITH BLOOD LEVEL DETECTION IN A RESERVOIR WITHOUT A SENSOR
20190001045 ยท 2019-01-03
Inventors
- Ryohei Katsuki (Kanagawa, JP)
- Tsuyoshi Hasegawa (Kanagawa, JP)
- Yuuki Hara (Kanagawa, JP)
- Tomoaki Hashimoto (Kanagawa, JP)
Cpc classification
G01F23/18
PHYSICS
A61M1/3666
HUMAN NECESSITIES
A61M1/3639
HUMAN NECESSITIES
A61M2205/52
HUMAN NECESSITIES
International classification
A61M1/36
HUMAN NECESSITIES
Abstract
An extracorporeal blood circulation system monitors blood level in a reservoir which temporarily stores the blood. A memory storage unit stores blood pressure measurements from a pressure sensor monitoring a blood pressure within a tube unit conveying blood from the reservoir relative to atmosphere. A processing unit that detects a height of a top surface of the blood stored in the reservoir based on changes in the blood pressure measurements and a conservation of mechanical energy of a blood flow inside the tube unit. A notification is generated if an abnormality is detected in the height of the blood in the reservoir.
Claims
1. An extracorporeal blood circulation system for monitoring blood level in a reservoir temporarily storing the blood, comprising: a memory storage unit for storing blood pressure measurements from a pressure sensor monitoring a blood pressure within a tube unit conveying blood from the reservoir relative to atmosphere; and a processing unit that detects a height of a top surface of the blood stored in the reservoir based on changes in the blood pressure measurements and a conservation of mechanical energy of a blood flow inside the tube unit.
2. The extracorporeal blood circulation system according to claim 1: wherein the memory storage unit further stores blood density information, gravitational acceleration information, and flow velocity information from a flow rate measurement unit which is located in the tube unit; and wherein the processing unit 1) determines a calculated liquid level energy at the top surface of the blood stored in the reservoir based on the blood density information, the gravitational acceleration information, and the flow velocity information, 2) determines a measured energy at the tube unit based on the flow velocity information, the pressure measurements, the blood density information, and the gravitational acceleration information, and 3) determines the height based on the calculated liquid level energy and the measured energy.
3. The extracorporeal blood circulation system according to claim 2, wherein the height is further based on a pressure loss coefficient characterizing a pressure loss from the top surface of the blood stored in the reservoir to the tube unit.
4. The extracorporeal blood circulation system according to claim 3, wherein the processing unit generates corrected pressure loss coefficient information based on a plurality of pressure loss coefficients determined in time series, and wherein the height is based on the corrected pressure loss coefficient information.
5. The extracorporeal blood circulation system according to claim 1, wherein the processing unit detects occurrence of a height indicating an abnormality, and generates a notification upon detection of the occurrence of abnormality.
6. An extracorporeal blood circulator comprising: a blood reservoir; a tube unit conveying blood from the reservoir; a pressure measurement unit coupled to the tube unit generating blood pressure measurements of a blood pressure within a tube unit relative to atmosphere; an artificial lung unit that performs gas exchange on the conveyed blood of a target person; a memory storage unit for storing blood pressure measurements; and a processing unit that detects a height of a top surface of blood stored in the reservoir based on changes in the blood pressure measurements and a conservation of mechanical energy of a blood flow inside the tube unit.
7. The extracorporeal blood circulator according to claim 6 further comprising a flow rate measurement unit located in the tube unit; wherein the memory storage unit further stores blood density information, gravitational acceleration information, and flow velocity information from the flow rate measurement unit; and wherein the processing unit 1) determines a calculated liquid level energy at the top surface of the blood stored in the reservoir based on the blood density information, the gravitational acceleration information, and the flow velocity information, 2) determines a measured energy at the tube unit based on the flow velocity information, the pressure measurements, the blood density information, and the gravitational acceleration information, and 3) determines the height based on the calculated liquid level energy and the measured energy.
8. The extracorporeal blood circulator according to claim 7, wherein the height is further based on a pressure loss coefficient characterizing a pressure loss from the top surface of the blood stored in the reservoir to the tube unit.
9. The extracorporeal blood circulator according to claim 8, wherein the processing unit generates corrected pressure loss coefficient information based on a plurality of pressure loss coefficients determined in time series, and wherein the height is based on the corrected pressure loss coefficient information.
10. The extracorporeal blood circulator according to claim 6, wherein the processing unit detects occurrence of a height indicating an abnormality, and generates a notification upon detection of the occurrence of abnormality.
11. A method of operating an extracorporeal blood circulation system, comprising: temporarily storing blood in a reservoir; conveying blood from the reservoir via a tube unit; generating blood pressure measurements of a blood pressure within the tube unit relative to atmosphere; and detecting a height of a top surface of the blood stored in the reservoir based on changes in the blood pressure measurements and a conservation of mechanical energy of a blood flow inside the tube unit.
12. The method of claim 11 wherein the detecting step is comprised of: measuring a flow velocity in the tube unit; determining a blood density; determining gravitational acceleration information; determining a calculated liquid level energy at the top surface of the blood stored in the reservoir based on the blood density information, the gravitational acceleration information, and the flow velocity information; determining a measured energy at the tube unit based on the flow velocity information, the pressure measurements, the blood density information, and the gravitational acceleration information; and determining the height based on the calculated liquid level energy and the measured energy.
13. The method of claim 11 wherein the height is further based on a pressure loss coefficient characterizing a pressure loss from the top surface of the blood stored in the reservoir to the tube unit.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0026]
[0027]
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DETAILED DESCRITPION OF PREFERRED EMBODIMENTS
[0036] Hereinafter, preferred embodiments according to the present invention will be described in detail with reference to the accompanying drawings. The embodiments described below are preferable specific examples according to the present invention. Therefore, the embodiments have various technically preferable limitations. However, the scope of the present invention is not limited to the aspects unless the present invention is particularly limited in the following description.
[0037]
[0038] Incidentally, the extracorporeal circulation system 1 illustrated in
[0039] Specifically, the management server 3 is configured to manage various information items relating patients or drugs, and to provide each controller 20 with required information relating to the patients or the drugs, if necessary. In addition, in the present embodiment, an example will be described below where the controller 20 mainly performs processing on various information items. However, the present invention is not limited thereto. Instead of the controller 20, the management server 3 may perform the processing on various Information items.
[0040] Next, a configuration of the extracorporeal circulator 2 illustrated in
[0041] That is, as illustrated in
[0042] The venous cannula (blood removal side cannula) 7 illustrated
[0043] This reservoir 11 is configured to reserve (i.e., temporarily store) the blood on the vein side of the patient P. This reservoir 11 is located to remove air bubbles inside the blood received mainly from the blood removal tube 10. In addition, as illustrated in
[0044] In this way, the blood from which the air bubbles are removed in the reservoir 11 is conveyed to the centrifugal pump 5 via a first intermediate tube 12, for example, which is the tube unit in
[0045] In addition, the blood subjected to gas exchange in the artificial lung 6 is supplied to the arterial cannula 8 via a blood supply tube 16, which is, for example, a tube unit, and the connector 9b. An arterial filter 17 for removing the air bubbles is located in the blood supply tube 16.
[0046] In addition, the controller 20 is connected to communicate with the pressure sensor 14, the flow rate sensor 15, and the drive motor 4. Therefore, the controller 20 can acquire measurement value information of the pressure sensor 14 or the flow rate sensor 15, and is configured to be capable of transmitting a drive signal to the drive motor 4. Therefore, the controller 20 is configured to control the rotation of the centrifugal pump 5 via the drive motor 4.
[0047] As illustrated in
[0048] In addition, the artificial lung 6 illustrated in
[0049] Incidentally, the controller 10 or the management server 3 of the extracorporeal circulator 1 illustrated in
[0050]
[0051] Furthermore, the control unit 23 controls a first various information storage unit 30, a second various information storage unit 40, and a third various information storage unit 50 which are illustrated in
[0052]
[0053] Next, the process proceeds to ST2. In ST2, an operator refers to data of the flow rate sensor 15, and adjusts a flow rate. Next, the process proceeds to ST3. In ST3, the operator visually observes the scale 11a of the reservoir 11 illustrated in
[0054] Next, the process proceeds to ST4. In ST4, a pressure loss coefficient calculation processing unit (program) 32 in
[0055] That is, in this step, a pressure loss within a portion of a perfusion circuit (the reservoir 11, the first intermediate tube 12, and the pressure sensor 14) between the liquid level (x) and the pressure measurement point (y) in
stored in the pressure loss coefficient computation expression data storage unit 35 used in this case will be described below.
[0056] With regard to energy of a liquid, Bernoulli's theorem is known. The theorem provides a law of conservation of energy in a steady flow of a non-compressible and non-adherent liquid. Specifically, a value of p(fluid pressure)/(fluid density)+g(gravitational acceleration)z(vertical height)+v2(flow velocity)/2 is constant.
[0057] The energy at the liquid level (x) inside the reservoir 11 in
On the other hand, the energy at the pressure measurement point (y) of the pressure sensor 14 is expressed by
[0058] In addition, according to the Bernoulli's theorem described above, the energy (an example of the liquid level energy information) of the liquid level (x) in the reservoir 11 and the energy (an example of the measurement unit energy information) at the pressure measurement point (y) of the pressure sensor 14 are the same as each other, and, the following expression is obtained:
[0059] Here, vx (flow velocity) in the liquid level (x) in the reservoir 11 is different from vy (flow velocity) at the pressure measurement point (y) of the pressure sensor 14, and vx<vy is satisfied. Therefore, the following correction is performed:
1/2(vy2vx2)1/2vy2(Expression 2)
That is, vx (flow velocity) in the liquid level (x) in the reservoir 11 is set to substantially 0. The flow velocity vx expressed by 1/2(vy2vx2)1/2vy2 is an example of the liquid level flow velocity information.
[0060] In addition, the pressure (px) in the liquid level (x) in the reservoir 11 is measured by relative pressure. Accordingly, the atmospheric pressure is set to 0. That is, px=0 is satisfied (Expression 3). This expression, px=0 is an example of the liquid level pressure information.
[0061] Here, if Expression 2 and Expression 3 are combined with Expression 1, and if Expression 1 is transformed into an expression for obtaining zxzy, then
is satisfied. That is, if the gravitational acceleration (g) and (density) are known, a height change in the liquid level (x) can be recognized using a change in py (i.e., pressure at the pressure measurement point (y)), which is an example of the pressure change information.
[0062] However, in actual practice, there exists a pressure loss (f) which cannot be ignored due to a flow path between the liquid level (x) and the pressure measurement point (y). Accordingly, it is necessary to add a term of the pressure loss in proportion to the square of the flow velocity (v). Therefore, (Expression 4) is transformed into an expression for obtaining the pressure, and the term of the pressure loss is introduced wherein f is the pressure loss coefficient (depending on a circuit or a flow path), as follows:
[0063] According to the present embodiment, as will be described later, the pressure loss is obtained using a computation expression. However, the present invention is not limited thereto. The pressure loss at the liquid level (x) in the reservoir 11 and the measurement point (y) of the pressure sensor 14 may be fixed to each other.
[0064] Next, if (Expression 5) including the term of the pressure loss is transformed into an expression for obtaining zxzy, an expression for estimating a blood reserve level is obtained as follows:
[0065] Next, if this (Expression 6) is transformed into an expression for obtaining f (pressure loss coefficient), then
is satisfied so as to obtain pressure loss coefficient computation expression data of the above-described pressure loss coefficient computation expression data storage unit 35 in
[0066] In ST4, after the pressure loss coefficient is obtained and stored in the pressure loss coefficient data storage unit 36 in
[0067] In ST5, if a plurality of the pressure loss coefficient data items are stored, the process proceeds to ST6. In ST6, a pressure loss coefficient average data calculation processing unit (program) 41 in
[0068] A pressure loss coefficient average expression, for example, f.sub.n={f.sub.n+f.sub.n1(n1)}/n is stored in the pressure loss coefficient average expression storage unit 37. Therefore, pressure loss coefficient average data is obtained by substituting the pressure loss coefficient data into the pressure loss coefficient average expression, and is stored in a pressure loss coefficient average data storage unit 42 in
[0069] This pressure loss coefficient average data is an example of the corrected pressure loss coefficient information. Therefore, for example, even if the pressure loss coefficient in the circuit or the flow path in the extracorporeal circulator 2 is changed during a medical procedure, based on a plurality of change information items in time series, a health care worker can generate more accurate pressure loss coefficient average data.
[0070] Next, the process proceeds to ST7. In ST7, a blood reserve level estimation calculation processing unit (program) 43 (an example of the processing unit) in
[0071] An expression
which is the same as (Expression 6) serving as the above-described expression for estimating the blood reserve level is stored in the blood reserve level estimation computation expression data storage unit 44. Therefore, data of the density data storage unit 33, the gravitational acceleration data storage unit 34, the flow rate sensor 15, the pressure sensor 14, the pressure loss coefficient data storage unit 36, or the pressure loss coefficient average data storage unit 42 in
[0072] Then, the distance (height), that is, zxzy between the liquid level (x) in the reservoir 11 and the pressure measurement point (y) of the pressure sensor 14 is stored as blood reserve level estimation data together with the measured time data in a blood reserve level estimation data storage unit 45. In this case, as the data of the pressure loss coefficient (f), the data of the pressure loss coefficient average data storage unit 42 in
[0073] In this way, according to the present embodiment, the change in the distance (height), that is, the change in zxzy between the liquid level (x) in the reservoir 11 and the pressure measurement point (y) of the pressure sensor 14 can be accurately recognized using the change in the measurement value of the pressure sensor 14. Accordingly, it is possible to hygienically and precisely recognize the change amount of the blood inside the reservoir 11 without locating the sensor in the reservoir 11. In addition, according to the present embodiment, the determination is made taking factors of the pressure loss into consideration. Accordingly, it is possible to more accurately recognize the change in the liquid level (x) in the reservoir 11.
[0074]
[0075] Incidentally, subsequent to ST7, the process proceeds to ST8. In ST8, a blood reserve level hazard area determination processing unit (program) 46 in
[0076] In ST9, when it is determined that the value of the blood reserve level estimation data is included in the value of the blood reserve hazard level data, the process proceeds to ST10. In ST10, warning/alarm is displayed on the touch panel 21 of the controller 20. Therefore, the operator of the extracorporeal circulator 2 can quickly and reliably recognize that the liquid level (x) of the blood inside the reservoir 11 is abnormally lowered.
[0077] On the other hand, in ST9, when it is determined that the value of the blood reserve level estimation data is not included in the value of the blood reserve hazard level data, the process proceeds to ST11. In ST11, it is determined whether or not a plurality of the blood reserve level estimation data items are present in the blood reserve level estimation data storage unit 45 in
[0078] In ST12, a blood reserve level change amount estimation processing unit (program) 51 in
[0079] In this manner, it is possible to generate data relating to a normal change amount and the safety margin data of the liquid level of the blood inside the reservoir 11 per predetermined time when the blood inside the reservoir 11 is supplied at the flow velocity. That is, in a case where the change amount per predetermined time exceeds the normal change amount and the safety margin (for example, 1, 5 times), it can be determined as abnormality (an example of the changed abnormality information).
[0080] For example, in some cases, the first intermediate tube 12 may be pinched with forceps in order to adjust the flow rate in an intermediate portion of a circuit of the extracorporeal circulator 2. In this case, the information relating to the pressure loss coefficient is changed, and thus, it becomes difficult to generate accurate blood reserve level estimation data. In this regard, according to the present embodiment, it is possible to determine the occurrence of the abnormality. Specifically, the process is as follows.
[0081] In ST13, a blood reserve level actual change amount data generation processing unit (program) 54 in
[0082] That is, based on the actual data of the blood reserve level estimation data storage unit 45, it is determined whether or not zxzy is changed and how much is the change amount, and a determination result is stored in the blood reserve level actual change amount data storage unit 55.
[0083] Next, the process proceeds to ST14. In ST14, a blood reserve level change amount abnormality determination processing unit (program) 56 in
[0084] Next, in ST15, if it is determined that (zxzy)Z, caution (an example of the changed abnormality information), warning/alarm is displayed on the touch panel 21 of the controller 20 in ST16. In this case, an operator of the extracorporeal circulator 2 recognizes a situation where accurate blood reserve level estimation data is less likely to be generated, and the operator can quickly perform required measures such as changing the information on the pressure loss coefficient.
[0085] On the other hand, if (zxzy)Z, caution is not satisfied in ST15, that is, if it is determined that there is no abnormality, the process proceeds to ST17. In ST17, a message of is any change provided between the liquid level (x) and the pressure measurement point (y)? is displayed on the touch panel 21.
[0086] In ST18, when it is determined that some change is provided, for example, that the flow rate is slightly adjusted with forceps, the process proceeds to ST19. In ST19, if a message of Is the change to be maintained? is displayed on the touch panel 21 and if the change is not maintained in ST20, a message of Please dismiss the change in the circuit is displayed on the touch panel 21 in ST21. Therefore, in a case where the flow rate is slightly adjusted with the forceps, the forceps are removed as early as possible. In this manner, the controller 20 can prevent poor accuracy in the blood reserve level estimation.
[0087] Incidentally, the present invention is not limited to the above-described embodiments.