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WO2005075007A1 - Dispositif et procede d'elimination du dioxyde de carbone du sang - Google Patents

Dispositif et procede d'elimination du dioxyde de carbone du sang Download PDF

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Publication number
WO2005075007A1
WO2005075007A1 PCT/IT2005/000047 IT2005000047W WO2005075007A1 WO 2005075007 A1 WO2005075007 A1 WO 2005075007A1 IT 2005000047 W IT2005000047 W IT 2005000047W WO 2005075007 A1 WO2005075007 A1 WO 2005075007A1
Authority
WO
WIPO (PCT)
Prior art keywords
blood
concentrator
haemo
inlet
fibres
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/IT2005/000047
Other languages
English (en)
Inventor
Angela Caramuta
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of WO2005075007A1 publication Critical patent/WO2005075007A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
    • A61M1/1698—Blood oxygenators with or without heat-exchangers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
    • A61M1/1621—Constructional aspects thereof
    • A61M1/1623—Disposition or location of membranes relative to fluids
    • A61M1/1625—Dialyser of the outside perfusion type, i.e. blood flow outside hollow membrane fibres or tubes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/34—Filtering material out of the blood by passing it through a membrane, i.e. hemofiltration or diafiltration
    • A61M1/342—Adding solutions to the blood, e.g. substitution solutions
    • A61M1/3424—Substitution fluid path
    • A61M1/3431—Substitution fluid path upstream of the filter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/34—Filtering material out of the blood by passing it through a membrane, i.e. hemofiltration or diafiltration
    • A61M1/342—Adding solutions to the blood, e.g. substitution solutions
    • A61M1/3455—Substitution fluids
    • A61M1/3468—Substitution fluids using treated filtrate as substitution fluid

Definitions

  • TITLE "Device and apparatus for the elimination of the carbon dioxide from the blood.”
  • the present invention relates to a device for the elimination of the carbon dioxide from the blood and apparatus equipped with the same device.
  • the device is 'usable, even if not exclusively, combined with an apparatus for therapeutic treatments of the type known with the acronym CRR ' (Continuous Renal Replacement Therapy) or in an extra-corporeal simple circuit not featuring renal depuration.
  • the present device can be advantageously employed in a treatment which utilizes an extra-corporal circuit without the renal depuration, i.e. for patients suffering of a bronchopathy of obstructive type, with a non invasive ventilation (NIV) , or in other cases where it is suitable such treatment.
  • NMV non invasive ventilation
  • procedures are employed for this purpose, including haemodialysis, haemofiltration and ultrafiltration, all of which provide fro removing waste products from the patient. That is, the patient's blood is fed through filters or membranes to eliminate the waste substances in it, and is then fed back to the patient.
  • procedures include Continuous Arterio-Venous Haemofiltration (CAVH) , Continuous Veno-Venous Haemofiltration (CVVH) , or, in general, CRRT as defined above.
  • CAVH Continuous Arterio-Venous Haemofiltration
  • CVVH Continuous Veno-Venous Haemofiltration
  • CRRT in general, CRRT as defined above.
  • the patient is connected permanently to the haemofiltration machine for a prolonged period of time. Examples of known CRRT machines are described in US-5,211,849 and US- ⁇ ,349,170.
  • a CRRT machine comprises a central unit connected at the input and output to the patient, e.g. by means of one or more catheters inserted inside corresponding blood vessels, to continuously withdraw the blood for treatment and feed back the treated blood.
  • the central unit of a CRRT machine normally comprises a blood pump, blood heating and processing means, such as, heparin adding means, means for feeding refill liquid into the blood, ad a haemofilter.
  • the blood withdrawn continuously from the patient is thus pumped by the blood pump along the machine circuit, heparin and appropriately heated refill liquid id added, and the blood is then filtered before being back to the patient.
  • a drawback of the conventional systems is that they are very complex and of difficult management.
  • Another drawback of the known systems for CRRT relates to the need of utilizing the infusion pockets, i.e. containers for the blood dilution.
  • the main aim of the present invention is to eliminate the said drawbacks. This result has been achieved, according to the invention, by adopting the principles of the independent claims. Further ⁇ characteristics being set forth in the dependent claims.
  • the advantages of the present invention substantially lie in a greatly improving "decapneisation", i.e. in greatly reducing the C0 2 values of the blood, with a pre-dilution of the blood obtained by a simple mechanism of re-infusion in line that allows, moreover, the elimination of the infusion pockets necessary in the known technique.
  • the present invention uses a haemo-concentrator external to the decapneisator device, it is obtained a simplification of the internal circuit followed by the blood within the device, with a reduction of the resistances and with an improvement of the clinical management of the device according to the present invention.
  • Another advantage lies in the principle of the present invention being applicable to existing machines, which can be altered to achieve more complete, more effective performance; in practice, the present device has a great flexibility of use which allows its utilization in any CRRT system with open circuit (i.e. with filter not being integral to the lines). With the present invention, moreover, the treatment techniques of the patients result considerably simplified in respect to those of known CRRT type, with lower costs and better characteristic of installation and management.
  • Fig.l shows a possible embodiment of an apparatus which utilizes a device according to the present invention; the particulars are not to scale and represented only schematically;
  • Fig.2 shows a possible embodiment of a device according to the invention, represented in a schematic longitudinal section.
  • Reference numeral 1 in the drawings indicates as a whole an apparatus in accordance with the present invention.
  • Apparatus 1 is connected, a the inlet, to a patient P by a first conduit 161, which may be constituted, for example, by a Horizon Medical Product DLC600 KC 11.5 Fr or DLC 800 KC femoral catheter, or by other suitable elements, since other means may, of course, be used to connect the apparatus to the patient, and data relative to other component parts described herein is also provided purely by way of non-limiting examples .
  • a first conduit 161 which may be constituted, for example, by a Horizon Medical Product DLC600 KC 11.5 Fr or DLC 800 KC femoral catheter, or by other suitable elements, since other means may, of course, be used to connect the apparatus to the patient, and data relative to other component parts described herein is also provided purely by way of non-limiting examples .
  • the catheter 161 is connected to a conduit 16.
  • a blood pump 3 is fitted and acting on the conduit 16 downstream to the catheter; on the conduit 16 is also provided a gauge 2 to measure intake arterial pressure of the patient.
  • the pump 3 pumps the blood downstream (the direction of the blood flow is indicated by the arrows VS) in the conduit 16 which, downstream of the pump 3, receives a conduit 18 (also said refill conduit in this description) which is connected to a haemo-concentrator 5, described later on.
  • Prosecuting downstream, on the conduit 16 is provided a device 4 for introducing an anticoagulant substance and, subsequently, the conduit 16 is connected to an inlet 90 of a decapneisator or oxygenating device 9, which is schematically shown in Fig.l and better visible in Fig.2.
  • the hae o- concentrator 5 Downstream of the oxygenating device 9 (or device for eliminating the carbon dioxide) it is provided the hae o- concentrator 5, from which the treated blood, through the conduit 160 return back to the patient P, passing through a respective catheter 162.
  • a gauge 12 for the venous pressure Along the conduit 160, upstream of said catheter 162, are provided a gauge 12 for the venous pressure, a device 13 for detecting possible air bubbles and a clamp 14 for closing the conduit.
  • an apparatus 1 is provided with a device 59 for eliminating carbon dioxide which comprises a decapneisator 9 and a haemo- concentrator 5.
  • the decapneisator or oxygenating device is connected, by a conduit 7, to an oxygen tank 78 and it is provided with an outlet 94 through which the C0 2 is eliminated, i.e. conveyed toward relevant measuring means not shown (the outlet flow of C0 2 is indicated by the relevant arrows) .
  • the device 9 for eliminating the carbon dioxide comprises an external container o shell 97, which can be made of rigid polyurethane.
  • the external shell 97 has an inlet aperture 98 for the oxygen disposed upwardly, to which said conduit 7 is connected.
  • the blood coming in from the inlet 90 arrives into a substantially frusto-conical chamber 77, disposed above said inlet 90 and provided with a plurality of holes 72 disposed circumferentially and apt to allow the passage of the blood outwardly in a radial direction.
  • a plurality of hollow polypropylene fibres 71 defining a kind of barrier; said fibres can be wound to form a skein or hank or disposed parallel each other.
  • the fibres have a surface substantially comprised between 0,6 and 0,8 m 2 and are jointed by a polycarbonate potting.
  • the oxygen entering the aperture 98 is insufflated, passing through an upper chamber 74 and through the fibres 71 with a preferable flow of about 3 litres/minute.
  • the blood flows outwardly the fibres with a flow rate of 250-400 ml/ in and the haemogloblin contained in the erythrocytes exchanges carbon dioxide with oxygen.
  • the device for eliminating carbon dioxide 59 comprises a haemo-concentrator 5 which is disposed externally and upwardly to the oxygenating device 9.
  • the haemo-concentrator 5 can be disposed laterally to the oxygenating device 9 or also internally to the same.
  • the haemo-concentrator device 5 is constituted of a substantially cylindrical polyurethane hollow body containing hollow polysulfone fibres 53 featuring high permeability.
  • the hollow fibres 53 are disposed parallel each other and are joined by a polycarbonate potting. The passage of the blood flow through the fibres 53 determines the removal of the water in excess so that the blood returns to the patient in the correct concentration.
  • the haemo-concentrator device 5 is provided with an outlet section 52 connected, by the outlet 50, to the conduit 160 for the treated blood and with an outlet 51 to which is connected said refill conduit 18 through which passes the ultrafiltrate (flow indicated with the arrow V ⁇ ) .
  • a device 10 of the type called bubble-trap destined to intercept possible bubbles of air in the flow. Downstream of the device 10 are disposed, in succession, a . pump 11 for the ultrafiltrate, a device 8 detecting blood in the ultrafiltrate (of the type called BLD or blood detector) and a clamp 15.
  • the refill conduit 18 lets in the conduit 16 upstream of the decapneisator 9. In such a way it is realized a pre-dilution of the blood obtained by a simple mechanism of in-line re-infusion, thus eliminating the use of the infusion pockets.
  • the ultrafiltrate pump 11 conveys the same ultrafiltrate upstream of the decapneisator for determinating a dilution share which allows to have a blood more fluid in the system, reducing the coagulation danger and maintaining a positive pressure within the oxygenating-decapneizating fibres to avoid the risk of passage of air bubbles in the - blood.
  • the apparatus is advantageous in all the cases in which it is necessary to product an integration of the blood saturation in oxygen concentration, but especially, a removal of C0 2 in the patients for whom it is difficult to adopt a correct respiratory substitutive therapy. • In use, the beginning of the treatment or priming it is executed with saline solution.
  • the shell 97 of the device is substantially cylindrical shaped, with a height (L) comprised between 5 and 20 cm and a diameter (D) comprised between 3,5 and 15 cm.
  • the height (L) is about 10 cm and the diameter (D) of about 7 cm.

Landscapes

  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Hematology (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Urology & Nephrology (AREA)
  • Emergency Medicine (AREA)
  • External Artificial Organs (AREA)

Abstract

L'invention porte sur un dispositif d'élimination du dioxyde de carbone du sang, équipé d'une entrée (98) pour l'oxygène pressurisé, d'une entrée (90) pour le sang à traiter, d'une sortie (50) pour le sang traité et d'une sortie (94) pour le dioxyde de carbone à éliminer. Ce dispositif (59) comprend un dispositif d'élimination du CO2 (decapneisator) ou un dispositif d'oxygénation (9) et un hémo-concentrateur (5) pourvu d'une section de sortie (51) pour l'ultrafiltrat, cette section de sortie (51) étant reliée en amont du un dispositif d'élimination du CO2 (decapneisator) (9), de manière à pré-diluer le sang qui entre dans ladite entrée (90).
PCT/IT2005/000047 2004-02-05 2005-02-01 Dispositif et procede d'elimination du dioxyde de carbone du sang Ceased WO2005075007A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
IT000025A ITFI20040025A1 (it) 2004-02-05 2004-02-05 Dispositivo per l'eliminazione dell'anidride carbonica dal sangue ed un'apparecchiatura equipaggiata con il dispositivo medesimo
ITFI2004A000025 2004-02-05

Publications (1)

Publication Number Publication Date
WO2005075007A1 true WO2005075007A1 (fr) 2005-08-18

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ID=34835564

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IT2005/000047 Ceased WO2005075007A1 (fr) 2004-02-05 2005-02-01 Dispositif et procede d'elimination du dioxyde de carbone du sang

Country Status (2)

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IT (1) ITFI20040025A1 (fr)
WO (1) WO2005075007A1 (fr)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2009141149A1 (fr) * 2008-05-23 2009-11-26 Maquet Cardiopulmonary Ag Système de perfusion optimisé à usage universel
DE102009008601A1 (de) * 2009-02-12 2010-08-19 Novalung Gmbh Vorrichtung zur Behandlung einer biologischen Flüssigkeit
US10201649B2 (en) 2013-03-15 2019-02-12 MAQUET CARDIOPULMONARY GmbH Carbon dioxide removal system

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0240101A2 (fr) * 1986-04-03 1987-10-07 Guest, Weldon S., Trustee Appareil pour circuit extra corporel
EP0534386A2 (fr) * 1991-09-24 1993-03-31 Bernward Oedekoven Dispositif médical pour l'échange de matière entre deux milieux à travers une membrane
EP0705610A1 (fr) * 1994-10-03 1996-04-10 SORIN BIOMEDICA S.p.A. Système intégré de circulation extracorporelle
EP0990444A2 (fr) * 1998-09-14 2000-04-05 American Immuno Tech, LLC Système et traitement pour la prévention de la septicémie
DE10017690A1 (de) * 2000-04-08 2001-10-25 Simmoteit Robert Vorrichtung zum Stoffaustausch und Kultivierung von Zellen
US20020077581A1 (en) * 2000-12-19 2002-06-20 Alan Davidner Simplified cerebral retroperfusion apparatus and method

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0240101A2 (fr) * 1986-04-03 1987-10-07 Guest, Weldon S., Trustee Appareil pour circuit extra corporel
EP0534386A2 (fr) * 1991-09-24 1993-03-31 Bernward Oedekoven Dispositif médical pour l'échange de matière entre deux milieux à travers une membrane
EP0705610A1 (fr) * 1994-10-03 1996-04-10 SORIN BIOMEDICA S.p.A. Système intégré de circulation extracorporelle
EP0990444A2 (fr) * 1998-09-14 2000-04-05 American Immuno Tech, LLC Système et traitement pour la prévention de la septicémie
DE10017690A1 (de) * 2000-04-08 2001-10-25 Simmoteit Robert Vorrichtung zum Stoffaustausch und Kultivierung von Zellen
US20020077581A1 (en) * 2000-12-19 2002-06-20 Alan Davidner Simplified cerebral retroperfusion apparatus and method

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2009141149A1 (fr) * 2008-05-23 2009-11-26 Maquet Cardiopulmonary Ag Système de perfusion optimisé à usage universel
DE102008024835A1 (de) 2008-05-23 2009-12-10 Maquet Cardiopulmonary Ag Universell anwendbares optimiertes Perfusionssystem
DE102009008601A1 (de) * 2009-02-12 2010-08-19 Novalung Gmbh Vorrichtung zur Behandlung einer biologischen Flüssigkeit
US9095817B2 (en) 2009-02-12 2015-08-04 Novalung Gmbh Device for the treatment of biological fluid
US10201649B2 (en) 2013-03-15 2019-02-12 MAQUET CARDIOPULMONARY GmbH Carbon dioxide removal system

Also Published As

Publication number Publication date
ITFI20040025A1 (it) 2004-05-05

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