JP2020531122A - 血液ポンプ - Google Patents
血液ポンプ Download PDFInfo
- Publication number
- JP2020531122A JP2020531122A JP2020509454A JP2020509454A JP2020531122A JP 2020531122 A JP2020531122 A JP 2020531122A JP 2020509454 A JP2020509454 A JP 2020509454A JP 2020509454 A JP2020509454 A JP 2020509454A JP 2020531122 A JP2020531122 A JP 2020531122A
- Authority
- JP
- Japan
- Prior art keywords
- pump
- control device
- blood
- blood flow
- control
- 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.)
- Granted
Links
- 210000004369 blood Anatomy 0.000 title claims abstract description 208
- 239000008280 blood Substances 0.000 title claims abstract description 208
- 230000017531 blood circulation Effects 0.000 claims abstract description 162
- 210000002216 heart Anatomy 0.000 claims abstract description 72
- 238000000034 method Methods 0.000 claims abstract description 39
- 210000004204 blood vessel Anatomy 0.000 claims abstract description 17
- 238000003780 insertion Methods 0.000 claims abstract description 10
- 230000037431 insertion Effects 0.000 claims abstract description 10
- 230000000747 cardiac effect Effects 0.000 claims description 71
- 230000010351 cardiac pulsation Effects 0.000 claims description 16
- 210000001765 aortic valve Anatomy 0.000 claims description 13
- 230000001360 synchronised effect Effects 0.000 claims description 10
- 230000004872 arterial blood pressure Effects 0.000 claims description 8
- 238000012544 monitoring process Methods 0.000 claims description 5
- 230000000541 pulsatile effect Effects 0.000 claims description 2
- 239000000463 material Substances 0.000 claims 1
- 238000011084 recovery Methods 0.000 description 18
- 238000012545 processing Methods 0.000 description 16
- 230000002861 ventricular Effects 0.000 description 16
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- 210000000709 aorta Anatomy 0.000 description 11
- 238000002565 electrocardiography Methods 0.000 description 7
- 206010067171 Regurgitation Diseases 0.000 description 6
- 230000036772 blood pressure Effects 0.000 description 6
- 230000008859 change Effects 0.000 description 6
- 230000004217 heart function Effects 0.000 description 6
- 210000000115 thoracic cavity Anatomy 0.000 description 6
- 238000004590 computer program Methods 0.000 description 5
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- QVGXLLKOCUKJST-UHFFFAOYSA-N atomic oxygen Chemical compound [O] QVGXLLKOCUKJST-UHFFFAOYSA-N 0.000 description 2
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Images
Classifications
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- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Heart & Thoracic Surgery (AREA)
- Cardiology (AREA)
- Public Health (AREA)
- Biomedical Technology (AREA)
- General Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
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- Hematology (AREA)
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- Mechanical Engineering (AREA)
- Medical Informatics (AREA)
- Vascular Medicine (AREA)
- Epidemiology (AREA)
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- Pathology (AREA)
- Transplantation (AREA)
- General Business, Economics & Management (AREA)
- Business, Economics & Management (AREA)
- Data Mining & Analysis (AREA)
- Databases & Information Systems (AREA)
- Physics & Mathematics (AREA)
- Biophysics (AREA)
- Molecular Biology (AREA)
- Surgery (AREA)
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- Liquid Crystal (AREA)
- Eye Examination Apparatus (AREA)
Abstract
Description
「心臓の特性パラメータ」という用語は、例えば過負荷または無負荷などの負荷に関するような、ならびに/あるいは虚弱、健康、または回復などの生理学的状態に関するような、心臓の状態の特徴を表すことができる生理学的信号から得られる特定値として理解されるものである。
Claims (25)
- 患者の血管の中に経皮的に挿入されるための血管内血液ポンプ(50)の血流Qpump(t)を制御するための制御デバイス(100)であって、前記血液ポンプ(50)が、ポンプユニット(52)と、血流入口(54)から血流出口(56)に向かって血液を運搬するように構成される、前記ポンプユニットを駆動するための駆動ユニット(51)とを備え、
前記制御デバイス(100)が、選択可能なゼロ流量制御モードで前記血液ポンプ(50)を動作させるように構成され、血流コマンド信号Qpump set(t)が選択され、前記制御デバイスが第1の制御装置(401)および第2の制御装置(402)を備え、
前記第1の制御装置(401)が、前記駆動ユニット(51)に対する速度コマンド信号npump set(t)を調整することにより前記血流Qpump(t)を制御するように構成され、前記第2の制御装置(402)が前記駆動ユニット(51)の駆動速度npump(t)を制御するように構成される、
ことを特徴とする制御デバイス(100)。 - 請求項1に記載の制御デバイス(100)であって、前記第1の制御装置(401)が、前記血流コマンド信号Qpump set(t)と前記血流Qpump(t)との間の差ΔQに基づいて前記速度コマンド信号npump set(t)を決定するようにさらに構成される、ことを特徴とする制御デバイス(100)。
- 請求項1または2に記載の制御デバイス(100)であって、前記第2の制御装置(402)が、前記駆動ユニット(51)に供給される駆動電流Ipump(t)を調整することにより前記駆動速度npump(t)を制御するように構成される、ことを特徴とする制御デバイス(100)。
- 請求項1から3のいずれか1項に記載の制御デバイス(100)であって、前記第1の制御装置(401)および前記第2の制御装置(402)がカスケード制御システムの一部であり、前記第1の制御装置(401)が外側制御装置であり、前記第2の制御装置が内側制御装置(402)である、ことを特徴とする制御デバイス(100)。
- 請求項1から4のいずれか1項に記載の制御デバイス(100)であって、前記制御デバイス(100)が、所定のゼロ流量制御時間にわたって前記血流Qpump(t)を制御するように構成される、ことを特徴とする制御デバイス(100)。
- 請求項5に記載の制御デバイス(100)であって、
前記所定のゼロ流量制御時間が、補助を受けている心臓の1回の心臓周期の一部分にわたって継続するように設定されるか、または
前記所定のゼロ流量制御時間が、少なくとも1回の完全な心臓周期にわたってまたは所定の回数の連続する完全な心臓拍動サイクルにわたって継続するように設定される、
ことを特徴とする制御デバイス(100)。 - 請求項1から6のいずれか1項に記載の制御デバイス(100)であって、前記制御デバイス(100)が、前記ゼロ流量制御時間を、少なくとも1つの特徴的な心臓拍動サイクル事象の発生と同期させるように構成される、ことを特徴とする制御デバイス(100)。
- 請求項7に記載の制御デバイスであって、前記ゼロ流量制御時間の開始および/または終了が、前記少なくとも1つの特徴的な心臓拍動サイクル事象の発生と同期される、ことを特徴とする制御デバイス。
- 請求項8に記載の制御デバイス(100)であって、前記少なくとも1つの特徴的な心臓拍動サイクル事象が大動脈弁の開放または大動脈弁の閉鎖である、ことを特徴とする制御デバイス(100)。
- 請求項1から9のいずれか1項に記載の制御デバイス(100)であって、前記制御デバイス(100)が、1つ以上の特徴的な心臓パラメータの値を監視するように構成される、ことを特徴とする制御デバイス(100)。
- 請求項1から10のいずれか1項に記載の制御デバイス(100)であって、前記制御デバイス(100)が、前記血液ポンプ(50)を定期的にまたは不規則に前記ゼロ流量制御モードで動作させるように構成される、ことを特徴とする制御デバイス(100)。
- 請求項1から11のいずれか1項に記載の制御デバイス(100)であって、前記制御デバイス(100)が、監視される特徴的な心臓パラメータの1つ以上の値の傾向を特定するように構成される、ことを特徴とする制御デバイス(100)。
- 請求項12に記載の制御デバイス(100)であって、前記少なくとも1つの特徴的な心臓パラメータが、動脈圧の拍動性AOP|max−AOP|min、平均動脈圧、心臓の収縮性dLVP(t)/dt|max、心臓の弛緩dLVP(t)/dt|min、心拍数HR、のうちの少なくとも1つである、ことを特徴とする制御デバイス(100)。
- 請求項1から13のいずれか1項に記載の制御デバイス(100)であって、制御デバイス(100)が、センサにより前記血流Qpump(t)を測定するように、または前記血流Qpump(t)を計算もしくは推定するように構成される、ことを特徴とする制御デバイス(100)。
- 請求項1から14のいずれか1項に記載の制御デバイス(100)であって、制御デバイス(100)が、前記血流Qpump(t)と、前記駆動速度npump(t)と、前記血流出口(56)と前記血流入口(54)との間の圧力差ΔPpump(t)および前記駆動ユニット(51)に供給される駆動電流Ipump(t)のうちの少なくとも一方と、の間の関係を表す参照テーブルを使用して前記血流Qpump(t)を決定するように構成される、ことを特徴とする制御デバイス(100)。
- 患者の血管の中に経皮的に挿入されるための血管内血液ポンプ(50)と、請求項1から15のいずれか1項の制御デバイス(100)とを備えることを特徴とするシステム。
- 請求項16に記載のシステムであって、前記血液ポンプ(50)が、以下の特性、血液ポンプの例えばロータまたは羽根車などの具体的には回転部品である可動部品が、例えばプラスチックなどの軽量材料で作られることにより低質量を有すること、電気モータなどの駆動ユニット(51)が、前記駆動ユニット(51)によって駆動される例えばロータまたは羽根車などの可動部品の近くに配置され、好適には非常に近くに配置され、最も好適には隣接するように配置されること、カテーテルベースである場合、好適には回転駆動ケーブルまたは回転駆動ワイヤを有さないこと、前記駆動ユニット(51)によって駆動される例えば前記ロータまたは前記羽根車などの回転部品との、前記駆動ユニット(51)の例えばシャフトなどの結合部分または接続部分が短いこと、ならびに、前記血液ポンプの具体的には回転部品などのすべての可動部品が小さい直径を有すること、のうちの1つ以上の特性を有することにより、低慣性デバイスである、ことを特徴とするシステム。
- 患者の血管の中に経皮的に挿入されるための血管内血液ポンプ(50)の血流Qpump(t)を制御するための方法であって、前記血液ポンプ(50)が駆動ユニット(51)を備えるポンプユニット(52)を備え、血流入口(54)から血流出口(56)に向かって血液を運搬するように構成され、前記方法が、
第1の閉ループサイクルで制御誤差e(t)を得るために、設定血流値Qpump set(t)を血流値Qpump(t)と比較するステップと、
前記制御誤差e(t)から、駆動手段のための設定速度値npump set(t)を決定するステップと、
第2の閉ループサイクルで、前記設定速度値npump set(t)を駆動速度npump(t)と比較することにより、前記駆動ユニット(51)の前記駆動速度npump(t)を制御するステップと
を含む、
ことを特徴とする方法。 - 請求項18に記載の方法であって、
所定のゼロ流量制御時間にわたって前記設定血流値Qpump set(t)がゼロである、ゼロ流量モードを提供するステップと、
好適には、補助を受けている心臓の1回の心臓周期の一部分にわたって継続するように、あるいは少なくとも1回の完全な心臓周期または所定の回数の連続的な心臓周期の一部分および/もしくは完全な心臓周期にわたって継続するように、前記所定のゼロ流量制御時間を設定するステップと
をさらに含む、ことを特徴とする方法。 - 請求項18または19に記載の方法であって、前記第1の閉ループサイクルがカスケード制御の外側制御ループであり、前記第2の閉ループサイクルが内側制御ループである、ことを特徴とする方法。
- 請求項18から20のいずれか1項に記載の方法であって、
前記ゼロ流量制御時間を少なくとも1つの特定の特徴的な心臓拍動サイクル事象と同期させるステップ
をさらに含む、ことを特徴とする方法。 - 請求項18から21のいずれか1項に記載の方法であって、前記ゼロ流量制御時間の開始および/または終了が、前記少なくとも1つの特徴的な心臓拍動サイクル事象の発生と同期される、ことを特徴とする方法。
- 請求項18から22のいずれか1項に記載の方法であって、
特徴的な心臓パラメータの1つ以上の値を監視するステップ
をさらに含む、ことを特徴とする方法。 - 請求項18から23のいずれか1項に記載の方法であって、
特徴的な心臓パラメータの1つ以上の監視される値の傾向を特定するステップ
をさらに含む、ことを特徴とする方法。 - 請求項18から24のいずれか1項の方法を実行するように構成される、請求項1から14のいずれか1項に記載の制御デバイス(100)。
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