JP4643642B2 - 血液の体外処理のための装置及び方法 - Google Patents
血液の体外処理のための装置及び方法 Download PDFInfo
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Description
パラメータが回転速度ωである場合、限外濾過アクチュエータ2の少なくとも1つの動作パラメータを変更(増加及び/又は低減)し、
上述の変更の影響による限外濾過流量の変化量ΔQUFを測定し、
上述の変更の影響による膜透過圧の変化量ΔTMPを測定し、
上述の変化量ΔQUF及びΔTMPが、基準限界値ε(εはゼロに近い一定値)と以下の所定の関係ΔQUF/ΔTMP≦εを満たすかどうかをチェックし、
上述のチェックの結果としての信号を生成する。
限外濾過アクチュエータ2の少なくとも1つの動作パラメータを変更し、例えば速度Ω1から速度Ω2に変化させ、
上述の変更の影響による、限外濾過流量の変化量ΔQUF又は膜透過圧の変化量ΔTMPを測定し、
変化量ΔQUF又はΔTMPが基準限界値との所定の関係、ΔQUF≦(ΔQUF)min(ここで、(ΔQUF)minは最小しきい値)、又はΔTMP≧(ΔTMP)max(ここで、(ΔTMP)maxは最大しきい値)に一致するかどうかを確認し、
上記の制御の結果としての信号を生成し、これにより、ΔQUF≦(ΔQUF)minであるか又はΔTMP≧(ΔTMP)maxである場合には、関数ΔQUF(ω)又は1/TMP(ω)が最大値となるωの値が探索されたものとみなされる。
この例は、ライン上の透析液を準備するために置換液が透析循環路から引き出される、HDF又はHF装置に関する。しかし、この例は、例えば、バッグからの透析液及び/又は置換液が供給されるHF/HDF処理又は置換液が分離/独立に供給されるHF/HDF(例えばLVHDF)といった、さまざまな種類の圧力制御されるHF/HDF処理に適用することも可能である。
2)所定の時間、例えば30秒間待機する。
6)ステップ<事前定義された値(例えば|2|)になるまで1)から繰返す。
pUFR=(前の繰返しにおいて保存された)前のUF流量
cUFR=現在のUF流量(10秒平均)
ステップの初期値は、例えば50mmHgに事前定義される
上記で特定されるとおりに限界値を連続的に監視する
上述の(安定したTMPを待つ)ステップ2)は、測定されたTMPの値から、安定したTMsetに到達するときを決定する基準と組み合わせ、又はこの基準に(及び/又は)置き換えることができ、これによって、小さいステップを取るときのスキャン速度を上げ、大きいステップに対しては長い時間を許容することができる。
Claims (15)
- 血液チャンバ及び流体チャンバを有し、半透膜により相互に分離され、前記半透膜を通して液体を限外濾過する血液処理デバイスを備え、
以下の動作、すなわち、
前記限外濾過デバイスの動作状態を変更し、
前記動作状態を変更するときの前記膜を通る限外濾過流量の複数の値を検出し、
前記値を比較して、膜透過圧の関数としての、前記膜を通る限外濾過流量の最大値又は略最大値を探索することにより、前記限外濾過流量の最適値を求め、
膜透過圧の関数としての限外濾過流量が最大値又は略最大値を有する最適値で前記限外濾過デバイスを動作させる、
各動作を実行するようにプログラムされているコントローラを備えている、体外血液処理装置。 - 前記コントローラは前記最大の限外濾過流量に対応する膜透過圧の関数としての、前記膜透過圧を設定する動作を実行するようにプログラムされている、請求項1に記載の装置。
- 前記膜透過圧が所定の範囲内にある場合、前記設定された膜透過圧は所定のパーセンテージだけ、又は所定の量だけ減少された前記最大の限外濾過流量に対応する透過圧である、請求項2に記載の装置。
- 前記限外濾過デバイスは少なくとも1つの限外濾過アクチュエータを備え、
前記最大値は前記限外濾過アクチュエータの動作パラメータの関数として、前記膜を通る限外濾過流量の最大値を備えている、請求項1に記載の装置。 - 置換液を血液中に注入するデバイスを備えている、請求項1から4のいずれか1項に記載の装置。
- 前記限外濾過デバイスの動作状態を変更する前記動作の前に、前記コントローラは、所定の期間の間、設定された値として又は血液流量の関数として決定される置換液の注入流量で、容積制御モードで作動させる動作を実行するようにプログラムされている、請求項5に記載の装置。
- 前記限外濾過デバイスは少なくとも1つの限外濾過アクチュエータを備え、
動作状態を変更する前記動作は、前記限外濾過アクチュエータの少なくとも1つの動作パラメータを変更することを備えている、請求項1から6のいずれか1項に記載の装置。 - 少なくとも1つの動作パラメータの前記変更は、前記少なくとも1つの動作パラメータの所定の量の変更を命令することを備えている、請求項7に記載の装置。
- 前記限外濾過アクチュエータは限外濾過される液体のラインに作用する、請求項7又は8に記載の装置。
- 前記限外濾過アクチュエータは少なくとも1つの流体循環ポンプを備え、前記動作パラメータの変更は流体循環ポンプの回転速度を変更することを含んでいる、請求項7から9のいずれか1項に記載の装置。
- 膜透過圧の関数としての、前記膜を通る限外濾過流量の最大値又は略最大値の探索は、
上述の流体循環ポンプの回転速度の変更の影響による限外濾過流量の変化量(ΔQUF)を測定し、
上述の流体循環ポンプの回転速度の変更の影響による膜透過圧の変化量(ΔTMP)を測定し、
上述の限外濾過流量の変化量(ΔQUF)、及び膜透過圧の変化量(ΔTMP)が、基準限界値ε(εはゼロに近い一定値)と以下の所定の関係、ΔQUF/ΔTMP≦εを満たすかどうかをチェックし、
上述のチェックの結果としての信号を生成する、
ことを備えている請求項10に記載の装置。 - 前記限外濾過流量を測定する第1センサ、放出流体循環ポンプの回転速度の第2センサ、及び膜透過圧を検出する第3センサを少なくとも備えている、請求項1から11のいずれか1項に記載の装置。
- 前記コントローラは前記動作を定期的に繰返すようにプログラムされている、請求項1から12のいずれか1項に記載の装置。
- 血液濾過処理及び血液透析濾過処理の1つ又は複数の処理を実行するようにされている、請求項1から13のいずれか1項に記載の装置。
- 血液透析処理及び純粋な限外濾過処理の1つ又は複数の処理を実行するように仕向けられている、請求項1から14のいずれか1項に記載の装置。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
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IT000191A ITMO20040191A1 (it) | 2004-07-23 | 2004-07-23 | Macchina e metodo per il trattamento extracorporeo di sangue. |
PCT/IB2005/001482 WO2006011009A2 (en) | 2004-07-23 | 2005-05-27 | A machine and a procedure for extracorporeal treatment of blood. |
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JP2008507313A JP2008507313A (ja) | 2008-03-13 |
JP4643642B2 true JP4643642B2 (ja) | 2011-03-02 |
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JP2007522043A Expired - Fee Related JP4643642B2 (ja) | 2004-07-23 | 2005-05-27 | 血液の体外処理のための装置及び方法 |
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US (2) | US8105260B2 (ja) |
EP (2) | EP1773427B1 (ja) |
JP (1) | JP4643642B2 (ja) |
KR (1) | KR101146048B1 (ja) |
CN (1) | CN101010110B (ja) |
AU (1) | AU2005266108B2 (ja) |
CA (1) | CA2574172C (ja) |
ES (2) | ES2647064T3 (ja) |
IT (1) | ITMO20040191A1 (ja) |
PL (2) | PL2420264T3 (ja) |
WO (1) | WO2006011009A2 (ja) |
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EP2420264B1 (en) | 2017-10-04 |
CN101010110A (zh) | 2007-08-01 |
CN101010110B (zh) | 2011-04-13 |
US8771215B2 (en) | 2014-07-08 |
WO2006011009A3 (en) | 2006-04-06 |
EP2420264A2 (en) | 2012-02-22 |
US8105260B2 (en) | 2012-01-31 |
CA2574172C (en) | 2013-05-21 |
US20080215247A1 (en) | 2008-09-04 |
PL2420264T3 (pl) | 2018-02-28 |
CA2574172A1 (en) | 2006-02-02 |
EP1773427A2 (en) | 2007-04-18 |
JP2008507313A (ja) | 2008-03-13 |
AU2005266108B2 (en) | 2010-12-23 |
KR20070035606A (ko) | 2007-03-30 |
US20120095381A1 (en) | 2012-04-19 |
ITMO20040191A1 (it) | 2004-10-23 |
EP1773427B1 (en) | 2014-01-15 |
KR101146048B1 (ko) | 2012-05-16 |
ES2647064T3 (es) | 2017-12-19 |
PL1773427T3 (pl) | 2014-06-30 |
WO2006011009A2 (en) | 2006-02-02 |
EP2420264A3 (en) | 2014-03-19 |
ES2456941T3 (es) | 2014-04-24 |
AU2005266108A1 (en) | 2006-02-02 |
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